Globalization has brought about increased diversity in the workplace. Healthcare is facing considerable challenges as the practitioners try to keep up with the ever-changing economics and demographics of a multicultural universe. This has brought about increased health disparities, and people have always challenged healthcare administrators to lay down frameworks that can aid in maintaining cultural diversity. Nurses must have all the information about the various cultural customs and backgrounds for them to provide optimal care. This has brought about an emergence of different transcultural nursing models that provide the nurses with knowledge on how to integrate multiple cultures within a healthcare setting. The Josepha Campinha Bacote model is the most effective as it will help eliminate health disparities at the organization by proving a step by step cultural diversity learning process.
Purnell's Cultural Competency Model is made up of 12 main domains. These include “healthcare professionals, healthcare practices, spirituality, death rituals, pregnancy, nutrition, high-risk behavior, bio-cultural ecology, workforce issues, family roles and organization, communication, and heritage or overview” (Albougami et al., 2016, p.3). The model focuses more on allowing nurses to fully understand the various patients' attributes such as experiences, incitement, and perception related illness and healthcare. This will enable the nurses to have an awareness of the traits and characteristics of different ethnic groups.
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The Josepha Campinha-Bacote model was formulated in 1998, and it views cultural competence as being a process rather than a consequence. In this case, or a nurse to attain cultural competence, a nurse must go through a series of steps that will enable him/her to perform effectively and efficiently in a culturally diverse setting. The model consists of five main domains, which include “cultural awareness, cultural skill, cultural knowledge, cultural encounter, and cultural desire” (Abitz, 2016, p.75). According to the model, a nurse must undergo a process that consists of the five essential components which will enable one to provide high quality and efficient care.
The Josepha Campinha-Bacote model is the most effective in decreasing health disparities brought about by a lack of having cultural awareness. Braithwaite compared multiple transcultural models basing on six core criteria; perspective, clinical utility, abstraction level, conceptual clarity, logical congruence, and comprehensiveness (Albougami et al., 2016). Campinha-Bacote is the only model that met all six criteria (Albougami, 2016). The model has five core components that lay a foundation for each other hence allowing there to be a clearly defined process. Moreover, the model has been cited and used by various scholars (Campinha-Bacote, 2019; Pulido-Fuentes et al., 2017).
Contrast and Comparison of Model Concepts
Fitzgerald & Campinha-Bacote (2019, n.p) state that “the Josepha Campinha Model consists of five key components: cultural encounter, cultural desire, cultural skill, cultural knowledge, and cultural awareness.” According to the cultural awareness concept, the main focus is allowing the nurses to develop an awareness of their individual beliefs, culture, and values and their effect on healthcare (Siswadi et al., 2018). The cultural knowledge concepts are focused on seeking knowledge about various characteristics related to specific groups, including religious, linguistic minorities, and racial (Abualhaija, 2019). Once one acquires the information, it is now incorporated into practice. The cultural skill component revolves around a nurse’s ability to gather meaningful and accurate information related to the patient (Abualhaija, 2019). Cultural encounter refers to the nurse having face-to-face contact with another patient who is not from your own culture (Abualhaija, 2019). This enables nurses to gain cultural awareness of the beliefs and values of the patient. The cultural desire is the ability of a nurse to respect, be open, accept and learn from other people,
The Purnell Model of Cultural Competence ones includes death rituals, high-risk behavior, communication, spirituality, and workforce issues. The death rituals concept revolves around trying to understand the various viewpoints people have related to death, including how to behave and perform various rituals (Marzilli, 2016). The spirituality component includes the many beliefs people have referred to health, such as using prayer and religious practices. High-risk behavior involves trying to understand the usage of recreational drugs, alcohol, and tobacco (Marzilli, 2016). Workforce issues revolve around language barriers, autonomy, and acculturation, while the communication concept involves the various elements that allow for efficient communication such as non-verbal cues (Marzilli, 2016).
The primary health disparities at the hospital include discrimination and stereotyping, bias amongst healthcare professionals, and lack of trust. In most cases, almost every individual has some form of prejudice. These biases are bound to bring about discrimination and stereotypical attitudes. In health care, this is bound to bring about a lack of trust between nurses and patients hence leading to increased adverse health outcomes.
The Joseph Campinha Model provides one with a step by step process through which the nurses will be able to achieve full efficiency in a cross-cultural healthcare setting. For one to eliminate the health disparities at the organization, the nurses must first understand what is causing them and even interact with the various patients. This model provides nurses with the opportunity to have face-to-face interaction (Siswadi et al., 2018). However, for the Purnell Model of Cultural Competence, the components will not help as it focuses on specific factors, some of which do not reflect the health disparities.
Currently, there is a lack of trust between nurses and patients. However, after the implementation of the model, there will be a good rapport between the patients and nurses. This shall enable the nurses to understand the patients’ feelings and communicate with them well. The various means through which rapport will be created is by having open communication with patients, showing empathy to patient feelings, situation, and perspectives, and being an active listener.
Patient satisfaction at the organization has dropped tremendously over the first quarter. According to patient surveys, it shows that the nurses have continually discriminated against some of the patients. A majority of the complaints are from minority ethnic groups. However, after the implementation of the Josepha Campinha Bacote Model, feedback from patients should be more positive. Moreover, patients’ numbers should increase by 15% one month after implementing the model. This will be an indication that the discriminatory and stereotypical attitude amongst nurses was reduced.
The formulation of diversity campaigns by nurse leaders at the organization. These will not just target the nurse but also educate the patient. These awareness programs will aim at bringing the nurses and patient together and trying to understand each other and have a common ground
Summary
The Josepha Campinha-Bacote Model allows a nurse to undertake a process that will develop their cultural competence and deliver high-quality and efficient care. According to the model, it is made up of five elements cultural desire, cultural encounter, cultural knowledge, cultural awareness, and cultural skill. A nurse will go through these five interlinked processes before gaining the skills and abilities of fully operating in a multicultural healthcare setting. The identified health disparities at the organization include unconscious bias, discrimination and stereotypes, and lack of trust. These make it hard for patients to seek health care services at the organization. However, through the model, the nurses were able to have face to face interaction with patients and gather information about the cultural beliefs and norms and the importance of avoiding biases and discrimination. From the essay, I have been able to learn that the adoption of a transcultural attitude is not a one-day endeavor. One must first understand the other party's perceptions, their importance, and work towards supporting diversity.
References
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Abualhaija, N. (2019). The transformational expedition of cultural competence in nursing. International Journal of Nursing and Health Care Research .
Albougami, A. S., Pounds, K. G., & Alotaibi, J. S. (2016). Comparison of four cultural competency models in transcultural nursing: A discussion paper. International Archives of Nursing and Health Care , 2 (3), 1-5.
Campinha-Bacote, J. (2019). Cultural competemility: A paradigm shift in the cultural competence versus cultural humility debate—Part I. Online Journal of Issues in Nursing , 24 (1).
Fitzgerald, E., & Campinha-Bacote, J. (2019). An Intersectionality Approach to the Process of Cultural Competemility–Part II. OJIN: The Online Journal of Issues in Nursing , 24 (2).
Marzilli, C. (2016). A Review of the Theoretical Framework of Culture and Value Applied to Nursing. International Journal of Nursing , 5 (1).
Pulido-Fuentes, M., González, L. A., da Silva Vieira, M. D. F., & Martos, J. A. F. (2017). Health competence from a transcultural perspective. Knowing how to approach transcultural care. Procedia-Social and Behavioral Sciences , 237 , 365-372.
Siswadi, Y., Prabawati, D., Purwarini, J., & Pongantung, H. (2018). Cultural Competence of Nursing Faculty in Indonesia. International Journal of Medical Research & Health Sciences , 7 (8), 97-102.
