Guide to nursing care in

consideration of variations in
beliefs, practices and traditions
Using the Transcultural Nursing Assessment Model
TRANSCULTURAL
ASSESSMENT MODEL
• Joyce Newman Giger and
Ruth Davidhizar
1. Communication
Communication

• Verbal or non-verbal in the presence of another individual

Nursing communication

Increase access to information

Increase communication skills by health workers

Increased research in to improve health care communication

 Physical health and emotional well-being

The situation being discussed and its meaning

Factors
influencing Distractions to the communication process

communication
Knowledge of the matter being discussed

Personal needs and interests

Background: cultural, social, philosophical values
 Senses involved and their functional
ability

Personal tendency to make judgment

Factors and be judgmental of others

influencing
communication The environment in which the
communication occurs

Experiences that relates to the situation

Guidelines in relating to patients from
different cultures:

Review Assess Plan Modify Understand

Review your Assess Plan care Modify Understand
personal beliefs communication according to communication that respect for
and variables the approaches. Be patient and
experiences. communicated attentive to communicated
Set aside your needs and signs of fear, needs is
values that are cultural anxiety, essentuial to
judgmental or background. confusion the
bias that can relationship.
affect care.
Guidelines in relating to patients from
different cultures:

No threat Validate Considerate Special approach Interpreters

Communicate in non- Use validating Be considerate of Adopt special Use interpreters to

threatening manner. techniques. Get reluctance to speak approaches when improve
Do not hurry. feedback. specially on matters patient speaks other communication
about sex. language. Use caring
tone of voice and
facial expression.
2. Distance
 Personal space and
objects within a space

Space Comfort level

Inner personal space – invisible lines

of demarcation
• inner spirit
• acceptable and unacceptable thoughts and feelings
• Superficial public image
 Space and visual-auditory system

AUDITORY SPACE VISUAL SPACE SPACE AND TOUCH CYBERSPACE

Guides and implication of
space

1. Space provides a healing environment

2. Space provides security which ensures
actual safety from harm
3. Provide space where patient is in control
4. Personal space provides relaxation
5. Personal space promotes self-identity –
to promote self-expression, express
rituals, use symbols in space
3. Social organization
 Family
Religious groups
Ethnic groups
Social Racial group
organization Tribe
Kinship, clan
Other special interest groups
Guidelines for nursing care in
the use of social organizations:

1. Be aware of and be sensitive to the

socio-cultural background
2. Include family of client in nursing care
• As client’s environment
• As a client as well
4.
Time
Time
• Can refer to duration or instances
• Clock time vs social time
• Time orientation
Time orientations by culture
Cultural group Time orientation
Most Americans Future over present
African black Present over future
Puerto Rican Present over future
Mexican Present
Chinese Past over present
American Indians Present
Guidelines for nursing care in
the use of time:
1. Time management to render care for patients
2. Nurses are more conscious of time (hourly)
than doctors who looks at the duration of
illness and treatment
3. Consider the time for client to
change/adopt/adhere to management
4. Punctuality has different meanings to different
cultures
5. Clients may not be aware of the time with
regards to illness, treatment duration or
impending death
5.
Environmental Control
Environmental Control
• Individual’s perception of their ability to
direct factors that affect them
• Locus-of-control
• Environment:
1. Organisms in the environment
(living and non-living)
2. Social relationships
3. Cultural relationships
Guidelines for nursing care in
environmental control:

1. Some clients may believe in internal or

external locus of control
2. Anything that is too much destroys
harmony and balance
3. Be aware of cultural group’s belief on
natural phenomena (ex. Yin and Yang,
phases of the moon, zodiac signs,
dreams, etc)
6. Biological variations
 Biological variations
Body structure and weight
Skin color
Gene variations
Drug interactions and metabolism
Susceptibility to disease (blood groups, genetics, etc)
Nutritional differences and deficiencies (patterns,practices)
Psychological variations
Domestic violence
Guidelines for nursing care
considering biological variations:

1. Perform comprehensive physical

assessment
2. Include laboratory tests results in nursing
care plan
3. Refer to other discipline when necessary
4. Control reactions when faced with strange
biological features
Thank you for participating