Transcultural Nursing

Transcultural nursing is viewed as a culturally competent practice field that client centered and research focused. Although transcultural nursing is viewed as client centered, it is important for nurses to remember that culture can and does influence how clients are viewed and the care they are given.

Every individual is culturally unique, and nurses are no exception. Therefore, nurses must use caution to avoid protecting their own cultural uniqueness and world views on the client if culturally appropriate care is to be provided. Nurses must carefully identify their own cultural beliefs and values and then separate them from the client’s beliefs and values. To deliver culturally sensitive care the nurse must remember that each individual is unique and a product of past experiences beliefs and values that have been learned and passed down from one generation to the next. According stokes 91991), nursing as a profession is not “culturally free “ but rather is “ culturally determined.” Nurses must recognize and understand this fact to avoid becoming grossly ethnocentric (Strokes, 1991).

The more nurses know about their client’s cultural beliefs and values the more culturally will be the care they provide. Nurses must continually assess and evaluate each client’s responses and never assume that all individuals within a specific cultural group will think and behave in a similar manner. Nurses must remember that there is as much diversity within a cultural group as there is across cultural groups. The goal of transcultural nursing is to discover culturally relevant facts about the client that can be used to provide culturally appropriate and competent care. Although transcultural nursing is becoming a highly specialized field, every nurse who is entrusted with the care of clients must make every effort to deliver culturally sensitive care that is free of inherent biases based on gender, race or religion.

As awareness of transcultural health care has increased so has the use of the term cultural competence. There are many definitions for the term cultural competence. For the beginning nursing student Giger and Davidhizar (1999) provide a clear, understandable definition.. They view cultural competence as a dynamic, fluid, continuous process whereby and individual, system, or health care agency finds meaningful and useful care delivery strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behaviors of those to whom they render care. To develop cultural competence, it is essential for the health care professional to use knowledge gained from conceptual and theoretical models of culturally appropriate care. The culturally competent nurse develops meaningful interventions to promote optimal health among individuals regardless of racial or ethnic group, gender, or sexual identity, or cultural heritage.

To provide culturally appropriate and competent care it is important to remember that each individual is culturally unique and as such is a product of past experiences cultural beliefs, and cultural norms. Cultural expressions become patterned responses and give each individual a unique identity. Although there is as much diversity within cultural and racial groups as there is across and among cultural and racial groups, knowledge of general baseline data relative to the specific cultural or racial group is an excellent starting point for providing culturally appropriate care.

Culturally diverse health care can and should be tendered in all clinical settings. Knowledge of culturally relevant information will assist the nurse in planning and implementing a treatment regimen that meets the unique needs of each client.

Culturally Diverse Nursing Care

Culturally Diverse Nursing Care refers to the variables in nursing approaches model to provide culturally appropriate and competent care. As we move to the twenty-first century, it will be necessary for nurses to sue transcultural knowledge in a skillful and artful manner to render culturally appropriate and competent care to a rapidly changing, heterogeneous client population. Culturally diverse nursing care must take into account six cultural phenomena that vary with application and use, yet are evident in all cultural groups (1) communication, (2) space, (3) social organization, (time), (5) environmental, and (6) biological variations. It is these elements that make up Giger and Davidhizar’s transcultural assessment model.

In response to the need for a practical assessment tool for evaluating cultural variables and their effects on health and illness behavior a transcultural assessment model is offered that greatly minimizes the time model to conduct a comprehensive assessment in an effect to provide culturally competent care. Before applying this model, the nurse must understand the concept and assumptions that it is based on.

Communication

The word communication is derived from the verb communicate meaning “to make common, share, participate, or impart. “Communication, however, goes further than this definition implies and embraces the entire realm of human interaction and behavior. All behavior, whether verbal or non verbal, in the presence of another individual is communication. Communication provides the means by which people connect. It establishes a sense of commonality with other and permits the sharing of information, signals, or messages in the form of ideas and feelings.

Communication and culture are closely intertwined. Communication is the means by which culture is transmitted and preserved. Culture influences how feelings are expressed and what verbal and nonverbal expressions are appropriate. Cultural partners of communication are embedded early and are found in childbearing practices. The communication practices of persons in individual cultural groups affect the expression of ideas and feelings, decision making, and communication strategies. The communication

of an individual reflects, determines, and consequently molds the culture. In other words a culture may be limited and molded by as communication practices.

Sensitivity to communication variances is needed to accurately assess and intervene in multicultural situations. The potential for misunderstanding the client is accentuated when the nurse and the client are from different ethnic, racial, and cultural groups. Although the most significant variations occur when two people speak different languages, difficulties can also be encountered when the nurse and client speak variations of English.

Whether the nurse relates to the client in an interview setting, during the process of client care, in a more informal level on the hospital unit, or in the clinic, the guidelines in box will increase the likelihood that the nurse-client relationship will be positive.

Nursing assessment Summarize data obtained Communication

Language spoken Voice quality Pronunciation Use of silence Use of nonverbalCulturally unique individual

Client’s cultural and racial identification Place of birth Time in country

Space Degree of comfort observed (conversation) Proximity to others Body movement Perception of space

Biological variation Body structure Skin color Hair color Other physical dimensions Enzymatic and genetic existence of

disease specific to populations Susceptibility to illness and disease Nutritional preferences and

deficiencies Psychological characteristics, coping,

and social support

Time Use of Measures Definition Social time Work time Time orientation

Future Present Past

Social orientation Culture Race Ethnicity Family

Role Function

Work Leisure Church Friends

Environmental control Cultural health practices

Efficacious Neutral Dysfunctional Uncertain

Values Definition of health and illness