1.N3036- Transcultural Nursing Diverse 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 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 -> 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 Culturally Unique Individual Biological Variations Environmental Controls Time Social Organization Space Communication 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) Commitment Drivers measurements Linkages 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