Greetings from the University of Alabama

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Greetings from the University of Alabama
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Cultural Competence in Nursing

• Susan W. Gaskins, DSN, ACRN

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Culture

• Socially transmitted behavioral patterns, arts,
  beliefs, values, customs, lifeways, and all other
  products of human work and thought characteristic
  of a population of people that guide their
  worldview and decision making.

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Culture has a powerful influence on health and
illness!
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Twelve Domains of Culture

• Overview, inhabited localities, and topography
• Communication
• Family roles and organization
• Workforce issues
• Biocultural ecology
• High-risk health behaviors

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Twelve Domains of Culture

• Nutrition
• Pregnancy and childbearing practices
• Death Rituals
• Spirituality
• Health-care practices
• Health-care practitioners

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Cultural Competence

• A set of knowledge-based interpersonal skills
  that nurses use to effectively care for an
  individual, family, or community (Campinha-Bacote
  , Yahle, Langenkamp, 1996 Frei, et al, 1994).

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Components of Cultural Competence

• Similar to culture, it is learned
• Based on self-awareness of ones own culture
• Requires not only the knowledge about other
  peoples culture, but also the willingness and
  skills to apply that knowledge

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Components of Cultural Competence

• Is expected of organizations as well as
  individuals
• Is a process of becoming, not a state of
  accomplishment

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Developing Cultural Competence Requires

• Cultural Awarenessan appreciation of and
  sensitivity to others values, beliefs,
  practices, lifestyles, and problem-solving
  strategies.
• Cultural knowledgean understanding of the
  elements of cultures and the information
  necessary to provide effective nursing care

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Developing Cultural Competence Requires

• Cultural Skillthe effective use of cultural
  awareness and knowledge to meet the patients
  needs.
• Cultural Encounterinteractions with others
  related to their life experiences and the
  importance of these experiences for health.

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Barriers to Developing Cultural Competence

• Stereotypingattributing ones beliefs about a
  group to an individual
• Prejudicethe emotional reaction to deeply held
  beliefs about groups
• Racismthe belief that individuals in a
  particular group are inferior
• Ethnocentrismthe belief that ones culture is
  superior

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Barriers to Developing Cultural Competence

• Cultural blindnessignoring differences between
  cultures
• Cultural impositionimposing ones values on
  others
• Cultural conflicta threat based on a
  misunderstanding of cultural differences
• Cultural shocka feeling of discomfort
  helplessness when dealing with another cultural
  group

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Nurses demonstrate culture competence when they

• Show respect for the inherent dignity of every
  human being (regardless of age, gender, religion,
  socioeconomic class, sexual orientation, ethnic
  or cultural group).
• Accepts the rights of individuals to choose their
  care provider, participate in care, and refuse
  care.

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Nurses demonstrate culture competence when they

• Acknowledges personal biases and prevents these
  from interfering with the delivery of quality of
  care of persons of other cultures.
• Recognizes cultural issues and interacts with
  people from other cultures in culturally
  sensitive ways

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Nurses demonstrate culture competence when they

• Incorporates cultural preferences, health beliefs
  and behaviors, and traditional practices into the
  management of care
• Develops client-appropriate educational materials
  that address the language and cultural beliefs of
  the client

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Nurses demonstrate culture competence when they

• Accesses culturally appropriate resources to
  deliver care to clients from other cultures
• Assist clients to access quality care within a
  dominant culture

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Cultural Competence in Nursing Education--Teaching
Strategies

• Integrating cultural concepts throughout the
  curriculum
• Teaching a specific unit within a course
• Offering a specific course, seminar or an
  elective
• Projects conducted within a course
• International experiences

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Culturally Competent Scholarship in Nursing
Research

• Contexuality-knowledge of the participants
  living situation
• Relevance-research questions are relevant to the
  population
• Communication Style-participants preferred
  language is used
• Awareness of identity and power
  differentials-awareness of differences in the
  researcher and the participants

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Culturally Competent Scholarship in Nursing
Research

• Disclosure-efforts to build trust
• Reciprocation-ensuring the researchers and the
  participants goals are met
• Empowerment-increasing the participants control
  of their lives
• Time-flexible, respectful use of time (Meleis,
  1996)

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Chiba University andThe University of Alabama

• Working towards increasing cultural competence in
  nursing.