Giger and Davidhizar’sTranscultural Assessment Modeland its use in assessing care of clients from         multicultural po...
Objectives• Describe Giger and Davidhizar’s Transcultural Assessment Model and  its use in assessing care of clients from ...
Giger and Davidhizar’s       Transcultural Assessment Model• The goal of transcultural nursing is to be cognizant of  cult...
Giger and Davidhizar’s     Transcultural Assessment Model                           NursingCulturally                     ...
Giger and Davidhizar’s      Transcultural Assessment ModelThe Transcultural Model has components of social structure and w...
Giger and Davidhizar’s      Transcultural Assessment Model     It is important to remember that this model does notpresupp...
Giger and Davidhizar’s       Transcultural Assessment ModelThe U.S. Census Bureau has projected that by the year 2020 only...
Giger and Davidhizar’s        Transcultural Assessment Model Further projections indicate that the number of Asian America...
Giger and Davidhizar’s        Transcultural Assessment ModelWe will began our discussion by:1. Assessing our client’s Viet...
Nursing Assessment                     Component 1Culturally unique individuals (includes place of birth and “time” incoun...
Nursing Assessment   Component 1Mai was born in Vietnamand left with her family atage 7. She is now 25 yearsold.Vietnam is...
Nursing Assessment                      Component 1Vietnam was initially divided into 2 spheres of influence with NorthVie...
Nursing Assessment  Component 2     Space (Proximity to others -     degree of closeness when talking     or standing near...
Nursing Assessment                 Component 3Communication (Language spoken – includes non-verbal)                       ...
Nursing Assessment                                    Component 3Respect is evident incommunication and“cornerstone” of Vi...
Nursing Assessment  Component 3    • Children are taught to think before      speaking    • Eye contact is avoided out of ...
Nursing Assessment                        Component 3              Communication Style – Expression of emotion            ...
Nursing Assessment                       Component 3For interviewing purposes:    – Use short and direct sentences    – Pl...
Nursing Assessment                   Component 4Biological variations (body structure, diseases specific topopulation and ...
Nursing Assessment  Component 5       Environmental HealthCultural health practices (definitionof health and illness)Empha...
Nursing Assessment  Component 5                 Environmental Health   • Laboratory tests (drawing of blood) - to     Viet...
Nursing Assessment                    Component 5                            Mental Health• Emphasis on “saving of face” f...
Nursing Assessment                    Component 5               Mental Health• Cultural adjustment and PTSD common with  i...
Nursing Assessment  Component 5                  Mental Health     Denial as a defense mechanism is seen and     congruent...
Nursing Assessment  Component 6                          Time         Emphasis is on ancestors and the         past. Orien...
Nursing Assessment                       Component 7        Social OrientationThe family is the backbone oftradition and h...
Treatment PlanNursing Diagnosis Communication, impaired verbal, related to foreign-language barrierClient Outcome         ...
Treatment PlanNursing Diagnosis - Noncompliance (risk for) related to misunderstanding of theprescribed treatment secondar...
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Presentation on Giger and Davidhizar’s Transcultural Assessment Model and its use in assessing care of clients from multicultural populations for medical professions.

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Mia's presentation revised

  1. 1. Giger and Davidhizar’sTranscultural Assessment Modeland its use in assessing care of clients from multicultural populations Presented by Gerri Virgil, M.S.N., R.N.
  2. 2. Objectives• Describe Giger and Davidhizar’s Transcultural Assessment Model and its use in assessing care of clients from multicultural populations.• Identify nursing diagnoses and interventions specific to Mai’s Vietnam culture using the Transcultural Assessment Model. 2
  3. 3. Giger and Davidhizar’s Transcultural Assessment Model• The goal of transcultural nursing is to be cognizant of culturally relevant facts about the client in order to provide culturally competent care. 3
  4. 4. Giger and Davidhizar’s Transcultural Assessment Model NursingCulturally assessment uniqueindividual Communication SpaceBiological Environmental Social Time Organizationvariations control 4
  5. 5. Giger and Davidhizar’s Transcultural Assessment ModelThe Transcultural Model has components of social structure and world view factors that influence health through language and environment. 5
  6. 6. Giger and Davidhizar’s Transcultural Assessment Model It is important to remember that this model does notpresuppose that all individuals of a specific cultural group think or behave in a similar manner. 6
  7. 7. Giger and Davidhizar’s Transcultural Assessment ModelThe U.S. Census Bureau has projected that by the year 2020 only 53%of the U.S. population will be of White European descent.By the year 2020 only 53% 7
  8. 8. Giger and Davidhizar’s Transcultural Assessment Model Further projections indicate that the number of Asian Americans willtriple and African Americans will double. An understanding of culturesdiffering from the so-called “norm” is crucial to providing relevant care for our clients.Asian Americans will triple African Americans will double 8 in population in population
  9. 9. Giger and Davidhizar’s Transcultural Assessment ModelWe will began our discussion by:1. Assessing our client’s Vietnamese culture using Giger and Davidihizar’s Trancultural Assessment Model2. Identifying nursing diagnoses followed by nursing interventions 9
  10. 10. Nursing Assessment Component 1Culturally unique individuals (includes place of birth and “time” incountry) 10
  11. 11. Nursing Assessment Component 1Mai was born in Vietnamand left with her family atage 7. She is now 25 yearsold.Vietnam is bordered byCambodia and Laos on thewest, Gulf of Thailand onthe south and on the eastby the China Sea. 11
  12. 12. Nursing Assessment Component 1Vietnam was initially divided into 2 spheres of influence with NorthVietnam communist and South Vietnam U.S. supported. It is now theSocialist Republic of Vietnam.There were 3 waves of migration to the U.S. after the Vietnam War:First Wave – 1978 included professionals and ranking South Vietnammilitary officialsSecond Wave – Chinese & Vietnamese business peopleThird Wave – I980 boat people left for economic and political reasons. Amajority in poor physical condition and unable to write/read English orVietnamese well. (Mai’s family was in this “wave”. 12
  13. 13. Nursing Assessment Component 2 Space (Proximity to others - degree of closeness when talking or standing near others) • In Vietnam culture, individuals are “comfortable” when others stand 18 inches to 3 feet away • Touch is not welcomed from “strangers” or non-family members 13
  14. 14. Nursing Assessment Component 3Communication (Language spoken – includes non-verbal) 14
  15. 15. Nursing Assessment Component 3Respect is evident incommunication and“cornerstone” of Vietnamsociety notably with use of“titles (i.e., Aunt, Uncle infront of “names” for familymembers). Last namecomes before first name(i.e., Nyguen Mai). Greatrespect for the family and“elders”. This Soviet or Communist style statue presents Ho Chi Minh as a kindly older male relative, with his arm protecting the girl beside him. The statue’s form suggests not only that Ho Chi Minh was, and is, like a father, educating the Vietnam nation and people, but also that the nation and its citizens are vulnerable, precious, and uneducated like young children. 15
  16. 16. Nursing Assessment Component 3 • Children are taught to think before speaking • Eye contact is avoided out of “respect” • Bowing of head to show respect (i.e., to nurse, teacher, elder) – “Beckoning” is done with palm and waving of fingers (upward palm is for “beckoning of an animal and is considered an insult) 16
  17. 17. Nursing Assessment Component 3 Communication Style – Expression of emotion Asian AmericanNon-verbal VerbalSubtle, indirect Open, directSerene, stoic, suppression of Expressive, spontaneous negative emotionsIndirect expression of Direct, verbal and physical affection by fulfilling expression of affection 17 obligations, needs
  18. 18. Nursing Assessment Component 3For interviewing purposes: – Use short and direct sentences – Plan questions carefully, focus on one item for yes and no questions – Avoid technical jargon – Avoid “jokes” – humor difficult to translateUse an interpreter for language of origin (same sex, if possible) 18
  19. 19. Nursing Assessment Component 4Biological variations (body structure, diseases specific topopulation and nutrition) Body size of Vietnamese • Averages 80 to 130lbs with a small frame • Blood type B (present in only 8% of White race) • Lactose intolerant (congenital) • Anemia • Prone to fungal infections and parasites (i.e., hookworm and amebiasis) 19
  20. 20. Nursing Assessment Component 5 Environmental HealthCultural health practices (definitionof health and illness)Emphasis on : – Naturalistic (Folk medicines) – Supernaturalistic (Demons, Gods) – Metaphysical (“Balance” harmony) 20
  21. 21. Nursing Assessment Component 5 Environmental Health • Laboratory tests (drawing of blood) - to Vietnamese means losing body fluids may lead to “suffering” and “loss” • Consider tablets as “strong” - may take 1/2 of tablet. Prefer liquid medicines. Studies show Vietnamese required dose for psychotropic is significantly lower than for American counterparts • Nutrition - staple is rice diet, up to 3 bowls of rice daily, osteoporosis common with low calcium intake. Children drink milk (evaporated milk) with ice and fruit 21
  22. 22. Nursing Assessment Component 5 Mental Health• Emphasis on “saving of face” for family - family member not brought in for “mental assistance” until the situation is “critical” 22
  23. 23. Nursing Assessment Component 5 Mental Health• Cultural adjustment and PTSD common with immigration. Emotional and behavioral problems often related to: – Underemployment – Loss of extended family – Stresses of adaptation – Symptoms of hopelessness – Acute distress – Fatigue – Mood instability seen 23
  24. 24. Nursing Assessment Component 5 Mental Health Denial as a defense mechanism is seen and congruent with Vietnamese values of harmony and submission to the common good. The culture is Chinese influenced, with overt expression of anxiety, disappointment, anger and negative feelings are considered “weaknesses.” Studies show mental illness expressed as physical illness is “preferred.” 24
  25. 25. Nursing Assessment Component 6 Time Emphasis is on ancestors and the past. Orientation is in terms of events, such as births, deaths and marriage, not specific dates on a calendar. This is important for nurses obtaining a chronological “history of illness.” Also, being “late or early” is not considered “important.” (factor with medication compliance and medical appointments.) 25
  26. 26. Nursing Assessment Component 7 Social OrientationThe family is the backbone oftradition and heritage, family,loyalty with “filial loyalty”commanding children to obeyparents. Mental illness, juveniledelinquency, academic failure, etc.are consider a disgrace to family. 26
  27. 27. Treatment PlanNursing Diagnosis Communication, impaired verbal, related to foreign-language barrierClient Outcome Nursing Interventions1. Client will be able to 1. Determine client’s understanding and communicate more ability to communicate in English. effectively customs and 2. Talk slowly, enunciating words. beliefs used in treating 3. Face client and speak in a slow, clear illnesses and nurse will voice. better understand these 4. Use gestures to convey meanings, but customs. do not use excessive “touching.” 5. Attempt to locate a translator for assistance (if needed). 6. Provide client adequate space to communicate without “crowding.” 7. Keep language simple. 27
  28. 28. Treatment PlanNursing Diagnosis - Noncompliance (risk for) related to misunderstanding of theprescribed treatment secondary to the belief that medications in the Western worldare much stronger than those found in the Far East.Client Outcome Nursing Interventions1. Client will demonstrate an 1. Assess client fear of prescribed treatment understanding of prescribed 2. Promote health teaching to educate client on medical regimen. the effects of prescribed medicine. 3. Warn client that some medications may make the client sleepy and that this is an expected occurrence. 4. Teach client about importance of adhering to prescribed medical treatment. 5. Reassure client that prescribed medication is appropriate and safe for client. 6. Review medication, dosage, and proper administration technique to help client feel more comfortable with the treatment. 28

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