Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
COMPETENCY IN
APRN PRACTICE
Culture is the integrated pattern of thoughts,
communications, actions, customs, beliefs, values, and
institutions associated, wholly or partially, with racial, ethnic,
or linguistic groups as well as religious, spiritual, biological,
geographical, or sociological characteristics. Culture is
dynamic in nature, and individuals may identify with multiple
cultures over the course of their lifetimes.
Minorityhealth.hhs.gov
Factors which negatively impact
cultural and linguistic
competency
BIAS
A preference, especially one that inhibits
impartial judgment
Explicit: Person is aware
Implicit: Unrecognized bias against
individuals in a social group
Implicit Bias
https://home.snu.edu/~hculbert/ethno.htm
Essentialism
Essentialism defines groups as essentially
different, with characteristics natural to a
group. Essentialism does not take into account
variation within a culture. Essentialism can lead
nurses to stereotype their patients. As such, their
clinical practice focuses on beliefs about
groups instead of individuals
Campinha-Bacote, 2002
ETHNIC Model: A Cultural
Competency Framework
Exploration
Why do you think you have these symptoms? What do your
family, friends, others say about these symptoms? Do you now
anyone else with this problem? What have you heard about
this problem? (TV, radio, newspapers?)
Treatment
What kinds of treatments have you tried? Is there anything you
eat, drink or do on a regular basis to stay healthy? What
treatment are you seeking from me?
Healer
Have you sought any advice from alternative healers, friends or
other non-traditional health professionals?
ETHNIC Model
Negotiation
What options are acceptable for both of us?
What results would you like to see?
Intervention
What is the best intervention for you?
Have we considered alternative treatments as well?
Collaboration
How can the patient, family, health team members, healers
and community collaborate?
A Chinese immigrant had surgery and was told to "force
fluids" by the nursing staff. The client refused to drink the
water from the pitcher left at his bedside and was told if
he did not drink then an IV would be started. The staff
decided that the client was uncooperative and
noncompliant. The next day the client's daughter told
the nursing staff that her father would drink hot herbal
tea, but not cold water (Leininger & McFarland, 2002).
Patient: Suzy Lee, age 36, Vietnamese, born in America to American-born parents, is in
the hospital after giving birth to her first child.
Case story: Mrs. Lee had felt increasingly depressed for several weeks. She did not
mention her depression to her doctor because she had heard that feeling down was a
normal part of pregnancy. Now, at the hospital after her child's birth, she feels very
depressed.
Case
At shift change time, Mrs. Lee's two nurses were discussing her care. "She just doesn't
seem right," said the nurse who was going off duty. "She's so quiet, and she doesn't
seem excited about the baby at all. She won't eat either, and she didn't want to feed
the baby. When she wakes up, I think maybe you should do a mini-mental, just to be
sure things are OK before the doctor discharges her today." The nurse who was coming
on duty replied, "I'm sure she's fine. Asian woman are all quiet like that, and they never
show emotion, especially in public. It's part of their culture. I'm sure she'll perk up once
she gets home."
Explanatory model
I know different people have different
"