Indian cultural competence impact on health behavior using Giger and Davidhizar’s Criteria
Introduction
In order for
nursing students in an undergraduate program to be able to assess and treat
patients from various cultural backgrounds, the Giger and Davidhizar’s
Transcultural Assessment Model was developed in 1988. Cultural phenomena such
as communication, time, location, social structure, environmental regulation,
and biological diversity all go into the concept's construction. Using these as
a guide, one can develop culturally appropriate treatment plans for your
patients. This essay will use the six criteria to assess India’s cultural
competence and its impacts on health behaviors.
1. Communication
While language is necessary, it is not the primary part
of intercultural communication. Nonverbal signs are also required for effective
communication, among other things, between employees, their families, and
occupational health nurses. Due to the nature of nonverbal communication, eye
contact is critical, however it differs by culture. Indians are taught to keep
their eyes open in nursing schools and the business sector. The contrary is
true in other cultures, as shown by the fact that, whereas Arabs detest eye
contact, Indians often look down to indicate that they are paying attention to
what is being spoken (Beasley et al., 2021). Elders in India
often make eye contact with youngsters. On the other hand, staff members are
unlikely to do so when children get medical or nursing care. When conversing
with patients about personal matters, occupational health nurses must keep in
mind how different cultures perceive eye contact. Nursing schools in India
teach students how to engage with sick people via touch. When it comes to
contact, individuals from distinct cultures may not have the same conception of
the word "touch." According to Maier's book, Lorentz's clientele from
Arab or Hispanic cultures do not want men to touch certain areas of the female
body. In the future, women of Arab or Hispanic ancestry may be unable to care
for males. Many Asians are averse to having their heads touched, believing that
their skulls contain a source of power that should be avoided at all costs(Beasley
et al., 2021). According to Maier-Lorentz (2008), occupational health nurses and
other healthcare professionals should explain to their customers why they are
about to be touched. As a consequence, they will be able to avert
misunderstandings on their own. For many nurses educated in the United States,
silence is an unsettling and impolite nonverbal technique. They despise it and
feel that its use is harmful. Silence may suggest that you do not understand or
do not want to respond to a question. According to Maier-Lorentz, American
Indians, Chinese, and Japanese people should keep their mouths shut when
listening to a speech. This is a considerate gesture. Additionally, they may
use quiet to convey the impression that they have pondered what they are going
to say before proceeding. In Asian cultures, it is common to stay quiet while speaking
with elders as a sign of profound respect. While quiet indicates a respect for
another's privacy for English and Indian speakers, it also indicates agreement
for French, Spanish, and Russian speakers(Beasley et al., 2021). As a
consequence of their perception of the environment, it has an effect on how
people view health care. They feel they have some influence over life events
and, as a result, over the medical care they get. They think they have little
control over their lives, which makes them more fatalistic about health care
and less cooperative with doctors when it comes to following treatment
prescriptions. Indian civilizations have educated its people to be incredibly
hopeful in all situations as a consequence of how they were taught and schooled
to talk about their own experiences.
2. Space
Generally speaking, space is defined as the amount of
distance between you and another person that helps you feel comfortable being
in close proximity to that other. It is difficult to define "personal
space" in India because of the cultural differences. Understanding it, on
the other hand, is a vital demand in our country. Despite the fact that prior
to covid19, space was not a factor to consider while researching health habits.
The Indian people are very gregarious beings who, according to their culture, like
spending a lot of time together and, as a result, believe themselves to be a
single large family. It is possible that withdrawal from this culture of
togetherness would lead to depression; as a result, health practitioners must
take this into consideration while treating depressed patients. Initially,
space was not considered to be a significant issue when it came to
administering occupational nursing services (Jongen et al., 2017). However, it
has recently been discovered to be a factor when it comes to treating people
from India who are depressed because their living space is large and they have
lost touch with some of the people they consider to be very close friends or
family members. Instead of being depressed because their personal space has been
infringed, Indians are more likely to feel depressed because they have been
abandoned by people who they think should be close by. What I'm talking to here
are traditional Indians, as opposed to the present Indians, who spend the
majority of their time on social media interacting with foreign characters.
Occupational therapists would recommend that their patients' families come see
them if they were sad since Native Americans place a high priority on
community.
3. Social
Organization
Understanding the
organization Indian society is organized is equally critical. Gender roles,
family goals and objectives, and health care decision-making are all influenced
by social organization. The decision-making authority may be given to a
maternal grandmother, even if the patient's care is supplied by someone outside
the immediate family. Both of these people should be included in the care
planning process in order to foster trust and understanding. Care should be
offered within the framework of a family, regardless of where it is received.
The concept of family to an Indian patient may be very different from what we
consider to be the norm in the West (Jongen et al., 2017). The Indian tribes of North Indians , like many
others, place a high value on family and use it as a means of expressing one's
identity in public. Ancestors who have gone on are part of an individual’s
thoughts, talks, and activities as well . Lumbees and other tribes may define
family to include those not tied by blood but by some other relationship, friendliness,
and understanding. Knowledge of the interconnections between several North Indians
tribes is a crucial component of
understanding social organization and identity. Many American Indians (AIs) in
North Indians have ancestors from a wide
range of ethnic groups, and a family's health history may indicate this if the
individuals of the family have a long history of poor health.
In AI
civilizations, time is not predicated on a linear viewpoint as it is in Western
countries, but rather on a current orientation that incorporates the past,
present, and future all at once. People in various tribes and families place
varied values on the past, present, and future because of the
interconnectedness of communication, social organization, and family dynamics.
When deciding on the kind and delivery of treatment for clients of Indian
ancestry, this understanding of time's construction must be taken into
consideration. The start time of a planned event in Native cultures could be
established, but it may not begin until all members of the community are there.
An example of respecting this feature of the culture would be speaking with the
person in the patient’s social structure recognized as the health care
decision-maker to identify suitable times for health care visits.
5. Time
There are many Indians who don't understand the concept of time, whether
at the federal or state level. They often show skepticism when Indians claim
indigenous status without full federal recognition, wrongly assuming that this
designation is the only thing that determines who is indian. Instead, federal
or state recognition is a legal agreement between governments, not an
endorsement of a person or group's identity. Many Native American tribes in
North Indians have had their legal
status changed or examined many times, which has led to them being given
different names.
Most of the AI communities in the Eastern United States have kept their
ancestral lands for a long time, like North Indians 's. They have also welcomed
non-AIs and members of other tribes into their old settlements. Members of one
extended family can belong to different tribes or live in different parts of an
American Indian organization. This is one of the most complicated things about
American Indian tribes(Wu, 2021). People who aren't Native don't always think
that AIs are lying about who they are based on their tribe's status or their
own appearance, even though tribes with the longest history of contact are the
least likely to look like the AI stereotype that is so well-known in the United
States. Du Bois came up with these ideas about race more than 100 years ago,
and they don't make sense.
They were
enslaved, moved around, and got sick over many years. The tribes in North Indians
were likely first exposed to European
illnesses through trade and direct contact in 1524. This is when they were
first exposed to them. AIs still care
about land, even though colonization has caused a lot of damage. Whether or not
they stay in their native communities, this is still important to them(Wu, 2021).
Land has always been very important to AIs' survival, but also because the
physical settings of tribal groups help define their identities. Due to its
limited land, colonialism, and Jim Crow laws' impact on its people, North Indians
clearly needs therapy that is culturally
relevant. People often have negative views about tribal identification or
unique phenotypes, which makes it clear that North Indians needs therapy that is culturally relevant..
5. Environmental
Control
When evaluating
the lives of others, it is important to understand one's own worldview and how
it affects one's sense of disease and choice of treatment. People think about
everything they see and hear through the lens of some kind of conceptual frame
of reference, says Fawcett. Conceptual models have been used to look at human
behavior and how it affects health care and the development of knowledge,
skills, and ethics. Indians use a unique way to think about and understand the
world. AI is a worldview that emphasizes historical knowledge, spirituality,
commitment to family, community, and locality, and harmony, even though
different tribes and people have different ideas. American Indian scholars have
come up with a way for nurses and other health care workers to understand how
to put the Indian worldview into practice. CFNNAC, the only model of its kind
in the literature, can be used by nurses and other health care professionals
who work with indigenous people to help them learn and practice.
There will be
167,809 Indians living in North Indians in the 2020 U.S. Census, which is a 7% drop
from 2010. Lumbee Indians are one of the country's largest tribes, even though
North Indians 's population has dropped. Some say this is because there has
been a rise in people who say they are of mixed ethnicity. The health problems
in this group have been going on for a long time, and most of the people who
work with Indians aren't Native. It is very important for all health care
workers in North Indians to know about
the Indian population so that they can give the best treatment possible. There
are three of us now who used to work in AI. We also teach nursing, American
Indian studies, and social work at our school. We live near a lot of college
students who are mostly interested in AI. When we started working with kids and
families, we were very excited about it. We have a lot of experience in nursing
and social work. We are unique in our jobs because we are AIs, and we get to
work with AI students right away.
It's important for
us to be able to understand and speak for the people we help. Our professional
associations also agree that we need to be culturally aware when we know, do,
and believe in what we do. Because culture is the lens through which we see our
surroundings, it is important for health care workers to always be on the
lookout for ways to be more culturally aware and competent.
6. Biological
Variations
In North Indians , there are eight tribes that are recognized by the
state. The Eastern Band of Cherokee Indians (EBCI) is one of them. These
tribes, no matter where they are, have different histories. These days, North Indians
's eight state-recognized tribes still have a lot of love for the places and
towns they call home. Most Indian tribes are made up of groups from other
tribes that came together in the areas we now call their "tribal
homelands." In addition to the North Indians tribes, there are people from all over the
United States and Canada living in every county in the state. Some of them are
American Indians (AIs).
Indians don't understand the process of tribal registration, whether at
the federal or state level. When AI people claim to be indigenous even though
they haven't been approved by the federal government, Indians can be shocked.
They think this classification is the only thing that determines who should be
called Indians. Instead, federal or state recognition is a legal agreement
between governments, not an endorsement of a person or group's personal or
group identity. Many AI groups in North Indians have changed their legal status many times,
including getting new names when their legal status is reviewed or appraised.
Many AI communities in the Eastern United States, such as North Indians ,
have kept their homes for years and let other tribes and non-AIs live inside
their ancient cities. One extended family organization may belong to multiple
tribes and live in different places, which makes it hard for American Indian
tribes to keep track of family history. People who aren't Native don't always
think that AIs are lying about who they are based on their tribe's status or
their own appearance, even though tribes with the longest history of contact
are the least likely to look like the AI stereotype that is so well-known in
the United States. These ideas don't take into account the social conceptions
of race that were first proposed by Du Bois more than 100 years ago.
It took hundreds of years of slavery, expulsion, migration, and exposure
to disease for the tribes of North Indians to get where they are today. The tribes were
likely first exposed to European illnesses through trade and direct contact in
1524. Even though colonization caused a lot of damage, land is still important
for AIs, even if they stay in their ancestral societies. Because tribes are
defined by their physical surroundings, land has always been important to AI
existence. North Indians has a limited
amount of land, a history of colonialism and Jim Crow laws, and people who
sometimes have negative views about tribe affiliation or individual phenotypes
make it important for people to be treated in a way that is culturally
appropriate..
Conclusions
This paradigm emphasizes how important it is to see
each person as unique in his or her culture. They say there are six things that
are common to all cultures: communication, space, social organization, time,
environmental management and biological variability [10]. This is what they
say. When people interact with each other, communication is one of the ways
that they do that There are many ways to communicate, both spoken and written,
as well as many ways to express yourself, such as facial expressions and
gestures, as well as nonverbal cues like loudness and pitch. Language can get
in the way of great therapy because of simple misinterpretations and a lack of
ability to communicate as expected. The "personal space" that people
keep while talking is another dimension that changes based on the cultural
backgrounds of the people who are talking to each other. The sense of space
also includes three more behaviors: how you connect with things in your
surroundings, where you are, and how you move around in the environment. It is
very important to be careful and not to cross the line when it comes to these
parts of contact, because doing so could cause a lot of pain to patients.
People in different cultures organize their lives in an organization that fits
their families, beliefs, and obligations. This is the third component. This
part asks nurses to keep in mind that patients' behavior may be affected by
things like their sexual orientation, how they use titles, and how much power
they have. An understanding of this part could help nurses avoid being seen as
rude or unfriendly. In terms of how it affects people, time is the same as
social organization. Groups can be categorized by how they spend their time,
like if they are clock-focused or if they spend their time with others. People
who pay more attention to the ticking of the clock aren't as happy as those who
don't. If they don't keep their appointments on time, they don't want to be
seen as unfriendly or rude. Those who work for a good cause place a lot of
value on the present. People who think of time this way see it as a spectrum
that changes over time based on the length of time between events. The fifth
component is environmental control, which is about how the person thinks about
society and how they think about things like how illness happens, how it should
be treated, and how health is promoted and maintained. The biological
orientation is the last and most important part. It is also the most important
part. Races are different physically because they have different DNA. Some
races are more likely to get certain diseases than others are. Other important
parts of this paradigm include being more aware of how much pain you can take
and having more problems and preferences in your diet.
References
Beasley, C.,
Jones-Locklear, J., & Jacobs, M. A. (2021). Cultural
competence with American Indian clients: Workforce and personal
development. North Carolina Medical Journal, 82(6),
423-426. https://doi.org/10.18043/ncm.82.6.423
Jongen, C., McCalman, J.,
Bainbridge, R., & Clifford, A. (2017). Health workforce
development interventions to improve cultural competence. SpringerBriefs
in Public Health, 49-64. https://doi.org/10.1007/978-981-10-5293-4_4
Working with diverse clients using
cultural competence and humility. (2020). Skill Development for
Generalist Practice: Exercises for Real-World Application, 15-24. https://doi.org/10.4135/9781506384894.n6
Wu, J. (2021). Personal competence
from the perspective of cultural knowings. Journal of International
Education and Development, 5(3), 125-130. https://doi.org/10.47297/wspiedwsp2516-250020.20210503
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