Transcultural Concepts in Nursing Care


Part Three Healthcare Systems

one another to be extra careful, to avoid travel ing or going to gatherings, and to stay within their own group. Being extra cautious worked. The Tribal Government emphasized the importance of working closely with public health officials. Early testing and vaccines were emphasized, and this unified response and efforts to keep every one informed has made a remarkable difference (COVID-19: Disproportionate Impact on Navajo Nation and Tribal Communities, 2020). Recovery The recovery period from a disaster or emer gency can be prolonged. Examples of recovery activities include preventing or reducing stress related illnesses and excessive financial burdens, and rebuilding damaged structures. A priority in a disaster such as Hurricane Ian that struck the Ft. Myers area of Florida with such a vengeance in October 2022 was the reestablishment of electric ity and water. Damages to homes and structures was substantial and finding shelter was essential in the immediate aftermath. Nurses are often needed at the initial rescue and in the immediate aftermath of a disaster or emergency to admin ister first aid to injured survivors. In terms of long-term recovery after a disaster or emergency, community nurses have trust and relationships with individuals and local leaders. They also develop a strong understanding of people’s expe riences, backgrounds, and the social factors that influence health, helping them to incorporate cul tural knowledge in their nursing practice. Nurses who have experience in working with vulnerable communities and/or high-risk individuals will be critical to improving health equity and popula tion health ( The Future of Nursing 2020-2030 ). Assessment of Culturally Diverse Communities A cultural assessment is the process used by nurses to assess cultural needs of individual cli ents (Leininger, 1991, 1995) (see Appendix A). In general, the purpose of all successful cultural

assessments is to collect information that helps health professionals better understand and address the specific health needs and interests of their target populations. Individual cultural assessments are accomplished through the use of a systematic process. In community health nurs ing, the community is considered the client, and several models have been proposed to help nurses assess the community (Rector, 2022), includ ing the Andrews/Boyle Transcultural Nursing Assessment Guide for Groups and Communities (Appendix B). A community nursing assessment requires gathering relevant data, interpreting the data (including problem analysis and prioritiza tion), and identifying and implementing inter vention activities for community health (Rector & Stanley, 2022). The community nursing assess ment often focuses on a broad goal, such as improvement in the health status of a group of people. It is often the characteristics of people that give each community its uniqueness, and these common characteristics, which influence norms, values, religious practices, educational aspirations, and health and illness behaviors, are frequently determined by shared cultural experi ences. Thus, including the cultural component to a community nursing assessment strengthens the assessment base. Box 11-4 provides basic prin ciples underlying all cultural assessments. Cultural Competence in Health Maintenance and Health Promotion Leininger (1978, 1995) suggested that cultural groups have their own culturally defined ways of maintaining and promoting health. Nursing interventions to improve the health of individu als, groups, and communities can best be planned and implemented by evaluating persons within their social, cultural, and environmental contexts (Adams-Leander, 2022).

Community nurses, who have direct access to clients in the context of their daily lives, should be especially aware of the importance of cul tural knowledge in promoting and maintaining health, because the promotion and maintenance Copyright © 2023 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.

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