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Providing culturally appropriate care is a challenge for the advanced practice nurse.. The phenomena of communication according to Giger and Davidhizar’s model can shape care. Describe appropriate ways to communicate with patients from various cultures.

Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses should be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text) for both posts. Refer to the Grading Rubric for Online Discussion in the Course Resource section.

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As in all relationships, communication is the key to understanding and respect. For health care professionals it is particularly a challenge. Our health care language itself can be confusing in any culture. The use of translators can have a powerful impact on dialogue and safety and it is vital to be aware of non-verbal and societal cues as well.

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Jeff MahoneySubscribe
Jeffrey Mahoney posted Aug 31, 2021 11:28 AM
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For instance, an advanced practice nurse may notice that an Amish child may exhibit the physical symptoms of pain but not express it verbally (Davidhizar et al., 2006). A provider may also note that some Asian cultures consider avoiding eye contact as respectful (Davidhizar et al., 2006). It is also interesting to consider how language directs cultures. For example, Davidhizar et al. (2006) illuminates the German wording for a job is the English equivalent to vocation. As such, Germans view their work as a calling and are far less likely to leave their workplace. Davidhizar, R., Giger, J. N., & Hannenpluf, L. W. (2006). Using the Giger-Davidhizar transcultural assessment model (GDTAM) in providing patient care. The Journal of Practical Nursing, 56(1), 20-5.less5 UnreadUnread13 ViewsViews
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View profile card for Francesca Provencher
Last post September 6 at 10:48 AM by Francesca Provencher
Giger, J. N., & Davidhizar, R. (2002). The Giger and Davidhizar transcultural assessment model. Journal of Transcultural Nursing, 13(3), 185-188. https://doi.org/10.1177/10459602013003004
References
As a provider, we must be mindful of these differences in culture. Additionally, it can be helpful to obtain a medical dictionary of commonly encountered languages, educational material in those languages, and utilizing a translator whenever possible (Davidhizar et al., 2006).
According to Giger and Davidhizar’s transcultural assessment model (2002), the culturally competent advanced practice nurse must keep in mind that patient’s will vary in terms of environment, biological variations, time, space, social organization, and communication. Similarly, communication can vary by dialect, language style, volume of speech, touch, context of speech or tone, and kinesthetics (Davidhizar et al., 2006).
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Frances Hall posted Aug 30, 2021 3:22 PM
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Intercultural communication in nursing is face-to-face, verbal or nonverbal communication that occurs between people of different cultures. Its defining attributes are (1) meeting between language and culture for a specific purpose and (2) face-to-face (in-person or virtual) human interaction between individuals from different cultures (Mosed et al., 2021).The LEARN (Listen, Explain, Acknowledge, Recommend, Negotiate) model is a framework for cross-cultural communication that helps build mutual understanding and enhance patient care (Ladha et al., 2018). I liked this model as it helps in better communication, and it starts by listening and bringing an attitude of curiosity and humility to promote trust and understanding. I also feel that negotiating with patient and their families regarding culturally relevant approaches also creates trust and forms a better partnership. Albougami, A. (2016). Comparison of four cultural competence models in transcultural nursing: A discussion paper. International Archives of Nursing and Health Care, 2(4). https://doi.org/10.23937/2469-5823/1510053Mosed, H., Periord, M., & Caboral‐Stevens, M. (2021). A concept analysis of intercultural communication. Nursing Forum. https://doi.org/10.1111/nuf.12622more1 UnreadUnread6 ViewsViews
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View profile card for Jerrica Goins
Last post September 5 at 10:01 PM by Jerrica Goins
Ladha, T., Zubairi, M., Hunter, A., Audcent, T., & Johnstone, J. (2018). Cross-cultural communication: Tools for working with families and children. Paediatrics & Child Health, 23(1), 66–69. https://doi.org/10.1093/pch/pxx126
References
According to Giger and Davidhizar, there are six dimensions common to every culture: communication, space, social organization, time, environmental control, and biological variation(Albougami, 2016). The first dimension is communication, which is the holistic process of human interaction and conduct. The use and preservation of communication takes several forms verbal, nonverbal, and written and differs in terms of expression, language and dialect, voice tone and volume, context, emotional implication, facial expression, gestures, and body language. Language can become a barrier to quality healthcare due to simple misunderstandings and failure to communicate as intended (Albougami, 2016).
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Jerrica Goins posted Sep 1, 2021 9:09 PM
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Communication is a foundational principle that connects people and allows interactions to take place. Communication is a crucial component in all steps of the health care process. Improved awareness helps eliminate assumptions made during care and gives voice to patients, so they can adequately express their concerns. Cultural competence includes providing effective health care across diverse cultures by working collaboratively and communicating effectively (Ladha et al., 2018). Understanding cultural diversity in nursing also helps close the gap in health equity, reducing health disparities affecting minority populations such as higher morbidity rates and lower-quality care. Crosscultural communication includes strategies that acknowledge individual cultural traditions, avoid generalizing a patient’s beliefs or values based on cultural norms, and take into account one’s own beliefs, values, and experiences (Brown et al., 2016). Using shared language during conversation is an effective strategy when communicating across cultures. Another communication strategy is the ask-tell-ask which engages in culturally competent communication. This framework encourages a two-way conversation, in which the patient is first asked for their input that will provide the clinician with an understanding of the kinds of information desired and ways to communicate the information. Finally, the patient will teach back what they have heard to ensure that the clinician gave information in a way that is easily understood. Additionally, being aware of non-verbal communication is equally as important as it can be interpreted in different ways by other cultures.References Ladha, T., Zubairi, M., Hunter, A., Audcent, T., & Johnstone, J. (2018). Cross-cultural communication: Tools for working with families and children. Paediatrics & Child Health, 23(1), 66–69. https://doi.org/10.1093/pch/pxx126less1 UnreadUnread2 ViewsViews
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View profile card for Emily Meeks
Last post September 5 at 4:01 PM by Emily Meeks
Brown, E. A., Bekker, H. L., Davison, S. N., Koffman, J., & Schell, J. O. (2016). Supportive Care: Communication Strategies to Improve Cultural Competence in Shared Decision Making. Clinical Journal of the American Society of Nephrology, 11(10), 1902–1908. https://doi.org/10.2215/cjn.13661215
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Donna Wrobel posted Sep 1, 2021 1:21 PM
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Giger and Davidhizar developed the Transcultural Assessment Model in order to guide patient care to culturally diverse populations. The model illustrates that all individuals are unique and that their care should be determined based on their distinct needs and beliefs. They determined that culture is based on beliefs and experiences in six areas: communication, time, space, social organization, environmental control and biological variations. According to the model, communication refers to the methods and means that beliefs and customs are exchanged among people in a specific cultural group. Communication occurs from verbal and nonverbal interactions and often can be the cause of difficulties in working with patients from different cultural backgrounds (Giger & Davidhizar, 2002).Communication also is important when the spoken language is the same, but the patient is a member of a different culture, such as with patients who have a mental illness or patients who identify as gay or transgender. Providers must be sensitive to the needs of these populations and utilize verbal and body language that is inclusive and respectful. Providers should be especially sensitive to socioeconomic and psychological needs regarding employment, housing and income as these can affect access to care (Safran et al., 2009). When discussing behaviors and beliefs with the patient, the provider must exhibit compassion so that the patient does not feel criticized. They should encourage and assist clients to participate in their own care in order to establish health-related goals, plans and interventions so that health outcomes can be improved (Okeya, 2021).ReferencesMcElfish, P., Long, C. R., Rowland, B., Moore, S., Wilmoth, R., & Ayers, B. (2017). Improving culturally appropriate care using a community-based participatory research approach: Evaluation of a multicomponent cultural competency training program, arkansas, 2015–2016. Preventing Chronic Disease, 14. https://doi.org/10.5888/pcd14.170014Safran, M. A., Mays, R. A., Huang, L., McCuan, R., Pham, P., Fisher, S., McDuffie, K. Y., & Trachtenberg, A. (2009). Mental health disparities. American Journal of Public Health, 99(11), 1962–1966. https://doi.org/10.2105/ajph.2009.167346less1 UnreadUnread3 ViewsViews
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View profile card for Jahenein Nagel
Last post September 5 at 12:12 PM by Jahenein Nagel
Okeya, O. E. (2021). A critical analysis of transcultural nursing. International Journal of Scientific Development and Research, 6(1), 31–34.
Giger, J., & Davidhizar, R. (2002). The giger and davidhizar transcultural assessment model. Journal of Transcultural Nursing, 13(3), 185–188. https://doi.org/10.1177/10459602013003004
In general, communication can dictate the patient’s perception of whether the care they receive is appropriate and can influence their health outcomes. Providers should make every effort to learn and understand the practices and beliefs of their patients in order communicate effectively as this is ultimately their responsibility.
As the US becomes more culturally diverse, it is important that healthcare providers make every effort to practice culturally competent care. The first step that providers should take is to examine their own beliefs and practices in order to uncover any hidden biases. One study discovered evidence of racial bias in interpersonal interactions between providers and patients of Hispanic culture undermined the care relationship resulting in decreased health outcomes (McElfish et al., 2017). Healthcare providers should learn about the cultural beliefs of the populations in their areas and make behavioral changes to facilitate better communication between themselves and their patients. Some techniques include learning and incorporating knowledge of cultural beliefs such as the significance of foods and natural medicines in plans of care. Understanding family dynamics when discussing health issues with the patient and utilizing visual cues such as body language or tone of voice may indicate when a patient is experiencing discomfort. Written materials and signage should be translated into commonly utilized languages to be more accessible to patients and healthcare interpreters can be utilized to ensure that patients can easily communicate with the provider, rather than relying on family members to communicate for them. Training is available for providers to learn basic medical terminology in other languages, which indicates a willingness to learn and to help facilitate better communication (McElfish et al., 2017).
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Julie Robichaud posted Aug 30, 2021 4:00 PM
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There are many ways to communicate with patients from various cultures. The Giger and Davidhizar Transcultural Model provides a framework for assessing and assisting with communication (Giger & Davidhizar, 2002). There are six cultural phenomena: communication, time, space, social organization, environmental control, and biological variations (Giger & Davidhizer, 2002). Communication encompasses the patient and provider interaction. Communication should be clear, both verbally and nonverbally. The specific culture needs are important in making this happen. Space is another consideration regarding different cultures when it comes to personal distance. This should be assessed prior to the interaction because it can deter treatment or upset the balance that has already taken place. Social organization and family structure need to be assessed. Many cultures live as a family structure and want everyone involved in their care. Time is an important consideration because different cultures can be past, present, or future oriented (Gigor & Davidhizer, 2002). This could impact preventative care. Environmental control may be different in many cultures. There should be a variety of clinical settings available for healthcare services related to cultural preferences. This will create a safe and comfortable space. Biological variations are prevalent among racial groups (Giger & Davidhizer, 2002). Culture, genetics, and race all need to be recognized when providing healthcare. Giger, J.N. & Davidhizer, R. (2002). The Giger and Davidhizer transcultural assessment model. Journal of Transcultural Nursing, 13(3). https://doi.org/10.1177/10459602013003004Jongen, C., McCalman, J. & Bainbridge, R. (2018). Health workforce cultural competency interventions: A systemic scoping review. BMC health services research, 18(1). https://doi.org/10.1186/s12913-018-3001-5less2 UnreadUnread9 ViewsViews
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View profile card for Emilia Rodriguez
Last post September 5 at 2:06 AM by Emilia Rodriguez
Gopalkrishnan, N. (2019). Cultural competence and beyond: Working across cultures in culturally dynamic partnerships. The International Journal of Community and Social Development, 1(1). https://doi.org/10.1177/2516602619826712
Cultural competence is necessary in transcultural nursing. According to Gopalkrishnan (2019), there are three elements in cultural competence: the affective element, the cognitive element, and the behavioral element. The affective element helps build positive relationships through sensitivity, openness, and respect (Gopalkrishnan, 2019). The cognitive element includes becoming knowledgable about the culture and the behavior element involves learning the skills that are needed for the patient/provider relationship (Golpalkrishnan, 2019). To ensure cultural competence across the board, education and training in healthcare facilities have shown benefit (Jongen et al., 2018). More research with evidence-based knowledge is needed on the evaluation and application of knowledge, and the impact of cultural competent interventions (Jongen et al, 2018).
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Gisselle Mustiga posted Aug 31, 2021 9:43 PM
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The patient’s cultural background has a significant impact on how they behave. Therefore, nurses need to be aware of and respect the culture of the patient they are caring for, even when it is different from theirs (Andrews et al., 2020). This is important because the patient will view the nurse as sensitive and exceptional and even incompetent in their work. The most appropriate way of communicating with patients from a different culture is to view them as individuals and not assume that all people from a particular culture behave and think the same way. In addition, nurses should find more information about the culture of the patient using a questionnaire or the culture assessment tool and record them to be used by other healthcare team members involved (Sagar, 2014). Notably, nurses could practice enhancing communication in patients with different cultures are; greeting the patient using their last name, using simple terms during an assessment, and using any word from a patient’s language that they know and is appropriate. Andrews, M., Boyle, J., & Collins, J.W. (2020). Transcultural concepts in nursing care (8th ed.). Wolters Kluwer. New York, NY: Pearson.Sagar, P. L. (Ed.). (2014). Transcultural Nursing Education Strategies. Springer Publishing Company.less1 UnreadUnread2 ViewsViews
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View profile card for Idida Aleman Musial
Last post September 4 at 10:08 PM by Idida Aleman Musial
Giger, J. N., & Haddad, L. (2020). Transcultural Nursing-E-Book: Assessment and Intervention. Elsevier Health Sciences.
References
Moreover, nurses should always prioritize modesty according to the patient’s cultural preferences when practicing their profession. For instance, some Islamic and Jewish women believe that clothing covering their legs, arms, and legs is modesty. Nurses should therefore respect their culture by ensuring that they remain covered during healthcare procedures and treatments. Also, the perspective of the patient and families might conflict with nursing guidelines when a patient does not want to be informed about their sickness and prefer the family to take the burden of making decisions for themselves. In as much as this conflict with the issue of full disclosure and informed consent, nurses should respect these opinions (Giger, 2020). They should not reveal the patient’s condition on their own, which will bring up the issue of cultural conflict.
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Emilia Rodriguez posted Sep 1, 2021 6:49 PM
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Culturally-Appropriate Communication Another strategy is practicing active listening which is an important tool for improving cross-cultural communication. It involves summarizing or restating the words of the other person that the nurse communicates with to ensure that they have been understood correctly. It also involves frequent asking of questions in areas in which the nurse needs clarification (Li et al., 2017). This method of communication is essential for building a rapport in cross-cultural communication and in ensuring that crucial information is not missed or misunderstood. The final strategy is to be supportive in the communication process. Effective communication with members of different cultures is dependent on all parties feeling comfortable( Derrington, Paquette & Johnson, 2018). In engaging patients, it is necessary to be respectful and to encourage them when they give their responses which help in building their confidence and establishment of trust.Betancourt, J. R., Green, A. R., & Carrillo, J. E. (2019). Cross-cultural care and communication. UpToDate, Waltham, MA Accessed, 7.Li, C., Son, N., Abdulkerim, B. A., Jordan, C. A., & Son, C. G. E. (2017). Overcoming communication barriers to healthcare for culturally and linguistically diverse patients. North American Journal of Medicine and Science, 10(3). https://doi.org/10.7156/najms.2017.1003103]more2 UnreadUnread1 ViewsViews
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View profile card for Jennifer Johnson
Last post September 4 at 4:11 PM by Jennifer Johnson
Derrington, S. F., Paquette, E., & Johnson, K. A. (2018). Cross-cultural interactions and shared decision-making. Pediatrics, 142(Supplement 3), S187-S192. https://doi.org/10.1542/peds.2018-0516J
References
Communication in a manner that is appropriate to different cultures means that advanced practice nurses must find a way of communicating effectively to the patients while also accepting and respecting the existing cultural differences. It is important to take into consideration the cultures of the patients before engaging them. Nurses that are aware of their own cultures, as well as the cultural backgrounds of patients, are better placed to achieve mutual understanding in their encounter with the patient (Betancourt, Green & Carrillo, 2019). Understanding the values, preferences, and beliefs of patients also helps in focusing on culturally appropriate health care interventions. There are several communication strategies that can be used in communicating with patients from various cultures. The first strategy is to make use of open-ended questions. This will help in ensuring the patients provide a comprehensive response to questions as opposed to saying yes or no without explaining the context of their answers. The provision of more information enables the nurse to understand the cultural perspective and beliefs of the patients.
Kadijatu SesaySubscribe
Kadijatu Sesay posted Sep 1, 2021 9:07 PM
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The ability to communicate effectively with people from different cultures is very important in all aspects of care. Healthcare providers need to be aware of personal values involving provider-patient relationships as well as how culture may be impacting the health and management of an illness. Ineffective cross-cultural communication can negatively impact patients’ health through misdiagnosis, frequent hospital admission, or inability to effectively comply with treatments plans, (Kodjo, 2009). Communication is important in every culture and communicating with patients based on their cultural belief and practices is important and as advanced practice nurses (APN) we need to acquire the necessary cultural competence to be better able to communicate with our patients effectively, based on their healthcare beliefs, values, and customs Andrews, M M., Boyle, J. S., & Collins, J. W. (2020). Transcultural concepts in nursing care (8th ed.). Wolters Kluwer. less1 UnreadUnread0 ViewsViews
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View profile card for Laura Riccardi
Last post September 4 at 11:47 AM by Laura Riccardi
Albougami, A. S., Pounds, K. G., & Alotaibi, J. S. (2016). Comparison of four cultural competence models in transcultural nursing: A discussion paper. International Archives of Nursing Care, 2(4), 1-5.
Kodjo, C. (2009, February). Cultural competence in clinician communication. Pediatrics in review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719963/.
References:
There are several ways to effectively communicate with patients from different cultures and ethnicity. Giger and Davidhizar’s Transcultural Assessment Model uses six different dimensions to explain and support the importance of the uniqueness of each culture (Albougami et al., 2016). These six dimensions are space, social organization, communication, time, biological variation, and environmental control (Albougami et al., 2016).. Communication is how individuals interact in either verbal, non-verbal, or written expression (Albougami et al., 2016). Cultures often differ in communication by having tones, volume, or facial expressions that are specific to their culture (Albougami et al., 2016). Additionally, an individual’s culture can affect their expectations and views of healthcare (Andrews et al., 2020). As a provider, communication is used in several ways, such as gathering a patient’s health history, developing goals of care, and providing education.
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Emily Meeks posted Sep 1, 2021 9:14 PM
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While the current population is becoming increasingly more diverse, advance practice nurses are also needing to change their approach to providing culturally competent care for all patients. In reviewing Giger and Davidhizar’s (2002) assessment model, the advanced practice nurse is able to identify the six dimensions necessary for providing culturally sensitive care; communication, time, space, social organization, environmental control, and biological variation.ReferencesPhiladelphia, PA: Wolters Kluwer.of transcultural nursing, 13(3):185-188. http://doi.10.1177/10459602013003004less1 UnreadUnread9 ViewsViews
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View profile card for Evelyn Anderson
Last post September 3 at 9:38 PM by Evelyn Anderson
Giger and Davidhizar (2002). The Giger and Davidhizar transcultural assessment model. Journal
Andrews, M., Boyle, J., & Collins, J. (2020). Transcultural concepts in nursing care. (8th ed.)
Communication, including verbal and nonverbal, is a key aspect in one’s life and essential for delivering care. Yet, creates a barrier when others are from a different culture and/or speak a different language. Methods in which to appropriately communicate with patients could include, utilizing a qualified translator. In my hospital, this can be done by means of in-person, telephone and video chat. It is also important to assess if one device is preferred over another, as I have found some cultures do not appreciate a telephone or even a particular gender. Another manner, is speaking in Lamins terms, or simply explaining not using medical jargon. It is essential to communicate in an unrushed pace and validate their understanding when needed (Andrews et al., 2020). Health literacy could be barrier, making it important to ensure the patient received the message that the advanced practice nurse is trying to convey.
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Heather Stetson posted Sep 1, 2021 10:41 AM
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https://doi.org/10.1177/1043659616676319Merritt, L. (2013). Communicating with Chinese American families in the NICU using the Giger and Davidhizar transcultural model. Neonatal Network, 32(5), 335-341. https://doi.org/10.1891/0730-0832.32.5.335less1 UnreadUnread2 ViewsViews
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View profile card for Jeffrey Mahoney
Last post September 3 at 1:15 PM by Jeffrey Mahoney
Harding, S. (2017). Self-stigma and veteran culture. Journal of Transcultural Nursing, 28(5), 438-444.
As advanced practice nurses (APNs) communicating in a clear, concise, and effective manner with our patients is essential to providing safe patient care. However, this may be a challenge, especially when communicating with individuals from various cultures. To overcome potential challenges the APN will need to first examine his or her own cultural beliefs and address any cultural biases. Frameworks such as Giger and Davidhizar’s Transcultural Nursing model can serve as a useful guide for APNs to utilize for the assessment and facilitation of effective communication practices within different cultures. This model emphasizes the uniqueness of the individual despite the cultural influences the person may have experienced throughout their lifetime (Merritt, 2013). According to Harding et al. (2017), “communication encompasses all verbal and nonverbal communication” (p. 438). Appropriate ways we can communicate with our patients from various cultures is through being aware and respectful of communication styles specific to that patient such as their voice quality, pronunciation, enunciation, use of silence, and use of nonverbal gestures (Merritt, 2013). For example, some cultures such as Chinese Americans may view the health provider as a person of authority and therefore may not ask clarifying questions or simply nod their head in agreement (Merritt, 2013). In this instance the APN can improve communication by observing the patient’s verbal and nonverbal cues, communicating in a non-threatening manner, and encourage the patient to ask questions.
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Idida Aleman Musial posted Aug 31, 2021 7:31 PM
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Providing culturally appropriate care can be challenging for nurse practitioners; Giger and Dabidhizar’s model is a great tool in nursing research that provides excellent examples on how to deliver quality care. As humans we have a tendency to make assumptions and we are quick to judge others that are different from us. Educating ourselves on other cultures can help us identify effective ways to communicate with others (Degrie, et al 2017). For example, in my situation, by being Latina doesn’t mean that I am catholic, which is a common presumption. I also don’t eat pork or shellfish because of my former religious preference. Our religious and cultural preferences can impact quality of care (Saunders, et al. 2019), being aware and open to educating ourselves on different cultures can improve the quality of care. less1 UnreadUnread2 ViewsViews
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View profile card for James Neal
Last post September 3 at 1:02 PM by James Neal
Van Keer, R. L., Deschepper, R., Huyghens, L., & Bilsen, J. (2017). Mental well-being of patients from ethnic minority groups during critical care: A qualitative ethnographic study. BMJ Open, 7(9), e014075-e014075. https://doi.org/10.1136/bmjopen-2016-014075
Saunders, R. P., Wilcox, S., Jake-Schoffman, D. E., Kinnard, D., Hutto, B., Forthofer, M., & Kaczynski, A. T. (2019). The faith, activity, and nutrition (FAN) dissemination and implementation study, phase 1: Implementation monitoring methods and results. Health Education & Behavior, 46(3), 388-397. https://doi.org/10.1177/1090198118818235
Degrie, L., Gastmans, C., Mahieu, L., Dierckx de Casterlé, B., & Denier, Y. (2017). “how do ethnic minority patients experience the intercultural care encounter in hospitals? a systematic review of qualitative research”. BMC Medical Ethics, 18(1), 2-2. https://doi.org/10.1186/s12910-016-0163-8
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By asking the patients questions and being open to learning about others during initial assessment, we are provided with an opportunity to learn about our patient and enhance care. Questions like, “tell me about your childhood” can provide us an idea of social assessment and the type of environment that the individual grew up in (Van Keer, et al. 2017).
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James Neal posted Sep 2, 2021 1:44 PM
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In their model, Giger and Davidhizar (2002) identified six dimensions of a cultural phenomenon through which each individual should be assessed; they identified communication as perhaps the most challenging aspect in providing optimal transcultural care. The act of care itself may be perceived differently in each culture. For example, placing a reassuring hand on someone’s shoulder may be perceived as a comforting gesture by a middle-aged, white American. However, touching an Orthodox Jew of the opposite sex is prohibited in that culture, and would be received very differently (Galanti, 2000). ReferencesGiger, J., & Davidhizar, R. (2002). The giger and davidhizar transcultural assessment model. Journal of Transcultural Nursing, 13(3), 185–188. https://doi.org/10.1177/10459602013003004less0 UnreadUnread
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Galanti, G.-A. (2000). An introduction to cultural differences. Western Journal of Medicine, 172(5), 335–336. https://doi.org/10.1136/ewjm.172.5.335
At the same time that we must be aware of cultural differences to aid our communication, we must also take care not to stereotype or make broad generalizations about groups of people (Galanti, 2000). Again, as Giger and Davidhizar remind us, each individual is unique.
In order to effectively communicate, one must be aware and mindful of the cultural background of the person receiving care. At the center of Giger and Davidhizar’s model is their assumption that each individual is culturally unique (2002). Therefore, we must carefully assess their cultural background as best as we can in order to provide culturally congruent care.
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Evelyn Anderson posted Sep 1, 2021 11:48 PM
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Health care providers can be the first to see a patient seeking care. The communication that is established between the patient and the health care provider is essential to establish a working, effective relationship. Culture and language barriers between health care providers and the patient can result in misunderstandings and lack of effective communication (Jongen et al. 2018). Lack of effective communication between provider and patient can lead to the patient not trusting the provider and poor treatment adherence (Jongen, et al. 2018). Cultural awareness and effective communication skills are essential for health care providers to better serve all individuals from any diverse cultural background to provide the best patient care. The Giger and Davidhizars cultural model encompass six areas of assessment that are biological, communication, environment, social organization, space and time (Harding, 2017). All these areas can be used during an assessment of a patient to effectively evaluate and identify a patients’ needs. Language barrier would be the first to identify if a patient needs a translator. Establishing effective communication between the health care provider and the patient establishes the foundation for a working relationship. less0 UnreadUnread
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Kaihlanen, A., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: Qualitative study of nurses’ perceptions about cultural competence training. BMC Nursing, 18(1), 38-38. https://doi.org/10.1186/s12912-019-0363-x
Jongen, C., McCalman, J., & Bainbridge, R. (2018). Health workforce cultural competency interventions: a systematic scoping review. BMC health services research, 18(1), 232. https://doi.org/10.1186/s12913-018-3001-5
Harding, S. (2017). Self-stigma and veteran culture. Journal of Transcultural Nursing, 28(5), 438-444. https://doi.org/10.1177/1043659616676319
References:
One way that a health care provider can understand cultural awareness is by attending cultural competence training. One study concluded on staff cultural training, that when an individual increases their own awareness about their own culture and their own cultural biases, a greater ease of cultural awareness occurs (Kaihlanen et al. 2018).
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Francesca Provencher posted Sep 1, 2021 10:17 PM
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Working in the healthcare field means we work with people from a variety of cultures and backgrounds. It is important as professionals that we provide safe and compassionate care to our patients no matter what that background is. The literature states, nursing is a profession that needs to identify and acknowledge individual cultural beliefs because it directly interferes with the quality and safety of care that is delivered to the patients (Lopes Campelo et al., 2018). One big part of a patient’s culture is the language that they speak. At times this can be an obstacle we could face when dealing with a language barrier. Marriotte (2020) states, roughly 14 million people in the United States 5 years or older do not speak English well or at all. As a nurse I am often responsible for explaining treatment plans, discharge instructions and general education to the patients I care for. A lack of understanding for any of these areas could lead to a bad outcome for the patient.Lopes Campelo, C., Alves de Sousa, S. de M., Carvalho Silva, L. D., Dias, R. S., Ribeiro Azevedo, P., Oliveira Nunes, F. D., & de Souza Paiva, S. (2018). Patient Safety Culture and the Cultural Nursing Care. Journal of Nursing UFPE / Revista de Enfermagem UFPE, 12(9), 2500–2506. https://doi-org.wilkes.idm.oclc.org/10.5205/1981-8963-v12i9a235048p2500-2506-2018https://wilkes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145452390&scope=siteless0 UnreadUnread
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Marriott, E. (2020). Language Barrier & Standard of Care: A Case Example. Journal of Legal Nurse Consulting, 31(3), 22–25.
At our hospital we utilize different techniques when dealing with patients that don’t speak our language, these include, in person translators, phone translators and we also have an iPad so the patient can see who is translating for them. Our discharge instructions can also be printed in a variety of languages. Any time a translation occurs the nurse is required to document that translators ID number so it could be verified if questions ever arise. We also print out pictured menus for patients that do not speak our language so they are able to see what they are ordering in hopes to get food they will enjoy.
Laura Week 1Subscribe
Laura Riccardi posted Aug 30, 2021 5:45 PM
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Registered nurses (RNs) come into contact with many different cultures in their careers. Cultural competency is developed through exposure and experience. Learning how to communicate can make or break a professional relationship. Cultural competency is something that cannot be taught as each individual is unique. It is essential that health care professionals exercise sensitivity in encountering patients as individuals and have a positive attitude towards those living in different circumstances (Marja & Suvi, 2021). Learning to communicate can start with listening to what the patient is saying, respect a patient’s boundaries, ask questions but not probing, being non-judgemental, and positivity can go a long way in a conversation in seeking answers.Giger and Davidhizar’s Transcultural Model assesses people in six cultural phenomena such as communication, space, social organization, time, environmental control, and biological variations (Giger & Davidhizar, 2002). Focusing on nonverbal communication cues is just as important as words. Nurses can learn a lot from body language alone. As a nurse making a good first impression is key to building a trusting relationship. Giger, J., & Davidhizar, R. (2002). The giger and davidhizar transcultural assessment model. Journal of Transcultural Nursing, 13(3), 185–188. https://doi.org/10.1177/10459602013003004Schouten, B. C., Cox, A., Duran, G., Kerremans, K., Banning, L., Lahdidioui, A., van den Muijsenbergh, M., Schinkel, S., Sungur, H., Suurmond, J., Zendedel, R., & Krystallidou, D. (2020). Mitigating language and cultural barriers in healthcare communication: Toward a holistic approach. Patient Education and Counseling, 103(12), 2604–2608. https://doi.org/10.1016/j.pec.2020.05.001less1 UnreadUnread3 ViewsViews
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Last post September 1 at 8:23 PM by Krista Romig
Marja, S.-L., & Suvi, A. (2021). Cultural competence learning of the health care students using simulation pedagogy: An integrative review. Nurse Education in Practice, 52, 103044. https://doi.org/10.1016/j.nepr.2021.103044
References
Understanding an individual’s communication can drive the quality of care. If there is a disconnect in communication it can ultimately delay or have unyielding results. Language barriers can limit communication and treatment. One study showed that patients who receive language-discordant care ask fewer questions, have lower understanding of their illness, are less adherent to treatment, are less satisfied with their providers and are more likely to miss medical appointments compared to patients who receive language-concordant care (Schouten et al., 2020). Interpreters help but some do not have professional certifications. Nurses need to have empathy when working with these patients and understand that talking through a third party can alter responses or not elaborate on questions the patient may have.
NSG 556 Module 1:2Subscribe
Jennifer Johnson posted Aug 31, 2021 6:11 PM
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Communication with patients is an integral part of competent nursing care. Being able to communicate in a way that creates a therapeutic relationship is necessary if we want to connect with our patients in a meaningful way and provide quality care. As nurses we use our cultural competence to communicate with patients from various cultures, contribute to their positive healthcare outcomes, and reduce health disparities among these populations (Marion et al., 2016; Papadopoulos et al., 2016). ReferencesMarion, L., Douglas, M., Lavin, M. A., Barr, N., Gazaway, S., Thomas, E., & Bickford, C. (2016). Implementing the new ANA standard 8: Culturally congruent practice. Online Journal of Issues in Nursing, 22(1). doi.org/10.3912/OJIN.Vol22No01PPT20less0 UnreadUnread
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Papadopoulos, I., Shea, S., Taylor, G., Pezzella, A., & Foley, L. (2016). Developing tools to promote culturally competent compassion, courage, and intercultural communication in healthcare. Journal of Compassionate Health Care, 3(1), 1-10. doi.org/10.1186/s40639-016-0019-6
Davidhizar, R., Giger, J. N., & Hannenpluf, L. W. (2006). Using the Giger-Davidhizar transcultural assessment model (GDTAM) in providing patient care. Journal of Practical Nursing, 56(1), 20.
In order for nurses to communicate well with patients from various cultures, it is necessary to treat each individual as unique within their culture; to see them as they are, not how we expect them to be; and to and understand how they perceive their illness, the healthcare system, and their goals for wellness (Davidhizar et al., 2006; Marion et al., 2016). Using Giger and Davidhizar’s model, nurses understand that communication and culture are closely intertwined and multifaceted, including: verbal and non-verbal cues, intonation, touch, volume, dialect, and emotion (Davidhizar et al., 2006). The culturally competent nurse is mindful of these communication intricacies and relies on them to communicate appropriately with patients from different ethnic and cultural backgrounds.
Module 1: Discussion 2 – Jahenein NagelSubscribe
Jahenein Nagel posted Aug 31, 2021 1:15 PM
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Giger and Davidhizar’s Transcultural Model presumes that each individual is culturally unique and should be assessed according to six cultural phenomena: communication, space, social organization, time, environmental control, and biological variations (Giger & Davidhizar, 2002, p. 185). Giger and Davidhizar’s model assumes that culture is a patterned behavioral response that develops over time as a result of imprinting the mind through social and religious structures and intellectual and artistic manifestations (Giger & Davidhizar, 2002, p. 187). Culture is shaped by values, beliefs, norms, and practices that are shared by members of the same cultural group (Giger & Davidhizar, 2002, p. 187). Culture guides our thinking, doing, and being and becomes patterned expressions of who we are (Giger & Davidhizar, 2002, p. 187).The LEARN (Listen, Explain, Acknowledge, Recommend, Negotiate) model is a framework for cross-cultural communication that helps build mutual understanding and enhance patient care (Ladha et al., 2015). Listen: Assess each patient’s understanding of their health condition, its causes and potential treatments (Ladha et al., 2015). Elicit expectations for the encounter, and bring an attitude of curiosity and humility to promote trust and understanding (Ladha et al., 2015). Explain: Convey your own perceptions of the health condition, keeping in mind that patients may understand health or illness differently, based on culture or ethnic background (Ladha et al., 2015). Acknowledge: Be respectful when discussing the differences between their views and your own (Ladha et al., 2015). Acknowledge areas of agreement as well as difference, and try to determine whether disparate belief systems may lead to a therapeutic dilemma (Ladha et al., 2015). Recommend: Develop and propose a treatment plan to the patient and their family. Negotiate: Reach an agreement on the treatment plan in partnership with the patient and family, incorporating culturally relevant approaches that fit with the patient’s perceptions of health and healing (Ladha et al., 2015).When communication is not culturally sensitive, patients and families are less likely to be satisfied with their perceptions and experiences of care, there is an increased risk of miscommunication, and cultural disparities may result; leading to poor adherence to treatment, poorer health outcomes and an increased prevalence of adverse events (Brooks et al., 2019, p. 384). The use of culturally sensitive communication substantiates an understanding of patient and family beliefs, goals and values.Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383-391. https://doi.org/10.1016/j.colegn.2018.09.007Ladha, T., Zubairi, M., Hunter, A., Audcent, T., & Johnstone, J. (2015, February 14). Cross-cultural communication: Tools for working with families and children. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815116/less0 UnreadUnread
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Giger, J. N., & Davidhizer, R. (2002). The Giger and Davidhizar transcultural assessment model. Journal of Transcultural Nursing, 13(3), 185-188. https://doi.org/10.1177%2F10459602013003004
References
The use of cultural interpreters is another way of improving communication. Cultural interpreters can provide clear, precise translations that include nuances in meaning and nonverbal cues, while being careful not to lead the conversation (Ladha et al., 2015). The use of a trained interpreter rather than a family member is the preferred method to translate when needed. Booking longer and repeat visits with the same interpreter can forge trust and understanding (Ladha et al., 2015). It is important that we build awareness of differences in communication style (e.g., verbal and nonverbal) that may influence care (Ladha et al., 2015). Additionally, the APN should consider the role of silence in each patient encounter (Ladha et al., 2015). According to Ladha et al. (2015), silence may represent discomfort with a topic or uncertainty about a question being asked. Paying attention to nonverbal cues can help determine whether a differential power relationship is hindering communication (Ladha et al., 2015). Building trust and understanding legitimizes families and advances patient care. Remain aware of tone, body language and other nonverbal cues. Recognize that diversity exists within ethnic and cultural groups as much as between groups, and avoid generalizing or stereotyping cross-cultural encounters (Ladha et al., 2015). Adjust the use of written material based on literacy levels of patients and/or families.
The first step in communicating with patients from other cultures is an awareness of one’s own cultural beliefs, values, attitudes, and practices (Ladha et al., 2015). Communication encompasses the entire world of human interaction and behavior (Ladha et al., 2015). It is the means by which culture is transmitted and preserved (Ladha et al., 2015).
Discussion 2Subscribe
Karimah Moss posted Aug 31, 2021 12:26 PM
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Module 1-Discussion 2“The LEARN (Listen, Explain, Acknowledge, Recommend, Negotiate) model is a framework for cross-cultural communication that helps build mutual understanding and enhance patient care” (Ladha et al., 2018, p. 66). Listening entails evaluating the patient’s knowledge of their current health condition, its causes and treatment options. The clinician will show interest and prompt patient expectations which assists in promoting trust and understanding. When the provider explains, they are expressing their own perceptions of the patient’s current health condition. It is important to be aware that varying cultures may understand health or illness differently. To acknowledge is to identify areas of agreement and difference between the clinician and patient. The act of acknowledgement requires the provider to show respect when speaking of how their views differ from the patients. The final components of this model are recommend and negotiate. The provider creates and suggests a treatment plan to the patient in the step of recommendation. Negotiate is when all parties come to an agreement on a treatment plan that is culturally appropriate for the patient and is congruent with their perception of health and healing (Ladha et al., 2018).ReferencesLadha, T., Zubairi, M., Hunter, A., Audcent, T., & Johnstone, J. (2018). Cross-cultural communication: Tools for working with families and children. Paediatrics & Child Health, 23(1), 66–69. https://doi.org/10.1093/pch/pxx126 more0 UnreadUnread
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Albougami, A., Pounds, K. G., & Alotaibi, J. (2016). Comparison of four cultural competence models in transcultural nursing: A discussion paper. International Archives of Nursing and Health Care, 2(4), 1–5. https://doi.org/10.23937/2469-5823/1510053
It is important to recognize and understand facial expressions, body language, tone of voice and other nonverbal cues that may be related to one’s unique culture. The use of professional medical interpreters will benefit communication between provider and patient when language becomes a barrier. This will ensure that everyone has an understanding of what is being said and is able to effectively convey their thoughts and questions (Ladha et al., 2018).
Giger and Davidhizar’s Transcultural Assessment Model focuses on the significance of viewing each patient as unique in their specific culture. This model consists of six aspects which are common to every culture. These aspects include communication, space, social organization, time, environmental control, and biological variation (Albougami et al., 2016). For this week’s discussion, I will only discuss the component of communication. The different types of communication are verbal, nonverbal, and written. These three forms of communication can be presented in varying ways in terms of expression, language and dialect, voice tone and volume, context, emotional implication, facial expression, gestures, and body language. Language is often a barrier to effective communication and impacts the quality of care delivered (Albougami et al., 2016).
Romig- Module 1, Discussion 2
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Krista Romig posted Aug 31, 2021 1:00 AM
Providing culturally appropriate care is so important in all aspects of healthcare, but it is especially important as an advanced practice nurse. It is important for nurses to recognize how their culture affects them and to appreciate and understand the differences in cultures and how it impacts beliefs in healthcare (Tonsun & Sinan, 2020). As nurses, it is our responsibility to identify any assumptions or prejudices we have so that we can give all our patients the care and respect they deserve.Cultural distress can occur when patients do not receive care that is congruent with their culture. The theory of cultural distress addresses whether patients heal quicker when given care that aligns with their culture (DeWilde & Burton, 2016). By providing patients with culturally appropriate care, we can improve their health outcomes and patient satisfaction.DeWilde, C., & Burton, C. (2016). Cultural distress: An emerging paradigm. Journal of Transcultural Nursing, 28(4). https://doi-org.wilkes.idm.oclc.org/10.1177/1043659616682594less
Tonsun, B., & Sinan, O. (2020). Knowledge, attitudes, and prejudices of nursing students about the provision of transcultural nursing care to refugees: A comparative descriptive study. Nurse Education Today, 85. https://doi.org/10.1016/j.nedt.2019.104294
References
I believe the most important aspect in communicating with patients from differing cultures is to ask questions to better understand their culture. By having a better understanding of their culture, we can address the patients needs in a holistic manner and better address their needs.

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