The Eight-Stage Process of Concept Analysis
Discuss about the Concept Analysis of Cultural Competence.
Nursing is a profession that has so many concepts. Each of the concepts is necessary because it plays a significant role in defining the discipline and giving it a meaning. The role of the nursing practitioners and researchers is, therefore, to have a deeper understanding of each of the concepts since it means a lot to them, their patients and the organizations to which they are attached. Cultural competence is one of the most outstanding concepts in nursing. It basically means the provision of healthcare services to people irrespective of their cultural diversities. The purpose of this paper is to use Walker and Avant’s eight-stage process to provide a comprehensive analysis of the concept of cultural competence. The concept was chosen because it is essential enhancing the practice of delivering quality and safe healthcare services to the patients without caring about their cultural background. Its synthesis, understanding, and application can, therefore, be relied upon to achieve health equity and equality which has been under a threat of cultural exclusivity and intolerance.
As already hinted, this analysis is based on the eight-stage process that was proposed by Walker and Avant in 2011. This proposal was made after an earlier one that had been developed by John Wilson in 1963. According to Wilson, the process of concept analysis was presumed to be a lengthy process made up of 11 stages which encompassed the activities like the concept identification, isolation, and construction of actual meaning (Lusk & Fater, 2013). However, in their research, Walker and Avant disputed this claim and instead came up with an eight-stage process that is still popular with the nurses up to date. The eight-stage process precisely consist of concept selection, determination of the purpose of the analysis, identification of the discovery of the uses of the concept, determination of the attributes of the concept, construction of a model case, construction of the borderline, identification of antecedents and consequences, and the definition of empirical referents respectively (Garside & Nhemachena, 2013). All these were used in the analysis of the concept of cultural competence.
Cultural concept has been identified as the most suitable concept to be analyzed in this paper. As already highlighted, cultural competence simply refers to the practice of providing services to the people who are affiliated to different cultural backgrounds. A culturally-competent nurse is, therefore, a one who does not consider the cultural backgrounds of the patients and provide them with equal treatment irrespective of their culture (Almutairi, McCarthy & Gardner, 2015). All the nurses should possess cultural-competence skills because it can benefit them as well as the patients in many ways.
Cultural Competence in Nursing
The concept of cultural competence was, hence, selected for analysis because it is useful and should be understood ad applied by all the nurses who deal with patients. if all the nurses learn to be culturally-competent, they can do a great service to the public which depends on them. In fact, all nurses must embrace this concept because it can help in guaranteeing quality and safe healthcare services to all the patients (White, 2014). At the same time, it can help in improving the health standards of the people because no one would refrain from seeking for medical services fearing for cultural exclusivity or intolerance. The other reason why the concept was chosen is because it the cultural competence is manageable and can be enhanced if individual nurses know about all that it entails. Therefore, by analyzing this concept, a nurse can have an opportunity to be challenged, boost the understanding, and take the necessary steps to improve (Robert, Tilley & Petersen, 2014). All these are appropriate because they can benefit the patients, the healthcare facility and individual nurses as they develop their career and learn to fit into the society no matter how diverse it might be.
This analysis is worthwhile because it is done for a worthy cause. There are two main reasons why the concept of cultural competence is analyzed. The first aim of analyzing this concept is to create an understanding on the topic for research purposes. Since cultural competence is a concept that should be deeply understood by all the healthcare providers, it should be upon them to know exactly what it entails for them to apply it in their day-to-day practice. As a matter of fact, all nurses should have practical and theoretical knowledge on the matters to do with the patients’ health (Garneau & Pepin, 2015). Therefore, by analyzing this concept, the nurses would get an ample opportunity to comprehend and use it to improve the quality of their services as much as they can. The other aim of this analysis is to disseminate the information that can be used to empower the nurses and enable them to improve on their communication and interpersonal relation skills. These are key competencies that should be possessed by the nurses who are ready to serve plural societies where cultural competence is a prerequisite knowledge. This shows that the analysis focused since it is aimed at achieving something that will make a positive contribution towards the efforts of delivering culturally-competent care.
Importance of Cultural Competence
Cultural competence is a concept that has been in use for many decades. The concept is not only applied in nursing, but also in other disciplines as well. Culture has been, for a long time, used to divide the society. It has been viewed as one of the social factors that determine people’s health. In a country like Australia, for instance, the indigenous communities like the Aboriginals have been lagging behind when it comes to the matters of health because of their culture. The cultural values and beliefs held by such communities have been depriving them from accessing quality and safe healthcare services (Blais, Hayes, Kozier & Erb, 2015). This happens because they hold conservative views on modern health care or are discouraged because they are served by the culturally-incompetent personnel who do not understand, tolerate and appreciate their culture.
However, all such challenges are a thing of the past because modern healthcare setting favors the acquisition of culturally-competent skills. All the nurses are expected to be culturally-competent because they are serving in a diverse society which is made up of people from various backgrounds. Cultural competency is therefore important because it helps in promoting the delivery of healthcare services to everyone in the country (Shen, 2015). Since it has become a key competency, all the nurses are required to learn how to relate well with the people from other cultural backgrounds because without that, it might not be possible to serve and meet their needs as expected.
Today, the practice of cultural competence has been largely-intertwined with intercultural communication, a skill that all the nurses are supposed to have. During their training, the nurses should take a course on intercultural care because without it, they might be ill-equipped to serve in cultural settings other than their own. However, to achieve this, all the nurses are required to have excellent interpersonal and intercultural communication competencies at all times. At the same time, they should be respectful people who are always ready to show a regard to people from other diversities regardless of the preconceived opinion they have against them (Jeffreys, 2015). Such a spirit of cultural competence is what suits the contemporary setting because it is becoming more diverse as time goes by thanks to new developments like globalizations which have essentially made it easier for people to move from one place to another without caring about the geographical and cultural boundaries that separate them a part.
Attributes of Cultural Competence
Cultural competence is concept which is gaining importance as time goes by. It has reached a time when all the nurses should embrace the concept of cultural competence care because the world is becoming a small village where people interact with one another without caring about their geographical borders or cultural beliefs. The healthcare practitioners should also be ready to serve all the people, not only those from the same culture with them. Therefore, this analysis identifies the following as the main attributes of cultural competence: dynamic process, cultural skill, cultural knowledge, cultural sensitivity, and cultural awareness.
Cultural awareness refers to the knowledge on the existence of culture. For a nurse to be culturally competent provider, the first attribute that he or she must possess is the knowledge about what culture is and all the kinds of cultural practices, traditions, values, and views of the people including their own. This knowledge should however start from one’s own culture. Then, it should proceed to others as well. Without cultural awareness, it might not be possible for anyone to be culturally-competent because of ignorance on what it entails and what should be done about it. Cultural sensitivity is also another attribute which means that a nurse should be conscious of the cultures around him or her. For one to be culturally-competent, one has to be sensitive to other people’s culture and be ready to treat them with the respect that they deserved however unique they might be. Cultural sensitivity is an attribute that must be possessed by any nurse because without it, it might not be possible to know what else to do.
Cultural skill is also another attribute that defines what cultural competence is. Cultural skill refers to the ability to master the competencies that can be used to work with people from other diversities. It encompasses activities like respect, tolerance, understanding, and appreciation. Without such qualities, no nurse can effectively operate in a multicultural setting without facing challenges. In this regard, it is incumbent upon all the nurses to acquire and apply such skills because they mean a lot to them as far as their progress is concerned. Last, but by no means the least, dynamic process has been identified as another attribute of cultural competence. As a matter of fact, cultural competence is all about dynamism (McFarland & Wehbe-Alamah, 2014). If the society were homogenous, there would be no need of becoming culturally-diverse because all the people would be having similar behaviors, beliefs, views, traditions, and values. However, since we are in a diverse society, there is a need to be dynamic and flexible enough to cope-up with any differences that might conflict with our culture.
Borderline Case
Cultural competence is not a new phenomenon. It is an old concept that has been in practice for quite some time now. Its existence has been proven by a number of scenarios that have been witnessed in a clinical setting. Here, I would like to give a model case of a situation where an Aboriginal patient went to a medical facility to seek for medical attention. Although the nurse was a non-indigenous, she did her best to provide healthcare services to this patient. The nurse took her time to warmly welcome the patient and effectively communicated to him because she knew that as an Aboriginal, the patient had to be handled keenly. The nurse also did her best to assess the patient’s condition and managed to come up with the right care plan that finally made the patient to leave the facility in a happy mood. This case is appropriate for use in this analysis because it has all the attributes of the cultural competence care that had been identified. These include dynamic process, cultural skill, cultural knowledge, cultural sensitivity, and cultural awareness. The nurse was aware of the cultural differences between her and the patient. Therefore, she had to use her cultural dynamism, sensitivity, and skills to create a favorable environment that suited the patient.
Contrary Case
A borderline case is different from a borderline one because it does not actually represent the model and shows how it can be effectively used. It is the exact opposite of the borderline case because it shows how the identified attributes are either misused or unused. A perfect example of a contrary case is where an indigenous patient left the hospital untreated because of the cultural conflict between him and the non-indigenous nurse. The patient felt underserved because the nurse who obviously comes from a different cultural background never communicated well and tried to disrespect his cultural views on the healing process that was to be initiated (Montenery, Jones, Perry, Ross & Zoucha, 2013). Failure of the nurse to attend to and meet the needs of this patient demonstrates the he was lacking the essential cultural competence attributes including cultural dynamism, sensitivity, and skills because it would have eased his work and made it possible to establish a good working relationship with the patient.
Antecedent refers to an event that precedes the concept. Antecedent for the concept of cultural competence, hence, include the incidents like cultural desire, cultural encounter, and cultural diversity. These are all issues that must occur before a case of cultural competence is identified. Each of them is important because it gives rise to a cultural competence scenario. For example, if there is cultural encounter between two people, the result might include tolerance or intolerance (Clifford, McCalman, Bainbridge & Tsey, 2015). Consequences, on the other hand, refer to the effects of what happens after the concept. As an impact, consequence takes place following antecedent. An example of a consequence for the concept of cultural competence is the satisfaction of the patient or the reputation of the nurse and the healthcare facility.
The last step in this analysis is the identification of the empirical referents. This last step is essential because it helps in the coming up with the measurement strategies to use in understanding the concept of cultural competence. Just like any other nursing concept, cultural competence is measurable because it has outcome which can be quantified. Its success can be determined by focusing on patient outcome especially the level of satisfaction, safety, and quality of care given in such a multicultural setting. These are self-centered tools used by carrying out an objective assessment of the patient’s condition.
Conclusion
Concept analysis is a skill that all the nurses should have. Apart from enabling them to identify the differences and similarities between concepts, it can give them an opportunity to identify their attributes, eliminate any vagueness that might be encountered, and create a precise, and clear meaning for each and every concept. That is what this analysis has achieved for the concept of cultural competence. The use of Walker and Avant eight-step process has made it possible to provide a comprehensive analysis of cultural competence and provide an insight on how it can be applied to improve patient experience in a healthcare setting. the use of the steps to illuminate the model cases, referents, antecedents, consequences, and the attributes made it quite easier to give an informative analysis for the concept of cultural competence and show how well it should be applied by the nurses who are committed towards the delivery of safe, quality, and satisfying healthcare services in a multicultural setup.
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