The theory of Implied Community – Based Communication in Transcultural Nursing

Joremei D. Longcob, RN,

Lady Jane C. Makiputin, RN

Marchelle Fe B. Adalim, RN

Eva Ann G. Rondrique, RN

Trinidad A. Obedencia, RN

Graduate School, Misamis University

NRG201N: Theory

Professor: Dr. Merasol O. Duyag, MAN, PhD

December 17, 2022

 The Theory of Implied Community – Based Communication in Transcultural Nursing

Introduction

Culture is the sum of all material and spiritual values created during the process of social

development, as well as the tools used to create and pass these values down to future generations,

demonstrating the extent of man's authority and control over his natural and social environment.

(Deger, 2017). People and culture are un-written linked in a spiraling way, from the past to the

present, connecting individuals in society. In a way that cultures appear to be something that

human’s product and carried, that each individual molds his or her life in accordance with

cultural norms to create a society. (Altun, TRANSCULTURAL NURSING, 2016). In this

regard; culture serves as our common language, making sense that we are united with the

concept of culture, varies from society to civilization and how individuals influence perceives

thing like health, illness and melancholy. Along with being social and cultural reality, health and

illnesses are biological phenomenon. Thus, each individuals owns the entire societies perceives

through the cultural lens of people’s beliefs, values and social attitudes regarding health and

illness in addition to their own perception of health. However, as a result of growing

globalizations in the world multi-cultural communities and demographic changes that has

become known, health and diseases shape its perception. Which has made health care system

face a huge difficulty in providing patients with individualized and comprehensive care, thus

providers and organizations should address cultural disparities owing to variations in health

levels of people from various cultures (Oskay, 2013)

The Changing Face of the Population

Cultural variety will continue to expand in the "great melting pot" (Parson) . As member

of the largest and fastest growing healthcare industry, healthcare practitioners should know the
“what it is and why” in transcultural communication. Cultural face is changing among

community, according to Philippines census; there are 134 ethnic groups in the Philippines, the

majority of which are indigenous, though much of the overall Philippine population is

constituted by only 8-10 lowland ethnic groups. On Mindanao we have 18 tribal Filipinos. This

was taken last 2015 (Wikipedia). Despite of our growing diversity, nurse’s ability to foster

transcultural communication will remain a significant challenge in providing culturally

competent in health care. Accepting differences in people and exhibiting a nonjudgmental

attitude are required for the nurse to successfully communicate among cultural groups, in order

to establish an effective and therapeutic relationship. Lastly, nurses must engage in a dynamic

dialogue to improve transcultural communication, to avoid language barriers, and implement

strategies to improve nurse-patient rapport.

Transcultural Communication

Communication is an essential ingredient in transcultural care. Nursing interventions

must be sensitive to cultural needs, beliefs, and values including communication, in order to be

more effective in rendering holistic care. One of the most obvious difficulties in the ground of

healthcare system is the incapability of the nurse and patient to speak in the same language.

Acclaimed concerns that there was a delayed in fostering care because of the inability of the

nurse to in act directly with patients who uses their native tongue. Sometimes, the delayed in

response might mislead to a patient’s misinterpretation. (J, Sedrl, Donaubauer, Phillips, & and

Miller). And a coupled with, learning patient’s native tongue is a positive factor in order to allow

the nurse to comprehend a patients demand and health conditions. The perspectives of health

care providers, patients, and families may be at odds in some aspects of care. It was commonly

known to us that sometimes a significant other is also a source of concerned, specially when they
stand as the interpreter to withheld patient’s information because they might jeopardize their

relationship. In such situation, there might be a full detained in rendering care. Using an

interpreter who is not formally trained and is not biased toward the patient's care may result in

incorrectly interpreted messages; if nurses are unable to verify patient responses, there is no

assurance that the message was accurate. (Nailon , 2006)

Over the years, transcultural nursing care has evolved into a new field of practice that

make as an essential aspect of healthcare today. Indeed, this requires a cultural competency as a

nursing guiding principle that is directly linked to the society’s standard caliber of care. With

regards to health attitudes and behaviors, knowledged to care is address based on patient’s

culture. Therefore, health care personnel must acquire the necessary knowledge, skills and

attitudes towards cultural diversities. In line with the code of ethics of nursing; Nursing practice

must be conducted ethically, and nurses must take personal responsibility for upholding their

competence through lifetime learning and ongoing professional development. Nurses function as

patient advocates and uphold a practice culture that encourages moral conduct and open

communication that indicates respect. (International Council of Nurses, 2021). In actuality,

nurses today are growing more perceptive and understands how cultural differences and

similarities effect of how people are being cared for. (Leininger, 2002).

Description of a phenomenon

The most important part in establishing trust is recognizing individuals culture

perspective. A nurse must establish trust and respect with the patient to develop a therapeutic

relationship. The theory of implied community-based communication in transcultural nursing

focuses on effective communication that best fit in understanding patient’s condition on various

patient care to support healing, wellness, and beneficial health outcomes. With this, how we
communicate can be a make-or-break factor in acquiring vital information thus an accurate

diagnosis and treatment regimen will be given to the patient.

According to an article by Amy Lucas on Livestrong.com, “We can reinforce, contradict,

substitute, complement, or emphasize our verbal communication with non-verbal cues such as

gestures, expressions and vocal inflection.” Nonverbal cues are so strong because they

communicate to others on a subconscious level, causing individuals to regard nonverbal

communication as “true” communication because it provides real cues and emotions. When

verbal language and body language are congruent, this works to enhance the overall quality of

the message and allow it to resonate with the individual receiving the message

(www.stevenson.edu). Awareness on once culture is vital especially in dealing patients with

different beliefs, values, and cultural background that way we will know how we can provide

health care services respectively.

Metaparadigms of Nursing

Person

The voice of the patient should be heard and given importance. This enables a positive

connection between the healthcare professional and the patient to build rapport, obtaining vital

information’s and work in a more effective manner with the patient, members of the team and

the community. Health care workers should be open and encourage patient to disclose all

relevant details. Earning patient’s trust is essential so clear and honest flow of communication is

built and with this in the process will make way for accurate diagnosis and treatment regimen to

take place. Every individual requires different kind of medical services. That being said, there

are also some aspects that needs to be respected and look into because it might change the course

of action the professionals have to do. Knowing one’s background, how they are raised and what
beliefs they have plays a significant role in providing health care services as it makes an impact

and difference in rendering it. For example, some religion/culture does not believe in blood

transfusion or in some more conservative countries, female patients are only allowed to be seen

by female physician or nurses. All these needs to be taken account to serve patient in her best

interest.

Nursing

Communication is healthcare is essential. Whether you are speaking to a patient, their

significant others or workmates, having a good interpersonal skill goes a long way. Being in the

health industry which not only promotes and improves health and lifestyle but saves life as well.

There are things that health workers cannot control like deaths and critical illnesses, they have

the burden to relay the bad news to the family. Balancing professionalism and empathetic and

compassionate attitude make a big impact. Cold and indifferent persona could sever client-care

relationship. The nursing practice needs to repattern their knowledge and skills to best serve the

interest of the patient. And by this, health care professionals and the patient himself needs to

work hand in hand to identify the problem, propose a solution and put it all in action to directly

deal the patient’s need that is culturally and medically acceptable. In this manner, the health care

and its provider can evolve and design newer medical patterns based on knowledge about a

certain culture.

Health

Health care practice requires intellect, interpersonal skills and able body to deliver the

needed treatment. Doctors, nurses and members of the health care team uses critical thinking

and up to date research to revert that knowledge to human skills and commitment and

consistency to make sure that medical care is a success. Patient needs to be involved in the
entirety of the process. In this action, patient should be fully informed and be given options so he

could exercise his/her freedom to choose his/her course of treatment and it should be taken into

consideration and be respected. Patient confidentiality ought to be practiced as well. All health

problems have its own specific solution. It only boils down to what is acceptable to the patient.

Respecting one’s culture is also part of the health care services.

Environment

Environment is where most things take place. But this does not only mean the place but

environment also entails religion, culture and interactions with family and friends as well as this

aspect affect the client’s wellbeing. Medical staff should be well aware of those factors to hold a

bearing to the patient’s health. Health is predetermined by factor including such as personal

behaviors, accessibility to health care and socio-economic status. People who lived in far-flung

areas that health care has problem accessing and looking out for are accounted to be a

disadvantage community. They tend to opt out to medical services as they don’t believe in such

or having problems paying for it. Education plays a vital role in this as well. People who are

knowledgeable are open about how to better their health and uneducated ones tends to believe

anything they hear and instill it to their family too.

NURSING PROCESS

Miscommunication between patients and providers is one of the leading causes of

medical errors mostly in every institution. Patients are less likely to comply with medical

instructions and receive vital services when they are unable to understand or speak a common

language and cannot adequately communicate their needs. (Doctor of Nursing Practice, Family

Nurse Practitioner, Master of Science in Nursing, 2019). The ability of the nurse to foster

transcultural communication is the secret formula for success, and it will continue to be a very
real challenge in providing culturally competent health care. Cultural understanding and

interpersonal communication are the critical pillars of care in all health care settings. Thus,

interpersonal communication entails emphatic comprehension, unconditional positive regard

warmth and sincerity. (Pavord E. & Donnelly , 2015) (Interpersonal Communication). That

easily establishes a relationship in which both communicators participate equally.

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