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The health care system mirrors the growing diversity of America's population. This changing face of the nation is particularly evident to nurses who care of increasing numbers of culturally diverse clients with varying beliefs, values, and practices. Both clients and nurses approach health care situations from unique perspectives based on personal experience. These perspectives influence the manner in which nurses assess the healthcare needs of diverse clients and their ability to create culturally appropriate care plans. How effective the nurse is when working with culturally diverse clients depends on his or her level of cultural competence. A good foundation in transcultural nursing is essential, because it can provide a conceptual framework for holistic client care across cultures. In order to provide culturally appropriate care, the nurse needs to be motivated to develop the knowledge, skill, and ability necessary to care for diverse clients, families, and communities.
This manuscript has been written for the expressed purpose of encouraging nurses to understand the manner in which clients interpret and react to illness and has been divided into three parts: PART I lays the foundation. The process begins with chapter 1 in which demographics clearly point to the fact that the United States is one of the most culturally diverse nations on earth and that the diversity of the population is expected to increase dramatically over the next ten years. Transcultural nursing is a method of providing effective healthcare services to culturally diverse clients and exploring the history of transcultural nursing lays the foundation of understanding the evolution of the theory.
Chapter 2 concentrates on the theoretical premises (with relevant terminology) of transcultural nursing. This is followed by Chapter 3 and Chapter 4, in which the practical aspects of communicating effectively across cultures are discussed. Communication skills for culturally competent nurses arc presented in Chapter 3, while Chapter 4 gives basic guidelines to nurses for effective communication with clients from various cultures. Transcultural nursing assessment is addressed in Chapter 5 which reviews various instruments presently used by transcultural nurses in various culturally diverse settings. Chapter 6 reviews community cultural assessments to help the community based nurse assess the culturally diverse community in which they are providing care.
PART II lays the foundation of cultural competence with specific cultural groups, starting with Chapter 7 in which Anglo-American culture is discussed using culture care values and perspectives as a format. Variations, based on classism and environmental factors are included in this chapter. Chapter 8 addresses the history, family social structure, communication patterns, and strategies for providing effective health care for African-Americans. Chapter 9 presents information on four major population groups of the Hispanic population; Mexican-Americans, Cubans, Puerto Ricans, and Central Americans. Basic information on family social structure is followed by value orientations that tend to be manifested by Hispanic individuals, including cultural health care beliefs and folk medicine. This chapter closes with strategies for providing effective healthcare to Hispanic clients and issues to consider when working with recent immigrants. The Asian American population is addressed in Chapter 10 and four major groups are discussed; Chinese Americans, Japanese Americans, Korean Americans, and the most recent group of Asians to immigrate to America; Southeast Asians (Vietnamese, Cambodian, Laotian, Hmong). The ethnohistory of each group is presented, as well as family social structure. Communication issues, and strategies for providing effective care. Refugee issues, and the effect of being a refugee on mental and physical health, are discussed in relation to the Southeast population. Chapter 11, the final chapter in Part II, is devoted to Native Americans, who were on this land centuries before Europeans "discovered" America. The ethnohistorical view addresses the effects of European colonization on the diverse Native American groups. Due to the fact that Native American society is pluralistic, cultural identity is operationally defined. Cultural values, family social structure, and communication is discussed in general terms, acknowledging the fact that there are 505 federally recognized tribes in American and 252 languages. Strategies for providing effective healthcare addresses the spectrum of acculturation seen in Native Americans.
PART III concludes with putting transcultural nursing concepts into action. Chapter 12 discusses the effects of working with diverse clients based on their level of racial/cultural identity. Chapter 13 focuses on cultural competence which can be achieved through understanding the effects of cultural values, cross-cultural communication and traditional/folk medicine beliefs on culturally appropriate clinical decisions. Chapter 14 discusses the importance of teaching transcultural care in nursing educational institutions and effective methods that can be used to ensure success.