Practice Issues Related

To Cultural Competence
• Health Information and Education
• Education and Certifcation
• International Marketplace
• Nursing Literature
• Responsibility of Health Care Facilities for Cultural
Care
• Recommended Standards for Culturally and
Linguistically Appropriate Services (CLAS)
Health Information and
Education
• Minority populations appear less knowledgeable
about specifc health problems, prevalence,
warning signs, diagnosis opportunities, and
preventative techniques over risk factors.
• Example: African Americans tend to
underestimate the prevalence of cancer, give less
credence to the warning signs, obtain fewer
screening tests, and are diagnosed at later stages
of cancer than are whites.
• The problem is that minority groups are not
receiving the information.
• Although there are successful programs being
ofered to increase public awareness about health
to minority groups the majority of the population
is not being reached.
Health Information and
Education continued…
• The efort has to be focused on supplying families,
churches, employers, and community
organizations with the necessary information and
the leadership to be involved in facilitating
behavior changes for healthier lives.
• Education programs have huge efects on
diseases that are afected by lifestyle, such as
hypertension, obesity, and diabetes.
• These programs help develop self-management
skills to give the individual the knowledge to
identify warning signs and minimize complications
in the individual’s health.
Education and
Certifcation
• Transcultural nursing is the study of the
diferences and similarities of various cultural
health values and beliefs among diferent ethnic
and minority groups.
• Transcultural, cross-cultural, and international
nursing is beginning to be seen as another
avenue for nurses as universities are ofering
more graduate programs in these areas.
• Recognition is partly attributed to certifcation of
transcultural nursing and it distinguishes
transcultural nursing as its’ own specialty.
• The Transcultural Nursing Society has been
certifying nurses in transcultural nursing since
1988.
Education and
Certifcation continued…
• The main focus behind transcultural nursing is
implementing universal care for clients that will
improve, maintain, and restore health and
improve client satisfaction.
• Example: Mary Seacole and Lillian Wald both dealt
with diferent cultures of their own and were
determined to improve, maintain, and restore
health and improve client satisfaction through
their care.
International
Marketplace
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International
Marketplace continued…
• For nurses to care for an individual to the best of
their ability, it is a necessity that the nurses have
an understanding of intercultural issues.
Nursing Literature
• Since the 1950s, there has been an increase in
journal articles pertaining to culturally diverse
clients, transcultural nursing research,
international nursing, and the inclusion of
transcultural concepts in nursing curricula.
• Example: The Journal of Transcultural Nursing,
frst published in 1989, was created to advance
transcultural nursing knowledge and practices. It
provides much information on theory research,
and practice dimensions of transcultural nursing.
• Although research articles on transcultural issues
are becoming a common feature in health care
journals there are still a lot of issues that are not
being addressed that need to be.
Nursing Literature
continued…
• Not enough articles are being published on the
clients’ cultural views and health care needs in
the journals in which the nurses reading these
journals are caring for those specifc patients from
diverse cultures.
• Additional research must also be done on a more
individualistic level dealing with behavior
responses to life processes such as pregnancy,
birth, death, and human growth and development.
• Studies also must be conducted across culturally
that explore biologic, psychologic, sociologic, and
spiritual diferences within, between, and among
cultural groups.
• Dr. Madeline Leininger created the theory of
culture care diversity and universitality to guide
transcultural research.
Nursing Literature
continued…
• There has been progress on research being
conducted on culturally diverse issues but the
problem is that when the research is conducted to
the time it takes to publish the results changes to
actual culture may have occurred during this time
gap.
• This time gap then leads to a lack of acceptance
of new interventions that could improve health
care practices of culturally diverse populations.
• Computer information technology and online
networks are beginning to narrow the time gap
and research is being spread in a more efcient
and timely manner.
Responsibility of Health
Care Facilities for
Nursing is a holistic care approach and requires
Cultural
nurses not onlyCare
•

to care for the patient physically

but also mentally, emotionally, and spiritually.
• Nursing policies should refect openness to
include extended family members and folk
healers in the nursing care plan, provided their
presence is not harmful to the patient’s well
being.
• Example: American Indians may seek assistance
from a shaman or medicine man.
• Many hospitals do provide chaplaincy programs in
which access to representatives of numerous
religious afliations are available to that patient.
Responsibility of Health
Care Facilities for
Nurses must respect the patient’s right to privacy
Cultural
and allow time Care…
•

for the patient to interact with his

or her spiritual or cultural healers.
• This respect must also transcend to the
unconventional beliefs, health practices, and the
nontraditional healers, and focus on developing a
plan of care that builds on the patient’s beliefs
and incorporates nontraditional health practices
that are not harmful.
• Health care facilities should be prepared to care
for patient’s with culture-specifc needs by having
a list of translators fuent in the languages spoken
by the patients using the facility.
Responsibility of Health
Care Facilities for
Due to cultural diversity, there are more aspects
Cultural Care…
•

to consider when selecting a translator such as

gender, birth origin, and socioeconomic status.
• Without consideration of these things a nurse
could break a cultural taboo of a man talking to a
women with public issues, diferent dialects
between languages could cause information to be
misinterpreted, and diferent socioeconomic class
between patient and interpreter can also lead to
problems of interpretation.
• To help with cultural diversity, a clinical nurse
specialist in transcultural nursing should be
added to the staf in order to act as a role model
and educator for the other nurses when dealing
with patients from other cultures.
Responsibility of Health
Care Facilities for
Education is a huge part in order for nurses to
Cultural
understand andCare…
•

be able to treat individuals from

other cultures.
• Education programs should be provided to nurses
by health care institutions.
• These programs need to promote awareness of
the nurses’ own culturally based values, beliefs
and attitudes, cultural assessment, biologic
variations of cultural groups, cross-cultural
communication, culture-specifc beliefs and
practices related to childbearing and rearing,
death and dying, issues of mental health, and
cultural aspects of aging.
Recommended Standards for
Culturally and Linguistically
Appropriate Services
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