Transcultural Nursing

Transcultural nursing is viewed as a culturally competent practice field that client

centered and research focused. Although transcultural nursing is viewed as client
centered, it is important for nurses to remember that culture can and does influence how
clients are viewed and the care they are given.

Every individual is culturally unique, and nurses are no exception. Therefore, nurses must
use caution to avoid protecting their own cultural uniqueness and world views on the
client if culturally appropriate care is to be provided. Nurses must carefully identify their
own cultural beliefs and values and then separate them from the client’s beliefs and
values. To deliver culturally sensitive care the nurse must remember that each individual
is unique and a product of past experiences beliefs and values that have been learned and
passed down from one generation to the next. According stokes 91991), nursing as a
profession is not “culturally free “ but rather is “ culturally determined.” Nurses must
recognize and understand this fact to avoid becoming grossly ethnocentric (Strokes,
1991).

The more nurses know about their client’s cultural beliefs and values the more culturally
will be the care they provide. Nurses must continually assess and evaluate each client’s
responses and never assume that all individuals within a specific cultural group will
think and behave in a similar manner. Nurses must remember that there is as much
diversity within a cultural group as there is across cultural groups. The goal of
transcultural nursing is to discover culturally relevant facts about the client that can be
used to provide culturally appropriate and competent care. Although transcultural
nursing is becoming a highly specialized field, every nurse who is entrusted with the care
of clients must make every effort to deliver culturally sensitive care that is free of
inherent biases based on gender, race or religion.

As awareness of transcultural health care has increased so has the use of the term
cultural competence. There are many definitions for the term cultural competence. For
the beginning nursing student Giger and Davidhizar (1999) provide a clear,
understandable definition.. They view cultural competence as a dynamic, fluid,
continuous process whereby and individual, system, or health care agency finds
meaningful and useful care delivery strategies based on knowledge of the cultural
heritage, beliefs, attitudes, and behaviors of those to whom they render care. To develop
cultural competence, it is essential for the health care professional to use knowledge
gained from conceptual and theoretical models of culturally appropriate care. The
culturally competent nurse develops meaningful interventions to promote optimal health
among individuals regardless of racial or ethnic group, gender, or sexual identity, or
cultural heritage.
To provide culturally appropriate and competent care it is important to remember that
each individual is culturally unique and as such is a product of past experiences cultural
beliefs, and cultural norms. Cultural expressions become patterned responses and give
each individual a unique identity. Although there is as much diversity within cultural and
racial groups as there is across and among cultural and racial groups, knowledge of
general baseline data relative to the specific cultural or racial group is an excellent
starting point for providing culturally appropriate care.

Culturally diverse health care can and should be tendered in all clinical settings.
Knowledge of culturally relevant information will assist the nurse in planning and
implementing a treatment regimen that meets the unique needs of each client.

Culturally Diverse Nursing Care

Culturally Diverse Nursing Care refers to the variables in nursing approaches model to
provide culturally appropriate and competent care. As we move to the twenty-first
century, it will be necessary for nurses to sue transcultural knowledge in a skillful and
artful manner to render culturally appropriate and competent care to a rapidly changing,
heterogeneous client population. Culturally diverse nursing care must take into account
six cultural phenomena that vary with application and use, yet are evident in all cultural
groups (1) communication, (2) space, (3) social organization, (time), (5) environmental,
and (6) biological variations. It is these elements that make up Giger and Davidhizar’s
transcultural assessment model.

In response to the need for a practical assessment tool for evaluating cultural variables
and their effects on health and illness behavior a transcultural assessment model is
offered that greatly minimizes the time model to conduct a comprehensive assessment in
an effect to provide culturally competent care. Before applying this model, the nurse must
understand the concept and assumptions that it is based on.

Communication

The word communication is derived from the verb communicate meaning “to make
common, share, participate, or impart. “Communication, however, goes further than this
definition implies and embraces the entire realm of human interaction and behavior. All
behavior, whether verbal or non verbal, in the presence of another individual is
communication. Communication provides the means by which people connect. It
establishes a sense of commonality with other and permits the sharing of information,
signals, or messages in the form of ideas and feelings.

Communication and culture are closely intertwined. Communication is the means by

which culture is transmitted and preserved. Culture influences how feelings are
expressed and what verbal and nonverbal expressions are appropriate. Cultural partners
of communication are embedded early and are found in childbearing practices. The
communication practices of persons in individual cultural groups affect the expression of
ideas and feelings, decision making, and communication strategies. The communication
 of an individual reflects, determines, and consequently molds the culture. In other words
a culture may be limited and molded by as communication practices.

Sensitivity to communication variances is needed to accurately assess and intervene in

multicultural situations. The potential for misunderstanding the client is accentuated
when the nurse and the client are from different ethnic, racial, and cultural groups.
Although the most significant variations occur when two people speak different
languages, difficulties can also be encountered when the nurse and client speak variations
of English.

Whether the nurse relates to the client in an interview setting, during the process of
client care, in a more informal level on the hospital unit, or in the clinic, the guidelines in
box will increase the likelihood that the nurse-client relationship will be positive.

Nursing assessment
Summarize data obtained Communication
Language spoken
Voice quality
Pronunciation
Use of silence
Culturally unique individual Use of nonverbal
• Client’s cultural and racial identification Space
Place of birth
Degree of comfort observed (conversation)
Time in country
Proximity to others
Body movement
Perception of space
Biological variation
• Body structure
• Skin color Social orientation
• Hair color Time
Culture
• Other physical dimensions Use of
Race
• Enzymatic and genetic existence of Measures
Ethnicity
disease specific to populations Definition
Family
• Susceptibility to illness and disease Role Social time
• Nutritional preferences and Function Work time
deficiencies Work Time orientation
• Psychological characteristics, coping, Leisure Future
and social support Present
Church
Past
Friends

Environmental control
Cultural health practices
Efficacious
Neutral
Dysfunctional
Uncertain
Values
Definition of health and illness