The Significance Of Cultural Competence

The paper is focused on concept analysis of cultural competence in nursing and psychological aspects. The process of concept analysis widely discuss elements related to complex concepts. Concept analysis reviews the simple attributes, which makes any theory or model significant for a discipline. The purpose of concept analysis is to analyse functions or methods constructively. Cultural competence is a part of nursing, which ensures the maintenance of beliefs, knowledge, attitudes of patients by nurses. Nurses should enhance the experience, skills, and supportive care to maintain the integrity of provided facilities to the nurses. Cultural competence is a social value, which is an emerging factor for the health care industry and nursing (Betancourt, Green, Carrillo & Owusu Ananeh-Firempong, 2016).

Culturally competent nursing is a particular practice, which is not only related to the health care industry but also psychology, biology and social care. Cultural competence focuses on ethnicity, individuality and minority background to maintain cultural awareness, knowledge, practices in the patients of culturally vulnerable groups. Nurses should maintain the balance for improving facilities without bias. Therefore, cultural competence can help in nursing researches to avoid violation of ethnic disparities, prompt responses in patients. Competency can help nursing teachers and leaders for reducing discrimination among student nurses also. Social care or psychology are intensively related to cultural competency as this practice of nursing reduces biases in individuals. This paper focuses on cultural competence as this can describe the social background of any patient with the process of treatment. Cultural competence is an integral part of nursing. With the help of concept analysis of a selected theory related to cultural competence, the essay will critically analyse the importance of culturally competent nursing in the healthcare setting.  Concept Analysis Of Cultural Competence In Nursing Discussion Paper

The term ‘cultural competence’ consists of two keywords, such as ‘culture’ and ‘competence’. Culture is related to beliefs of individuals and a group of people, standards, customs and lifestyles that can be transferred, transmitted and taught by older generation people. Culture can inspire people’s rationale, choices, and behaviours in their daily life. Cultural competence was initially described as a set of similar approaches, information, and responses of experts that allows active effort in cross-cultural circumstances. Behaviours, influences, diversity and attitudes towards patients are referred to as the most significant aspect of nursing care (Jeffreys, 2015). The cultural competence is one wide-ranged aspect, which includes individual as well as multidisciplinary teams for patient care. The National Center for Cultural Competence in America focuses on individual professionals and administrations; this process is a non-linear field that includes stages from cultural ferocity, inability, sightlessness, pre-competence, capability(Bailey, 2015). Therefore, to understand the importance of cultural competence, this topic has been chosen for concept analysis. Cross-cultural competence can be defined as the acceptance of cultures in two or more different populations with sensitivity, awareness (Lopes-Murphy & Murphy, 2016). Nurses and patients are inter-related to each other in the aspect of cultural competence as they can achieve collaborative initiatives for the nursing interventions. The only nurse cannot maintain competency single-handedly. Teams associated with patient care are responsible for the maintenance of competency in the patients. Transcultural nursing models deliver nurses with the underpinning requirements in advance knowledge about diverse cultures during healthcare conveyance (Cai et al.,2017). The models are under repeated progress, and they guide nursing facilities all over the world (Giger, 2016).

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Cultural Competence Models

There are multiple models that support the concept of cultural competence in nursing; such as; Giger and Davidhizar Transcultural assessment model, the Purnell model for cultural competence, Campinha-Bacote Model of Cultural Competence in Healthcare Delivery and the most primitive model for cultural competence named Leininger Sunrise Model. The essay will analyse the significance of the Purnell model for cultural competence. The theory is related to the global representation of nurse and patient relationships with cultural differences and ethnicity of the patients or the community (Purnell & Fenkl, 2019). The universal aspect of the theory is included with the family and individuals. Culture and heritage, communication, the role of family and organisation, workforce environment, bio-cultural ecology, sensitive behaviour, nutrition and pregnancy (Purnell, 2019). Integrating cultural competency models are a valuable accumulation to nursing curriculum and medical guidance in student and professional nursing programs. Leininger model has been analysed without acknowledging the political and organisational processes of healthcare. Kardong-Edgren and Campinha-Bacote evaluates the efficiency of curriculum of nursing programs’ in presenting the culturally competence in the graduate nurses (Byrne, 2018). Campanha-Bacote and Leininger had adopted models to advocate the concepts of transcultural-nursing theories. Purnell model frequently is used in communication and health appraisal programs. Purnell model is accepted in several healthcare settings for its flexibility which is a help as well as useful in the different context of a healthcare organization (Constantinou et al., 2018).

Additionally, this model of healthcare structure permits nurses to be trained the diverse distinctiveness and concepts of cultural diversity. The model connects chronological elements and their effects on a patient’s global aesthetic viewpoint and defines the key relationships for culturally competent care. This model’s framework influences nurses to think about and reveal the exceptional individuality of every patient. The model includes the views of poor health, inspiration, and healthcare in patients and nurses. In conclusion, the model’s formation influences the study of cultural information, allowing nurses to provide to families, communities, and persons in terms of their particular cultural distinctiveness by applying different communication strategies.

Communication between nurses and the patient includes language dialect, paralanguage variation, and interest to share their own views and feelings. Nonverbal communication is another crucial factor in communication between nurses and patients. Non-verbal communication includes eye contact, expressions, touch, and body language with greetings. The spatial distance practices are also essential for continuing effective communication. Communication is depended on the past, present condition of the patient. Communication is depended on the specification in the use of names. Applications of the names are related to the confidence of patients and the reliability of the nurses.

Communication And Cultural Competence In Nursing Practice

The workforce environment should be bias-free and without any preferences. The workplace environment should maintain the integrity of autonomy and ethnic communication style. Individualism and acculturation of patients should be maintained in the workplace. Health care practices have to keep the ethnicity and beliefs of the patients.

Various racial communities and ethnic populations depend on different topological or geographical continents. They can be affected by various diseases and physical differences. Gender discrimination and skin color should not be an obstacle in acquiring the facilities. Differentiation in the physical appearance and body stature should be maintained and observed with the proper medical intervention. Their genetic, hereditary and endemic characteristics are some significant aspects in the determination of diseases. Nurses should prescribe drugs as per patients’ biological and ancestral background.

Patients’ culture and heritage are considered for healthcare treatment by the nurses and health care workers. This model is responsible for maintaining and integrating the cultural and spiritual values of the patients. Sometimes the patients experience new medical interventions or treatments different from their own religious beliefs. The language barrier and communication gap, are some evidence, which should be incorporated in nursing health care practices. The nurses and health practitioners can maintain moral values and religious beliefs. Spirituality can be maintained through holistic care. Nurses involve materialistic and non-materialistic values in inpatient care.

Significance of cultural competence can be explained with the help of examples of case studies. The case studies comprise of the defining attributes of the concepts. The case studies are examples of cultural competence in nursing practices. Different case examples are able to explain various aspects of cultural competence in nursing. The examples of the cases are capable of describing the consequences of maintenance of cultural competence. Lack of competence in nursing practices is also addressed in the model cases of nursing.

The primary characteristic is to prevent the social stigma, which is interconnected to any societal aspects in the health care industry. Secondary features include political beliefs, socio-economic status, professional experiences, and gender biases. Biological background or ethnicity are two aspects that can be focused and correlate with every attribute of society. On the contrary, Leininger Sunrise Model signifies the arrangement of social care philosophy by defining the relationship between anthropological and nursing principles and values. On the contrary, Benner’s theory can depict the changes in the understanding of the nursing practice of novice nurses and how to maintain the abstract principle of past experiences and guided actions.Model case

The model case is an example of the concept for the analysis. The model case is a real-life example with defining the critical attributes. The model case study is depended on the idea of cultural competence in nursing practice.

The family health care nurse has visited a 70 years old Latino American woman named Mariam Winfrey. The patient was suffering from hypertension, osteoporosis, diabetes and peripheral neuropathy. The nurse takes care of the wound management of the patient. The nurse took the precautions to prevent the risks of fall in the patient. She observed that the patient’s house is responsible for falls faced by Mariam. As the floor of the house is made up of, hardwood and rugs are scattered on the floor. The nurse put the light on the risks of falls and discussed those causes with the patient. Mariam understood those problems and permitted the nurses to take appropriate steps for managing the risks of falls.

Workforce Environment And Cultural Competence

The patient was not able to go out of the house without any assistance. She was a lonely older woman, so the nurse understood her views and emotional state. The patient was not efficient to communicate in English. She wanted to meet her family members, who lived in different states of America. After seeing her condition, the nurse advised her to shift in an in-patient care home, but the patient denied. The patient suffered from severe headaches after two days of a nurse’s visit to her house. The nurse shifted her to the hospital, and the doctor reported that she had faced a mild stroke. After admittance to the hospital, she was moved to the older patient care ward, but she encountered some problems communicating in English confidently. Therapists came to know that she is from a refugee family and her husband died years ago. Her children live in Austria for their profession. The therapist tried to talk with her compassion and constructive way. Borderline case

The borderline case is comprised of critical attributes of the case study. The borderline case explains some parts of the model case. The appointed registered nurse could not comprehend the needs of the client as family health nurses could. For instance, the nurse explained the functionalities of prescribed medicines in English, but the patient was not able to understand properly, and she felt inferior to communicate with the nurses. The nurse could not understand the problem of the patient and did not take any step towards this matter. This practice does not support the cultural competence of nursing.

A related case is a situation, which is comparable to the perception but does not allow severe characteristics. The family health nurse provided one attendant. The attendant called an ambulance while Mariam faced a stroke. The patient was so panicked that she could not tell her name to the doctors, but with the help of the attendant, they got the details of the patient. Mariam had faced several panic attacks when she was admitted to the hospital. The doctors suggested the attendant call any of her family members to ensure her better health. The attendant called her sister with the help of the family health care nurse. However, doctors helped her to secure the treatment procedure until her sister came to visit her. These incidences are prominent examples of maintaining cultural competence. Concept Analysis Of Cultural Competence In Nursing Discussion Paper  The situation was handled properly, and the nurses should support the mental health of older patients.

Racial Communities And Ethnic Populations In Healthcare

A contrary case is a strong example of an occurrence, which is not, including the concept. The patient’s sister was not fully aware of her condition. Mariam’s sister was comfortable to communicate in English. Her sister helped the attendants and doctors to understand their backgrounds in a better way. In the presence of her sister, Mariam felt relieved.

On the contrary, her sister, who did not know about inpatient care treatment and felt insecure about her sister’s condition. She expressed her concern to the doctors and the nurses of the hospital. They described the benefits of inpatient care for elderly patients like Mariam. However, the patient told the doctors that she wanted her attendant June would take care of her if she opted for the inpatient care.

An invented case is a situation that has all the severe attributes but is used in a developed consequence. This created case has all the serious features of the notion of risk-chance of damage or loss, cognitive appreciation, and a decision-making process based on evaluating the opportunities or potentialities. The patient was African American by the origin, and no one should ask about her skin color. However, she felt uncomfortable, as most of the caregivers were Whites. She did not talk about it with the nurses and doctors. Appointed therapists understood her inferior and counselled her for boosting confidence.

By avoiding, the physical characteristics will lead to the digression of the perception. The antecedents and consequences of reaching cultural competence are optimistic and equally, have influences on patient relations to healthcare professionals. Therefore, the enhanced conclusions are achieved in the comprehensive presentation of cultural competence. Antecedents are predefined conditions, which have to be present former to the incidence of a concept (Cai, 2016). Here several antecedents have spotted in the model case. The comprehension level of the health workers and the nurses should be developed for the patients, who are from different cultures. Health literacy was not enough in the patient; as a result, she had not agreed to admit in the hospital first. The nurse could help her to understand why it is essential for the patient to recognize in the hospital. Involvement of family members should be considered earlier in this case as she was not confident enough. Consequences are the conditions that have an outcome from the analysis of concept (Jakimowicz & Perry,2015). The patient might feel more reliable after the treatment. The second consequence is contentment when the client recognizes the health provider includes cultural perspectives in her treatment. The third consequence is effective communication, which results from medical service providers incorporating their educational skills for interacting with clients. The implementation of quality in care, faith in treatment, and fulfillment with care due to healthcare providers signifying cultural competence.

Patients’ Culture And Heritage In Nursing Practice

Cultural Competence Assessment Instrument and Nurse Cultural Competence Scale are two tools which can compare the cultural competence of health care providers Nurse Cultural Competence Scale can assesses cultural awareness , cultural action, cultural stability and cultural source of application in treatments(Han & Cho Chung, 2015). Cultural Competence Assessment Instrument is based on basics of cultural competence models such as knowledge, fact, behavior and attitude (Flinkman et al.,2017).The in-patient questionnaires   another tool which can help to assess cultural competence provided by nurses (Zachariae et al., 2015). These questionnaires are used for the assessment of care by both the management and the nurses or health care providers.

Cultural Competence helps to guide nurses to acquire better understanding of patients around them. In this developing atmosphere of health-care industry; culture, ethics and morals of other individuals require respect from the healthcare workers to ensure integrity of communities. Cultural Competence in nursing helps in acquiring better knowledge to increase the ability of achieving proper healthcare facility. In this essay, Purnell’s model of Cultural Competence has been discussed with the help of model cases. The advance nursing practice demands cultural competency and involves in patients lifestyle with the resulted outcomes. In the model case, it can be seen that the nurses and attendants tried to help the patient with proper treatment. They ensure patients ethnicity and cultural competency in every circumstances. Antecedents and consequences are also discussed in this essay. Through this essay, the importance of cultural competency in nursing and analysis of concept regarding nursing models give a constructive understanding of cultural competence.

References

Bailey, M. L. (2015). Cultural competency and the practice of public administration. In Diversity and Public Administration (pp. 179-196). Routledge.

Betancourt, J. R., Green, A. R., Carrillo, J. E., & Owusu Ananeh-Firempong, I. I. (2016). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public health reports.

Byrne, D. (2018). Evaluating the level of cultural competence in undergraduate nursing students using standardized patients in simulation.

Purnell, L. D., & Fenkl, E. A. (2019). The Purnell Model for Cultural Competence. In Handbook for Culturally Competent Care (pp. 7-18). Springer, Cham.

Giger, J. N. (2016). Transcultural Nursing-E-Book: Assessment and Intervention. Elsevier Health Sciences.

Lopes-Murphy, S., & Murphy, C. (2016). The influence of cross-cultural experiences & location on teachers’ perceptions of cultural competence. Journal of the Scholarship of Teaching and Learning, 16(3), 57-71.

Purnell, L. (2019). Update: The Purnell Theory and Model for Culturally Competent Health Care. Journal of Transcultural Nursing, 30(2), 98-105.

Jeffreys, M. R. (2015). Teaching cultural competence in nursing and health care: Inquiry, action, and innovation. Springer Publishing Company.

Constantinou, C. S., Papageorgiou, A., Samoutis, G., & McCrorie, P. (2018). Acquire, apply, and activate knowledge: A pyramid model for teaching and integrating cultural competence in medical curricula. Patient education and counseling, 101(6), 1147-1151.

Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321.

Cai, D., Kunaviktikul, W., Klunklin, A., Sripusanapan, A., & Avant, P. K. (2017). Identifying the essential components of cultural competence in a Chinese nursing context: A qualitative study. Nursing & health sciences, 19(2), 157-162.  Concept Analysis Of Cultural Competence In Nursing Discussion Paper