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Presentator : Taufik Febrianto
Kultum : Yupi Nurhastuti
Moderartor: Wiji Hastuti
Nursing is the care provided nursing services to patients both individuals, groups, families and society in a state of ill health and holistic (biology, psychology, social, spiritual and cultural) in a range of approaches life with the nursing process (assessment, nursing diagnosis, intervention, implementation and evaluation). Orphanage nursing can be given medical surgical nursing care, children, maternity, mental, emergency, family, community and gerontik.
Nursing farm family is nursing care that is important to be discussed, because the families of nursing care is part of the nursing care of communities where the family is the smallest part of the community of individuals and groups. The success of family health or nursing is one measure of success in health or community nursing.
In the family inter-cultural interaction, adaptation and sustain a culture where the culture is a belief or behavior that humans inherited or taught to the next generation.
Kultum : Yupi Nurhastuti
Moderartor: Wiji Hastuti
Nursing is the care provided nursing services to patients both individuals, groups, families and society in a state of ill health and holistic (biology, psychology, social, spiritual and cultural) in a range of approaches life with the nursing process (assessment, nursing diagnosis, intervention, implementation and evaluation). Orphanage nursing can be given medical surgical nursing care, children, maternity, mental, emergency, family, community and gerontik.
Nursing farm family is nursing care that is important to be discussed, because the families of nursing care is part of the nursing care of communities where the family is the smallest part of the community of individuals and groups. The success of family health or nursing is one measure of success in health or community nursing.
In the family inter-cultural interaction, adaptation and sustain a culture where the culture is a belief or behavior that humans inherited or taught to the next generation.
Cultural characteristics can be described as follows:
- culture is a universal experience that there is no exact same culture,
- culture are stable, but also dynamic because of the culture passed on to the next generation so that the experience changes and
- culture charged and determined by human life itself (Leininger, 1978)
From the above phenomenon can be seen that the nursing care of families not be separated from the culture or who are always transkultural can affect the results of the assessment of nursing care that families need to examine the nursing care of families returning from the assessment, determination of nursing diagnoses, interventions, implementation to evaluation by that approach transkultural can enhance the professional skills that include intellectual abilities, technical and interpersonal skills in carrying out nursing care, especially in the family. In this paper will discuss the nursing care of families with transkultural approach in theory, applications in the field until the gap between theory and fact.
Orphanage nursing is a process or series of activities in practice nursing provided to clients in accordance with the background culture. Orphanage nursing directed individual according memandirikan with the client culture. Strategies used in nursing care is the protection / maintain the culture, accommodating / negotiation culture and change / replace the culture of clients (Leininger, 1991).
DEFINITIONS
Transcultural Nursing is an area / areas of cultural science at process of learning and the focus of nursing practice at the differences and similarities among cultures with respect to the care, health and illness based on the value of human cultures, beliefs and actions, and this knowledge is used to provide nursing care in particular culture or cultural integrity to humans (Leininger, 2002).
provide support to individuals as a whole. Caring behavior should given to humans since birth, in the development and growth, the defense until the man is dead dikala. Human caring is generally said to be all things relating to the support and guidance on a whole human being. Human caring is a phenomenon that where the universal expression, structure and patterns vary between cultures one place with other places.
- The concept of Transcultural Nursing
- Culture is the norm or rule of action group members studied, and divided and provides guidance in thinking, acting and decision.
- Cultural values is the desire of individuals or a more desirable actionor something that sustained action at a particular time andunderlying actions and decisions.
- Cultural differences in nursing care is a form of
- Daei optimal provision of nursing care, referring to the possibility ofvariations in nursing approach is needed to provide care culture that values individual cultural values, beliefs and actions including sensitivity to the environment of the individuals who come and individuals who may come back again (Leininger, 1985).
- Is ethnocentric perceptions held by individuals who consideredthat culture is the best among cultures that haveby others.
- Ethnically related to humans from a particular racial or cultural groupclassified according to the characteristics and habits of the ordinary.
- Ras is the difference of human kinds is based ondiscredit human origins
- Ethnography is the study of culture. Methodological approachon ethnographic research allows nurses to develophigh awareness of cultural differences of each individual, explainsbasic observations to study the environment and the people, and eachprovide reciprocal between the two.
- Care is a phenomenon associated with guidance, assistance,behavioral support to individuals, families, groups with the incident to meet the needs of both actual and potential to improve conditions and quality of human life.
- Caring is a direct action aimed at guiding,support and guide individuals, families or groups on the circumstances actual or anticipated the need to improve the living conditions humans.
- Cultural Care with respect to cognitive ability to know the value,beliefs and patterns of expression that is used to mebimbing, support or provide an opportunity individuals, families or groups to maintain health, healthy, grow and survive, livethe limitations and achieve a peaceful death.
- Culturtal imposition with regard to the tendency of health workers to impose its beliefs, practices and cultural values on other people because they believe that the idea held by nurses is higher that other groups.
Paradigm Transcultural Nursing
Leininger (1985) defines a paradigm as a Transcultural Nursing
perspective, beliefs, values, concepts in the implementation of care
nursing in accordance with the cultural backgrounds of the four concepts
central nursing, namely: human, health, environment and nursing (Andrew
and Boyle, 1995).
1. Humans
Humans are individuals, families or groups who have values
and norms and are believed to be useful to set options and
make a choice. According to Leininger (1984) humans have
tendency to maintain the culture at any time anywhere
he was (Geiger and Davidhizar, 1995).
2. Healthy
Health is the overall client-owned activities in the filling
life, lies in the range of ill health. Health is a
beliefs, values, patterns of activity in the cultural context that is used to
preserve and maintain the balance / health which can be observed
in daily activities. Clients and nurses have the same goal
namely to maintain good health in a range of healthy-sick
adaptive (Andrew and Boyle, 1995).
3. Environment
Environment is defined as a phenomenon that affects the overall
development, beliefs and behavior of the client. Environmental viewed
as a totality in which the client lives with another culture
interact. There are three forms of the environment: physical, social and symbolic.
Physical environment is the natural environment or created by humans such as
equatorial regions, mountains, dense settlement and climate at home
Eskimo area almost closed because there was no sun
throughout the year. Social environment is the entire social structure
associated with the socialization of individuals, families or groups in
the wider community. In the social environment of individuals must
follow the structure and rules that apply in that environment.
Symbolic environment is the overall shape and symbols
cause individuals or groups feel united like music, art,
life history, language and attributes used.
4. Nursing
Orphanage nursing is a process or series of activities in practice
nursing provided to clients in accordance with the background
culture. Nurturing individual nursing memnadirikan addressed in accordance
with the client culture. Strategies used in nursing care
is the protection / maintain the culture, accommodating / negoasiasi
culture and change / replace the culture of clients (Leininger, 1991).
a. I: Maintaining the culture
Maintaining a culture done if the patient does not contradict the culture
health. Planning and implementation of nursing provided
in accordance with the values that have been relevant to the client that owned
clients can improve or maintain their health status,
such cultural exercise every morning.
b. II: Negotiation of culture
Nursing intervention and implementation at this stage is to
help clients adapt to a more specific cultural
health benefit. The nurse helps the client
to choose and determine the other cultures are more supportive of increasing
health, such as pregnant client has refused to eat the
smells fishy, the fish can be replaced with animal protein sources
other.
c. III: Restructuring culture
Cultural restructuring done when the client-owned cultural
adverse health status. The nurse seeks to restructure the force
client's life which usually become non-smokers to smoke. Pattern plans
usually chosen to live a more profitable and in accordance with
held beliefs.
Transcultural Nursing Process
Conceptual model developed by Leininger in explaining
nursing care in a cultural context described in the form of the sun
published (Sunrise Model) as found in Figure 1. Geisser (1991)
states that the nursing process is used by nurses as
foundation of thinking and provide solutions to client problems (Andrew and
Boyle, 1995). Management of nursing care from the beginning stages implemented
assessment, nursing diagnosis, planning, implementation and evaluation.
1. Assessment
Assessment is the process of collecting data to identify
clients' health problems according to the cultural background of clients (Giger and
Davidhizar, 1995). Assessments are designed based on existing components 7
on the "Sunrise Model" are:
a. Technological factors (tecnological factors)
Health technology allows individuals to choose or
a supply problem in the service
health. Nurses need to assess: the perception of ill health, habits
medical or health problems, reasons to seek help
health, the reason clients choose alternative medicine and client perception
about the use and utilization of technology to overcome
current health problems.
b. Factors religion and philosophy of life (religious and philosophical factors)
Religion is a symbol that resulted in the view
very realistic for its adherents. Religion provides the motivation
very strong to put truth above all else, even in
for her own life. Religious factors that must be reviewed by a nurse
is: religious beliefs, marital status, the client perspective
the causes of disease, treatment and religious customs
positive impact on health.
c. Social factors and attachment to family (Kinship and social factors)
Nurses at this stage to assess factors: a
complete, nickname, age and place of birth date, gender,
status, family type, decision-making in the family, and
client relationship with the head of the family.
d. Cultural values and lifestyles (cultural values and life ways)
Cultural values is something that is formulated and determined
by adherents of the culture was considered good or bad. Norms
culture is a rule that has limited the application properties
the relevant cultural adherents. That need to be assessed on this factor are:
position and the position held by the head of the family, language
use, eating habits, food conditions dipantang
pain, pain perception associated with daily activities and habits
cleaned up.
e. Policy and regulatory factors that apply (political and legal factors)
Policies and regulations applicable hospital are all
something that affects the care of individual activities
cross-cultural nursing (Andrew and Boyle, 1995). That need to be assessed
at this stage are: regulations and policies related to
visiting hours, number of family members who can wait, how
payments for the client being treated.
f. Economic factors (economical factors)
Clients are treated in hospital utilizing the resources
materials owned to finance his illness to be cured.
Economic factors that must be assessed by nurses include: job
client, the source of medical costs, savings that are owned by the family,
cost from other sources such as insurance, replacement cost of the office
or a joint venture between family members.
g. Educational factors (educational factors)
Client's educational background is in the client experience
formal education through the highest point today. The higher
client education is the belief the client is usually supported by buktibukti
scientific and rational individual can learn to adapt
to culturally appropriate health conditions. Thing
need to be assessed at this stage are: the education level of clients, types
education and its ability to actively self-learning
about the experience of pain that does not happen again.
2. Nursing Diagnosis
Nursing diagnosis is appropriate response to clients' background
culture that can be prevented, modified or reduced through the intervention
nursing. (Giger and Davidhizar, 1995). There are three diagnostic
nursing is often enforced in the care of nursing transkultural
namely: verbal communication disorders associated with differences in culture,
disruption of social interactions related to sociocultural disorientation and
in the treatment of non-compliance related to the value system
believed.
3. Planning and Implementation
Planning and implementation in nursing trnaskultural is
a nursing process that can not be separated. Planning is
a process of choosing the right strategy and execution are
implement appropriate actions cultures denganlatar client (Giger
and Davidhizar, 1995). There are three guidelines are offered in
nursing transkultural (Andrew and Boyle, 1995) are: retain
client-owned culture when the culture of the client does not conflict with the
health, cultural accommodate the client when the client culture is less
health benefits and changing the culture of the client when the culture
owned by clients against health.
a. Cultural preservation care / maintenance
1) Identify the difference between the client and the concept of nurses about
childbirth and infant care
2) Be calm and unhurried as interact with clients
3) Discuss the cultural gap that has clients and nurses
b. Cultural careaccomodation / negotiation
1) Use language that is easily understood by the client
2) Involve the family in care planning
3) If the conflict is not resolved, do the negotiations which
agreement based on biomedical knowledge, the client's view
and ethical standards
c. Cultual care repartening / reconstruction
1) Give the client an opportunity to understand the information
given and do
2) Determine the level of patient differences of culture saw itself
groups
3) Use a third party if necessary
4) Translate the terminology of symptoms in patients to health
which can be understood by clients and parents
5) Provide information to clients about the health care system
The nurse and the client should try to understand the culture
Each of the acculturation process, ie the process of identifying similarities and
cultural differences that will ultimately enrich the culture of their culture.
If nurses do not understand the culture of the client will arise a sense of not
believe that the therapeutic relationship between nurse with the client will
upset. Understanding the underlying culture of the client so the effectiveness of success
creating nurse and client relationship that is therapeutic.
Evaluation
Evaluation of nursing care done on transkultural
the success of the client about maintaining appropriate culture
health, reduce the client's culture is not in accordance with the health or
adapt to a new culture that may be contrary to
client-owned culture. Can be identified through the evaluation of farm
nursing in accordance with clients' cultural backgrounds.
CONCLUSION
From the descriptions that have been described in the previous chapter about the application of farm
Transkultural nursing can be summarized as follows:
1. Transkultural Nursing is a process of providing nursing care
which focused on individuals and groups to maintain,
increase healthy behaviors in accordance with the cultural background
2. Assessment of nursing care in a cultural context is necessary for
bridge the gap of knowledge possessed by nurses with clients
3. Transkultural nursing diagnoses can be established to identify
actions required to maintain the appropriate culture
health, new cultural forms appropriate to the health or even
cultural change that is not in accordance with the new culture of health.
4. Planning and implementation of nursing process can not be so transkultural
imposed on the client just before the nurse understand the cultural background
clients so that actions can be done in accordance with the client culture.
5. Evaluation of nursing care transkultural clung to the planning and
implementation process transkultural nursing care.
