Running head: THE GIGER AND DAVIDHIZAR TRANSCULTURAL ASSESSMENT MODEL
The Giger and Davidhizar Transcultural Assessment Model
Jamee Gosch
Florida Southwestern College
The Giger and Davidhizar Transcultural Nursing Assessment Model
Introduction
Theories of transcultural nursing with established clinical approaches to clients were founded in the mid-1960s and are an essential aspect of healthcare today. The ever-increasing multicultural population in the United States poses a significant challenge to nurses providing individualized and holistic care to their patients. Accurate assessments identify factors that define transcultural nursing and analyze methods to promote culturally competent nursing care.” (Maier-Lorentz, 2008) In 1988 Giger and Davidhizar created their Transcultural Assessment Model (TAM) to facilitate “…the discovery of culturally sensitive facts… (and) provide culturally appropriate and competent care.” (Giger & Davidhizar, 2002) The TAM was developed for an undergraduate nursing curriculum to train students to assess and provide care for patients that are culturally diverse. This paper will employ the six cultural phenomena defined by TAM to assist in identifying cultural attributes of Mexican Americans that should be considered by nurses in assessment and care.
Demographic overview of Mexico, 2009 -2011: (Giger, 2014) o Most Mexicans are mestizos (of mixed Spanish and Indian
Cultural competency is becoming essential in American healthcare with the increasing and diversification of immigration. The Department of Homeland Security, 2014 statistics indicates over 750,000 immigrants received naturalization in the US. These naturalized citizens represent over 20 countries varying from Hispanic, Indian, Asian, African, and Middle Eastern cultures. A change in the way American healthcare treats these cultures is necessitated to provide efficient care and achieve positive outcomes. Douglas et al. (2014) guidelines are to empower patients to help diminish the inequities of their own healthcare. The guidelines for culturally competent care are meant to guide the nurse, nurse educators, and nurse managers in their competent treatment of persons of other cultures. These guidelines mandate a nurse use education, self-assessment and reflection, and diversification of the workforce to meet the demands. The ten guidelines are knowledge of culture, education and training in culturally competent care, critical reflection, cross-cultural communication, culturally competent practice, cultural competence in health care systems and organizations, patient advocacy and empowerment, multicultural workforce, cross-cultural leadership, and evidence-based practice and research.
The development of the Giger and Davidhizar Transcultural Assessment Model (GDTAM) came about because of nursing students’ need to provide culturally diverse care for patients. The model acknowledges that each culture is individually unique and assesses them according to six phenomena: communication, space, social organization, time, environmental control, and biological variations. In this model “nurses must use transcultural nursing knowledge as a skill and an art to provide care to diverse populations in a culturally appropriate and competent manner” (Sagar, 2012, p. 57). It goes on to discuss how the model sees cultural competence as “a dynamic process implemented by an individual or health care agency by using significant interventions based on the client’s ‘cultural
The Giger and Davidhizar cultural assessment in 1988 in response to there being only a few cultural assessment tools and increased amount of nursing students providing care to more diverse patients (Sagar, 2012, p. 57). The model has six cultural phenomena: biological variations, environmental control, time, social orientation, space, and communication. These phenomena are the basis of the model and help guide nurses through important cultural considerations.
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 &
I chose this article because I find it interesting and of great help to any nursing and health care professional; I am Hispanic myself and constantly looking for better ways to help my community. I personally see my grandmother struggling whenever she needs to see her physician, as she sometimes does not understand what him and his staff are telling her. On another note nursing is an ever changing career and the Hispanic culture is growing at an enormous rate, becoming culturally competent does not only provide the patient with good care but can make the nurses’ job easier and more rewarding. I do feel that there should be more research on this subject; the best way to learn about a patient’s cultural beliefs is to ask the patient. I think that the population that the author intended to target is health care professionals; however, I know that any immigrant can benefit from reading this article.
Throughout this paper I will be pulling information from the Giger and Davidhizar Transcultural Assessment Model. It is pertinent for health care workers to be familiar with this model because of the growing affects that culture has on a patient’s view of disease prevention and health restoration. This model focuses on six cultural phenomena: communication, time, space, social organization, environmental control, and biological variations. It is important for nurses to utilize this tool while performing assessments on patients because of the substantial effects that each one has on a patient’s perspective. Every person is unique and knowing that no one perspective is universal will aid the nurse in treating each patient with culturally competent care.
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.
Cultural competence can be defined as using the ability of one’s awareness, attitude, knowledge and skill to effectively interact with a patient’s many cultural differences. Madeline Leininger, a pioneer on transcultural nursing describes it this way; “a formal area of study and practice focused on comparative human-care differences and similarities of the beliefs, values and patterned lifeways of cultures to provide culturally congruent, meaningful, and beneficial health care to people” (Barker, 2009, p. 498). The importance of cultural diversity in healthcare allows for the delivery of appropriate cultural autonomy. Showing respect for others will lead to trust between nurse and
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.
The nursing profession has a long history of assessing and placing patient needs first when giving care. The tenets of nursing practice include meeting those needs using individualized care by collaborating with the patient, family, and health care team members. (American Nurses Association, 2010). The concept of transcultural nursing aligns with these tenets because it calls on nurses to provide patient-centered care by taking into account the patient’s background, beliefs, culture and values. In this paper, I will identify the factors that made it necessary to develop the transcultural nursing theory, describe the meaning of diversity and its relationship to the field of nursing, and explain three ways that I provide culturally sensitive care to my patients.
Giger and Davidhizar’s Transcultural Assessment Model is a valuable and functional assessment tool that evaluates the different cultural variables and how those variables effect health, illness and behaviors (Giger, 2013). This philosophy considers the uniqueness of each individual, understanding that the individual is unique, a product of their culture, religion, environment socioeconomic status and diversity. Giger and Dividhizar propose that, as health care providers, we need an acute awareness of the ethnicity and culture of each individual, having the knowledge and understanding to care for them as
Health in all cultures is an important aspect of life. A person’s cultural background, religion and/or beliefs, greatly influences a person’s health and their response to medical care (Spector, 2004). These diverse cultures guide decisions made in daily life; what food eaten, living arrangements made, medications taken and medical advice listened to. A nurse must be knowledgeable and respectful of these diverse cultures and understand their importance when providing care. This understanding helps to build a strong nurse/patient relationship, increasing patient compliance, which ensures positive outcomes are met. Patients who are satisfied
This paper explores the Jewish culture and end of life within the Jewish culture. It will focus on the Giger and Davidhizar’s Transcultural Assessment Model, which has six phenomena’s; communication, space, time, environmental control, biological variation and social organization. This model will provide a framework to assess the Jewish culture and their beliefs during the transition period of end of life. This paper will discuss two implications of nursing care. From those implications, a culturally appropriate nursing intervention will be discussed.
The Transcultural Assessment Model, developed by Giger and Davidhizar (2006), focuses on assessment and intervention from a transcultural nursing perspective. In this model, the person is seen as a unique cultural being influenced by culture, ethnicity, and
The purpose of this paper is to discuss the eight reasons why transcultural nursing (TCN) is a necessary specialty, according to Dr. Madeleine Leininger. Dr. Madeleine Leininger was a pioneer in this field of nursing. I will define the meaning of cultural diversity and relate it to nursing practice. I will explain three ways that I provide culturally sensitive care to my patients. I work in an outpatient obstetrics and gynecology office, where we see many different cultures.