Chapter 1 Theoretical Foundations of Transcultural Nursing Copyright

Chapter 1 Theoretical Foundations of Transcultural Nursing Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Origins of Transcultural Nursing • Transcultural nursing: – Dr. Madeleine M. Leininger, nurse anthropologist – Initial conception in the 1950 s – Formal creation as a specialty and new discipline within the profession in the 1960 s and 1970 s – Nurse scholars have generated a substantial and important body of transcultural theoretical, research, and evidence-based knowledge Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Origins of Transcultural Nursing (cont. ) • Anthropology: The study of humans including their – origins – behavior – social relationships – physical and mental characteristics – customs – development through time and in all places in the world Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Origins of Transcultural Nursing (cont. ) • Transcultural nursing: – Applies to more than merely • panethnic minorities • occupations or professions • nonethnic cultures Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Origins of Transcultural Nursing (cont. ) • Transcultural nursing is a nursing specialty focused on the comparative study and analysis of cultures and subcultures. – It examines these groups with respect to their • caring behavior • nursing care • health–illness values and beliefs • patterns of behavior Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Origins of Transcultural Nursing (cont. ) • Transcultural nursing’s goal is to: – develop a scientific and humanistic body of knowledge in order to provide nursing care that is both • culture-specific • culture-universal Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Origins of Transcultural Nursing (cont. ) • Culture-specific refers to: • particular values, beliefs, and patterns of behavior that tend to be special or unique to a group and that do not tend to be shared with members of other cultures • Culture-universal refers to: • the commonly shared values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyles Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Origins of Transcultural Nursing (cont. ) • Transcultural nursing requires: – Sophisticated assessment and analytic skills – Ability to • plan • design • implement • evaluate nursing care • for individuals, families, groups, and communities representing various cultures Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Origins of Transcultural Nursing (cont. ) • Transcultural nursing requires: – That nurses be able to apply that knowledge to the cultures of • organizations • institutions • health and nursing agencies Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question Is the following question True or False? Transcultural nursing has been formally considered a nursing specialty since 2000. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer False Rationale: Transcultural nursing was formally considered as a specialty and new discipline within the profession in the 1960 s and 1970 s. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

The Importance of Transcultural Nursing • Eight factors that affect transcultural nursing: 1. Marked increase in the migration of people 2. A rise in multicultural identities 3. The increased use of health care technology 4. Cultural conflicts, clashes, and violence Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

The Importance of Transcultural Nursing (cont. ) • Eight factors that affect transcultural nursing: 5. An increase in the number of people traveling and migrating for work 6. An increase in legal suits resulting from cultural conflict, negligence, ignorance, and imposition of health care practices 7. A rise in feminism and gender issues 8. An increased demand for community and culturally based health care services Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

The Importance of Transcultural Nursing (cont. ) • Transcultural nursing enables nurses to: 1. Communicate more effectively with clients from diverse cultural and linguistic backgrounds 2. Assist those of various cultures with mental health problems 3. Accurately assess the cultural expression of pain Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

The Importance of Transcultural Nursing (cont. ) • Transcultural nursing enables nurses to: 4. Provide culturally appropriate interventions to prevent or alleviate discomfort 5. Assess the for parent–child relationship that promote the health and well-being of children Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question This is a multiple choice question. Which outcome is most affected by effective transcultural nursing of a culturally diverse client? A. Pain assessment B. Cost of nursing care C. Respect of client’s rights D. Preserving the client’s independence Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer A. Pain assessment Rationale: An individual’s perception and display of pain is directly affected by cultural norms and behaviors. The other options are universally held nursing responsibilities and not directly impacted by an individual’s cultural beliefs or values. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

History of Transcultural Nursing • Leininger’s Conceptual Framework: – Sunrise Model • based on the concept of cultural care that guides nursing judgments and activities to provide culturally congruent care – Theory of Culture Care Diversity and Universality • focuses on describing, explaining, and predicting nursing similarities and differences focused primarily on human care and caring in human cultures Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

History of Transcultural Nursing (cont. ) • The three modes of nursing decisions and actions: – culture care preservation and/or maintenance – culture care accommodation and/or negotiation – culture care re-patterning and/or restructuring Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

History of Transcultural Nursing (cont. ) • Other Models: – Giger and Davidhizar Transcultural Assessment Model—six cultural phenomena are: • communication • time • space • social organization • environmental control • biological variations Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

History of Transcultural Nursing (cont. ) • Other Models: – Purnell Model for Cultural Competence • An organizing framework of 12 domains • Identifies the primary and secondary characteristics of culture, which determines an individual’s cultural heritage including: • beliefs • values • practices Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

History of Transcultural Nursing (cont. ) • Other Models – Andrews/Boyle Transcultural Nursing Assessment Guide: • provides a comprehensive and practical overview of key assessment areas • provides the foundation for culturally competent care Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

History of Transcultural Nursing (cont. ) • Other Models – Campinha-Bacote Model of Cultural Competence in the Delivery of Healthcare Services: • Five encompassing concepts that depict the process for developing cultural competence: • cultural awareness • cultural knowledge • cultural skill • cultural encounter • cultural desire Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question Is the following question True or False? Dr. Madeleine M. Leininger authored both conceptual frameworks, the Theory of Culture Care Diversity and Universality and the Sunrise Model. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer True Rationale: Dr. Madeleine M. Leininger is credited with authoring both of these conceptual frameworks related to transcultural nursing. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Critical Analysis of Transcultural Nursing • Major criticisms: – Ambiguous terminology – Lacks clarity in describing key concepts – Failure to recognize the relationship between knowledge and power Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Critical Analysis of Transcultural Nursing (cont. ) • Major criticisms: – Inattention to the complexities associated with prejudice, discrimination, and racism – Failure to address bias, prejudice, discrimination, and social injustice – Fostering stereotyping Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Critical Analysis of Transcultural Nursing (cont. ) • Major criticisms: – Failure to consider the variations within cultures that influence the ways in which people express their cultural orientation – Basing models on the assumption that understanding one’s own culture and the culture of others creates tolerance and respect for people from diverse backgrounds Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Standards for Transcultural Nursing • The standards for transcultural nursing were developed to: – Foster excellence in transcultural nursing practice – Provide criteria for the evaluation of transcultural nursing – Create a tool for teaching and learning – Increase the public’s confidence in the nursing profession – Advance the field of transcultural nursing Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Standards for Transcultural Nursing • The eight standards for transcultural nursing: 1. Theoretical foundations of transcultural nursing 2. Cultural information gathering 3. Caring and healing systems 4. Cultural health patterns and caring practices Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Standards for Transcultural Nursing (cont. ) • The eight standards for transcultural nursing: 5. Health care planning 6. Evaluation 7. Research 8. Professional development Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question This is a multiple choice question. Which nursing action addresses a commonly held criticism of transcultural nursing? A. Speaking to a client in their native language B. Requesting a dietary consult to address cultural diet requests diet C. Not assuming all members of a culture share all beliefs D. Allowing the family to perform cultural rituals Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer C. Not assuming all members of a culture share all beliefs Rationale: A criticism of transcultural nursing is its tendency to fostereotypes. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Certification • Transcultural nursing certification: – Sets apart those professional nurses who have: • Achieved a level of understanding of diverse cultures • Clinical experiences to provide knowledgeable and competent care to clients of diverse cultural backgrounds • Skills to assess and implement care that is congruent with the values, beliefs, and life ways of the clients being served Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins