Abstract This literature review begins with Leininger who as the founder of trans-culturalnursing provides an overview and brief history of the theory. The articles provide varying perspectives on trans-culturalnursing care from the contexts of potential child abuse and neglect, end of life care, use of the theory in health care administration in the Third World, and the need for this theory to be ethically and professionally protected. The paper discusses Mitchell and Gale who provide very insightful criticisms of the theory.
From the Paper "Literature Review: Trans-cultural Nursing Care This literature review begins with Leininger (2001) who, as the founder of trans-cultural nursing, provides an overview and brief history of the theory. The articles provide varying perspectives on trans-cultural nursing care from the contexts of potential child abuse and neglect, end-of-life care, use of the theory in health care administration, in the Third World, and the need for this theory to be ethically and professionally protected. Mitchell and Gale (2002) provide very insightful criticisms of the theory. Their criticisms lead to a valuable thesis that trans-cultural nursing care cannot stand alone, and some other structure is needed for social justice."
Abstract In this article, the writer performs an in-depth literature review and analysis of the current nursing shortage through social and cultural perspective. The writer explores how factors contributing to the shortage are understood by others and then attempts to analyze the following topics: the prevailing attitudes in society regarding the social and cultural factors of the nursing shortage, how the dominant culture influences the values and priorities regarding the social and cultural aspects of the nursing shortage and whether this influence provides the dominant culture with privileges over other members of society. In addition, the writer discusses personal beliefs and assumptions about the issue and identifies barriers to the solution and the strategies for possible resolution.
Outline:
Background of Social and Cultural Factors
History
Today's Reality
Looking Ahead
Prevailing Attitudes in society
Society's View of Nursing Influences of the Dominant Culture NursingCulture Barriers to Resolution
Resolution to Social and Cultural Issue
Personal Beliefs and Assumptions
Conclusion
From the Paper "There are many social and cultural strategies that can be utilized to help resolve the current nursing shortage in Canada. This nursing shortage is unique because of the unprecedented low supply of nurses and the high demand for their services. The usual solutions such as hiring bonuses and education reimbursement may help in the short run, but they won't solve the underlying issues. Addressing the core retention issues will be the most effective methodology. Currently, the nursing culture is such that new graduates can have a traumatic experience when they leave school to begin their nursing careers."
Abstract The paper relates that traditional nursing in the United States has been accused of being ethnocentric and unable to accommodate cultures other than white Caucasian. The paper examines the cultural issues related to the Appalachian region of the United States and issues that may affect nursing care. The paper explains that the needs of the Appalachian community are different than those in other parts of the country. The paper discusses how the question of spirituality causes a conflict between the needs of the patient and standard ethical practices of the health care system. The paper demonstrates how nurses can play a major role in bridging this gap and developing practices within the Appalachian region that specifically address the need to integrate some type of spirituality into the daily care routine.
Outline:
Understanding Cultural Differences
Bringing Trans-cultural Competence to the Nursing Floor
Health Behaviors and Appalachia
Putting it Into Practice
From the Paper "The Appalachian region represents a unique culture within the larger culture of the United States. The most obvious difference that one notices when they encounter someone from that region is their accent. However, if one questions them they may tell you that you are the one with the accent. The Appalachian region is a part of a proud Southern tradition that goes back to the founding days of the United States. Many people passed through the region on their way to the western frontier. Some decided to stay and set roots. These settlers blended into the patchwork quilt that became a symbol of the region."
Abstract In this essay, the writer shows Madeleine Leininger as a nursing theorist who had a specific vision. The writer points out that she foresaw the multicultural society in which all nurses currently work and provided a means to avoid cultural conflict. Further, the writer notes that trans culturalnursing is very helpful for nurses because it offers principles, concepts and theory that guide care decisions and nursing actions for very particular cultures.
From the Paper "Leininger is more than a theorist; she is a leader for nurses who offered nurses a direction along with specific strategies in their care for patients of diverse cultures. Furthermore, she guided nurses in the implementation of strategies in complex cultural situations. Leininger had to impart her vision to ... "
Abstract Culture is one of the defining concepts of nursing and is becoming more of an issue as demographics and population shift in the United States. If nurses are to provide truly holistic care, they must be prepared to cross the cultural divide and care for patients in the manner that they prefer. Understanding that there is vast diversity within every cultural group, nurses must rise above the stereotypes of any particular culture. Cultural and spiritual assessment is an important step towards providing safe, effective care with optimal outcomes. This paper discusses this point of view through the case study of a Cuban Jehovah's Witness.
Outline:
Introduction
Literature Review
Cultural Assessment
Client History/Overview
Communications
Family Roles and Organization
Biocultural Ecology
High-Risk Behaviors
Nutrition
Pregnancy and Childbearing Practices
Death Rituals
Health Care Practices
Health Care Practitioners
Spiritual Assessment
F: Faith or Beliefs
I: Importance and Influence
C: Community
A: Address/Application
Summary
From the Paper " Rice and beans provide the staple of the diet at home. It is customary for them to have bread at every meal. Salads are rarely served. Yucca and fried plantains are served with meals at least three times per week. In order for her to feel cared for, IH would desire a visit from the dietician. She does not really like vegetables and prefers her meals to be mostly carbohydrates. IH purchases and prepares all of the meals for her family. Cooking is not considered the males role. They do eat at restaurants occasionally on the weekends. Restaurant food choices include Mexican, Italian, and Chinese. They abstain from foods containing blood, which results in a predominately vegetarian diet. Fish is acceptable. Her dietary patterns would be highly considered in her care planning. She would be offended if she was served the traditional regular hospital breakfast of bacon and eggs."
Tags:nursing demographics america, case study, stereotypes outcomes
Abstract In this article the writer notes that in order to provide effective nursing care, nurses must have knowledge of the client's worldview which is influenced by their cultural beliefs, values and life ways. The writer points out that in Chinese culture, the approach of patients to health and illness centers on the concept of balance, and is holistic and traditional. The writer maintains that health is understood as a state of spiritual and physical harmony with nature and illness caused by some upset in body energy. The case study demonstrates the differences that often become apparent between cultural beliefs and practices versus the perspective of nursing. This paper focuses on the cultural factor of religious and philosophical factors. The writer concludes that religious and philosophical factors greatly influence what Chinese people do and what choices they make.
From the Paper "In contrast to Chinese religious and philosophical beliefs regarding health and disease, nurses in Western culture are trained in a much different way regarding nutrition. Nurses also are instructed to push fluids. For nurses, the focus on nutrition involves its role in healing in relation to the need for protein and fiber as well as electrolyte balance. The normal course of nursing actions is that when the problem is hypertension, then the amount of sodium is restricted. Whatever foods might be contributing to the health are either very limited or are eliminated from the diet. In the case study, nurses are following the usual procedure in promoting fluids for the patient in order to enable Mr. W. to recover from his bladder surgery. To achieve the health outcome, it is very common for nurses to provide patients with cold tap water. The issue is that both Chinese cultural practice and professional nursing practice both are concerned with the same outcome."
Abstract This paper reviews the instruments and tools that can be used to measure delivery of culturally competent/sensitive nursing care. The paper discusses the purpose of cultural competency training to improve the health care of ethnic minorities. The paper also investigates the application of culturally competent nursing to all areas of patient care. The paper concludes with an evaluation of the usefulness, validity and reliability of the instruments and tools.
From the Paper "Thom reports that cultural competency training is being widely promoted as a means to improve the quality of health care for ethnic minorities. However relatively little..."
Abstract In this article, the writer discusses that as the demands on nurses and the nursing profession have increased over the last several decades, it became evident to many nursing professionals that the ideology related to nursing practice had to be changed. The writer notes that cultural, environmental and mind-body considerations were significantly important because these factors were known to impact patients and their health. However, the writer points out that as more information became available through practice, it was also apparent that each person had to be evaluated independently in order for health care professionals to have a clear idea of all issues that affected the patient's well being. The writer then discusses that Roy, Neuman and Leininger each developed approaches to nursing practice that were intended to provide a well established vision of the person, which could be used in preventative medicine, as well as in the event of illness. These theories lead nurses to be capable of treating the whole individual, while providing the quality care that nursing is intended to ensure.
Outline:
Introduction
Leininger and the Transcultural Nursing Model
Application of Lieninger's Sunrise Model
Environment and Population
Cultural Values
Religious and Philosophical Factors
Kinship and Social Factors
Political and Legal Factors
Economic Factors
Educational Factors
Health Care System
Roy Adaptation Model
Application of the Roy Adaptation Model
Scientific and Philosophical Elements
Self-Concept and Group Identity
Role Function
Environment
Health and Adaptation
Nursing Neuman Systems Model
Application of the Neuman Systems Model
Basic Structure/Energy Resources
Stressors
Line of Resistance
Optimal System Stability
Prevention/Intervention and Nursing
From the Paper "The transcultural model, therefore, is comprised of numerous factors that must be taken into consideration if the proper care is to be presented for each individual patient. The most significant of these factors is culture. According to Leininger, the culture that an individual belongs to affects every aspect of that individual's existence. The elements associated with a culture are taught to the person from the time of birth and consistently impact thought, religious beliefs, behaviors and how the person relates to the health care environment."
Abstract The paper discusses how the nurse's ability to provide effective and appropriate support to family members in their grief is greatly dependent on the nurse's understanding of the processes of grief and bereavement. The paper defines grief, the tasks of grief and the social and cultural considerations inherent in grief. The paper points out that bereavement practices vary greatly depending on one's cultural background. The paper concludes that allowing for cultural and family traditions is the key in assisting the family members to effectively cope with grief following the death of a loved one. The paper also notes that the nurse should pay close attention to the family members to identify whether their grieving is normal or if the grieving has taken a unhealthy or self-destructive course.
Outline:
Objective
Introduction
Grief Defined
Types of Grief Identified
Social and Cultural Considerations of Grief
Summary and Conclusion
From the Paper "The experience of grief is one that is shared across all cultures and as well grief is universal among human beings in all age groups and in all cultures and is "an adaptational response to different kinds of acute life crises..." (Cowles and Rodgers, 1991a; 1991b; Curry and Stone, 1992; Jacob, 1993; as cited by Kaunonen, 2000) In the experiential theory of grief, six dimensions of grief have been defined. (Hogan et al, 1996; Hogan, 1988, 1999b) The nurse's ability to provide effective and appropriate support to family members in their grief is greatly dependent upon the understanding the nurse possesses of the process of grief and bereavement."
Abstract This paper explores the importance of cultural diversity in nursing. The paper examines both the legal, and the moral/ethical obligations of professionals in the field to represent and embrace diversity. The paper concludes that in order to reach this goal, nursing education must include more trans-cultural coursework and emphasis.
From the Paper "Developing sensitivity to diversity is not only a legal obligation in the United States. It is also a moral and ethical obligation that speaks directly to aspects of the social contract and the longstanding human need..."
Abstract This paper explains that Leining's Sunrise Model of trans-cultural patient assessment/nursing research suggests that a patient's familiarity with technology, including medical technology, helps in understanding of other elements of their background and their expectations of hospital care. The author provides various examples, along with the nurse's response. The paper relates that technological familiarity helps to locate patient's personal culture and to dictate how the nurse should respond.
From the Paper "Madeleine Leininger's Sunrise Model for ethnocultural nursing evolved between 1955 and 1985, in response to her realization of a broad range of factors shaping the worldviews of patients, groups and communities, that affected their ideas of health, illness, health care, and their expectations of medical professionals. (2002b) The model is useful in that is encourages nurses to approach patients with several broad determinants in mind, according to their ethnicity, but alert, too, to several particular factors that shape these ideas. Technology, and familiarity with it, is one of several influencing factors important in North American medical settings to feature much technology in practice, as North American patients grow more ethnically diverse."
Abstract This paper reviews culturally responsive psychiatric nursing from a personal position viewpoint. It reviews various nursing theories, presents personal experiences and draws conclusions. In addition, it mentions a personal assessment with respect to risk and protective factors associate with culturally responsive nursing.
From the Paper "Cultural Diversity in Psychiatric Nursing According to Thomas (1983) hospitals are being held together very finitely by nurses. With the twenty first century now upon us, there is even a greater need to foster an environment wherein there exists a professional coalition amongst educators, industrial leaders, politicians, regulatory agencies, and medical organizations to assist the nursing profession with what may seem as an insurmountable task; namely, to combine nursing education and experience into a conceptual model of best fit practice for optimal patient care."
This paper briefly explores the article "Cultural Considerations in End-of-Life Care" by Polly Mazanec and Mary Kay Tyler, about the significance of appreciating cultural considerations in end-of-life care situations.
Abstract This paper discusses a scholarly article, "Cultural Considerations in End-of-Life Care" by Polly Mazanec and Mary Kay Tyler, which touches upon the issue of cultural considerations in the nursing profession. The paper provides a rough outline of the article, re-defines it in terms of how the writer understands the practice, and illustrates the relationship between the practice of cultural sensibility and the client system of which the patient is but one part. In the end, the paper insists that cultural competence is one of the new core skills that any nursing practitioner will be expected to have as the twenty-first century proceeds along.
Outline:
Abstract
Cultural Considerations in End-of-Life Care
References
From the Paper "While cultural sensitivity may not be the first skill nursing practitioners think of when they are asked to contemplate the abilities they will most need in order to be successful in a tough, challenging profession, there can be little question that an increasingly diversified society has made it essential that nurses know how to deal with those whose cultural background differs from their own.
"Reviewing the aforementioned article, a number of things spring to mind. First of all, Mazanec and Tyler report that a clinician cannot possibly provide effective care without a strong understanding of the different cultural backgrounds of those with whom they will come into contact. Part of achieving this greater understanding entails eschewing the "ethnocentrism" that often pervades one's world-view; it is also considered appropriate that a nurse be well-aware of the family structures, communication styles, and ways in which different cultural groups respond to illness."
This paper looks at culturally competent care in the Veterans Health Administration (VHA) with regards to the future of nursing and health care in the United States.
Abstract In this article, the writer discusses that taking into consideration the knowledge that by 2020, the United States general population will be comprised of 47% of pan-ethnic minority groups, a new emphasis on culturally competent care has developed within the American healthcare system. This paper presents the definition of culture, culturally competent care and patient population demographics of the Veterans Health Administration (VHA). A discussion on the Hispanic cultural vulnerability along and standards of cultural competence as identified by the Office of Minority Health (OMH) is also offered. In addition, the writer presents an evaluation of the VHA's performance to meet these standards with nursing implication and potential solutions for areas where standards are not met.
Outline:
Culturally Competent Care
Culture Population Demographics
Cultural Vulnerability
Standard One
Standard Two
Standard Three
Standard Four
Standard Five
Standard Six
Standard Seven
Standard Eight
Standard Nine
Standard Ten
Standard Eleven
Standard Twelve
Standard Thirteen
Standard Fourteen
Conclusion
From the Paper " A possible solution is to adjust employment practices of the VHA. Currently the VHA uses a numerical evaluation program that assigns figures to experiences, education and more to generate a numeral indicator that represents an individual employability. This program removes interviewer biases and prevents discrimination of any form from occurring. This system currently gives 5 extra points to veterans to encourage the hiring of veterans so the patient population matches the workforce. The VHA could offer an extra 5 points for male nursing staff during this process to produce a workforce more representative of the patient population"
Abstract This paper addresses the bullying culture that is encountered by student nurses and graduate nurses in their work environment. The paper recommends an educational program to be run for student nurses that will aim to prepare them for work in a hospital. It describes the program in detail and discusses the advantages that will be gained by using a program such as this.
Table of Contents:
Assess Learner Readiness and Motivation
Development of the Educational Program
Identify Specific Educational Content or Topic
Create Program Objectives
Outline Content of Program/Class
Identify Teaching and Learning Activities and Strategies
Questions for the Students
Question about the Presenter
From the Paper "Implementation of the educational program will adapt an interactive approach to educating nursing students regarding bullying behavior. Each topic will be introduced in three phases (as outlined above). Each phase consists of a mini-lecture, not to exceed 15-20 minutes to introduce the main topic. The class is then broken up into focus discussion groups where the main topic will be expanded with the use of a situational vignette and guide questions, following the outline as a rough guide for topics to be discussed. A faculty member will act as a facilitator, adapting a laissez-faire approach to the students' learning. She also acts as a resource person and keeps the group from going off-topic."
