Transcultural Nursing Care Respect For Diversity

1y ago
17 Views
2 Downloads
1.49 MB
25 Pages
Last View : 2m ago
Last Download : 2m ago
Upload by : Milo Davies
Transcription

Transcultural Nursing Care –Respect for DiversityBEATA DOBROWOLSKAMEDICAL UNIVERSITY OF LUBLIN, POLAND

Plan of the lecture Culture – attempt to define the notion Transcultural nursing by Madeleine Leininger Cultural competence in geriatrics Cultural sensitivity in geriatrics Examples of good practices - Project HealthProElderly Conflicts of values and moral distress of nurses

CultureAccording to Taylor (1971) culture can bedefined as a "complex phenomenon whichincludes knowledge, beliefs, art, law, morality,customs and any other capabilities and habitsacquired by man as a member of society".

CultureCulture it is the way of life of a population, includingshared knowledge, beliefs, values, attitudes, rules ofbehavior, language, skills, and world view amongmembers of a given society. It shapes humanbehavior because it is the foundation of beliefsabout "proper" ways to live (McBride).

Culture„Culture is eǀerLJthiŶg aďout people: the ǁaLJthey live, the way they view things, the waytheLJ ĐoŵŵuŶiĐate.; Ϳ. Culture shapesiŶdiǀiduals’ edžperieŶĐes, perĐeptioŶs,deĐisioŶs aŶd hoǁ theLJ relate to others͟.[BearskiŶ R.L.B., 2011]

Transcultural nursing by MadeleineLeininger (1925-2012)Madeleine Leininger developed her Theory of CultureCare Diversity and Universality in the 70s. with the goalto provide culturally congruent holistic care.For Her, culture-speĐifiĐ Đare ͞is the art of usiŶg ĐulturespeĐifiĐ kŶoǁledge aŶd ŵakiŶg it fit ǁith ĐlieŶts’ Ŷeeds,ǀalues aŶd desires for Đultural aŶd health Đare reasoŶs͟.

Transcultural nursing by MadeleineLeininger (1925-2012)Leininger described two kinds ofcaringthat exist in every culture:-generic caring – it is the oldest formof caring. Is often referred to as thefolk caring or folk practices of aparticular culture.-therapeutic caring – it is cognitivelylearned, practiced and transmittedthrough formal and informalprofessional education.These two kinds of caring very often do notfit together.In order to provide culturally congruent care,professionals should link and synthesizegeneric and professional care knowledge tobenefit the patient.Three models are helpful:1.cultural care preservation/maintenance;2.cultural care accommodation/negotiation;3.cultural care repatterning/restructuring.

The need fortranscultural nursingAs nurses we need cultural competences andcultural sensitivity, especially in the context ofgrowing migration (both, patients and nurses) andreality of practicing nursing in multicultural societies.Cultural beliefs and practices influence anindividual's health behaviours including choices anduse of health care services.We should also take care for cultural safety of thepatient. Cultural safety culturally safe care.

Cultural safety culturally safe careCulturally unsafe nursingpractice iŶĐludes „aŶLJactions which diminish,demean or disempowerthe cultural identity andwell- ďeiŶg of aŶ iŶdiǀidual.͟Culturally safe nursingpractice iŶǀolǀes „aĐtioŶswhich recognise, respectand nurture the uniquecultural identity of thepatient, and safely meet hisneeds, edžpeĐtatioŶs aŶdrights͟[Polaschek, 1998]

Cultural CompetencesCultural competences in nursing refers to the skills, knowledgeand attitudes required to provide care with consideration forvarious cultural differences.But! Cultural competency does not require knowing everythingaďout eǀerLJ Đulture or ŶeediŶg to forget oŶe’s oǁŶ Đulture aŶdcultural identity – it means rather respecting differences and beingwilling to accept the fact that there are many ways to view theworld.[Bearskin R.L.B., 2011]HLAW, IP, BEATA DOBROWOLSKA 2015

Special cultural needs of the elderlyThe older patients have difficulties to adapt, toacculturate,experience islonger that istheirwhypersonaltheir beliefs,habits,attitudesarestroŶger ethnic groups liveOld peoplefromminoritywith several different health conditions (comorbidity). They very often have financialproblems, they are very often sociallymarginalizedand carehavesystemproblemswithaccessing healthor someculturalbarriers to do so.They have problem with understandinginformation regarding their health conditionbecause of age problems and also because oflaĐk of aďilitLJ to speak differeŶt laŶguage Additionally, very often religious aspects aremore important for them at this stage of life.Oldpersonsare in dangerageismwhen theyrepresentdifferentcultureoftheyare andadditionallyunderrisk of raĐisŵ That is why:Cultural safety in geriatrics should be considered noton micro level (patient – nurse relationship) but alsoonmacrolevel:paying attentionthe disparitieshealthcare;improvingaccess totohealthcare for inallŶatioŶs aŶd eaĐh Đulture

Cultural Competence in Geriatrics (McBride)This is an ability to give health care in ways that are acceptable and useful to older persons because it is congruent with theircultural background and expectations.At the provider level, it has been described as including the demonstrated integration of:1)Awareness of one's personal biases and their impact on professional behavior;2)Knowledge of: (-) population specific health-related cultural values, beliefs, and behaviors; (-) disease incidence, prevalenceor mortality rates; (-) population-specific treatment outcomes;3)skills in working with culturally diverse populations.At the institutional level, it can be viewed as those systems of care that acknowledge the importance of culture, assess crosscultural relations, are alert to cultural differences and their repercussions and adapt services to meet cultural needs.

Culturally sensitive care in geriatrics –ethnogeriatric assessment (McBride)EthnicityAcculturationReligion and spiritualityPatterns of decision makingPreferred interaction patterns It is good to ask about ethnicity of the old patient (as He identify Himself); Do Ŷot assess patieŶt’s ethŶiĐitLJ ǀisuallLJ ďeĐause it soŵetiŵes ŵaLJ ďe the Đause of ŵisuŶderstaŶdiŶg duriŶg ĐareproĐess It is good to know how long the patient lives in this city/country; And what is the level of integration of cultural beliefs, values, and practices of the society into His system of beliefs andvalues; It helps to ideŶtifLJ siŵilarities aŶd differeŶĐes ďetǁeeŶ this old patieŶt aŶd the so Đalled „Đultural ŵajoritLJ͟ It is fundamental to ask about religion of the patient and specific church affiliation, spiritual beliefs It ĐaŶ help to uŶderstaŶd the patieŶt’s Ŷeeds aŶd soŵe health ďehaǀiours duriŶg ŶursiŶg Đare (dietary behaviours, end-of-lifecare, etc) It is very helpful to be aware how the decisions regarding the patient health should be made e.g. individually (if it ispossible considering health condition) or together with family members. It is very important to know what language is preferred by the old patient to communicate regarding His health statusand decisions.

What can helps to support dignity of eldersfrom ethnic minority [RCN, 2008]

Culturally sensitive care in geriatrics (McBride)Ask experts whatis culturallyappropriate inrelation with thisspecific patientAcknowledge andgreet the old personfirst. Use formaltitle as Mr. or Mrs.to address thepatientConsider to startcontact with the oldpatient from informalconversation beforeformal assessmentDEMONSTRATING RESPECTAND BUILDING THE TRUSTTalk with the oldpatient about Hisculture andincorporatecultural elementsto the plan ofcareAǀoid „iŶǀisiďlepatieŶt sLJŶdroŵe͟– talk to and withthe patient notabout the patient

Culturally sensitive care in geriatricsAdapt your languageto age andacculturation of thepatientUse appropriate tothe patieŶt’s Đulturepace of conversationRemember aboutappropriate to thepatieŶt’s Đulturephysical distant, usingtouch (ask forpermission), eyecontact, clothing andĐoǀeriŶg of thepatieŶt’sbody while examiningCommunicationIf you do not speakthe same language asthe patient or if thepatient does not speakfluently your language– use the trainedmedical interpreter(verbal and nonverbal)Remember that somebody gestures whichare OK for you - canbe understood asimpolite ordisrespectfulBe aware aboutemotionalexpressiveness in thepatieŶt’s Đulture –some cultures valuestoicism other openlyexpressed emotions

Example„AŶ AŵeriĐaŶ patieŶt, JohŶ, iŶ health Đare settiŶg iŶ ChiŶa ŵight ŶotiĐe that hisnurse, Liu, does not establish intimacy through touch, nor does she maintaineye contact with him. If he fails to consider their cultural differences, this mightlead the patient to believe that his prognosis is much worse than it really is.A Chinese patient in health care setting in America might be taken aback by hisŶurse’s haďit of ŵaiŶtaiŶiŶg eLJe ĐoŶtaĐt ǁith hiŵ aŶd ŵakiŶg touĐh a part of hercommunication. He might fail to make allowances for their cultural differences.This might lead the patient to believe that his nurse is being rude andĐoŶteŵptuous of hiŵ͟[Zoucha & Husted, 2000]

Culturally sensitive care in geriatricsOther aspects which should be considered if it is possible:-the gender of nurse who is going to take care for this specific patient (e.g.in Muslims society it is preferred to be cared by provider of the same sexas the patient);-dietary preferences;-preferences regarding hygiene (in some cultures only family can washthe whole body of the patient);-visiting patterns (e.g. in Gipsy families)-end-of-life careAnd many others

Example

L-E-A-R-N Model in cross-culturalcommunicationo ListeŶ ǁith sLJŵpathLJ aŶd uŶderstaŶdiŶg to the patieŶt’sperception of the problemo Explain your perception of the problemo Acknowledge and discuss the differences andsimilaritieso Recommend treatmento Negotiate agreement

Respectful Practice in multicultural realityR – Reflect deeply on your own cultural values and beliefsE – Examine and question assumptions and biases in practiceS – Share and recognise ethical space of nurse-patient relationshipP – Participate and celebrate cultural uniquenessE – Engage in relationship buildingC – Create open and trusting environmentT – Treat people with dignity and compassion [Bearskin R.L.B., 2011]

Conflicts of values Among elements of the patient's culture, which may be the basis ofĐoŶfliĐts of ǀalues are ǁorth to ŵeŶtioŶ: religioŶ, laŶguage, culturallyspecific health habits, family relationships, perceptions of genderroles, perceptions of intimacy and privacy, communication verbaland non-verbal (e.g. touch), rituals that affect health.It should be noted that there is a difficulty in the proper recognitionof behaviours among these cultural elements which are thepatient's cultural rights, and which are harmful and should becorrected.

Moral distressIŶ soŵe Đases, ǁheŶ the ĐoŶfliĐt of Đultural ǀalues ;the patieŶt’s aŶdthe Ŷurse’sͿ is also of ŵoral ĐharaĐter aŶd ǁheŶ nurse has to dealwith it very often in her practice she or he can experience kind ofmoral distress.It can be experienced as kind of anxiety, guilt, frustration whennurse has to participate or undertake medical procedure which isagainst her/his moral identity.

Examples of good practices

ReferencesBearskin R.L.B., A critical lens on culture in nursing practice, Nursing Ethics, 2011, 18(4):548-559. LeningerM., Transcultural nursing: Concepts, theories, research & practice, McGraw-Hill, New York 1995.Zoucha R. & Husted G.L., The ethical dimensions of delivering culturally congruent nursing and health care,Issues in Mental Health Nursing, 2000, 21: 325-340.Polaschek N.R., Cultural safety: a new concept in nursing people of different ethnicities, Journal of AdvancedNursing, 1998, 27: 452-457.McBride M., Ethnogeriatrics and cultural competence for nursing atrics and cultural competence for nursing practice/want to know more [accessed: 18.05.2015]Dignity on the ward. Working with older people from ethnic /for-professionals/health-andwellbeing/id7733 dignity on the ward working with older people from ethnic minorities 2008.pdf?dtrk true [accessed: -Guidelines Online.pdf [accessed: 20.05.2015]

Transcultural nursing by Madeleine Leininger (1925-2012) Leininger described two kinds of caring that exist in every culture:-generic caring –it is the oldest form of caring. Is often referred to as the folk caring or folk practices of a particular culture.-therapeutic caring –it is cognitively learned, practiced and transmitted through .

Related Documents:

transcultural nursing as an essential formal area of study, research, and practice. She coined the term “transcultural nursing” to focus nursing worldwide on comparative cultural caring, health, and nursing phenomena. Transcultural nursing is direct

cultural Nursing: Concepts, Theories, Research, and Practice (1978). This publication is widely considered the first definitive work on the practice of transcultural nursing.5 vAPPLYING TRANSCULTURAL NURSING PRINCIPLES TO HOSPICE CARE In a single day, a hospice nurse may care for a foreign-born corporate executive, or a rural family on a .

Bruksanvisning för bilstereo . Bruksanvisning for bilstereo . Instrukcja obsługi samochodowego odtwarzacza stereo . Operating Instructions for Car Stereo . 610-104 . SV . Bruksanvisning i original

Transcultural Nursing II NURS 410 Transcultural Nursing III Continuum of Nursing Care for Women and Children . Unit a. Demographics b. Normal aging, cultural differences, geriatric assessment, theories of . 3. Nursing Management of Clients Requiring Cardiac M

Unit 1 Introduction to Community Health Nursing (5) Transcultural Nursing in the Community 1. The Meaning of Culture 2. Characteristics of Culture 3. Ethnocultural Health Care practices 4. Selected Cultural Communities 5. Transcultural Community Health Nursing Pr

10 tips och tricks för att lyckas med ert sap-projekt 20 SAPSANYTT 2/2015 De flesta projektledare känner säkert till Cobb’s paradox. Martin Cobb verkade som CIO för sekretariatet för Treasury Board of Canada 1995 då han ställde frågan

service i Norge och Finland drivs inom ramen för ett enskilt företag (NRK. 1 och Yleisradio), fin ns det i Sverige tre: Ett för tv (Sveriges Television , SVT ), ett för radio (Sveriges Radio , SR ) och ett för utbildnings program (Sveriges Utbildningsradio, UR, vilket till följd av sin begränsade storlek inte återfinns bland de 25 största

Hotell För hotell anges de tre klasserna A/B, C och D. Det betyder att den "normala" standarden C är acceptabel men att motiven för en högre standard är starka. Ljudklass C motsvarar de tidigare normkraven för hotell, ljudklass A/B motsvarar kraven för moderna hotell med hög standard och ljudklass D kan användas vid