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Defining the Transcultural Approach
In nursing, the transcultural approach primarily recognizes that, along with universal care delivery principles, there are also culture-specific ones. The general premise behind the approach is that nursing care providers should consider the cultural backgrounds of patients to ensure patient comfort and the effectiveness of treatment at different stages, including recovery. From this perspective, the context of family is particularly important because family is one of the source of a patients culture as well as the environment in which care is provided. In familial care, it is acknowledged that major health-related decisions are made in families, and families provide the necessary support to patients, which is why health care providers should not overlook the influence of families and should engage families in the care delivery processes.
Cultural Awareness and Cultural Sensitivity
In the context of transcultural care, Purnell (2012) describes two concepts: cultural awareness and cultural sensitivity. The former refers to nurses ability to recognize culture-specific characteristics of a patient based on external, vividly manifested signs. However, to understand those signs, a nurse should be familiar with cultural differences and be aware of cultural diversity. Further, cultural sensitivity is the ability to gain insight into the culture-specific needs of a patient based on signs that may not be explicitly displayed but still can be observed by a nurse through communication with the patient. However, communication with the family is important, too. For example, in terms of the work of a nurse, it may be relevant for him or her to identify the cultural practices of a family (e.g. religious practices) that may affect the familys attitude toward treatment and the familys compliance with support requirements and recovery guidelines.
Effectiveness
The effectiveness of the transcultural approach should be measured through the improvement of health care outcomes, which encompass not only recovery from disease or injury and successful prevention but also optimal conditions in which care is delivered, including patient comfort and perceived quality of care. This latter component of effectiveness evaluation can be shaped by collecting patient feedback. Also, nurses feedback is important, too, in terms of assessing the extent to which, according to a nurse, cultural considerations were important in a given care delivery case. It is noteworthy that the failure of the team of health care providers to employ the transcultural approach may result in cultural resistance to treatment from patients and families, and the resistance can have negative outcomes. To avoid this, cultural competencies should be incorporated into nursing education. Hawala-Druy and Hill (2012) confirmed that a higher level of students cultural awareness, knowledge, and skills as a predictor of more successful interventions in their practice after graduation.
Individual Care and an Example from Practice
The transcultural approach is different from the individual approach; the former is mostly seen as family-centered, while the latter is patient-centered. Also, in the individual approach, the emphasis is put on the personal needs of a patient, while in the transcultural approach, it is put on culturally specific needs. To practice the transcultural approach, it is necessary to develop cultural competencies, and a major such competency is an effective communication with patients and family members.
In my practice, there was a patient who was unwilling to stay in the hospital for the prescribed amount of time; from the communication with a visiting family member I learned that the patient had not wanted to go to the hospital in the first place because she did not believe in Western medicine; the acute state, however, had made the hospitalization inevitable. I believe I managed to persuade the patient to stay and receive treatment procedures by being respectful to her culture and communicating extensively with her family and other members of the medical team.
References
Hawala-Druy, S., & Hill, M. H. (2012). Interdisciplinary: Cultural competency and culturally congruent education for millennials in health professions. Nurse Education Today, 32(7), 772-778.
Purnell, L. D. (2012). Transcultural health care: A culturally competent approach. Philadelphia, PA: F. A. Davis.
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