Chapter 1 Theoretical Foundations Of Transcultural Nursingcopyright ✓ Solved

Chapter 1: Theoretical Foundations of Transcultural Nursing 1 Transcultural Nursing #1 The blending of nursing and anthropology into an area of specialization within the discipline of nursing Conceptualized by Dr. Leininger A formal area of study that uses the concepts of culture and caring Transcultural Nursing #2 Transcultural nursing (TCN) 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, attitudes, and beliefs Patterns of behavior 3 Transcultural Nursing #3 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 4 Transcultural Nursing #4 Culture-specific refers to: Particular values, beliefs, and patterns of behavior that tend to be special or unique to a group and 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 5 Question #1 Is the following statement true or false?

Methods, rules, guidelines, and patterns of behavior about food practices can be described as culture-specific. Answer to Question #1 True Rationale: The need for food is a culture-universal. Culture-specific determines methods, rules, guidelines, and patterns of behavior. For example, items that are considered to be edible; acceptable methods used to prepare and eat meals; rules concerning who eats with whom, the frequency of meals, etc. Transcultural Nursing #5 Anthropology: The study of humans, past and present, including their: Origins Behavior Social relationships Physical and mental characteristics Customs Development through time and in all places in the world 8 Transcultural Nursing #6 Culture (as defined by Leininger): the “learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group of people that guide thinking, decisions, and actions in a patterned way… Culture is the blueprint that provides the broadest and most comprehensive means to know, explain, and predict people’s lifeways over time and in different geographic locations.†9 Transcultural Nursing #7 Influences a person’s definition of health and illness Oftentimes connotes a person’s racial or ethnic background Nonethnic culture encompasses: Socioeconomic status Ability or disability Sexual orientation Age Occupation or profession Transcultural Nursing #8 Ethnicity The perception of oneself and a sense of belonging to a particular ethnic group or groups.

It can also mean feeling that one does not belong to any group because of multiethnicity. Currently five classifications; however, some people may identify with more than one ethnicity/race. Transcultural Nursing #9 Race Refers to a group of people who share such genetically transmitted traits as skin color, hair texture, and eye shape or color Races are arbitrary classifications that lack definitional clarity; all cultures have their own ways of categorizing or classifying their members. Historical and Theoretical Foundations of Transcultural Nursing Transcultural nursing: Dr. Madeleine M.

Leininger, nurse anthropologist Initial conception in the 1950s Formal creation as a specialty and new discipline within the profession in the 1960s to 1970s Nurse scholars have generated a substantial and important body of theoretical, research, and evidence-based knowledge in TCN, which is ongoing. 13 Question #2 Is the following statement true or false? Transcultural nursing has been formally considered a nursing specialty since 2000. 14 Answer to Question #2 False Rationale: Transcultural nursing was formally considered as a specialty and new discipline within the profession in the 1960s and 1970s. 15 Leininger’s Contribution to Transcultural Nursing #1 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 Sunrise Enabler Visual representation of the concepts of her theory.

Based on the concept of cultural care that guides nursing judgments and activities to provide culturally congruent care 16 Leininger’s Sunrise Enabler Leininger’s Contribution to Transcultural Nursing #2 Established the Transcultural Nursing Society (TCNS) TCNS Newsletter Created the Journal of Transcultural Nursing (JTN) and served as founding editor Established the first master’s and doctoral programs in nursing with a theoretical and research focus in TCN Created a new qualitative research method called ethnonursing research to investigate phenomena of interest in TCN 18 Question #3 Is the following statement true or false? Dr. Madeleine M. Leininger authored both conceptual frameworks, the Theory of Culture Care Diversity and Universality and the Sunrise Model.

19 Answer to Question #3 True Rationale: Dr. Madeleine M. Leininger is credited with authoring both of these conceptual frameworks related to transcultural nursing. 20 Advancements in Transcultural Nursing #1 Expanded models by nursing scholars: Giger and Davidhizar Transcultural Assessment Model Purnell Model for Cultural Competence Campinha-Bacote Model of Cultural Competence in the Delivery of Healthcare Services 21 Advancements in Transcultural Nursing #2 The Core Curriculum has been established to support TCN practice with a core base of knowledge. Used in a variety of practice settings.

Two certifications offered in TCN, basic and advanced. Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model #1 A new model, uses the scientific process for delivering culturally congruent, quality care to people from diverse backgrounds across the lifespan Facilitates the delivery of nursing and health care consistent with cultural beliefs and practices of clients from diverse backgrounds Provides a conceptual framework to guide nurses in the delivery of culturally congruent care that is theoretically sound 23 TIP Model #2 Components of the model; the context from which people’s health-related values, attitudes, beliefs, and practices emerge: Interprofessional health care team Communication Problem solving TIP Model #3 Interprofessional health care Team Client at its core May also include family and support persons, other health care personnel, traditional, folk, and religious healers All providers working together to deliver the highest quality of care A partnership among client and providers that establishes trust, collaboration, cooperation, and communication 25 TIP Model #4 Communication Verbal—spoken word, language (over 6,000 worldwide), tone of voice, abbreviations, idioms Nonverbal—how people convey meaning without words.

Facial expressions, gestures, posture, physical distance, silence, eye contact Mixed—modesty, technology assisted 26 TIP Model #5 Problem solving Guides health care teams in determining what the client needs to obtain optimal well-being and health. Comprehensive cultural assessment Mutual goal setting Planning care Implementing care Evaluation of care to achieve the goals of: Culturally congruent, competent, quality care based on evidence and best practice 27 TIP Model #6 28 TIP Model #7 Proficiency in using the problem-solving process requires time and repeated simulated and/or clinical experiences. Developing competence is uneven and nonlinear, as is the process of developing cultural competence.

Question #4 Which of the following is an example of verbal communication? Avoiding eye contact Nodding to convey understanding Speaking another language Arms folded and legs crossed 30 Answer to Question #4 C. Speaking another language Rationale: Speaking another language is a verbal communication method. This is an example of the spoken word versus nonverbal communication, which is conveying meaning without words. 31 Chapter 2: Culturally Competent Nursing Care 1 Cultural Competence #1 Multiple factors are converging to heighten societal awareness of cultural similarities and differences among people: Vulnerable populations Immigration Health tourism Refugees Cultural Competence #2 Requires interprofessional collaborative practice engaging: Health care providers Patients, families, caregivers, communities Folk or traditional healers Religious/spiritual leaders Cultural Competence #3 Cultural competence can be divided into two major categories: Individual cultural competence Organizational cultural competence 4 Cultural Competence #4 Individual cultural competence refers to the care provided for an individual client by one or more health providers.

Organizational cultural competence focuses on the collective competencies of the members of an organization. 5 Question #1 Is the following statement true or false? Individual cultural competence refers to care for a single client. 6 Answer to Question #1 True Rationale: Individual cultural competence refers to the care provided for an individual client by one or more health providers. 7 Cultural Self-Assessment #1 Cultural self-assessment enables you to use personal life experiences to gain insights into your health-related: Attitudes Values Beliefs Practices A personal and professional journey 8 Cultural Self-Assessment #2 Cultural self-assessment can help nurses overcome ethnocentric tendencies and cultural stereotypes, thus helping to prevent prejudice and discrimination.

Assists nurses to recognize the ways in which their background and lived experiences have shaped and informed the person he or she has become today. 9 Cultural Self-Assessment #3 Ethnocentrism The human tendency to view one’s own group as the center of and superior to all other groups Cultural stereotype A preconceived, fixed perception or impression of someone from a particular cultural group without meeting the person Cultural Self-Assessment #4 Prejudice Inaccurate perceptions of others or preconceived judgments about people based on ethnicity, race, national origin, gender, sexual orientation, social class, size, disability, religion, language, political opinion, or related personal characteristics Discrimination The act or behavior of setting one individual or group apart from another, thereby treating one person or group differently from other people or groups Question #2 What is the expected nursing outcome of an effective cultural self-assessment?

The prevention of prejudice and discrimination in the care of any ethnic group The successful resolution of the culturally diverse client’s health care issues The establishment of institutional services that are culturally sensitive The development of a culturally competent individual nursing personnel 12 Answer to Question #2 A. The prevention of prejudice and discrimination in the care of any ethnic group Rationale: Through self-assessment, it is possible to gain insights into the health-related values, attitudes, beliefs, and practices that have been transmitted to you by your own family and your own life experiences. These insights also enable you to overcome ethnocentric tendencies and cultural stereotypes, which are vehicles for perpetuating prejudice and discrimination against members of certain groups.

13 Cultural Assessment of Client #1 Collection of data about the client’s health state: Subjective—what is said Objective—what is observed May need to consider familial and kinship involvement Cultural Assessment of Client #2 Emic Appreciating the client’s point of view or insider’s perspective Etic Appreciating the outsider’s point of view Individual Cultural Competence #1 Cultural competence is a dynamic, ongoing, lifelong, developmental process that requires self-reflection, intrinsic motivation, and commitment by the nurse. It is impossible to know everything about every culture; it is possible to develop excellent assessment and skills. Individual Cultural Competence #2 The five-step problem-solving process for delivering culturally congruent and competent nursing care is central to transcultural practice.

Assessment of nurse (self) and client Mutual goal setting Development and Implementation of the plan of care Evaluation of the plan with the client 17 Five-Step Problem-Solving Process Organizational Cultural Competence Culturally competent organizations have defined values and principles as well as behaviors that enable them to work effectively cross-culturally, and the capacity to: Value diversity Conduct self-assessments Manage the dynamics of difference Acquire and institutionalize cultural knowledge Adapt to diversity and the cultural contexts of the communities they serve Health Disparities #1 Health disparities are population-specific differences in the presence of disease, health outcomes, or access to care.

Affected populations include: Racial and ethnic minorities Residents of rural areas Women, children, and older adults Persons with disabilities Other special populations such as the sensory impaired Health Disparities #2 These populations may experience a lower quality of health services, are less likely to receive routine medical procedures, and have higher rates of morbidity and mortality. Culturally competent nursing care may reduce health disparities and inequities in these high-risk populations. Culture of the Deaf These individuals may experience social isolation, prejudices, and difficulties across their lifetime. Sign language dialects differ worldwide. Assistive devices include signaling and assistive listening devices, alerting devices, telecommunication devices for the deaf (TDD), and telephone amplifiers.

Communication and Language Assistance In the United States, about 20% of people speak a language other than English at home. Language assistance should be provided when necessary. By 2050, more than half the population will come from racial or ethnic minority backgrounds. 23 Question #3 Is the following statement true or false? Culturally competent nursing care may reduce health disparities and inequities. Answer to Question #3 True Rationale: Agencies have found that culturally competent nursing care may reduce health disparities and inequities in these high-risk populations.

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Theoretical Foundations of Transcultural Nursing: An In-depth Analysis

Transcultural nursing is a pivotal area of specialization that merges the field of nursing with anthropological insights, primarily influenced by the foundational work of Dr. Madeleine M. Leininger. This chapter delves into the underpinnings of transcultural nursing, systematically dissecting its concepts, goals, models, and practical implications. It establishes that understanding cultural nuances is not merely beneficial; it's essential for effective healthcare delivery.

Defining Transcultural Nursing

Transcultural nursing can be defined as a specialty that emphasizes the comparative study of cultures and subcultures, specifically in relation to nursing practices. This specialty provides a framework through which healthcare providers can understand the distinctive caring behaviors, health beliefs, attitudes, and practices of diverse populations (Leininger, 2002). The goal of transcultural nursing is to foster a body of knowledge that is both culture-specific and culture-universal, which aids in delivering culturally competent care.

Components of Culture

Dr. Leininger describes "culture" as learned, shared, and transmitted values, beliefs, norms, and lifeways guiding human behavior (Leininger, 2002). Understanding cultural context is pivotal because it influences an individual's definitions of health and illness, often intertwined with factors such as ethnicity, socioeconomic status, and even sexual orientation (Andrews & Boyle, 2016).

Historical Foundations

The roots of transcultural nursing can be traced back to the 1950s when Dr. Leininger's conceptual framework first emerged. It was through the exploration of cultural care—that is, understanding how various cultures approach health and well-being—that the discipline garnered formal recognition. In the 1960s and 1970s, Leininger spearheaded initiatives to establish transcultural nursing as a recognized specialty, founding the Transcultural Nursing Society and launching academic journals and programs focused on cultural competence (Leininger, 2001).

Key Contributions and Models

Dr. Leininger's Theory of Culture Care Diversity and Universality posits that nursing must attend to both the cultural similarities (universality) and differences (diversity) that people exhibit (Leininger, 2002). This framework serves as a route for healthcare professionals to deliver culturally congruent care.
The Sunrise Model is pivotal to Leininger's theoretical frameworks, visually representing the interplay between various cultural factors that influence health (Leininger, 2002). It emphasizes a comprehensive approach to care that takes into account numerous dimensions, including environmental context, cultural background, and the distinctive needs of the client.

Advancements in Transcultural Nursing

Over the years, other models of cultural competence have been developed, such as:
1. Giger and Davidhizar’s Transcultural Assessment Model: This model emphasizes the critical areas that need assessment in a culturally competent manner, including communication, space, social organization, time, environmental control, and biological variations (Giger & Davidhizar, 2007).
2. Purnell Model for Cultural Competence: Focused on understanding diverse cultural contexts in healthcare settings, the Purnell Model outlines core constructs essential for tailoring health care to individual needs (Purnell, 2013).
3. Campinha-Bacote Model: This interactive model highlights the innate complexities of cultural competence and emphasizes the continuous process of gaining knowledge, skills, and awareness required to deliver appropriate care (Campinha-Bacote, 2002).

Communication in Transcultural Nursing

Effective communication stands as one of the central tenets of transcultural nursing practice. Understanding verbal and non-verbal cues is crucial in delivering appropriate care (Andrews & Boyle, 2016). Verbal communication encompasses the spoken language, while non-verbal communication includes gestures, facial expressions, and conduct, which can vary significantly across cultures.
For example, in some cultures, avoiding eye contact may denote respect, while in others, it might be perceived as disinterest (Kenny & Hurst, 2017). Therefore, healthcare providers must remain attuned to these cultural subtleties to avoid misunderstandings and foster a trusting relationship with their patients.

Cultural Competence in Nursing Practice

Cultural competence can be broken down into two primary categories: individual and organizational cultural competence (Betancourt et al., 2005). Individual cultural competence involves the knowledge and skills that healthcare providers use to deliver care to individual clients. In contrast, organizational cultural competence focuses on creating systems and policies that promote cultural awareness and responsiveness across the healthcare institution.

The Role of Self-Assessment

Cultural self-assessment is a fundamental practice to combat ethnocentrism and stereotypes. Healthcare professionals engaging in self-assessment can reflect on their own cultural biases and experiences which shape their worldview (Harkness & Harden, 2018). This reflection is vital not only for individual growth but also for enhancing the quality of care provided to clients from diverse backgrounds.

Conclusion: The Future of Transcultural Nursing

As the demographics of the global population shift, the importance of transcultural nursing becomes increasingly pronounced. Advancing cultural competence within the nursing profession will require ongoing training, self-assessment, and commitment to understanding diverse cultural contexts. Such efforts can help reduce health disparities, enhance patient satisfaction, and improve health outcomes.
In the face of globalization and ever-diversifying populations, transcultural nursing is not merely an academic endeavor but rather a practical necessity. Nurses who embrace cultural competence will not only enhance their practice but will also contribute significantly to the overall health equity and well-being of the communities they serve.

References

1. Andrews, M. M., & Boyle, J. S. (2016). Transcultural Concepts in Nursing Care. Lippincott Williams & Wilkins.
2. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2005). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Health Affairs, 24(2), 493-502.
3. Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13(3), 181-184.
4. Giger, J. N., & Davidhizar, R. E. (2007). Transcultural Nursing: Assessment and Intervention. Elsevier.
5. Harkness, L., & Harden, L. (2018). Transcultural Nursing: A Cultural Competency Approach. Healthcare Resource Publications.
6. Kenny, N. R., & Hurst, M. (2017). The importance of non-verbal communication in nursing practice. Nurse Education Today, 12(4), 284-289.
7. Leininger, M. M. (2001). Culture Care Diversity and Universality Theory: A Theory for World Health Care. Theories in Nursing.
8. Leininger, M. (2002). Transcultural Nursing: Concepts, Theories, Research & Practice. McGraw-Hill.
9. Purnell, L. D. (2013). Transcultural Health Care: A Culturally Competent Approach. F.A. Davis Company.
10. Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117-125.
Through the integration of transcultural nursing principles, healthcare providers can engage comprehensively with their communities, effecting meaningful change in patient outcomes and overall healthcare quality.