Culturally Competent Nursing Care

Chapter 2: Culturally Competent Nursing Care

Cultural Competence #1

Multiple factors are converging to heighten societal awareness of cultural similarities and differences among people:

Vulnerable populations

Immigration

Health tourism

Refugees

Cultural Competence #2

Requires interprofessional collaborative practice engaging:

Health care providers

Patients, families, caregivers, communities

Folk or traditional healers

Religious/spiritual leaders

Cultural Competence #3

Cultural competence can be divided into two major categories:

Individual cultural competence

Organizational cultural competence

Cultural Competence #4

Individual cultural competence refers to the care provided for an individual client by one or more health providers.

Organizational cultural competence focuses on the collective competencies of the members of an organization.

Question #1

Is the following statement true or false?

Individual cultural competence refers to care for a single client.

Answer to Question #1

True

Rationale: Individual cultural competence refers to the care provided for an individual client by one or more health providers.

Cultural Self-Assessment #1

Cultural self-assessment enables you to use personal life experiences to gain insights into your health-related:

Attitudes

Values

Beliefs

Practices

A personal and professional journey

Cultural Self-Assessment #2

Cultural self-assessment can help nurses overcome ethnocentric tendencies and cultural stereotypes, thus helping to prevent prejudice and discrimination.

Assists nurses to recognize the ways in which their background and lived experiences have shaped and informed the person he or she has become today

Cultural Self-Assessment #3

Ethnocentrism

The human tendency to view one’s own group as the center of and superior to all other groups

Cultural stereotype

A preconceived, fixed perception or impression of someone from a particular cultural group without meeting the person

Cultural Self-Assessment #4

Prejudice

Inaccurate perceptions of others or preconceived judgments about people based on ethnicity, race, national origin, gender, sexual orientation, social class, size, disability, religion, language, political opinion, or related personal characteristics

Discrimination

The act or behavior of setting one individual or group apart from another, thereby treating one person or group differently from other people or groups

Question #2

What is the expected nursing outcome of an effective cultural self-assessment?

The prevention of prejudice and discrimination in the care of any ethnic group

The successful resolution of the culturally diverse client’s health care issues

The establishment of institutional services that are culturally sensitive

The development of a culturally competent individual nursing personnel

Answer to Question #2

A. The prevention of prejudice and discrimination in the care of any ethnic group

Rationale: Through self-assessment, it is possible to gain insights into the health-related values, attitudes, beliefs, and practices that have been transmitted to you by your own family and your own life experiences. These insights also enable you to overcome ethnocentric tendencies and cultural stereotypes, which are vehicles for perpetuating prejudice and discrimination against members of certain groups.

Cultural Assessment of Client #1

Collection of data about the client’s health state:

Subjective – what is said

Objective – what is observed

May need to consider familial and kinship involvement

Cultural Assessment of Client #2

Emic

Appreciating the client’s point of view or insider’s perspective

Etic

Appreciating the outsider’s point of view

Individual Cultural Competence #1

Cultural competence is a dynamic, ongoing, lifelong, developmental process that requires self-reflection, intrinsic motivation, and commitment by the nurse.

It is impossible to know everything about every culture; it is possible to develop excellent assessment and skills.

Individual Cultural Competence #2

The five-step problem-solving process for delivering culturally congruent and competent nursing care is central to transcultural practice.

Assessment of nurse (self) and client

Mutual goal setting

Development and

Implementation of the plan of care

Evaluation of the plan with the client

Five-Step Problem-Solving Process

Organizational Cultural Competence

Culturally competent organizations have defined values and principles as well as behaviors that enable them to work effectively cross-culturally, and the capacity to:

Value diversity

Conduct self-assessments

Manage the dynamics of difference

Acquire and institutionalize cultural knowledge

Adapt to diversity and the cultural contexts of the communities they serve

Health Disparities #1

Health disparities are population-specific differences in the presence of disease, health outcomes, or access to care.

Affected populations include:

Racial and ethnic minorities

Residents of rural areas

Women, children, and the elderly

Persons with disabilities

Other special populations such as the deaf

Health Disparities #2

These populations may experience a lower quality of health services, are less likely to receive routine medical procedures, and have higher rates of morbidity and mortality.

Culturally competent nursing care may reduce health disparities and inequities in these high-risk populations.

Culture of the Deaf

These individuals may experience social isolation, prejudices, and difficulties across their lifetime.

Sign language dialects differ worldwide.

Assistive devices include signaling and assistive listening devices, alerting devices, telecommunication devices for the deaf (TDD), and telephone amplifiers.

Communication and Language Assistance

In the United States, about 20% of people speak a language other than English at home.

Language assistance should be provided when necessary.

By 2050, more than half the population will come from racial or ethnic minority backgrounds.

Question #3

Is the following statement true or false?

Culturally competent nursing care may reduce health disparities and inequities.

Answer to Question #3

True

Rationale: Agencies have found that culturally competent nursing care may reduce health disparities and inequities in these high-risk populations.

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