It has been predicted that the nation will increase its racial and ethnic diversity throughout the mid-century. Disparty in health care quality and access among minority populations, especially among African Americans, Hispanic Americans, and American Indians. By the middle of the century, racial and ethnic minority groups will comprise almost half of the US population. The barriers were recognized by Leininger and along with culturally and linguistically appropriate services, Leininger’s Culture and Diverse offers a structured approach to promoting culturally congruent care.
Leininger informed about cultural nuisance and the tendency of healthcare workers to push their own belief s and values others because of dominance.
Leininger’s CCDU and sunrise model depict nurses bridging generic folk practices and professional nursing. Furthermore, nurses are with patients 24 hours a day, 7 days a week, creating the potential for rendering culturally congruent care that enhances health care outcomes. It is of extreme importance to promote cultural
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Employing Leininger’s action modes the nurse will need to use strict clinical judgment and critical thinking skills as she diagnoses, assesses, plans, implements, and evaluates care that is culturally congruent. When looking at the the first step of the nursing process, it was suggested that some of the nursing diagnosis be revised to make them culturally sensitive. Noncompliance is one example. It needs to be modified to “non-adherence to clinical appointment schedule related to inability to access public or private transportation” (lll). The preservation and maintenance approach may be put into place when there are generic ways that are beneficial in care. Some examples include bathing, feeding, and other activities of daily living performed by family members who wish to directly participate in
“Health is influenced by culture and beliefs” (NRS-429V, 2011, p. 1). In order for the nurse to properly care for the patient, she must know and understand the patient’s culture. “Cultural care is a comprehensive model that includes the assessment of a client’s cultural needs, beliefs, and health care practices” (NRS-429V, 2011, p. 1). It is not enough to just know where the patient lives or where he came from. The nurse must embrace the concept of cultural competence and cultural awareness. This requires not only the awareness of the cultural beliefs and values of their patients, but also
Utilizing the culture care theory, nurses become knowledgeable of what constitutes health in understanding the meanings and symbols of the ways of culture. Care, caring knowledge, and actions are core components that will ensure the health or wellbeing of people in various cultures. Kaakinen et al (2015) asserts that clients may not be prone to nurse’s suggestions for health promotion because of cultural conflicts with the client’s belief and value systems.
Leininger (1988) defined nursing as a transcultural phenomenon requiring knowledge of different cultures to provide care that is congruent with the clients’ life ways, social structure, and environmental context. This definition from the founder of transcultural care would support applying a cultural sensitive nursing care in the clinical setting, and highly linked to her definition of transcultural nursing as a legitimate and formal area of study focused on culturally based care beliefs, values, and practices to help cultures or subcultures maintain or regain their health (wellbeing) and face disabilities or death in culturally congruent and beneficial caring ways (Leininger, 1970, 1978, 1995). Moreover Leininger summarized the process of applying transcultural care as providing care that fits with cultural beliefs and life ways. From a professional perspective, it refers to the use of emic (local cultural knowledge and life ways) in meaningful and tailored ways that fit with etic (largely professional outsiders’ knowledge), in other words care should be individualized according to patient’s culture to promote holistic and effective nursing care.
With the increasing immigrant population a third barrier affecting access to health care is a cultural barrier. Culture barriers can include values and beliefs, language and race and ethnicity. Health beliefs and behavior can become a barrier when patients decide not to seek medical treatment and instead turn to home remedies and healers when treating illnesses. Approximately 10% of Americans speak a language other than English and can be classified ad being limited in their proficiency. For these patients language becomes a barrier and they are less likely to receive optimal medical treatment (Flores, 2006). Horton and Johnson (2010) stress the importance of communication in reducing disparities and increasing the trust of patients in the health care system. As reported by the American College of Physicians, evidence reveals that racial and ethnic minorities are more likely to receive inferior care when compared with non-minorities. This occurs even when minorities have access to insurance and adequate income (Racial and ethnic disparities in health care, 2010).
In order to deliver nursing care to different cultures, nurses are expected to understand and provide culturally competent health care to diverse individuals. Culturally competent care is tailored to the specific needs of each client, while incorporating the individual’s beliefs and values (Stanhope & Lancaster, 2006, p. 90). By being culturally competent, nurses are able to help improve health outcomes by using cultural knowledge and specific skills in selecting interventions that are specific to each client (Stanhope & Lancaster). Therefore, nurses “should perform a cultural assessment on every client with whom they interact with” (Stanhope &
Although the United States is a leader in healthcare innovation and spends more money on health care than any other industrialized nation, not all people in the United State benefit equally from this progress as a health care disparity exists between racial and ethnic minorities and white Americans. Health care disparity is defined as “a particular type of health difference that is closely linked with social or economic disadvantage…adversely affecting groups of people who have systematically experienced greater social and/or economic obstacles to health and/or clean environment based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion” (National Partnership for Action to End Health Disparities [NPAEHD], 2011, p. 3). Overwhelming evidence shows that racial and ethnic minorities receive inferior quality health care compared to white Americans, and multiple factors contribute to these disparities, including geography, lack of access to adequate health coverage, communication difficulties between patients and providers, cultural barriers, and lack of access to providers (American College of Physicians,
With the large increase multicultural population in the United States, nurses encounter patients with differences in healthcare beliefs, values and customs. To provide adequate nursing care, nurses must be aware of these differences. They must respect and acknowledge the patient’s culture. To do this, nurses need education on cultural competence to ensure patient satisfaction and better patient outcomes.
Diversity within the United States has been growing progressively within the past century. About 36 percent of the U.S. population is a part of a minority group, according to the 2010 U.S. Census (CDC, 2017). According to the U.S. Census, a “majority-minority” country is projected by the middle of 21st century, resulting in the white population becoming less than 50% of the population (Elchoufani, 2018). Overall, the life expectancy and child mortality in the U.S. has bettered; however, the minority undergo unequal distribution of illness, disease, disability, and death in comparison to non-minority (CDC, 2017). According to the U.S. Department of Health and Human Services (HHS), even with all the attempts help diminish health care disparities for minorities, the minorities continue to face these unequal disparities (BLH, 2015).
In the United States today cultural diversity is growing more prevalent every day. The report from the Institute of Medicine (IOM: Unequal treatment, 2002) presented information that racial and ethnic minorities of all ages receive lower quality health care compared to their non-minority counterparts. Every effort should be made to stop the disparities surrounding cultural differences while attempting to understand the cultural health behaviors, increase cultural
In the last twenty years, the rising number of disparities in health and healthcare has increased simultaneously with the influx of minorities within the population (Baldwin, 2003) A4. As the size of an ethnically diverse population steadily continues to increase, so will the level of complexities of patients’ health needs, which nurses and other healthcare staff will be expected to address (Black, 2008) A1. The issue of racial, ethnic and health disparities for minorities exists for several complex reasons, however, even with this being widely known, very little action has been taken to try and correct it (Baldwin, 2003) A4. Research findings suggest that without actively implementing cultural diversity within the healthcare workforce, quality in healthcare will decline while health disparities continue to rise (Lowe & Archibald, 2009) A3. So although the shortage of nursing staff should be a high-priority for change in the U.S., the need for more registered nurses with racially
Health is defined a state of wellbeing which is equally viewed by many different cultures. However, the definition of wellbeing is seen differently among cultures, in relationship to their beliefs and values. (DeNisco & Barker, 2015). Cultural care in nursing is a very important part of nursing care, whether the nurse is a bedside RN or a practicing primary care NP. There are many theories in nursing related to cultural care. Most encompass the need for nurses to take into consideration the cultural caring behaviors and values of individuals and families to provide culturally competent nursing care.
Madeleine Leininger’s cultural care theory is one of the most influential modern day theories in nursing. Leininger describes her theory as one that is cultural sensitive that is tailored to address patients of different cultures, backgrounds, or origins. Leininger develops the cultural care theory due to the fact that she believes that nurses are caring for their patients as a one hat fits all, and not taking into consideration the patient 's background or their culture.
Nowadays, nurses not only need to know how to care of their patients, but they also must be able to care of patients from other cultures with many beliefs and values. Cultural views of individual influence the patient’s perception and decision of health and health care (Creasia & Parker, 2007). In order to care for people across different languages and cultures, nurses need to develop cultural sensitivity, knowledge, and skills.
Nursing theory is foundational to nursing practice; however, there exists a reciprocal relationship between practice and theory. Through examining nursing theory, the nurse can make better-informed decisions about the patient’s care. In addition, the theory will influence the care for future patients as well. One theorist that changed the landscape of nursing is Madeleine Leininger. Her culture care theory changed the dialogue of healthcare regarding care. This paper will discuss the importance of theory in nursing theory. Next, a summary of Leininger’s theory will precede a discussion about how the theory will be applied in a nursing context. Finally, the correlation between Leininger’s theory and the practice of a nurse practitioner will ensue. Her culture care theory will inform the practice of a nurse practitioner and how culturally competent care will be given.
The Theory of Culture Care Diversity and Universality is founded on the principle the compassion is the crux of nursing (Black, 2014, p.277). In order to provide care effectively, one must demonstrate empathy toward his or her patient. Additionally, Leininger’s theory calls for transcultural nursing, which is centered on culture as the basis for care delivery; essentially, it is the provision of culturally competent care (Narayanasamy, 1999). To allow the nurse to assess a patient culturally, Leininger devised the sunrise model, which encompasses multiple traits specific to an individual’s cultural background.