Abstract
Studies on the development of cultural competence among healthcare providers tend to focus on the clinical encounter, with little attention paid to the environment. In this paper, results from a grounded theory study conducted with nurses and students to understand cultural competence development are presented; with a focus on findings that call particular attention to nurse-environment interactions. Two concurrent processes, as students and nurses develop cultural competence through interactions with their environment, were identified: “dealing with structural constraints” and “mobilizing social resources”. These dynamic interactions between healthcare providers and the larger structures of healthcare systems raise critical questions about the power of healthcare providers to influence the structures that shape their practice. The intersection of nursing theory with social and critical theories is essential to gain a comprehensive understanding of cultural competence development and to transform healthcare providers’ education in the service of social justice and health equity.
Acknowledgements
The first author received a doctoral scholarship from the Social Sciences and Humanities Research Council of Canada (SSHRC), and the Ministère de l’Éducation du Loisir et du Sport (MELS) of Quebec. Équipe FUTUR, funded by the Quebec Research Foundation, Society and Culture (FRQSC), funded the editing of this paper. The funding sources had no involvement in the research process or in the writing of the submitted article.
References
Andermann, L., Fung, K., & Lo, H. Cultural competence: From policy to practice to policy. Paper presented at the Workshop presented at the Diversity & Equity in Mental Health/Addiction Conference, 2009 Toronto, ON.Search in Google Scholar
Berlin, A., Nilsson, G., & Tornkvist, L. (2010). Cultural competence among Swedish child health nurses after specific training: A randomized trial. Nursing & Health Sciences, 12(3), 381–391.10.1111/j.1442-2018.2010.00542.xSearch in Google Scholar PubMed
Brach, C., & Fraser, I. (2000). Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review, 57(Suppl 1), 181–217.10.1177/1077558700057001S09Search in Google Scholar PubMed PubMed Central
Blanchet Garneau, A., & Pepin, J. (2015a). A constructivist theoretical proposition for cultural competence development in nursing. Nurse Education Today, 35(11), 1062–1068. DOI:10.1016/j.nedt.2015.05.019.Search in Google Scholar PubMed
Blanchet Garneau, A., & Pepin, J. (2015b). Cultural competence: A constructivist definition. Journal of Transcultural Nursing, 26(1), 9–15. DOI:10.1177/1043659614541294.Search in Google Scholar PubMed
Browne, A. J. (2007). Clinical encounters between nurses and First Nations women in a Western Canadian hospital. Social Science and Medicine, 64(10), 2165–2176.10.1016/j.socscimed.2007.02.006Search in Google Scholar PubMed
Chinn, P. L., & Kramer, M. K. (2008). Nursing’s Fundamental Patterns of Knowing. In Integrated Theory and Knowledge Development in Nursing (7th ed.). St. Louis: MO: Mosby Elsevier.Search in Google Scholar
Corbin, J., & Strauss, A. (2008). Basics of qualitative research. Techniques and procedures for developing grounded theory (3rd ed.). Thousand Oaks, CA: Sage Publications.10.4135/9781452230153Search in Google Scholar
Cross, T. L. (1989). Towards a Culturally Competent System of Care. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.Search in Google Scholar
Dewey, J. Reconstruction in philosophy Dover. (Originally published in 1920), 2004 Mineola, NY.10.1037/14162-000Search in Google Scholar
Fawcett, J. (1978). The “what” of theory development. In Theory development: What, why, how?(pp. 17–33). New York: National League for Nursing.Search in Google Scholar
Fung, K., Lo, H.-T. T., Srivastava, R., & Andermann, L. (2012). Organizational cultural competence consultation to a mental health institution. Transcultural Psychiatry, 49(2), 165–184.10.1177/1363461512439740Search in Google Scholar PubMed
Giddens, A. (1984). The constitution of society. Cambridge: Polity Press.Search in Google Scholar
Guba, E. G., & Lincoln, Y. S. (1989). Fourth generation evaluation. Newbury Park, CA: Sage Publications.Search in Google Scholar
Guba, E. G., & Lincoln, Y. S. (2005). Paradigmatic controversies, contradictions, and emerging confluences. In Denzin, N. K., & Lincoln, Y. S.(Ed.), Handbook of qualitative research (3rd ed.)(pp. 191–215). Thousand Oaks, CA: Sage Publications.Search in Google Scholar
Guerrero, E. (2010). Managerial capacity and adoption of culturally competent practices in outpatient substance abuse treatment organizations. Journal of Substance Abuse Treatment, 39(4), 329–339.10.1016/j.jsat.2010.07.004Search in Google Scholar PubMed PubMed Central
Guerrero, E. (2012). Organizational characteristics that foster early adoption of cultural and linguistic competence in outpatient substance abuse treatment in the United States. Evaluation and Program Planning, 35(1), 9–15.10.1016/j.evalprogplan.2011.06.001Search in Google Scholar PubMed PubMed Central
Heitzler, E. T. (2012). An innovative approach to increasing the cultural competence of nurses who care for childbearing women and newborns. Journal of Obstetric, Gynecologic & Neonatal Nursing, 41(S1), S161.10.1111/j.1552-6909.2012.01362_60.xSearch in Google Scholar
Jarrin, O. F. (2012). The integrality of situated caring in nursing and the environment. Advances in Nursing Sciences, 35(1), 14–24.10.1097/ANS.0b013e3182433b89Search in Google Scholar PubMed PubMed Central
Kagan, P. N., Smith, M. C., & Chinn, P. L. (2014). Philosophies and practices of emancipatory nursing: Social justice as praxis. New York, NY: Routledge.10.4324/9780203069097Search in Google Scholar
Leininger, M., & McFarland, M. R. (2006). Transcultural nursing: Concepts, theories, and practice (4th ed.). New York, NY: McGraw-Hill.Search in Google Scholar
Longo, L., & Slater, S. (2014). Challenges in providing culturally-competent care to patients with metastatic brain tumours and their families. Canadian Journal of Neuroscience Nursing, 36(2), 8–14.Search in Google Scholar
McEldowney, R., & Connor, M. J. (2011). Cultural safety as an ethic of care: A praxiological process. Journal of Transcultural Nursing, 22(4), 342–349.10.1177/1043659611414139Search in Google Scholar PubMed
Nairn, S. (2009). Social structure and nursing research. Nursing Philosophy, 10(3), 191–202.10.1111/j.1466-769X.2009.00403.xSearch in Google Scholar PubMed
Newman, M. A., Smith, M. C., Pharris, M. D., & Jones, D. (2008). The focus of the discipline revisited. Advances in Nursing Science, 31(1), 16–27. DOI:10.1097/01.ANS.0000311533.65941.f1.Search in Google Scholar PubMed
Parker, V. A., & Geron, S. M. (2007). Cultural competence in nursing homes: Issues and implications for education. Gerontology and Geriatrics Education, 28(2), 37–54.10.1300/J021v28n02_04Search in Google Scholar PubMed
Purnell, L., Davidhizar, R. E., Giger, J. N., Strickland, O. L., Fishman, D., & Allison, D. M. (2011). A guide to developing a culturally competent organization. Journal of Transcultural Nursing, 22(1), 7–14.10.1177/1043659610387147Search in Google Scholar PubMed
Richard, L., Gendron, S., & Cara, C. (2012). Modélisation de la pratique infirmière comme système complexe: Une analyse des conceptions de théoriciennes en sciences infirmières. Aporia, 4(4), 25–39.10.18192/aporia.v4i4.2909Search in Google Scholar
Rising, M. L. (2017). Truth Telling as an Element of Culturally Competent Care at End of Life. Journal of Transcultural Nursing, 28(1), 48–55. DOI:10.1177/1043659615606203.Search in Google Scholar PubMed
Stiles, K. A. (2011). Advancing Nursing Knowledge Through Complex Holism. Advances in Nursing Science, 34(1), 39–50. DOI:10.1097/ANS.0b013e31820943b9.Search in Google Scholar PubMed
Taylor, R. A., & Alfred, M. V. (2010). Nurses’ perceptions of the organizational supports needed for the delivery of culturally competent care. Western Journal of Nursing Research, 32(5), 591–609.10.1177/0193945909354999Search in Google Scholar PubMed
White, J. (1995). Patterns of knowing: Review, critique and update. Advances in Nursing Science, 17(4), 73–86.10.1097/00012272-199506000-00007Search in Google Scholar PubMed
Woods, D. L., Mentes, J. C., Cadogan, M., & Phillips, L. R. (2017). Aging, Genetic Variations, and Ethnopharmacology: Building Cultural Competence Through Awareness of Drug Responses in Ethnic Minority Elders. Journal of Transcultural Nursing, 28(1), 56–62. DOI:10.1177/1043659615606202.Search in Google Scholar PubMed
© 2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Crazy Making: The Institutional Relations of Undergraduate Nursing in the Reproduction of Biomedical Psychiatry
- The Transition from Military Nurse to Nurse Faculty: A Descriptive Study
- Effects of Classical Background Music on Stress, Anxiety, and Knowledge of Filipino Baccalaureate Nursing Students
- Integrating Evidence-Based Practice into a Lebanese Nursing Baccalaureate Program: Challenges and Successes
- Transforming Nursing Education: Fostering Student Development towards Self-Authorship
- Making it Work – A BSN Faculty’s Process of Curriculum Redesign
- Online Teaching Efficacy: A Product of Professional Development and Ongoing Support
- Perspectives from Academic Leaders of the Nursing Faculty Shortage in Canada
- Nursing Students’ and Faculty Members’ Experiences of Comfort during Transition to Context-Based Learning
- Contested Practice: Political Activism in Nursing and Implications for Nursing Education
- Argumentation: A Methodology to Facilitate Critical Thinking
- The Relationship Between Levels of Fidelity in Simulation, Traditional Clinical Experiences and Objectives
- Strengthening Distance Nursing Laboratory Courses Through Application of Theoretical Foundations: A Literature Review
- An Integrative Review on Standardized Exams as a Predictive Admission Criterion for RN Programs
- Student-Directed Video Validation of Psychomotor Skills Performance: A Strategy to Facilitate Deliberate Practice, Peer Review, and Team Skill Sets
- Virtual Mentoring Program within an Online Doctoral Nursing Education Program: A Phenomenological Study
- Nurse-Environment Interactions in the Development of Cultural Competence
- The Applicability of the NCLEX-RN to the Canadian Testing Population: A Review of Regulatory Body Evidence
Articles in the same Issue
- Crazy Making: The Institutional Relations of Undergraduate Nursing in the Reproduction of Biomedical Psychiatry
- The Transition from Military Nurse to Nurse Faculty: A Descriptive Study
- Effects of Classical Background Music on Stress, Anxiety, and Knowledge of Filipino Baccalaureate Nursing Students
- Integrating Evidence-Based Practice into a Lebanese Nursing Baccalaureate Program: Challenges and Successes
- Transforming Nursing Education: Fostering Student Development towards Self-Authorship
- Making it Work – A BSN Faculty’s Process of Curriculum Redesign
- Online Teaching Efficacy: A Product of Professional Development and Ongoing Support
- Perspectives from Academic Leaders of the Nursing Faculty Shortage in Canada
- Nursing Students’ and Faculty Members’ Experiences of Comfort during Transition to Context-Based Learning
- Contested Practice: Political Activism in Nursing and Implications for Nursing Education
- Argumentation: A Methodology to Facilitate Critical Thinking
- The Relationship Between Levels of Fidelity in Simulation, Traditional Clinical Experiences and Objectives
- Strengthening Distance Nursing Laboratory Courses Through Application of Theoretical Foundations: A Literature Review
- An Integrative Review on Standardized Exams as a Predictive Admission Criterion for RN Programs
- Student-Directed Video Validation of Psychomotor Skills Performance: A Strategy to Facilitate Deliberate Practice, Peer Review, and Team Skill Sets
- Virtual Mentoring Program within an Online Doctoral Nursing Education Program: A Phenomenological Study
- Nurse-Environment Interactions in the Development of Cultural Competence
- The Applicability of the NCLEX-RN to the Canadian Testing Population: A Review of Regulatory Body Evidence