June Miller

Development of a cultural competence assessment instrument

This article describes initial testing of an instrument designed to provide evidence of cultural competence among health care providers and staff. The Cultural Competence Assessment (CCA) instrument was based on a model describing cultural competence components (fact, knowledge, attitude, and behavior). Content and face validity were confirmed through expert panel review, subject feedback, and field-testing. The CCA was administered to an interdisciplinary health care team in a community hospice setting. Preliminary findings suggest that the CCA performed well. Internal consistency reliability for the scale was 0.92. Construct validity by factor analysis demonstrated that 25 items had loadings above 0.42. Construct validity was supported with a significant correlation to the widely used Inventory for Assessing the Process of Cultural Competence among Health care Professionals (IAPCC). Validity also was supported by significant differences between individuals with different educational levels and prior diversity training. The CCA is a promising tool to measure cultural competence in populations with a wide range of educational levels and backgrounds.

Culturally Congruent Care Putting the Puzzle Together

This article presents the 3-D puzzle model of culturally congruent care, defines the levels and constructs employed by this model, presents some assumptions, and lays out some basic propositions as a foundation for further work. There are many extant frameworks and theories of culture and cultural competence in nursing and health care; the model presented here draws heavily from prior work and is an attempt to present a synthesis of concepts and processes in a new way. The ideas presented here build particularly on pioneering work in transcultural nursing by Leininger. Leiningers work specifically focuses on the use of qualitative methods to understand the ways in which culture influences nursing care from an emic, or insider, perspective. The 3-D puzzle model extends Leiningers work to include concrete articulations of constructs relevant to design and implementation of intervention strategies for teaching and measuring competency among nurses and other providers.

Collaborative Partnership for Culture Care: Enhancing Health Services for the Arab Community

The purpose of this study was to discover perceptions, experiences, and patterns of health care behavior among Arab Americans in an urban Midwestern area of the United States and then to discover perceptions and experiences of health care providers related to culturally competent care. The goal of the study was to generate findings that would provide the basis for implementing system-wide changes to include culturally competent care. A qualitative focus group methodology was used to discover the care patterns and perceptions of Arab Americans and the local health care providers. The nurse researchers conducted 10 focus groups. Six themes were identified, including the unique caring behaviors of Arab families, the complexity of the health care system to Arab Americans, communication gaps, the diversity of perceptions of cultural competency, obstacles to accessibility of care, and workforce diversity issues.

Standards of Practice for Culturally Competent Nursing Care: A Request for Comments

Authors’ Note: This document was developed through collaboration of members of The american academy of Nursing expert Panel on global Nursing and Health and The Transcultural Nursing Society, with participation by members of The american academy of Nursing expert Panel on Cultural Competence. Sharon M. Weinstein, MS, CRNI, RN, FaaN, Larry Purnell, PhD, RN, FaaN, Cheryl Leuning, PhD, RN, and Ruth Davidhizar, DNS, RN, aRNP, BC, FaaN, also participated in the discussion and critique during the development of this document. Standards of Practice for Culturally Competent Nursing Care: A Request for Comments

Transcultural Nursing Society Position Statement on Human Rights

In 2006, the Transcultural Nursing Society created a business plan with a firm commitment to social change and the support of human rights. One of the primary goals of the plan was to seek recognition from the United Nations as a Human Rights Organization. As a first step in articulating this goal, the board of trustees of TCNS tasked a small group of Transcultural Nursing Scholars to develop a position statement. This article is the culmination of the collaborative task forces efforts to define how TCNS seeks the fulfillment of human rights for people of all cultures worldwide.

Context of Care for Jordanian Women

The purpose of this research study was to document, describe, and analyze diverse and universal care patterns for Jordanian women. The authors used a qualitative design of observation-participation and interview data collected from 15 women in two cities and three villages in Jordan over a 4-month period. Methods used incorporated Leininger’s theory of culture care diversity and universality as well as the ethnonursing research method. Themes discovered from the data include (a) culture of caring connectedness, (b) caring for family honor: the agony and the ecstasy, (c) Islam as feminist thought, (d) political care as intertwined with tribal and religious influences, and (e) reviving Rufaida: return to community care. Findings are being used for collaborative curriculum design for new community health nursing roles focusing on women’s health.

Community Transformation Through Culturally Competent Nursing Leadership: Application of Theory of Culture Care Diversity and Universality and Tri-Dimensional Leader Effectiveness Model

Transcultural knowledge and competency have become a critical need for nurses to accommodate the global trends in cultural diversity and health care disparities. Today, nurses are increasingly taking on leadership roles in community settings. This article addresses the application of Leininger’s culture care theory with the sunrise model and Hersey and Blanchard’s tri-dimensional leader effectiveness model as potential collaborating theories for capacity building and community transformation from a global, transcultural nursing perspective. The two theories, used in collaboration, view the provision of competent leadership as the delivery of effective, culturally congruent nursing care in promoting health and health equity at the community level.

Politics and Care: A Study of Czech Americans Within Leininger's Theory of Culture Care Diversity and Universality

The domain of inquiry for this study was the influence of the American political environmental context on professional and generic care patterns, expressions, and meanings of Czech American immigrants. The purpose of the research was to document, describe, interpret, and analyze the diversities and universalities of professional and generic care for this cultural group, to provide culturally congruent care to Czech Americans, and to explicate the role of politics as an influence on care patterns, health, and well being. The researchers former transcultural ethnonmursing study in Prague, Czechoslovakia in 1991 served as a stimulus for this in-depth study on politics and care. Twelve key and twenty general informants were identified. interviewed. Five major themes were identified. The researcher discovered that the capitalist economic market structure of the United States influencedi informant lifeways in all dimensions of Leiningers Theory of Culture Care Diversity and Universality, as depicted in the Sunrise Model. Specific care patterns discovered included care as choice, care as responsibility, and care as helping each other. Findings related to professional and generic care supported researcher predictions that generic culture care patterns would be important to immigrats. Provisions for culturally congruent nursing care were articulated based on research fidings.

Developing a Culturally Competent Workforce through Collaborative Partnerships

Inthis article, the authors describe a federally funded project to implement a partnership model involving the Transcultural Nursing Society (TCNS) and two universities that have undergraduate and graduate programs in nursing. The overall goal of the project is to use transcultural nursing as a framework for developing the cognitive, affective, and psychomotor cultural competencies of nursing faculty, practicing .nurses, and nursing students. The purpose of this article is fourfold: (a) to describe the background and environmental context of the TCNS-university partnership; (b) to provide an overview ofthe project objectives, key partners, and organizational structure of the partnership; (c) to discuss the current and future project activities; and (d) to critically examine the benefits of partnering for both the TCNS and the two universities involved in this project.

Meanings of Care by Bereaved Relatives of Homicide Victims in Dar es Salaam, Tanzania Implications for Nursing

Purpose: The purpose was to describe the meanings of care, kutunza, for the deceased and the relatives of homicide victims. The secondary aim was to identify ways in which nurses could best console the families. Method: An ethnonursing method was employed. Relatives of homicide victims in Dar es Salaam, Tanzania, were interviewed at a mortuary, using an interview guide constructed with Leininger’s enablers as major elements. Content analysis was performed according to Leininger’s phases of ethnonursing analysis of qualitative data. Findings: Families of 30 homicide victims were studied. The mean age of the victims was 30.7 years, range 17 to 47 years. All victims, except 1, were male. The informants included 29 relatives and two close friends. The following four themes were identified: (a) providing basic needs, (b) paying attention as if one were kin, (c) consoling through gathering, and (d) caring for each other. Conclusions: Care is manifested by respectful attention to the preparation of the deceased and by providing an environment by which the community can gather to console the bereaved family. Implications for Nursing: Respectful preparation of the deceased’s body is essential. Nurses can provide emotional support to the families and find an area where the extended family can grieve and console each other.PURPOSE: The purpose was to describe the meanings of care, kutunza, for the deceased and the relatives of homicide victims. The secondary aim was to identify ways in which nurses could best console the families. Method: An ethnonursing method was employed. Relatives of homicide victims in Dar es Salaam, Tanzania, were interviewed at a mortuary, using an interview guide constructed with Leiningers enablers as major elements. Content analysis was performed according to Leiningers phases of ethnonursing analysis of qualitative data. FINDINGS: Families of 30 homicide victims were studied. The mean age of the victims was 30.7 years, range 17 to 47 years. All victims, except 1, were male. The informants included 29 relatives and two close friends. The following four themes were identified: (a) providing basic needs, (b) paying attention as if one were kin, (c) consoling through gathering, and (d) caring for each other. Conclusions: Care is manifested by respectful attention to the preparation of the deceased and by providing an environment by which the community can gather to console the bereaved family. IMPLICATIONS: Respectful preparation of the deceaseds body is essential. Nurses can provide emotional support to the families and find an area where the extended family can grieve and console each other. Language: en