Dean, E. 2017, “Cultural competence”, Nursing Standard, vol. 31, no. 22, pp. 15.
Our nurses must be awareness and assist their multidisciplinary team to work effectively with their from different cultural backgrounds and to gain a greater understanding of the diverse needs of patients from minority ethnic backgrounds. They have to work together in the tasks to which they give rise in the management of our health service.
Developing Cultural Competence
FRAMEWORK FOR DELIVERING CULTURALLY COMPETENT SERVICES
Campinha-Bacote and Munoz (2001) proposed a five-component model for developing cultural competence in The Case Manager.
1. Cultural awareness involves self-examination of in-depth exploration of one’s cultural and professional background. This component begins with insight into one’s cultural healthcare beliefs and values. A cultural awareness assessment tool can be used to assess a person’s level of cultural awareness.
2. Cultural knowledge involves seeking and obtaining an information base on different cultural and ethnic groups. This component is expanded by accessing information offered through sources such as journal articles, seminars, textbooks, internet resources, workshop presentations and university courses.
3. Cultural skill involves the nurse’s ability to collect relevant cultural data regarding the patient’s presenting problem and accurately perform a culturally specific assessment. The Giger and Davidhizar model offers a framework for assessing cultural, racial and ethnic differences in patients.
4. Cultural encounter is defined as the process that encourages nurses to directly engage in cross-cultural interactions with patients from culturally diverse backgrounds. Nurses increase cultural competence by directly interacting with patients from different cultural backgrounds. This is an ongoing process; developing cultural competence cannot be mastered.
5. Cultural desire refers to the motivation to become culturally aware and to seek cultural encounters. This component involves the willingness to be open to others, to accept and respect cultural differences and to be willing to learn from others.
Cultural needs in relation to equal access to treatment and care are paramount in transcultural health care (Gerrish et al, 1996; Polaschek, 1998; Royal College of Nursing, 1998; Gerrish and Papadopoulos, 1999; Henley and Schott, 1999; Narayanasamy,1999a) There is a consensus that a sense of cultural safety is most likely to promote trust and therapeutic relationships which are vital for interventions designed to meet cultural needs (Narayanasamy, 2002). Some people may share similar religious beliefs and practices but may differ in their cultural beliefs and values (Henley and Schott, 1999).
Nurses must respect beliefs and they have to practising and try to identify nursing care needs connected to cultural beliefs and practices. Numerous writers have identified the significance related to cultural beliefs and practices. Henley and Schott (1999) provide a guideline for health carers with respect to the cultural and spiritual needs of multi-ethnic patients.
Spinal cord injured patients are at considerable risk of developing pressure ulcers. The Waterlow score is the most commonly used pressure ulcer risk calculator in the UK (Dealey, 1997). Pressure risk assessment tools have been developed and validated on a largely white population and pressure ulcer risk assessment tools that have been validated for darkly pigmented skin may be required (Bethell, 2005). A large study to explore the relevance of ethnicity in the development of pressure ulcers compared white and Pakistani patients using the Waterlow scale, and found that once age is taken into consideration, there is no evidence that the risk of pressure ulcers to Pakistani patients is greater than to white patients (Anthony et al, 2002).
According to the literature, the crux of transcultural care is communication, comprising strategies such as consideration to appropriate body stances and proximities, gestures, languages, listening styles and eye contact (Peberdy, 1997; Narayanasamy, 2002). It is important for nurses to be aware that groups vary widely in their ideas about appropriate body stances and proximities, gestures, languages, listening styles and eye contact (Sherer, 1993; Narayanasamy, 2002). The implications of this are that communication difficulties may actually impede early detection of health needs, treatment and care. Where an interpreter is required, sometimes it may seem convenient to use a member of the patient’s family as an interpreter to facilitate the communication process. However, the patient may fabricate a new problem to save embarrassment in the presence of a family member. Also, the interpreter may interpret rather than translate a patient’s problems (Narayanasamy, 2002). The nurse who is unfamiliar with the language may not realize whose views are being expressed. For this reason, the Royal College of Nursing (1998) advises against the use of informal interpreters and suggests that substantial professional interpreting should be provided. With more courses and learning material in this subject, nurses can be helped to become more confident and competent in transcultural health care (Gerrish and Papadopoulos, 1999).
Transcultural care models originating from the work of Gerrish and Papadopoulos (1999), Papadopoulos and Lees (2002), and Narayanasamy (2002) offer strategies for improving cultural competence. Nurses response of cultural needs included religious practices, diets, communication, dying needs, prayer and cultural practices.
The future of nursing depends on the nurses’ability to meet healthcare needs in diverse communities (Hall et al, 1994) for such a concept offers one way to understand phenomena relevant to health needs of multiethnic populations.
CONCLUSION This empirical study offers some insights on accounts of nurse participants’ lived experiences and beliefs about transcultural health care. Although these nurses operated from narrow conditions related to transcultural health care, we may take comfort in the fact that at least some aspects of cultural needs are dealt with consideration and sensitivity. But Many nurses indicated the need for further education in meeting the cultural needs of their patients.
However, we can see in our practice that there is scope for improving nurses’ knowledge and competence in transcultural healthcare practice. There is an evidence to focus on education that nurses have the motivation to find further courses and discussion to become competent in transcultural care. Many nurses need further education in meeting the cultural needs of their patients.
Conclusion and Recommendations, it is clear that cultural diversity is a key challenge for the Irish health care sector, both in terms of diversity in the workplace and the development and enhancement of service delivery that has the potential to impact positively on minority ethnic groups. A key strategy in meeting this challenge is to build a cultural diversity dimension into key health care policy strategies including the National Health Strategy; the National Health Promotion Strategy; the National Health Information Strategy and the National Strategy for Health Research. A second key strategy to meeting this challenge is to develop policies that are specific to the needs of minority ethnic groups, such as Traveller Health, a National Strategy. A gender focus should be included in both general and specific strategies. A Third related strategy is developing good practice and policy guidelines within health care organisations, a framework for which is outlined in this report. A fourth related strategy is mainstreaming cultural diversity awareness and training. Providing care cwithin our global community is challenging. This discussion provided some resources that can be of use in one’s practice. Remember, culture is both external and internal and cannot be easily summarized in a reference book, but viewed through one’s own life experiences.
Providing culturally appropriate care for cross-cultural patients depends on many factors, including the health care worker’s own cultural beliefs and practices. Transcultural frameworks may help in the assessment and delivery of care, but it must be remembered that patients are individuals and care must be taken not to be influenced by cultural stereotypes (Holland and Hogg, 2001). There is a need for the range of programmes to improve the knowledge of nurses and their ability to deliver care in a multicultural society. I am looking to develop or implement a cultural care plan for our health system