Transcultural Concepts in Nursing Care

280

Part Three Healthcare Systems

A Transcultural Framework A distinguishing and important aspect of com munity-based nursing practice is the nursing focus on the community as the client (Rector & Stanley, 2022). Effective community nursing practice must reflect accurate knowledge of the causes and distribution of health problems and of effective interventions that are congruent with the values and goals of the community. A trans cultural approach can be used by the community nurse to collect, organize, and analyze informa tion about high-risk and vulnerable groups from different cultural backgrounds that are encoun tered in community practice. Identifying Subcultures and Devising Specialized Community Based Interventions

that may motivate clients to make successful changes in behavior because improvement in health status requires lifestyle and behavioral modifications. Transcultural nursing practice has the potential to improve the health of the community as well as the health of individual clients and families. An additional consider ation of nurses who practice in community set tings are the needs of populations at risk. Special at-risk groups can be found in all communities: people experiencing homelessness, those with low incomes, those engaging in harmful drug use, migrants, refugees, prison populations, and older adults are groups at risk for decreased health status. Consider the difficulty of designing a health program for a community composed primarily of refugees who recently arrived in the United States. By definition, refugees are individu als who have been forced to leave their home country due to war, violence, or persecution. They may have spent years in refugee camps in other countries, may have lost family members, or may have family members still living in their home country, and yet the refugees are now making a life for themselves in a strange coun try. While refugees may come from all levels of the socioeconomic status in their homeland, many refugees will have not had access to medi cal, dental, and other healthcare services while in refugee status, even if they may have had healthcare access prior to fleeing their native country. Certainly, language barriers would be a major problem, but so could many other cul tural differences, from nuances in communica tion to differences in beliefs of what constitutes health and illness as well as treatment and cure. A failure to understand and deal with these dif ferences would have serious implications for the success of any health or nursing intervention. Nurses who have knowledge of, and an ability to work with, diverse cultures can devise effec tive community interventions to reduce risks in a manner that is consistent with the commu nity and group, as well as individual values and beliefs of community members.

A transcultural framework for nursing care helps the nurse to identify subcultures within the larger community and to devise community based interventions that are specific to commu nity health and nursing goals. For example, in the multicultural society of the United States, it is common to speak of “the Black community,” “the Hispanic community,” or “the Francophone community.” We might also speak more broadly of “the immigrant community” or the “refugee community,” or of other unique groups within or near a local community. A cultural focus allows this variety and facilitates data collection about specific groups based on their health risks. A transcultural framework facilitates a view of the community as a complex collective yet allows for diversity within the whole. Interventions that are successful in one subgroup may fail with another subgroup of the same community, and often, the failure can be attributed to cultural differences or barriers that arise because of these differences. Often, the community location of a diverse sub culture reflects distinctive aspects of the cultural group. Figure 11-1 shows murals on the wall of a library in El Rio, a Mexican American barrio in Tucson, AZ. Copyright © 2023 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.