The components of comprehensive cultural competency will be explained following the Giger and Davidhizah transcultural assessment model. According to this model, every person is unique and require assessment based on six cultural competencies: communication, time, space, biological variation, environmental control and social organization (Gige & Davidhizar, 2002). Understanding these components is significant while delivering care for culturally diverse population. Nonetheless, the issues can be solved by understand the cultural values, beliefs, and practices while planning and delivering care.
Comprehensive Cultural Competency
Communication is a major component of comprehensive cultural assessment which embraces the whole process of interaction among the human race, and it is through this means that culture is transmitted and preserved (Shen, 2015). Communication is essential, as it presents the most issues while working with patients from diverse cultures. Space is a component of cultural assessment and it illustrates the distance between persons during interaction. Gige and Davidhizar (2002) explain that there are four zones of space: public, social and consultative, personal, and intimate and each zone is interpreted differently by a specific culture.
The third component is social organization which is the way in which families organizes themselves in a cultural group. The fourth component is time which according to Andrews and Boyle (2015) is significant in interpersonal communication where for example, preventive strategies are future oriented. Environmental control as a competent of cultural assessment is the ability of an individual to plan and control nature and to plan and direct environmental factors influencing them. Lastly is biological variations, particularly genetic variations which differs due to race. Shen (2015) explains that there is genetic difference between persons of different races. Genetic variations open the need for culturally appropriate care. As noted earlier, every person is unique, and each aspect will affect individuals differently.
Personally, I am a Filipino, a culture that is family oriented and religious in nature. I will discuss the aspect of space based on my practice experience. One day I was taking care of western parents who had brought their 12 years daughter to care. Through person-centered care, I provided the options to the parents and to my amazement they discussed the options to the kid, and they expected her to make the final decision about her care. This belief is different from my culture because the Wests allow their children to find their individuality while in Filipino, a kid is a kid, a teen a teen and is treated as a teen and not as an adult.
Communication is another aspect that illustrates the diversity of culture. For example, during practice, I met a girl, White who was 15 years old and was seeking for family planning methods. I was amazed because growing up, the Filipino families do not talk or allow dating until one is 18 years. Hence discussing such issues with a minor felt out of place. Interesting, the girl stated that her mother enrolled her in the program. It was my first experience to discuss a sexual life with a minor, but I later learned sex talks and dating life are openly discussed by white families at a tender age where they allow girls to date and have safe sex life.
Diagnosis for Attention-deficit/hyperactivity disorder (ADHD)
While working in a physician office, I encountered a couple who had a child who presented with impulsive behaviour, hyperactivity, and had difficulty paying attention. The child was diagnosed with Attention-deficit/hyperactivity disorder (ADHD). After explaining to the parents what ADHD was, the boy’s father stood and started shouting on the wife that her poor parenting skills were the cause. The wife on the other hand grew up knowing mental illness never occurs in children and if it does it is out of witchcraft. Nonetheless, this was solved through a clear understanding of the expectations, practices, values and beliefs of Indians. Religion of spiritual aspect was included in the intervention which turned successful.
During practice I met a couple during antenatal visit. The couple required to undergo a HIV testing. They both seamed composed but after the results, the female had HIV/AIDS while the male tested negative. The results brought issues as the woman vowed, she never had extra marital sexual relation. Empathetically, I explained to the couple about discordant couple and the way they were to live together without the woman contacting the virus. The woman started on PEP to prevent the child from contracting the illness.
Comprehensive cultural competency assessment is essential in a culturally diverse environment. Every individual is unique in their own ways and every culture is unique too. Understanding the differences is particularly important for health professionals to promote effective care. Hence, cultural competency through its components will facilitate care delivery to people from different cultures.
Andrews, M. M., & Boyle, J. S. (2015). Transcultural concepts in nursing care (Seventh edition.). Philadelphia: Wolters Kluwer/LWW.
Davidhizar, R., & Giger, J. N. (2001). Teaching culture within the nursing curriculum using the Giger-Davidhizar model of transcultural nursing assessment. Journal of Nursing Education, 40(6), 282-284.
Gige, J. N., & Davidhizar, R. (2002). The Giger and Davidhizar Transcultural Assessment Model. Journal of Transcultural Nursing, 13, 185. doi:10.1177/10459602013003004Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321.
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