Several models of service care delivery have emerged to meet the challenges of providing health care to our growing multi-ethnic world. This article will present Campinha-Bacote's model of cultural competence in health care delivery: The Process of Cultural Competence in the Delivery of Healthcare Services. This model views cultural competence as the ongoing process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of the client (individual, family, community). This ongoing process involves the integration of cultural awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire.
Cultural competence in the delivery of nursing care is an expectation of accreditation and approval boards for nursing in the United States. This study evaluated the effectiveness of four different nursing program curricula in developing culturally competent new graduates. Four methodologically and geographically diverse groups of graduating BSN students in the United States were given the Inventory for Assessing the Process of Cultural Competency Among Healthcare Professionals-Revised (IAPCC-R prior to graduation and after completion of course work. A variety of curricular methods for achieving cultural competency were included. Two programs utilise a theory or a model developed by recognised transcultural expert nurses, Madeline Leininger and Josepha Campinha-Bacote. One program utilised an integrated approach employing no specific model. One program utilised a free-standing two credit culture course within the curriculum, taught by nursing faculty with strong cultural preparation. Results indicate that these 212 graduating nursing students scored only in the culturally aware range, as measured by the IAPCC-R, regardless of what program model they attended.
For over 30 decades, cultural competence has commanded significant attention, being viewed as the cornerstone of fostering cross-cultural communication, reducing health disparities, improving access to better care, increasing health literacy and promoting health equity. However, a medley of definitions and conceptualizations has created intense debate, questioning its true ability to address cross-cultural problems in healthcare delivery. One ongoing debate centers around the relationship between cultural competence and cultural humility. Part I of this two-part series on cultural competemility will revisit this debate by discussing competing views of this relationship. A new paradigm of thought regarding the relationship between cultural competence and cultural humility will be proposed, one necessitating that cultural humility and cultural competence enter into a synergistic relationship. This synergistic relationship is embodied in a term coined "cultural competemility.” This article presents the debate regarding cultural competence verses cultural humility, defines the term cultural competemility, explains the relationship between cultural humility and cultural competence, describes the process of permeation and concludes by proposing a synergistic relationship between cultural competence and cultural humility to create the process of cultural competemility. Part II of this series will apply an intersectionality approach to the process of cultural competemility and offer strategies for nurses to actively challenge and address inequalities.
This paper focuses on the use of physical touch in nursing care in facilities for short-term stay. Extant research (Foy & Timmins, 2004; Mcilfatrick et al., 2006; Nystromö et al., 2003) has raised the questions, How can nursing care best be tailored to meet the patient‘s overall needs, both physical and emotional? and How to strike an optimum balance between caring and instrumental aspects of nursing? This paper discusses how the exchange of physical touch can be seen as an epitome of caring in nursing care in facilities for short-term stay; it is connected to psychological and spiritual aspects.
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