Transcultural Nursing in the End‑of‑Life: Factors Affecting Nurse’s Abilityto Cope with Culturally Diverse Patientsand Families
Rosh Einav Atzmona* , Livia Popescu**
Abstract. The present case study took place in a hospital in Northern Israel and explores transcultural nursing in the end‑of‑life situations. Based on Cultural Care Diversity and Universality Theory (Leininger, 1991), “Transcultural Assessment Model” (Giger and Davidhizar, 1990), Kubler‑Ross Model of Coping with Death (Kubler‑Ross, 1969), and the Dual Process Model of Coping with Bereavement (Stroebe and Schut, 2010), it aims at identifying factors that influence nurses’ practices in relation to culturally diverse patients and their families in those situation. For this purpose, systematic observations and interviews with culturally diverse nurses who work with terminal patients were con‑ ducted. The two sets of data showed in a consistent manner the importance and the role played by four main factors: nurse’s awareness of others’ mourning customs; nurse’s perception of end‑of‑life, death and loss; nurse’s approach; and communication with patients and families. Knowledge about factors affecting transcultural nursing are highly relevant for both the organization of care delivery and the education of professionals. Keywords: transcultural nursing, cultural congruent care, end‑of‑life, palliative care, coping
Introduction Recently, the nurse’s role has evolved from helping the patient suffering from a disease to the diagnosis and treatment of human responses. Thus, there has been an increase in the need for nurses who are knowledgeable and skilled, whose qualifications are appropriate for the environmental requirements, and who are able to work effectively as part of a multidis‑ ciplinary team in a variety of clinical fields (Bradley and Edinberg, 1990). In Israel, transcultural interactions are a matter of routine, especially in the healthcare services. Since the cultural background of both the nurses and patients and their families, is different in many instances, this shapes, in effect, the way they act. Lack of knowledge about the different cultural differences may lead to many failings while administering nurs‑ ing care with far reaching negative effects for both sides, mainly when it comes to such sensitive situations as end‑of‑life situations, where the patients’ families carry a heavy weight in the interaction with the nursing staff. In this view, Davidhizar, Giger, and Hannenpluf (2006) claimed that nurses will encoun‑ ter diverse patients and families as well as work with diverse members of the healthcare team. Thus, culturally diverse nursing care refers to the variability in nursing approaches needed to deliver culturally appropriate and competent care to patients and their families (Giger and Davidhizar, 2004). The research, then, expands the knowledge in the field of multi‑cultural nursing from the perspective of the nursing staff’s coping with patients from different cultures and their families in end of life situations, with the goal of providing culturally congruent nursing care, which will contribute to both nurse and patients and their families, leading to effective quality professional nursing care, and in the end contribute to the development of nurses’ cultural competence. This article, therefore, addresses the various aspects of end‑of‑life situations and their cultural context, and the nursing staff’s coping with patients and their families in these situations while paying attention to the significance of the family aspect along the way. Finally, this article exposes innovative interesting findings in the field of transcultural nurs‑ ing in end‑of‑life situations.
לקריאת המאמר המלא
