Trans Cultural Nursing 1
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Transcript of Trans Cultural Nursing 1
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TRANSCULTURAL NURSING
A humanistic and scientific area offormal study and practice in nursing
which is focused upon differences andsimilarities among cultures with respectto human care, health, and illnessbased upon the people's cultural
values, beliefs, and practices, and touse this knowledge to provide culturalspecific or culturally congruent nursingcare to people ... Leininger
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Leininger (1991) notes the main goal
of transcultural nursing is to provideculturally specific care. But beforetranscultural nursing can be adequately
understood, there must be a basicknowledge of key terminology such asculture, cultural values, culturally
diverse nursing care, ethnocentrism, "race " and ethnography.
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Culture refers to normsand practices of a particular
group that are learned andshared and guide thinking,decisions, and actions.
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Cultural values the individual'sdesirable or preferred way of actingor knowing something that issustained over a period of time and
which governs actions or decisions.
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Culturally diverse nursing care an
optimal mode of health care delivery,refers to the variability of nursing
approaches needed to provide culturally
appropriate care that incorporates anindividuals cultural values, beliefs, and
practices including sensitivity to the
environment from which the individual
comes and to which the individual may
ultimately return. (Leininger, 1985)
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Ethnocentrism the perceptionthat one's own way is best when
viewing the world (Geiger &
Davidhizar, 1991). Our perspective
is the standard by which all other
perspectives are measured and heldto scrutiny.
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Ethnic relates to groupidentification, large groups
of people classifiedaccording to common traits
or customs.
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Race Any of the differentvarieties of humans assumed
by some people to exist,based on the discredited
typological model of humanvariation.
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Ethnography is the study of a culture.The methodological approach of
ethnographic research central to the nurse's
ability to develop a heightened awareness ofculturally diverse needs of individuals, is to
define a field for observation for study of
the environment and its people, as well as
the reciprocal relationship that exists
between the two (Tripp-Reimer &
Dougherty, 1985).
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ORGANIZING PHENOMENA OF
CULTUREIn a multicultural society such as ours, nurses
are likely to encounter clients from diverse
settings. As nurses we need to develop a culturalinsight and a deeper appreciation and respect for
the rights of culturally diverse individuals. When
cultural beliefs and practices are not
appropriately identified, the significance ofbehavior may confuse the nurse and result in the
delivery of inappropriate care.
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Biological
VariationsBiological variations are those diversemanifestations of "normal" that existbetween people with respect to, bodystructure- skin color- other visiblephysical characteristics- enzymatic andgenetic variations- electrocardiographic
patterns- susceptibility to disease-nutritional preferences and deficiencies,and - psychological characteristics.
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Biological differences between
human beings, that is the smallgene variations that give peopledifferent hair colors, make
individuals more prone to certaindiseases and determine how peoplereact to drugs, are in most cases,the result of both hereditary factorsand the influence of natural andsocial environments.
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ENVIRONMENTAL CONTROL
Abilities of members of a
particular group to plan activities
that control nature, such as factors
causing illness. Health practices,
values, definitions of health andillness.
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SOCIAL ORGANIZATION
Refers to the family unit, and the
social group organizations with
which the patients and familiesmay identify. It refers to ways in
which groups determine roles of
individual members.
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Culture is determined not only by
ethnicity but by factors such asgeography, age, religion, gender,
sexual orientation, andsocioeconomic status. Understand
that age and life cycle factors must
be considered in interactions withall individuals and families.
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Patterns of cultural behavior learned
through enculturation. Recognize and
accept that individuals from culturally
diverse backgrounds may desire
varying degrees of acculturation into
the dominant culture. Life cycle factors
must be considered in interactions withindividuals and families
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COMMUNICATION
Communication is the vehicle for
transmitting and preserving
culture. Communicationdifferences present themselves
in many ways, including
language differences, verbal andnon-verbal behaviors, and
silence.
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Miscommunication is a frequent
problem in hospitals. The most
obvious is when the patient and
hospital staff do not speak the same
language. But the more subtleproblems are those that result from
cultural differences in meanings of
non verbal behavior. Knowing whatis the norm within the culture will
facilitate understanding and lessen
miscommunication.
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SPACE
Particularly the comfort level
related to personal space. - comfort
in conversation, proximity to others,
body movement, perception of
space. Eye contact, space, and touchpractices may be very different than
your sphere of reference.
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SPACE ZONES
INTIMATE ZONE extends up to 1
feet.PERSONAL DISTANCE extends
from 1 to 4 feet.SOCIAL DISTANCE extends from 4
to 12 feet.
PUBLIC DISTANCE extends 12 feetor more
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TIME ORIENTATION
Concept of the passage of time,
duration of time, and points in time.
Countries such as England and Chinaseem to be past oriented. They value
tradition, doing things the way they
have always been done. Individualsfrom these countries might be reluctant
to try new procedures.
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People from present oriented cultures
tend to focus on the here and now.
They may be relatively unconcerned
with the future, they will deal with it
when it comes. Latin Americans,
Native Americans, and Middle
Easterners are present oriented culturesand may neglect preventive health care
measures. They may show-up late or
not at all for appointments.
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European Americans are future
oriented as evidenced by their
development of plans, such as
retirement and savings. People
who are future-oriented are
concerned with long-range goals
and with health care measuresin the present to prevent the
occurrence of illness in the
future.
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CULTURAL COMPETENCE
Refers to the process through which
the nurse provides care that is
appropriate to the client's culturalcontext
Culturally competent nurses are those
who demonstrate knowledge and
understanding of the client's culture;
accept and respect cultural
differences; and adapt care to be
con ruent with the client's culture.
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ELEMENTS OF CULTURAL
COMPETENCE
CULTURAL AWARENESS a
cognitive process in which the
nurse becomes aware of andsensitive to the client's cultural
values, beliefs, and practices.
CULTURAL KNOWLEDGE thenurse seeks a sound
educational base about different
cultures
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CULTURAL SKILLS the nurse's
ability to perform a culturally
specific assessmentCULTURAL ENCOUNTERS the
nurse interacts with client's from
diverse cultural backgrounds.CULTURAL DESIRE the nurse's
motivation to become culturally
competent
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ASSESSMENT
History of the origins of the patients' culture. Value orientations, including view of the world, ethics,
and norms and standards of behavior as well as
attitudes about time, work, money, education, beauty,
strength, and change. Interpersonal relationships, including family patterns,
demeanor, and roles and relationships.
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ASSESSMENT
Communication patterns and forms. Religion and magic. Social systems, including economic values, political
systems, and educational patterns. Diet and food habits. Health and illness belief systems, including behaviors,
decision making, and use of healthcare providers.