Nurses deal with patients who are drawn from diverse cultural and ethnic backgrounds necessitating culturally competent nursing practice. The Giger and Davidhizar’s Transcultural Assessment Model is a tool that has been developed to assess patients as unique individuals with cultural values on health behaviors as well as their effects. The model contains six cultural dimensions: space, communication, time, social organizations biological variations, and environmental control (Karabudak et al., 2013). Nursing professionals could apply these six dimensions in their practice to access the needs of Jamaican patients who present certain health and disease behaviors that are different from other cultures. In particular, Giger and Davidhizars model could be applied to Jamaican nutritional practices, which in turn, contribute to overall health behaviors and outcomes. Jamaican culture, which incorporates nutritional practices, is considered a melting pot of ethnicities, which are drawn from all over the world. The inhabitants of this Caribbean nation are a mixture of Taino Indians, Spanish, British and Africans making it a diverse and unique culture.
Applying Giger and Davidhizars Transcultural Assessment Model to Jamaican Nutritional Practices
Communication
Communication is a crucial aspect among all cultural groups as it creates connections, which then becomes a basis for relationships. English is Jamaica’s official language, which adopts the local dialect Patois, which in turn makes the language dynamic and colorful. Silence is uncommon in Jamaican culture even during meals necessitating the use of placeholder words. Nursing professionals ought to know that Jamaicans use nonverbal communication such as nodding, eye contact and touch quite a lot. However, nurses should understand that the use of nonverbal communication does not translate to the fact that the client is paying attention.
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Space
Jamaicans are polychromic individuals who tend to engage in different activities at the same time, which means that they are willing to have an intrusion into their personal space. Jamaicans are usually involved with their families so much so that they are not bothered by proximity. This degree of closeness and lack of concern for the intrusion of personal space ought to guide nurses from other cultures as they conduct an assessment on Jamaican patients. A nurse needs to confirm if a Jamaican client is comfortable with the distance between them since if it is too far or close, it may interfere with the assessment.
Social Organizations
Segregation and slavery have destabilized and transposed Jamaican social organizations, making it more of a matriarchal as opposed to a patriarchal society. Unavailability of men and boys meant that women had to step up and take care of their families and communities to enhance their continuity (Burke & Kuczynski, 2018). Jamaicans support system is quite extensive as it covers the nuclear and extended family as well as the neighbors, which are usually involved when it comes to seeking healthcare services. In this case, nurses need to understand the need to liaise with the women and the entire community when designing healthcare plans and initiatives if they are to be successful.
Time
Time as a continuous and a universal concept is determined by cultural and individual experience. The Jamaicans have different perspectives of time depending on how they have related to other cultures. Those that have interacted with the Western world value punctuality while those that have not, believe that time is flexible and can be adjusted. Jamaicans expect punctuality, but they are not always punctual owing to the ‘Jamaican time’ phenomenon associated with delays (Commisceo Global Consulting Ltd, 2019). This is not that case with American nurses who are future-oriented and value time. In such a case nurses ought to emphasize that some aspects of nursing care such as appointments return visits and medication schedules are time-specific. It is the role of the nurse to educate Jamaican patients on timeliness when it comes to dietary intake so that they understand when and how to partake meals.
Environmental Control
Environmental aspects in the Jamaican culture vary from those of the Americans though it is possible to find the Western aspects in the Jamaican healthcare system. The Body Mass Index and Apgar score are American concepts, which inform the Jamaican healthcare sector. Nonetheless, Jamaicans still uphold certain healthcare beliefs that have been passed down through generations. Jamaican health practices are advised by religion and the family is involved in making crucial healthcare decisions. Besides, Jamaicans value folk or traditional medicine with the spiritualist, the granny, and the voodoo priest being the three types of folk practitioners. The spiritualist “attempts to combine rituals, spiritual beliefs, and herbal medicines to effect a cure for certain illnesses or ailment” (Giger 2017, p. 170). A nurse who is assessing a Jamaican patient needs to help the client to understand that there will be no use of cultural but rather scientific approaches.
Biological Variations
Jamaicans present biological differences that vary from those of the white majority in terms of DNA, which determines their growth patterns, body proportion, birth weights and, distribution of body fat. Cunningham et al. (2017) assert that most Jamaicans are born with a lower weight, which increases infant mortality rates. During growth, Jamaicans tend to mature very fast with straighter and longer femurs narrower thoraxes and broader shoulders as compared to their white counterparts. This differentiated kind of growth is responsible for some conditions such as venous thrombosis, arteriosclerotic vascular disease, and type 2 diabetes owing to TNFa, a gene in African Americans (Giger 2017). A nurse ought to assess Jamaican patients to establish if their biological variations have posed adverse health risks.
References
Burke, T., & Kuczynski, L. (2018). Jamaican mothers’ perceptions of children’s strategies for resisting parental rules and requests. Frontiers in Psychology, 9, 1786. https://doi.org/10.3389/fpsyg.2018.01786
Commisceo Global Consulting Ltd. ( 2019). Jamaica - Language, culture, customs, and etiquette. https://www.commisceo-global.com/resources/country-guides/jamaica-guide
Cunningham, T. J., Croft, J. B., Liu, Y., Lu, H., Eke, P. I., & Giles, W. H.(2017). Vital signs: Racial disparities in age-specific mortality among blacks or African Americans United States, 1999–2015. Morbidity and Mortality Weekly Report 66(17), 444-456. 10.15585/mmwr.mm6617e1
Giger, J. N. (2017). Transcultural nursing assessment and intervention (7th ed.). Elsevier.
Karabudak, S. S., Tas, F., & Basbakkal, Z. (2013). Giger and Davidhizar's transcultural assessment model: A case study in Turkey. Health Science Journal , 7(3),342-345
