N3036 Transcultural Nursing Diverse Populations and Health Care

1
N3036-Transcultural NursingDiverse Populations
and Health Care
2
Globalization Q How to define
globalization? A Princes Dianas death Q How
come? A An English princess with an Egyptian
boy- friend crashes in a French tunnel, in a
German car with a Dutch engine, driven by a
Belgian who was pissed on Scottish whiskey,
followed closely by an Italian paparazzi, on
Japanese motorcycles, treated by an American
doctor, using Brazilian medicines. And this is
sent to you by a Israeli, using Bill
Gates Technology which he stole from the
Taiwanese.
3
Health Disparities

• Infant mortality,
• Cancer screening and management,
• Cardiovascular disease,
• Diabetes,
• HIV/AIDS,
• Immunization

4
Problems with Health Disparities- with cultural
factors

• Flaskerud, J. et al (2002) a review of 79
  articles in the past 5 decades
• Ignorance of certain groups (indigenous peoples)
• Inappropriate lump together ie. Hispanic members
  of disparate groups with their own cultural
  identity eg., Prerto Ricans, Mexicans, Cubans,
  Dominicans

5
Impact of Cultural Competency

• More successful patient education
• Increases in pts health care seeking behavior
• More appropriate testing and screening
• Fewer diagnostic errors.
• Avoidance of drug complications
• Greater adherence to medical advice
• Expanded choices and access to high-quality
  clinicians.

6
Transcultural Nursing- Leininger, 1997

• Definition- A formal area of study and practice
  focused on comparative holistic culture care,
  health and illness patters of people with respect
  to differences and similarities in their cultural
  values, beliefs, and lifeways with the goal to
  provide culturally congruent, competent and
  compassionate care

7
Cultural needs

• Equal access to treatment and care
• Respect for cultural beliefs and practices
• Leininger, (1995) Narayanasamy, (2003)
• Religious beliefs, taboos, customs
• Dietary, personal care needs, daily routines
• Dying needs
• Communication needs
• Cultural safety needs,

8
Cultural needs (Contd)

• Pain
• Health practice
• Time orientation
• Space
• Family

9
Equal access to treatment and care

• Ethnicity
• racial discrimination,
• racial harassment and
• oppression
• Secondary problems
• stress
• psychological trauma

10
Communication needs

• Barrier
• Impede early detection
• delay prompt treatment and care
• Forms
• Language
• Non-verbal communication
• Translation services
• Interpreters
• Family interpreters
• Health condition acute illness crisis

11
Cultural safety needs

• Engage clients as partners
• Respect rapport -gt self-esteem
• Cultural negotiation culture compromise

12
Transcultural Care Practice

• Initiative
• Enthusiasm
• Commitment of individuals and groups
• Strategic planning
• Organization coordination of services
• Funding
• Education
• Recruitment research

13
Giger-Davidhizar (2002) - Assessment Model
Communication
Culturally Unique Individual
Space
Biological Variations
Social Organization
Environmental Controls
Time
14
ACCESS Model Narayanasamy, 2002

• Assessment
• Communication
• Culture negotiation and compromise
• Establishing respect and rapport
• Sensitivity
• Safety

15
Campinha-Bacotes Cultural Competence Model

• Cultural awareness
• Cultural skill
• Cultural knowledge
• Cultural encounters
• Cultural desire

16
Purnells Model

• Macro level global society, community, family,
  individual, health
• Cultural domains overview, communication,
  family roles, workforce issues, biocultural
  ecology, high-risk behaviors, nutrition,
  pregnancy childbearing practices, death
  rituals, spirituality, health care
  practice/practitioners
• Cultural consciousness
• Unknown phenomenon

17
Culturally Competent Organization

• Ethnic minorities accounts for one fourth of the
  nations population
• In 2020, it will be near to 40
• 10 of RNs in the US are from racial/ethnic
  minority background (2000)

18
Organizational Diversity Competence
Model(Frusti, Niesen, Campion, 2003)
Drivers
measurements
Linkages
Commitment
Culture
19
Negotiation Process

• Listen to the clients perspective
• Teach from your knowledge in language
  appropriate for client family
• Compare similarities differences, disagree but
  do not devalue clients view
• Compromise
• if client treatment not harmful, promote
• If harmful, explain harm and suggest alternatives

20
(No Transcript)