N204
Diverse Populations and Health Care
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Agenda – 2/26/08
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Paper presentation
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Next Week
Paper presentation
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Virginia – 3 articles
Elisa – 2 articles
Indira - 3 articles
Gracie – ?
Rose - 2 articles
Gracie - ?
Transcultural Nursing Practice
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Diversity
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Divertere in Latin
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Being different or having differences
Diversity in nursing practice
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Providing competent care to clients from
different cultures, conducting research in multicultural settings, and implementing educational
programs to diverse population
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Human migration
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175 million migrants
Pull & push factors–
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Misnomer – need and demand
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no job opportunities, unsafe work environment, lack of
political stability, high workloads, or lack of economic
remuneration
In US. 500,000 qualified nurses who are not active or
employed
Misconception –
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Migration does not take place only from developing
countries to industrialized nations.
Padilla, P. (April/May,2006). Nurse migration and the nursing shortage.
Breakthrough to Nursing, IMPRINT, 18-22
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International travel & tourist
Year #
$
Meaning
1950 25 M
2006 763 M 622 B 10.3% of global economic
output (excluding tourist
spending)
Employing 243 million
Resource: Bremner, B. (April 23, 2007). Guiding tourists to Asia.
Businessweek, retrived October 20, 2007 from http://
www.businessweek.com/globalbiz/content/apr2007/gb20070423_942361.htm?chan=search
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Medical tourism
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Def: combination of travel to a foreign country to
receive medical treatment while taking advantage
of local tourism opportunities
1.3 million tourists per year seeking low-cost
medical care abroad
One of the world’s fastest growing industries –
30% a year (4 billion dollars industry within next
few years)
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Transcultural Nursing- Leininger, 1997
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Definition- A formal area of study and
practice focused on comparative holistic
culture care, health and illness patters of
people with respect to differences and
similarities in their cultural values, beliefs,
and lifeways with the goal to provide
culturally congruent, competent and
compassionate care
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Cultural needs
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Equal access to treatment and care
Respect for cultural beliefs and practices
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Leininger, (1995) & Narayanasamy, (2003)
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Religious beliefs, taboos, customs
Dietary, personal care needs, daily routines
Dying needs
Communication needs
Cultural safety needs,
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Cultural needs (Cont’d)
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Pain
Health practice
Time orientation
Space
Family
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Equal access to treatment and care
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Ethnicity
 racial discrimination,
 racial harassment and
 oppression
Secondary problems
 stress
 psychological trauma
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Communication needs
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Barrier
 Impede early detection
 delay prompt treatment and care
Forms
 Language
 Non-verbal communication
Translation services
 Interpreters
 Family interpreters
Health condition – acute illness & crisis
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Cultural safety needs
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Engage clients as partners
Respect & rapport -> self-esteem
Cultural negotiation & culture compromise
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Transcultural Care Practice
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Initiative
Enthusiasm
Commitment of individuals and groups
Strategic planning
Organization & coordination of services
Funding
Education
Recruitment & research
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Giger-Davidhizar (2002) Assessment Model
Culturally
Unique
Individual
Communication
Space
Biological
Variations
Environmental
Controls
Social
Organization
Time
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ACCESS Model – Narayanasamy, 2002
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Assessment
Communication
Culture negotiation and compromise
Establishing respect and rapport
Sensitivity
Safety
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Campinha-Bacote’s
Cultural Competence Model
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Cultural awareness
Cultural skill
Cultural knowledge
Cultural encounters
Cultural desire
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Purnell’s Model
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Macro level – global society, community,
family, individual, health
Cultural domains – overview, communication,
family roles, workforce issues, bioculturl ecology, highrisk behaviors, nutrition, pregnancy & childbearing
practices, death rituals, spirituality, health care
practice/practitioners
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Cultural consciousness
Unknown phenomenon
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Culturally Competent Organization
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US Census Bureau, 2000 – total population = 281,421,906
 Latio 35.5 million = 12.1%
 African American = 12.9%
 Asians
= 4.2% (60% is foreign born)
 Multiracial
= 2.4%
Ethnic minorities accounts for one fourth of the nation’s
population
In 2020, it will be near to 40%
10% of RNs in the US are from racial/ethnic
minority background (2000)*
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Organizational Diversity Competence Model
(Frusti, Niesen, Campion, 2003)
Drivers
measurements
Commitment
Linkages
Culture
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Negotiation Process
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Listen: to the client’s perspective
Teach: from your knowledge in language
appropriate for client & family
Compare: similarities & differences, disagree but
do not devalue client’s view
Compromise:
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if client treatment not harmful, promote
If harmful, explain harm and suggest alternatives
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Useful websites Internet:
http://www.
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apna.org – American psychiatric nurses’ association
sen.ca.gov – California State Senate
cdc.gov – Center of disease control
nami.org –National alliance for the mentally ill
health.gov/healthypeople/document/ - healthy people 2010
library.sjsu.edu/staff/Peterson/Peterson.htm
For statistical data:
Census.gov/main/cen2000.html
google.com/unclesam
firstgov.gov
factfinder.census.gov
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