Transcultural Care

Dr Tina Harris, Lead Midwife for Education

Adapted from a presentation originally developed by Maggi Brimson

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Transcultural issues and care

– What is transcultural care?– The importance of culture in midwife practice– What is Culture?– Differences between culture, ethnicity and race.– The population of Leicester and Leicestershire– Meeting clients’ needs– Stereotyping and prejudice

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What is transcultural care

• The goals of transcultural care are to,– “... give culturally congruent nursing care, and to

provide culture specific and universal nursing care practices for the health and well-being of people or to aid them in facing adverse human conditions, illness or death in culturally meaningful ways.”

http://en.wikipedia.org/wiki/Transcultural_nursing

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Why do we need to know about transcultural care?

• Meeting needs of population we serve– Needs of the local pop we serve are important and that is why we look

at the society around us when considering the care they need. Particularly relates to needs assessment of minority ethnic groups.

• Regulatory requirement– NMC (safeguarding the public)

• The code • Standards for pre-registration midwifery education

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Cultural competence

• Cultural competence refers to an ability to interact effectively with people of different cultures, particularly in the context of human resources, non profit organisations and government agencies whose employees work with persons from different cultural/ethnic backgrounds.

] http://en.wikipedia.org/wiki/Cultural_competence

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What is culture

• Culture is the learned and transmitted knowledge about a particular culture with its values, beliefs, rules of behaviour and lifestyle practices that guides a designated group in their thinking and actions in patterned ways.

(Leininger, 1978)

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Culture may be:-

• Knowledge • Values• Beliefs• Rules of behaviour• Lifestyle practices• Guidelines• Attitudes

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Culture can be transmitted by;

• Symbols• Language• Art• Ritual

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What is your own culture

• Values • Beliefs• Rules• Attitudes• Lifestyle practices

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How is your culture transmitted

• Symbols • Language• Art• Rituals

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What about cultures within healthcare?

• Loros• Maternity services– Home birth service– Midwifery led units– Large maternity unit managing complex cases

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How are these different?

• Culture• Race• Ethnicity• Religion

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Health Beliefs

• Individual but influenced by culture

• Fundamental for holistic practice

• Midwives bring in their own health beliefs and and expres the culture of midwifery practice as a professional group

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Types of Health Belief

• Biomedicine

• Personalistic (magico-religious)

• Naturalistic (holistic)

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Check list for midwifery care

• Care of women and their families needs to be both appropriate to the individual/group and also to take into account their cultural and religious beliefs.

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Checklist for midwifery care

• Midwives need to ensure that they undertake an assessment which takes into account the cultural and religious background of the person they are offering care to.

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Checklist for midwifery care

• Although midwives do not need to be cultural experts they need awareness of the possible effects cultural differences can have on all aspects of care.

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Ways of describing ethnic origin

• White: British• White: Irish• White: Other White• Mixed: White and Black Caribbean• Mixed: White & Black African• Mixed: White and Asian• Mixed: Other Mixed

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Ways of describing ethnic origin

• Asian or Asian British: Indian• Asian or Asian British: Pakistani• Asian or British Asian: Bangladeshi• Asian or British Asian: Other Asian

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Ways of describing ethnic origin

• Black or Black British: Caribbean• Black or Black British: African• Black or Black British: Other Black • Chinese• Other Ethnic Groups

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Leicester City population (304,000)

Census 2011

• 183,000 (60%) white British• 3200 (1%) White Irish• 9100 White other• 3100 (1%) white/black Caribbean• 900 white/black African• 2900 white/Asian• 1900 Mixed other• 56900 (19%) Indian Asian• 14000 (5%) Pakistani• 2800 (1%) Bangladeshi• 5800 (2%) Asian other• 4800 black Caribbean• 5800 (2%) black African• 1000 black other• 6500 (2%) Chinese• 3000 (1%) other

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Cultural issues in delivering care to pregnant women and their families

Can you think of how culture may impact on the care women will want and the care we will

give?

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Religion: Census 2001

• Leicester• Christian 44.72%• Buddhist 0.23%• Hindu 14.74%• Jewish 0.15• Muslim 11.03%• Sikh 4.21

• England & Wales• Christian 71.75%• Buddhist 0.28%• Hindu 1.06%• Jewish 0.5%• Muslim 2.97%• Sikh 0.63%

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Religion: Census 2001

• Leicester• Other religions 0.42%• No religion 17.43%• Religion not stated 7.07%

• England & Wales• Other religions 0.29%• No religion 14.81%• Religion not stated 7.71%

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Sources of information

– http:www.bbc.co.uk/religion (accessed 4/10/12)

– http:www.statistics.gov.uk/census (accessed 4/10/12)

– Holland K, Hogg C, (2001) Cultural Awareness in Nursing and Health Care, (Arnold: London)

– Watt S, Norton D (2004) Culture, ethnicity, race: what’s the difference? Paediatric Nursing.16, 8, 37-42.

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Further readingAndrews M and Boy J S (2012) Transcultural concepts in nursing care. 6th ed.

London:Lippincott Williams and Wilkins.

Kotsapas et al (2009) Transcultural considerations in obstetrics and gynaecology: what the clinician needs to know. Journal of Obstetrics and Gynecology. April 29(3) pp175-180

Lewallen L P (2011) The importance of culture in childbearing. JOGNN. 40(1) pp4-8Papadopoulos I et al (2006) Transcultural health and social care: development of

culturally competent practitioners. Edinburgh:Elsevier

Sookhoo D (2009) Race ethnicity and childbirth in C Squire (Ed) Social context of birth. Abingdon:Radcliffe Publishing pp85-99

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