Nursing Transcultural Nursing Theory Discussion

Chapter 7 Transcultural Perspectives in the Nursing Care of Adults Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural Influences on Adulthood Considerations: – Physiologic development – Psychosocial development – Chronologic standards • Young adulthood • Middle adulthood Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural Influences on Adulthood (cont.) Considerations: – Developmental tasks • Generativity versus stagnation (See Evidence-Based Practice 7–1) Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Culture and Adult Transitions Transitions: – Achieving success in one’s career (See Box 7-1) – Achieving social and civic responsibility – Marriage and raising children to adulthood (See Figure 7-1) – Changing roles and relationships (See Table 7-1) Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Health-Related Situational Crises Influencing factors: –Situational transitions –Developmental transitions –Caregiving roles –HIV/AIDS Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Health-Related Situational Crises (cont.) HIV/AIDS and the African American community –Prevention challenges (See Evidence-Based Practice 7-2) –Barriers to HIV preventive efforts are: • poverty • denial • drug use • reactions to homosexuality Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Health-Related Situational Crises (cont.) Culturally competent nursing care: Health promotion strategies and nursing interventions for African American women (See Case Study 7-1): • The “virus” • “Stroke belt” • “High blood” • “Bad nerves” Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Transcultural Concepts in Nursing Care ● Seventh Edition Margaret M. Andrews, PhD, RN, CTN-A, FAAN Director and Professor of Nursing School of Health Professions and Studies University of Michigan-Flint Flint, Michigan Joyceen S. Boyle, PhD, RN, MPH, FAAN Adjunct Professor of Nursing College of Nursing University of Arizona Tucson, Arizona Adjunct Professor of Nursing College of Nursing Georgia Regents University Augusta, Georgia 0002491983.INDD 1 7/10/2015 12:53:53 PM Acquisitions Editor: Christina C. Burns Product Development Editor: Christine Abshire Development Editor: Elizabeth Connolly Editorial Assistant: Cassie Berube Marketing Manager: Dean Karampelas Production Project Manager: Joan Sinclair Design Coordinator: Joan Wendt Illustration Coordinator: Jennifer Clements Manufacturing Coordinator: Karin Duffield Production Service: SPi Global 7th edition Copyright © 2016 by Wolters Kluwer Two Commerce Square 2001 Market Street Philadelphia, PA 19103 USA LWW.com All rights reserved. Nursing Transcultural Nursing Theory Discussion

This book is protected by copyright. No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the abovementioned copyright. Printed in China Library of Congress Cataloging-in-Publication Data Transcultural concepts in nursing care / editors, Margaret M. Andrews, Joyceen S. Boyle. — Seventh edition.    p. ; cm. Includes bibliographical references and index. ISBN 978-1-4511-9397-8 I. Andrews, Margaret M., editor. II. Boyle, Joyceen S., editor. [DNLM: 1. Transcultural Nursing. 2. Culturally Competent Care. WY 107] RT86.54 362.17’3—dc23 2015015790 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner.

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International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6 pm, EST. 10 9 8 7 6 5 4 3 2 1 0002491983.INDD 2 7/10/2015 12:53:53 PM Contributors Margaret M. Andrews, PhD, RN, CTN-A, FAAN Patti Ludwig-Beymer, PhD, RN, CTN-A, NEA-BC, FAAN Director and Professor of Nursing School of Health Professions and Studies University of Michigan-Flint Flint, Michigan Vice President and Chief Nursing Officer Edward Hospital and Health Services Naperville, Illinois Margaret A. McKenna, PhD, MPH, MN Martha B. Baird, PhD, APRN/CNS-BC, CTN-A Assistant Professor School of Nursing University of Kansas Medical Center Kansas City, Kansas Joyceen S. Boyle, PhD, RN, MPH, FAAN Adjunct Professor of Nursing College of Nursing University of Arizona Tucson, Arizona Adjunct Professor of Nursing College of Nursing Georgia Regents University Augusta, Georgia Joanne T. Ehrmin, PhD, RN, CNS Professor Department of Health Promotion College of Nursing University of Toledo Toledo, Ohio Patricia A. Hanson, PhD, RN, APRN-BC, GNP Professor College of Nursing and Health Madonna University Livonia, Michigan Jana Lauderdale, PhD, RN, FAAN Assistant Dean for Cultural Diversity School of Nursing Vanderbilt University Nashville, Tennessee Andrews7e9781451193978-FM.indd 3 Clinical Associate Professor Department of Health Services University of Washington Seattle, Washington Margaret Murray-Wright, MSN, RN Associate Director, Undergraduate Programs and Clinical Assistant Professor of Nursing University of Michigan-Flint Flint, Michigan Dula F. Pacquiao, EdD, RN, CTN-A, TNS Cultural Diversity Consultant Education, Research and Practice Lecturer, University of Hawaii Hilo School of ­Nursing Hilo, Hawaii Maureen J. Reinsel, MA, MSN, APRN, AGPCNP-C Technical Writer for Patient and Program Monitoring Improving Data for Decision-Making in Global Cervical Cancer Programs (IDCCP) Jhpiego Corporation Baltimore, Maryland Barbara C. Woodring, EdD, CPN, RN Professor Emerita Byrdine F. Lewis School of Nursing and Health Professions Georgia State University Atlanta, Georgia iii 3/16/2016 12:16:43 PM Foreword I am pleased for the opportunity to write the Foreword to Drs. Margaret Andrews and Joyceen Boyle’s seventh edition of their book, which illuminates the historical and theoretical foundations and evolution of transcultural nursing emerging from the disciplines of nursing and anthropology. Nursing Transcultural Nursing Theory Discussion

I have been asked to “fill the shoes” of our mentor and colleague, the late Dr. Madeleine Leininger, who wrote the previous Forewords to their book. Dr. Leininger, the first nurse anthropologist and the “mother” of transcultural nursing, passed away in 2012 leaving us a legacy of transcultural nursing scholarship and a body of knowledge that has accelerated exponentially from its earliest beginnings in Cincinnati, Ohio, in the 1950s to its adoption in most nations of the world. Leininger addressed the human condition through knowledge of what it means to be human, caring, understanding, and open to all cultural traditions by creating the discipline of transcultural nursing. At the outset of the programmatic development of the discipline of Transcultural Nursing, Joyceen Boyle and I were asked by Dr. Leininger to become her first two doctoral students in 1977 at the University of Utah, College of Nursing, Salt Lake City, Utah. Both of us had backgrounds in public health or anthropology and a great interest in the study of diverse cultures. As friends and students, Joyceen and I felt privileged to be pioneers as Dr. Leininger put into motion her beliefs, and values of transcultural nursing, focusing on nursing and human science, caring science, theory development, anthropology, culture, and transcultural nursing. Leininger advanced her theoretical understanding developing The Worldwide Nursing Theory of Culture Care Diversity and Universality and her Ethnonursing methodology. Her transcultural beliefs and values have been infused into nursing program o ­ bjectives for iv 0002491983.INDD 4 e­ ducation, ­research, administration, and practice and were the foundation for the development of standards of practice for culturally competent care for individuals, groups, local and global communities, and organizations. Dr. Andrews teamed up early in her scholarly career with her mentor, Dr. Joyceen Boyle and they, with other major contributors, wrote one of the earliest textbooks, Transcultural Concepts in Nursing Care published first in 1989 who also was influenced by Dr. Leininger. Because of their long history of knowledge generation in transcultural nursing, this work of Andrews and Boyle is very comprehensive and shows the depth of their scholarship in terms of culture, theory development and application, research, and their commitment to the delivery of culturally competent care in practice. Nursing Transcultural Nursing Theory Discussion

Rapid changes in science, technology, genetics, health care, economics, geopolitics, transportation, demographics, migration and immigration, religious ideologies, unrelenting wars, and global issues including human rights and social justice have challenged nurses to understand new ways of engaging with clients and families, and also professional colleagues in terms of transcultural nursing. By means of the new sciences of complexity and the generation of enormous quantities of research of every affiliation, and diverse philosophical, political, and religious perceptions, we can see the interconnectedness of everything in the universe and the necessity for discernment and evaluation of what is really happening in the world. Theoretical and experiential knowledge about our responsibilities to one another thus is growing and impacts the need for intense communication to examine and solve problems both locally and globally. Continuing to identify relevant issues to promote health, human safety, and 7/10/2015 12:53:56 PM Foreword improve the quality of life of all people is a major goal of thoughtful national and international health care professionals. For example, we can explore, within the United Nations Millennium Development Goals for 2015 and beyond, the framework for the world community. These developments are now shaping Andrews’ and Boyle’s paradigmatic thinking in the seventh edition and their interest in addressing the challenges of the interconnectedness of all by their Transcultural Interprofessional Practice (TIP) Model with a theoretical foundation. Their model illuminates the necessity for increased collaboration and communication with clients and multiple health care and folk participants to address complex approaches to transcultural issues in the provision of culturally congruent, safe, and competent care. Nursing Transcultural Nursing Theory Discussion

The beginning chapters in their book highlight foundational and evolutionary knowledge of the concepts of culture, subculture, race, ethnicity, context, communication including digital communication—the Internet and social media— evidence-based practice and problem solving, culture-specific nursing care, interprofessional collaboration and best practices, transcultural nursing, genetics, and theory development. The chapters focus on culturally competent nursing care by highlighting transcultural nursing across the life span, multicultural health care settings including the culture of organizations, the delivery of mental health care, a focus on family and community, a spotlight on the cultural diversity of the workforce, and the challenges in transcultural nursing (religion, ethics, and international nursing). Each chapter follows with a set of review questions and learning activities that illuminate what students, faculty, and clinical practitioners will have integrated into their plan of care to meet mutual goals presented in the chapter case studies. The seventh edition reflects many of the changes in the concept of the culture-at-large, especially genetics. While giving attention to Leininger’s theory in Chapter 1, what is significant in this seventh edition, as stated, is the development of their own theory, the Andrews and Boyle Transcultural Interprofessional Practice (TIP) 0002491983.INDD 5 v Model. The key concepts identified in the TIP model are context, interprofessional health care team, communication, and problem-solving process. The cultural context (health-related beliefs and practices that weave together environmental, economic, social, religious, moral, legal, political, educational, biophysical, genetic, and technological factors), the interprofessional health care team (nurses, physicians, social workers, therapists, pharmacists, and others), cross-cultural communication among client, family, and significant others, and members of the interprofessional health care team including folk and traditional healers, and religious and spiritual healers facilitate the foundation of the problem-solving process that has five steps. These five steps include comprehensive holistic client assessment, mutual goal setting, planning, implementation of the plan of action and interventions, and evaluation of the plan for effectiveness to achieve the stated goals, and desired outcomes; provide culturally congruent and competent care; deliver quality care that is safe and affordable; and ensure that the care is evidence based with best practices. As I reflect on the work of my colleagues, Andrews and Boyle, not only within the pages of this book but also what each of them has accomplished over many years as leaders, teachers, researchers, online educators, and as Presidents of the Transcultural Nursing Society, what comes to mind is their deep dedication and devotion to the discipline and profession of Transcultural Nursing. Through their intellectual astuteness and creative actions, they have been and are role models and mentors to students and other leaders who have spread and broadened transcultural care knowledge worldwide. They are committed to the primary goal of transcultural nursing to facilitate culturally congruent knowledge and care so that people of the world are understood and their health care needs can be met within the dynamics of their cultures and cultural understanding. Nursing Transcultural Nursing Theory Discussion

A seventh edition of a book attests to the fact that students, faculty, and other practitioners find within its pages relevant and challenging information to learn about cultures and 7/10/2015 12:53:56 PM vi Foreword ethnic groups, know how to relate and serve them, conduct research, facilitate the solving of problems, and “making things work.” Today collaboration and communication are the key. Margaret Andrews and Joyceen Boyle have captured that essence in their Transcultural Interprofessional Practice (TIP) theory and model, which is presented in this work. I wholeheartedly endorse this new edition. I am most proud to call these authors not only my colleagues but also my friends as they move forward in the evolution of what can be termed authentic transcultural nursing by means of collaboration and interprofessionalism. Nursing students, faculty, other health care ­professionals, and practitioners 0002491983.INDD 6 of every health care and anthropological discipline will be stimulated by the theory and the content expressed by the authors and the many contributors in this new edition to improve the health of and help people of diverse cultures worldwide. Marilyn A. Ray, RN, PhD, CTN-A, FSfAA, FAAN Colonel (Retired), United States Air Force, Nurse Corps Professor Emeritus The Christine E. Lynn College of Nursing Florida Atlantic University Boca Raton, Florida 7/10/2015 12:53:56 PM Preface Given the large number of cultures and subcultures in the world, it’s impossible for nurses to know everything about them all; however, it is possible for nurses to develop excellent cultural assessment and cross-cultural communication skills and to follow a systematic, orderly process for the delivery of culturally competent care. The Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model, which we are introducing in this seventh edition of Transcultural Concepts in Nursing Care and describe in more detail in Chapters 1 and 2, emphasizes the need for effective communication, efficient, client- and patient-centered teamwork, and collaboration among members of the interprofessional health care team. The TIP Model has a theoretical foundation in transcultural nursing that fosters communication and collaboration between and among all members of the team and enables multiple team members to manage complex, frequently multifaceted transcultural care issues, moral and ethical dilemmas, challenges, and care-related problems in a collegial, respectful, synergistic manner. Nursing Transcultural Nursing Theory Discussion

The process used in the TIP Model is an adaptation and application of the classic scientific problem-solving method used to deliver nursing and health care to people from different national origins, ethnicities, races, socioeconomic backgrounds, religions, genders, marital statuses, sexual orientations, ages, abilities/disabilities, sizes, veteran status, and other characteristics used to compare one group of people to another. The Commission on Collegiate Nursing Education, the American Association of Colleges of Nursing’s Essentials of Baccalaureate Education for Professional Nursing Practice, the National League for Nursing, most state boards of nursing, and other accrediting and certification bodies require or strongly encourage the inclusion of cultural aspects of care in nursing curricula. This, of course, underscores the importance of the purpose, goal, and objectives for Transcultural Concepts in Nursing Care, Seventh Edition. Purpose: To contribute to the development of theoretically based transcultural nursing knowledge and the advancement of transcultural nursing practice. Goal: To increase the delivery of culturally competent care to individuals, families, groups, communities, and institutions. Objectives: 1. To apply a transcultural nursing framework to guide nursing practice in diverse health care settings across the lifespan. 2. To analyze major concerns and issues encountered by nurses in providing transcultural nursing care to individuals, families, groups, communities, and institutions. 3. To expand the theoretical bases for using concepts from the natural and behavioral sciences and from the humanities to provide culturally competent nursing care. 4. Provide a contemporary approach to transcultural nursing that includes effective crosscultural communicat … Nursing Transcultural Nursing Theory Discussion