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Identify a Nursing Theory and Align the Concepts From the Theory to Strategies That Can Aid Healthcare Workers in the Delivery of Culturally Sensitive Care

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The U.S. is expanding culturally at an unprecedented rate

According to a study published by the American Association of Colleges of Nursing, 37% (more than a third) of the American population are individuals from racial and ethnic minorities. It’s estimated that by the year 2043, they will no longer be the minority. Unfortunately, only 19% of RNs in the workforce are from racial or ethnic minority backgrounds and this disparity has presented a number of challenges in caring for a culturally diverse population. The number of ethnically and culturally diverse groups is growing, and each has its own cultural traits. Additionally, some racial groups present unique health challenges specific to that group. From triage to discharge, nurses spend an increasingly significant amount of time with their patients, making it critical for them to become culturally competent. Cultural competency in the health care sector supports positive patient outcomes and improves medical research accuracy.

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In Canada, the general population is becoming increasingly diverse in colour, culture, religion, ethnicity, and origin

Data suggest that in 2011, 20 per cent of the Canadian population were immigrants, and projections are that the percentage of immigrants in Canada will continue to increase. The influx of immigrants to Canada has been characterized by sustained immigration and an increased diversification of immigrants, which has been designed to meet Canada’s economic needs and to provide a welcome refuge for vulnerable refugees. The number of new immigrants and their geographical locations could affect the ethnocultural diversity of various regions in Canada. For example, the top ten countries from which immigrants come to Saskatchewan have been Philippines, India, China, Pakistan, Ukraine, United Kingdom, United States, Bangladesh, Iraq, and South Africa. Such changes to the cultural reconfiguration of the prairie landscape will affect workplace diversity. These changes have led to a growing challenge in nursing leadership related to the management of a culturally diverse work environment. Cultural and generational differences related to attitudes, beliefs, work habits, and expectations have proven to be challenging for nurse leaders and will continue to be a critical managerial and leadership priority. Demographics, language, education, cultural, gender, race, and generational differences are factors that have increased conflict within health care teams, which is associated with burnout and decreased job satisfaction. When conflict and disharmony occur within a team, the nurse leader plays a significant role. Results of misunderstandings and misinterpretations related to cultural and generational differences can be costly to organizations as they can result in increased absenteeism, decreased staff satisfaction, and decreased quality patient care. Cultural diversity in our country requires that nurses become culturally knowledgeable and conscious of their attitudes toward people from other ethnocultural groups. Issues of race and ethnicity are often conflated and emerge as problematic issues arising from cultural conflicts or misunderstandings between individuals and groups. It is, therefore, important to understand the differences between ethnicity and race.

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Transcultural nursing has been integrated into modern nursing education due to the increased heterogeneity of patient populations. As more people from a variety of cultures and with a variety of ethnicities now utilize healthcare facilities, nurses need to be aware of their varying perceptions and levels of tolerance for healthcare. This situation can lead to departures from the practice norms that would otherwise direct patient care, thus opening up a wide array of options regarding treatments and follow-ups. Decision making in patient care involves many important considerations, including patients' attitudes and how they will react to treatment advice [Dayer-Berenson L, 2010]

For these reasons, the adaptability of nursing professionals is crucial, particularly when it comes to cultural diversity, because this issue can affect the quality of service provided to patients. Nurses should have sufficient information about different cultural backgrounds and customs to be able to conduct holistic patient assessments. For optimal care, the completion of a thorough assessment is particularly important when a patient comes from a different culture. The provision of high-quality care builds patients' comfort and confidence in the healthcare system while promoting patient satisfaction [Tucker C, Roncoroni J, Sanchez J,2015]. Therefore, the assessment process should be designed to be accurate, comprehensive, and systematic; in essence, it should assist nurses in reaching concrete conclusions regarding suitable patient interventions. To this end, researchers have developed models to help nurses overcome challenges when caring for culturally diverse patients. These models were designed to encourage culturally appropriate and culturally competent care, and the developers of the models emphasize how nurses can use this skill to work effectively with any population. Following an introduction to transcultural nursing, this paper includes the comparison of four prominent models of cultural competence: Leininger, Giger and Davidhizar, Purnell and Campinha-Bacote. It also discusses the application of these models with respect to the present literature and outlines the recommended standards for achieving best practices.

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As shown above, medical educators should partner with social scientists, anthropologists and researchers to develop and evaluate educational programs to improve the patient centeredness and cultural competence of health professionals. Those responsible for ensuring health system quality should employ measurement of both patient centeredness and cultural competence as part of the process of delivering high-quality care

Finally, all patients should take advantage of every opportunity to provide feedback (e.g., participate in surveys and focus groups) to improve the design and evaluation of healthcare systems that reflect patients’ diverse needs and preferences.

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Andrews MM, Boyle JS (2008) Transcultural concepts in nursing care (5th edn.) Wolters Kluwer Health, Philadelphia, PA.

Dayer-Berenson L (2010) Cultural competencies for nurses: Impact on health and illness. Jones and Bartlett, Sudbury, MA.

Higginbottom GMA, Richter MS, Mogale RS, Ortiz L, Young S, et al. (2011) Identification of nursing assessment models/tools validated in clinical practicefor usewith diverse ethno-cultural groups: An integrative review of the literature. BMC Nursing 10: 16.

National Center for Cultural Competence (2010) Welcome to the curricula enhancement module series.

Tucker C, Roncoroni J, Sanchez J (2015) Patient-centered, culturally sensitive healthcare. American Journal of Lifestyle Medicine 9: 64-77.

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