****APA Format**** In your own words and using the proper evidence-based references define transcultural diversity and Health care and discuss how both term interact and how they help in the delivery of health care to different heritages.2. Mention and discuss at least 4 variant characteristics of culture.A minimum of 2 evidence-based references no older than 5 years are required. A minimum of 500 words are required.
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ch01_nursing_culture.ppt

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Theories, Models, and
Approaches
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Cultural Theories, Models, and
Approaches
▪ Leininger: First nurse cultural theorist from
early 1950s. She states it is for nursing only
▪ Campinha-Bacote: basic simple model without
complex constructs but applicable to all
healthcare providers. Also has a Biblical based
model.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Cultural Theories, Models, and
Approaches
▪ Giger and Davidhizar: Nursing only
▪ Purnell: For all health care providers and is an
example of a complexity and holographic
conceptual model with an organizing
framework.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Cultural Theories, Models, and
Approaches
▪ Papadopoulous, Tilki, and Taylor Model for
Transcultural Nursing and Health
▪ Andrews and Boyle Nursing Assessment Guide
▪ Spector’s Health Traditions Model
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Cultural Theories, Models, and
Approaches
▪ Ramsden’s Cultural Safety Model
▪ Jeffrey’s Teaching Cultural Competence in
Nursing and Health Care: Inquiry, Action, and
Innovation
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leininger’s Theory of Cultural Care
Diversity and Universality
www.madeleine-leininger.com
▪ Leininger described the phenomena of cultural care
based on her experiences.
▪ Began in the 1950s with her doctoral dissertation
conducted in New Guinea
▪ www.tcns.org and go to theories and then to the
Sunrise Enabler and her model is displayed as well as
publications.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Transcultural Nursing
▪ “Transcultural nursing has been defined as a formal
area of study and practice focused on comparative
human-care (caring) differences and similarities of
the beliefs, values, and patterned lifeways of cultures
to provide culturally congruent, meaningful, and
beneficial health care to people.“
Leininger and McFarland text, 3rd ed.,2002, pp5-6.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leininger: Purpose and Goal
▪ To discover, document, interpret, explain and predict
multiple factors influencing care from a cultural
holistic perspective.
▪ The goal of the theory was to provide culturally
congruent care that would contribute to the health
and well being of people, or to help them face
disability, dying, or death using the three modes of
action.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leninger: Theoretical Tenets
▪ Leininger’s tenets: Care diversities
(differences) and universalities
(commonalties) existed among cultures in the
world which needed to be discovered, and
analyzed for their meaning and uses to
establish a body of transcultural nursing
knowledge.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leininger: Assumptions
▪ Care is essence of nursing and a distinct, dominant,
central, and unifying focus. Some would say that
caring is not unique to nursing.
▪ Care is essential for well being, health, growth,
survival, and to face handicaps or death.
▪ Culturally based care is the broadest means to know,
explain, interpret, and predict nursing care
phenomena to guide nursing care decisions and
actions.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leininger Assumptions
▪ Nursing is a transcultural humanistic and scientific
care to serve individuals, groups, communities, and
institutions worldwide.
▪ Caring is essential to curing and healing for there can
be no curing without caring.
▪ Cultural care concepts meanings and expression
patterns of care vary transculturally with diversity
and universality.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leininger Assumptions
▪ Every human culture has generic care knowledge and
practices and some professional care knowledge that
vary transculturally.
▪ Culture care values, beliefs, and practices are
influenced by the (rays of the sun see the Model).
▪ Beneficial, healthy, and satisfying culturally based
care influences the health and well-being of
individuals, families, groups, and communities within
the cultural context.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leininger Assumptions
▪ Culturally congruent care can only occur when
individuals’, groups’, and communities’ patterns are
known and used in meaningful ways.
▪ Culture care differences and similarities between
professionals and clients exist in all human cultures
worldwide.
▪ Culture conflicts, imposition practices, cultural
stresses, and pain reflect the lack of professional care
to provide culturally congruent care.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leininger’s Sunrise Enabler to
Discover Culture Care
To view the model go to:
http://leiningertheory.blogspot.com/
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Leininger Orientational Theory
Definitions
▪ Cultural Care Preservation or Maintenance: all is well with the
patient so encourage to continue what has been done
▪ Cultural Care Accommodation or Negotiation: Needs some
change. What is acceptable weight from the patient’s
perspective
▪ Cultural Care Repatterning or Restructuring: Practices are
deleterious to overall health and need restructured: sexually
promiscuous and has not been practicing safe sex
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Cultural Competence in the Delivery of
Healthcare Services: A culturally
Competent Model of Care
▪ Dr. Josepha Campinha-Bacote but cannot
display her model. Go to

Home

Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Process of Cultural Competence
▪ Cultural Competence is a process not an event.
▪ The process consist of five inter-related constructs:
Cultural desire, cultural awareness, cultural
knowledge, cultural skills, and cultural encounter.
▪ The key and pivotal construct is cultural desire.
▪ There is more variation within a cultural group than
across cultural groups.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Process of Cultural Competence
▪ There is a direct relationship between healthcare
professionals level of cultural competence and their
ability to provide culturally responsive health care.
▪ Cultural competence is an essential component in
delivering effective and culturally responsive care to
culturally diverse clients.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Cultural Desire
▪ . . . Cultural desire is defined as the motivation
of the healthcare professional to “want to”
engage in the process of becoming culturally
competent; not the “have to”.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Concepts
▪ Cultural awareness is the self-examination and in-depth
exploration of one’s own cultural background.
▪ Cultural knowledge is the process of seeking and obtaining a
sound educational base about culturally diverse groups.
▪ Cultural Skills is the ability to collect relevant cultural data
regarding the client’s presenting problem as well as accurately
perform a culturally based physical assessment.
▪ Cultural encounter is the process which encourages the
healthcare professional to directly engage in face-to-face
interactions with clients from culturally diverse backgrounds.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
The Giger and Davidhizar
Transcultural Assessment Model
Dr. Joyce Giger
Dr. Ruth Davidhizar (deceased)
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Giger and Davidhizar Assumptions
▪ The Giger and Davidhizar Transcultural Model
postulates that each individual is culturally
unique and should be assessed according to
the six cultural phenomena.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Giger and Davidhizar Communication
▪ Communication embraces the entire world of
human interaction and behavior.
Communication is the means by which culture
is transmitted and preserved. Both verbal and
non-verbal communication are learned in
one’s culture.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Giger and Davidhizar
Space
▪ Space refers to the distance between
individuals when they interact. All
communication occurs in the context of space.
▪ Zones of personal space: intimate, personal,
social, and consultative and public. Rules
concerning personal distance vary from
culture to culture.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Giger and Davidhizar
Social Organization
▪ Social organization refers to the manner in
which a cultural group organizes itself around
the family group. Family structure and
organization, religious values and beliefs, and
role assignments may all relate to ethnicity
and culture.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Giger and Davidhizar
Time
▪ Time is an important aspect of interpersonal
communication.
▪ Cultural groups can be past, present, or future
oriented.
▪ Preventive health requires some future time
orientation because preventative actions are
motivated by a future reward.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Giger and Davidhizar Environmental
Control
▪ Environmental control refers to the ability of
the person to control nature and to plan and
direct factors in the environment that affect
them.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Giger and Davidhizar
Biological Variations
▪ Biological differences, especially genetic
variations, exist between individuals in
different racial groups.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Boyle and Andrews Culturological
Assessment
▪ Biocultural variations and cultural aspects of the
incidence of disease
▪ Communication
▪ Cultural affiliations
▪ Cultural sanctions and restrictions
▪ Developmental considerations
▪ Economics
▪ Educational background
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Boyle and Andrews Culturological
Assessment





Health related beliefs and practices
Kinship and social networks
Nutrition
Religion and spirituality
Values orientation
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Ramsden Cultural Safety
▪ “the effective nursing practice of a person or a
family from another culture, as determined by
that person or family”, while unsafe cultural
practice is “any action which diminishes,
demeans or disempowers the cultural identity
and wellbeing of an individual” (Nursing
Council of New Zealand (NCNZ).
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Ramsden Cultural Safety
http://culturalsafety.massey.ac.nz/RAMSDEN%20THESIS.pdf
▪ Assumes that nurses and the culture of nursing is exotic to
people
▪ Gives the power of definition to the person served
▪ Concerned with human diversity
▪ Focus internal on nurse or midwife, exchanges power,
negotiated
▪ A key part of Cultural Safety is that it emphasises life chances
rather than life styles
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Papadopoulos, Tilki, and Taylor
Cultural Awareness
Self awareness
Cultural identity
Heritage adherence
Ethnocentricity
Stereotyping
Ethnohistory
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Papadopoulos, Tilki, and Taylor
Cultural Knowledge
Health beliefs and behaviours
Anthropological, Sociological,
Psychological and Biological understanding
Similarities and differences
Health Inequalities
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Papadopoulos, Tilki, and Taylor
Cultural Sensitivity
Empathy
Interpersonal/communication skills
Trust
Acceptance
Appropriateness
Respect
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Papadopoulos, Tilki, and Taylor
Cultural Competence
Assessment skills
Diagnostic skills
Clinical Skills
Challenging and addressing prejudice,
discrimination, and inequalities
Copyright © 2013 F.A. Davis Company

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