Integration of Population Health, Social Determinants, and Social Justice in Transcultural Nursing and Culturally Competent Care: White Paper by the Scholars Education Interest Group.

INTRODUCTION: As part of its mission to advance Transcultural Nursing worldwide, the Transcultural Nursing Society Scholars upholds the central role of the discipline and cultural competence in advocacy, empowerment, and transformation of the life conditions of disadvantaged populations. This White Paper affirms the Scholars' core belief in the value of Transcultural Nursing and culturally competent care in addressing social determinants to promote health equity. METHODS: The Scholars Education Interest Group proposes recommendations for changes in education, practice, and research undergirding the discipline and expand cultural competence to directly address social structural and historical forces that perpetuate health vulnerability in diverse populations. RESULTS: Collaborative leadership between the TCNS Scholars, Board of Trustess and members should develop initiatives to foster implementation of the recommendations and promote global dissemination of exemplars in education, research and practice. DISCUSSION: Collaborative implementation of recommendations will generate evidence of health equity outcomes through TCN and culturally competent care.

Update: The Purnell Theory and Model for Culturally Competent Health Care.

The Purnell model and theory were created in 1998 and received input for clarity and parsimonious assumptions from several faculty at the University of Delaware. Initially, they were used in education and clinical practice settings to develop them further and to determine their usefulness in those settings. Since that time, changes have been made with additional assumptions, variant characteristics of culture, and an extensive assessment guide that can be used by all health professionals.

Are We Really Measuring Cultural Competence?

One of the major goals of culturally competent nursing and healthcare practice is to decrease health and healthcare disparities. All healthcare professionals need similar information for cultural competence. However, to date, most of the tools measure knowledge, skills and abilities but not true competence from a clinical practice setting. Several tools measure and/or evaluate the organization's cultural diversity mission but not the providers of healthcare.

CULTURAL NURSING ANDROGOGIES WITH FOREIGN-EDUCATED PHYSICIANS ENROLLED IN BSN TO MSN PROGRAM.

Many health-care organizations and associations recommend that registered nurses be culturally competent and technologically savvy to compete in today's global society. This article reports both traditional and innovative technology-based teaching strategies that increased cultural competencies in nursing students in a BSNIMSN program for foreign-educated physicians. The Inventory for Assessing the Process of/Cultural Competency among Healthcare Professionals-Revised, was used at the beginning and at the end of the program. Cultural simulation scenarios and critical-reflection essay were some of the strategies used. The program prepared culturally competent advanced practice nurses while creating a smooth transition for the students to adapt to and acculturate into the cultures of the United States and nursing.

Oncology nursing: educating advanced practice nurses to provide culturally competent care.

More than 37 million persons or 12.4% of the U.S. population are older than 65 years. These numbers are expected to reach 71.5 million (20% of the population) by 2030. This older population is becoming more racially and ethnically diverse as the overall minority and culturally diverse populations increase. Although the incidence and mortality rates from several major cancers have declined due to advances in cancer care, these advances have lagged among the underserved and more vulnerable racially and culturally diverse populations. Moreover, the disparity between the gender and the racial mix of nurses and the overall population continues to widen. Thus, a growing need for professional nurses and advanced practice nurses with formal educational preparation in all areas of oncology nursing exists. This article (a) highlights significant cancer disparities among diverse populations, (b) describes how cultural belief systems influence cancer care and decision making, and (c) explicates the need to prepare advanced practice nurses for careers that include cancer care of diverse and vulnerable populations through formal oncology educational programs. The "Top 10" reasons for becoming an advanced practice nurse specializing in the oncologic care of patients from diverse and underserved populations are presented.

A guide to developing a culturally competent organization.

The journey to organizational cultural competence for a health care organization, educational setting, freestanding clinic, or long-term-care organization is a process that requires the collaborative efforts from people at all levels in every department as well as external consumers such as public policy officials, students, and community leaders. Broadly speaking, four main but overlapping areas must be considered in institute activities and strategies to accomplish a comprehensive culturally competent organization. These four areas are (a) administration and governance, (b) orientation and education, (c) language, and (d) staff competencies. This article presents key content areas and activities to consider on the journey to cultural competence. Tables with suggested departmental responsibilities for implementation are included. In some cases, the journey may best be facilitated by a consultant who is well versed in cultural competence and organizational dynamics.

Cultural Competency in Baccalaureate Nursing Education.

This article presents the work of the American Association of Colleges of Nursing Advisory Committee in developing an integrated curriculum for cultural competence in baccalaureate nursing education. Five competencies for Cultural Competency in Baccalaureate Nursing Education were developed with supporting rationale. Suggestions for developing and implementing curricula for cultural competency, teaching content, specific integrative learning strategies, methods for evaluating nursing students' cultural competence and recommendations for effective implementation of the integrated curriculum are presented.

Traditional Vietnamese health and healing.

Approximately 1.2 million Vietnamese live in the United States. Health care providers need to understand that this population differs greatly from other cultures depending on gender, religion, generation, reason for migration, enclave identity, educational level, and language preference. This article will explore the history, communication practices, biocultural ecology, and health care principles among this population.

American Academy of Nursing Expert Panel report: developing cultural competence to eliminate health disparities in ethnic minorities and other vulnerable populations.

The members of the Expert Panel on Cultural Competence of the American Academy of Nursing (AAN) envisioned this article to serve as a catalyst to action by the Academy to take the lead in ensuring that measurable outcomes be achieved that reduce or eliminate health disparities commonly found among racial, ethnic, uninsured, underserved, and underrepresented populations residing throughout the United States. The purposes of this article are to (a) assess current issues related to closing the gap in health disparities and achieving cultural competence, (b) discuss a beginning plan of action from the Expert Panel on Cultural Competence for future endeavors and continued work in these areas beyond the 2002 annual conference on Closing the Gap in Health Disparities, and (c) provide clearly delineated recommendations to assist the Academy to plan strategies and to step forward in taking the lead in reshaping health care policies to eliminate health care and health disparities.

The Purnell Model for Cultural Competence.

This article provides an overview of the Purnell Model for Cultural Competence and the assumptions on which the model is based. The 12 domains comprising the organizing framework are briefly described along with the primary and secondary characteristics of culture, which determine variations in values, beliefs, and practices of an individual's cultural heritage. All health care providers in any practice setting can use the model, which makes it especially desirable in today's team-oriented health care environment. The model has been used by nurses, physicians, and physical and occupational therapists in practice, education, administration, and research in Australia, Belgium, Canada, Central America, Great Britain, Korea, South America, and Sweden. The model has also been translated into Flemish, French, Korean, and Spanish. Although the model is only 4 years old, it shows promise for becoming a major contribution to transcultural nursing and health care.