Culture matters

Zebaa Arif reflects on changes during her career as a mental health nurse in relation to cultural care issues: Cultural awareness is becoming embedded in patient care. All aspects of care are influenced by cultural beliefs and should form part of assessment. Leadership is essential in influencing cultural care, as is organisational commitment.     

Beyond cultural competence: a model for individual and institutional cultural development

Nursing's attention to cultural diversity has been influenced by the changing demographic composition of the U.S. population. Nursing must continue to increase awareness and promote attitudinal and behavioral changes that will result in the delivery of culturally appropriate nursing care. The nursing literature includes several models of cultural development to assist nurses and other health care professionals in conducting a cultural assessment and incorporating cultural data into nursing care plans. This article presents a synthesis model of cultural development that illustrates that cultural awareness, cultural sensitivity, and cultural competence do not achieve the level of cultural development necessary to meet the health care needs of a diverse population. Cultural proficiency is a concept that extends cultural competence into nursing practice, administration, education, and research. It is a philosophical and behavioral approach to cultural diversity that guides and prescribes individual and institutional behavior toward "cultural others."     

Meeting the challenge of the new millennium: caring for culturally diverse patients

The world is shrinking, and as a consequence, the United States is changing rapidly. In this new environment, health care providers must navigate a new cultural terrain and develop new skills to provide appropriate care for patients from increasingly diverse backgrounds. The new millennium demographic data of the United States and the essential elements of cultural assessment are necessary to understand how patient care should be approached in an increasingly diverse population.     

"Culture matters for the patient in pain"

It is important for each nurse to be alert for not only individuals who are experiencing pain but also the impact that cultural phenomena may have on the way pain is experienced, expressed, and the assistance that is desired. The Giger-Davidhizar Transcultural assessment model provides a model for assisting in the assessment of pain. It is only by consideration for cultural phenomena that culturally appropriate care can be delivered.     

Transcultural nursing assessment: a method for advancing nursing practice

Today a new generation of nurses with different cultural insights and a deeper appreciation of human life and values are developing a sensitivity for culturally appropriate individualized care. Although literature on clinical approaches in cultural diverse situations is mushrooming, relatively few theories on transcultural nursing provide a systematic method for comprehensive nursing assessment, which is necessary for both the nursing practitioner and the researcher to provide appropriate nursing care tailored for each client. Below an outline of the areas that need to be assessed when working with clients from multicultural populations.     

Cultural aspects of orthopaedic nursing.

In today's highly mobile and transnational healthcare world, attention to the cultural background of orthopaedic patients is no longer a luxury when implementing care. Nurses can overcome cultural blindness by developing an awareness of their own cultural backgrounds and an understanding about nursing values as an expression of cultural norms of the discipline. Developing cultural sensitivity without stereotyping patients is a challenge to the professionalism of the nurse. However, assessment and care of orthopaedic patients can be enhanced by attention to aspects of both the nurse's and the patient's cultural backgrounds. Such analysis can lead to some depth of understanding of the patient and a genuine desire of the nurse to interact with the patient.     

Cultural considerations and the Hispanic cardiac client

This article examines the cultural influences of the Hispanic patient, such as health beliefs, communication styles, family and religious values, and time perception. In order to design and deliver individualized comprehensive care with the client and family, these assessment factors must be explored to create a plan of care that is tailored to meet the individualized needs of the patient and family. Understanding cultural influences that are important to the Hispanic cardiac client in the home care setting will have a positive impact on the nurse-patient relationship, the plan of care, and the management of the cardiac disease.     

Assessing culture: pediatric nurses' beliefs and self-reported practices.

Assessment of culture is an essential step in providing effective nursing care to a culturally diverse patient population. The purpose of this study was to describe the beliefs and self-reported practices of pediatric nurses from four Children's Hospitals regarding the process of assessing culture. The 584 respondents indicated they worked with a culturally diverse patient population and frequently experienced cultural conflicts. Findings indicated cultural assessments were not routinely performed. The majority indicated that learning more about the child's culture would improve the effectiveness of their nursing care. Respondents were willing to conduct cultural assessments on selected patients if this task could be accomplished in less than 15 minutes. Recommendations include guidelines for developing and implementing an appropriate cultural assessment process within a hospital setting.     

Enhancing Cultural Sensitivity in a Community Health Care Setting for LGBTQ Patients

Lesbian, gay, bisexual, transgender, or queer (LGBTQ)-identified individuals, particularly transgender individuals, experience significant health inequities such as increased risk for chronic health conditions and mental health concerns. Discrimination by health care professionals is a major deterrent for LGBTQ individuals to seek health care. The purpose of the article is to offer practice recommendations using targeted community actions to enhance LGBTQ cultural sensitivity in community health care settings. Strategic planning, assessment for readiness to change, environmental strengths, weaknesses, opportunities, and threats analysis, and use of community resources are recommended as part of a basic model for change in a community setting. Outcomes are measured using a cultural competency tool.     

Cultural Competence in the Master's Curriculum—A Course Exemplar

Multiple teaching–learning strategies such as the online cultural self-assessment, clinical case scenario, critiques of multicultural skill vignettes, and the cultural assessment of the clinical agency helped move nurse practitioner students along the continuum to becoming culturally competent practitioners. Ongoing integration of cultural content in course curricula is necessary to prepare health care providers to meet the challenge of caring for a more diverse society. These students acknowledged this challenge and worked at conquering the cultural divide, making gains and adjustments in the areas of cultural knowledge, skills, and attitudes. There is a gap that exists between those who have been trained recently as it relates to providing culturally sensitive care and those who have not had integrated cultural content in their educational preparation. This will continue to be a challenge for educators, clinical institutions, and governmental agencies. The goal is to ensure that the implementation and integration of cultural competence concepts are not academic exercises but should serve as opportunities to reduce the gap that presently exists.     

Occupational health nursing with Navajo workers. Providing culturally competent care.

1. Native Americans in the southwestern United States are considered a "vulnerable population." Native Americans have economic difficulties, poor health, and little access to health care. The Navajo nation is the largest Native American reservation in the United States. 2. Occupational health nurses who provide culturally competent care increase the likelihood for Navajo workers to obtain optimal benefits from workplace health services. 3. The nurse uses cultural assessment skills and critical thinking abilities to maximize therapeutic interactions and minimize barriers in communications with workers of other cultural backgrounds. 4. The nurse who is knowledgeable about the Navajo way can help achieve a balance between the traditional ways and Western ways of addressing serious health care issues facing the Navajo worker. This knowledge and cultural awareness also increases the effectiveness of health promotion and health education programs offered to workers, their families, and their communities.     

Pediatric palliative care

Progress in pediatric palliative care has gained momentum, but there remain significant barriers to the appropriate provision of palliative care to ill and dying children, including the lack of properly trained health care professionals, resources to finance such care, and scientific research, as well as a continued cultural denial of death in children. This article reviews the epidemiology of pediatric palliative care, special communication concerns, decision making, ethical and legal considerations, symptom assessment and management, psychosocial issues, provision of care across settings, end-of-life care, and bereavement. Educational and supportive resources for health care practitioners and families, respectively, are included.     

The palliative care needs of ethnic minority patients attending a day-care centre: a qualitative study

The aim of this study was to assess the culture-specific palliative care needs of ethnic minority patients. Qualitative semi-structured interviews were conducted using elements of phenomenology with four ethnic minority patients who were attending a day-care centre. Although the aim was to assess cultural needs, it was found that the patients expressed basic human needs rather than culture-specific ones. The theme of acculturation, where patients 'fit in' with the dominant culture, was predominant. This suggests that stereotypical cultural care may not always be appropriate, as micro-cultures and individual diversity within cultures exist. These should be explored in the cultural assessment of ethnic minority patients.     

Transcultural nursing care of Arab Muslims

Nursing care of the Arab Muslim client can be extremely rewarding providing the nurse is knowledgeable about important features of the culture. Knowledge of the complex social structure, world view and cultural context features is critical in promoting a sense of care for these clients. The centrality of religion and the family are closely interrelated and reflect many aspects of health care. This article has presented an overview of some of these features. The importance of culturological assessment for each client and family cannot be over emphasized, since cultural background, education and degree of acculturation will lead to variation in these patterns. The use of Leininger's theory and modes of nursing interventions can be most helpful as a basis for decision-making processes related to care of the Arab Muslim client. Only through knowledge, respect and sensitivity can nurses be effective in meeting the goals of the theory which is culturally congruent care to all clients of diverse cultures.     

Body piercing: issues and challenges for nurses

To provide safe and effective care for patients with body piercings, nurses must become more knowledgeable about this increasingly common practice. Competent nursing care is more than simply noting the presence or absence of body piercings, but includes accurate assessment, cultural sensitivity, and related patient education. Body piercings can create treatment challenges during trauma or post-assault care. An increased awareness of the history of body piercing, the piercing process, care of piercings, (including related wound care), and issues related to patient education, can enhance comprehensive nursing care.     

Transcultural nursing: a perspective derived from Jean-Paul Sartre

Transcultural nursing care is a well-established theoretical framework. This theory, developed by Madeleine Leininger, can have an impact on clinical practice, academic preparation and nursing research. The heightened interest in applying transcultural care and the increased need to espouse this framework have been triggered by constant population changes. This paper defines transcultural nursing care and expands its definition further by comparing and contrasting it with Jean-Paul Sartre's existentialist perspective. The two modes of existence as defined by Sartre are closely examined. Concrete examples are offered as cultural phenomena and the components of a cultural assessment are discussed and applied. The philosophical thesis is approached from a transcultural nursing perspective and existentialism is shown to serve as a foundation for transcultural nursing. The advantages and disadvantages of transcultural nursing practice and the preparation of transcultural nurses are finally addressed.     

Assessing the patient from a cultural perspective

If effective and efficient care is to be provided, the licensed practical/vocational nurse must be aware of differing cultural health practices and beliefs among people. Nurses should identify sources of discrepancy between the client's health beliefs and practices and health providers' perceptions of health. However, nurses must also recognize that while there are differences between cultural groups, many differences also exist between people of the same culture. Thus, an individualized assessment must be conducted if culturally appropriate care is to be planned and delivered.     

高危孕妇待产期间的评估和整体护理

目的:探讨护理人员对高危孕妇围产期间的评估和实施整体护理的方法。方法:以对高危待产孕妇实施整体护理的经验为基础,从高危病人病史、身体状态、睡眠状况、情绪、社会文化等方面及对其家属进行详细评估,充分了解其生理、心理过程,给予适时的心理支持和护理。结果:高危妊娠的病人会因自身的妊娠合并症或并发症的影响在待产期间引发焦虑、恐惧等心理,护理人员经给予适时的心理支持和整体护理,减少了孕产妇和围产儿的死亡率。结论:对高危孕产妇进行评估和整体护理能降低其合并症的发病率,改善护患关系,提高护理服务质量。     

Geriatric Rehabilitation and Resilience from a cultural perspective

Resiliency is a key aspect to aging successfully. Promoting healthy lifestyles, strong social bonds, enhancements to one's environment, accessibility to quality care and rehabilitation are critical in a positive aging experience. Issues of personal, social, medical, and rehabilitative care are addressed in the context of resiliency from a cultural perspective. Various research studies explore resiliency through the progression of aging within changing environments, medical needs, and social conditions. Findings suggest that a strong connection to culture, accessibility to medical attention, and comprehensive assessment of a patient's background can effectively improve the rehabilitation for an aging individual. This article addresses aspects of caregiving that are essential in raising cultural sensitivity and resiliency, discussing three case studies (i.e. fall risk; stroke; congestive heart failure) in the geriatric patient. Resiliency in culture and rehabilitation has a connection needed to advance the quality of care and quality of life for an aging patient population.