You are a provider of a Haitian patient with a severe open wound infection. How can you deal with this patient that insists that his Vodou priest assure hi

Culture Care Theory, Research, and Practice in Diverse Cultures (Part 1) In the modern world, nurses are often forced to use transcultural-based theories and practices to care for people of diverse cultures. Providing culturally congruent care can be achieved when the nurse and the patient work creatively to design a new or different care lifestyle to meet the client's health and well-being needs. This method requires using both generic and professional knowledge and incorporating various nursing care actions and goals. The knowledge and skill of healthcare professionals are frequently remodeled for the benefit of patients. Thus, all nursing care modalities require the collaboration of the nurse and the client (consumer) to identify, plan, implement, and evaluate each nursing care mode in a culturally appropriate manner. It can arouse nurses to design nursing activities and decisions using new knowledge and ethnically based ways to provide evocative and satisfying holistic care to individuals, groups, or institutions.

The concepts of Leininger's theory were defined in added terms by her. The model addresses the following concepts:

1. Assistance with actual or anticipated needs to improve a human condition or to prepare for death.

2. Providing care is an action or activity.

3. In its most basic form, culture refers to a set of values, beliefs, norms, and lifeways that are acquired, shared, and transmitted from one individual or group to another to guide their thinking, decisions, actions, and living patterns.

4. Culture Care encompasses the numerous aspects of culture that influence and support a person or group in improving their

health or dealing with illness or death.

5. Cultural diversity refers to the differences between groups regarding meanings, values, and acceptable forms of care.

6. The concept of culture care universality refers to standard care or similar meanings in many cultures.

7. Nursing is a disciplined profession that focuses on care phenomena.

8. A worldview is how one looks at the world or the universe to form one's personal perspective.

9. Dimensions of Cultural and Social Structure encompass factors influencing cultural responses within a given culture, such as spirituality, social structure, political concerns, economics, educational patterns, technology, cultural values, and ethnohistory.

10. A culture's definition of health and the value of well-being is culturally determined.

11. In nursing, cultural preservation or maintenance refers to activities designed to facilitate the retention and use of core cultural values of care related to a specific health concern or condition.

12. As the name suggests, Cultural Care Accommodation and Negotiation refer to creative nursing actions designed to assist patients of a particular culture in adapting or negotiating with other healthcare professionals to achieve an optimal health outcome for those individuals.

13. A culturally competent nurse engages in cultural care re-patterning or restructuring to provide therapeutic care. A patient can modify personal health behavior to achieve beneficial results while respecting the patient's cultural values(Nursing Theory, 2022).

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1. Provide Culturally Congruent Care to Haitians using Leininger’s Culture Care Theory Culturally congruent (nursing) care refers to cognitively based actions or decisions that have been personalized to meet the requirements of individuals, groups, or institutions, cultural values, beliefs, and lifeways to provide or support meaningful, beneficial, and satisfying health care, or well-being services.

This program consists of a set of values, beliefs, and patterns of lifeways that are acquired and transmitted subjectively and objectively. This type of program assists facilitates, or enables another individual or group to maintain their health and happiness, improve their human condition lifeways, or cope with illnesses, handicaps, or death by assisting, supporting, facilitating, or enabling them.

The nursing profession (care) is a form of cognition and formal learning of professional care knowledge and practice skills acquired through educational institutions. Through aiding, supporting, enabling, and facilitating another individual or group, one improves health conditions (or well-being), disabilities, lifeways, or working with dying individuals.

Cultural care diversity refers to the variation and/or difference in meanings, patterns, values, lifeways, or symbols of care within or between collectives, supportive, or enabling human care expressions within or across cultures (Gonzalo, 2021).

Culture

As a result of the fusion of African, French, and West Indian elements, Haitian culture is unique. Originally used as a social divider, the Creole language is now used to define a national culture. As well as being used in literature, drama, music, and dance, the language is also used in some government functions.

There is a specific lingo associated with Voodoo Culture. The ancient language of the ancients is the source of many incomprehensible words in voodoo culture. It is important to note that these objects or actions had no other words in our ancestors' language. The connotations of some of these arguments have shifted over the centuries, and today voodoo is a fusion of African and American cultures from the seventeenth century.

Children are kept close to their parents, and the family structure is vital. As far as family life and child- rearing are concerned, Haitian society is dominated by matriarchy. Most people agree that common- law marriages are the norm. In most cases, the man is likely to deal with matters relating to the outside world. A standard method of disciplining children is through corporal punishment. Furthermore, Haitians hold several values, including respect for adults, support for their families, and academic excellence.

Food Practices Related to Life Cycle and Major Celebrations

Most Haitians are Roman Catholics and practice their religion. It is an integral part of Haitian culture and life. In addition to Good Friday, Easter Sunday, and Christmas, they also observe other religious holidays. Celebrations are not only an opportunity to visit family and enjoy delicious meals together but also an opportunity to forget about the problems and hardships of everyday life. Roman Catholics attend midnight mass on Christmas Eve in Haiti, followed by a celebration dinner and gift exchange. A Christmas tree is typically only found in the homes of the wealthy, but everyone in a village might enjoy a firework display (pis d'etoil).

There is also a high demand for national holidays. All Souls’ Day (Day of the Dead) falls on November 2nd. This day is devoted to telling stories, eating food, and drinking alcohol. Food is often placed at the graveside of a loved one or at the table at which they used to eat. For the family to be served their

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meals, the food must first be offered to them. Carnival, also known as Mardi Gras, is one of Haiti's most celebrated events.

Each November, Haitians who practice voodoo celebrate harvest festivals over two days. It is observed today by Haitian peasants known as Manger-Yam (mahn-djay YAM), which means "eat yam.” As well as singing and dancing, the festival also involves feasting and drinking. In honor of this day, it is essential to recognize the importance of the yam in the cuisine of rural Haiti. Some Americans may celebrate this holiday.

Establishing communication

1. In Haiti, Creole is the primary language spoken.

2. As a rule, Haitians make direct eye contact and use a vibrant tone of voice when speaking with friends. It is common for them to avoid eye contact when conversing with others.

3. Hand gestures are usually used in conjunction with speech. Conversations can become loud, but this does not necessarily indicate anger.

4. When discussing certain personal topics, the conversation tends to be direct.

5. Those uneducated may smile and nod when they do not understand or may appear timid and keep to themselves when they do not understand.

6. In informal situations, touching is acceptable between friends, except between members of the opposite gender.

7. It is common for Haitians to approach you when speaking, and they require much less personal space than Americans.

8. Furthermore, they tend not to be punctual unless it is stressed that punctuality is a priority. Consequently, they may be late for appointments and not consider it rude (Framingham State College, 2008).

The nurse caring for a Haitian American client should understand that data from studies indicate that Haitians find touch from caregivers to be supportive, comforting, and reassuring. There is an indication from this that Haitian women may be fewer probable than women from other cultural groups to insist on having female nurses present during the delivery process.

There is a solid construction between Haitians and African Americans that dates to Africa, but both groups rarely mix socially and tend to mistrust each other. Nurses must comprehend that just because two customers might be Black does not mean they will share mutual attention or be suitable companions for sharing a hospital room. Like members of other social groups, the Haitian people are not free from social prejudice. Understanding these cultural and socioeconomic issues will facilitate the task of staff to care for Haitian clients and the assignment of client rooms.

As a result of the large social class gap, nurses need to consider the economic background of Haitian American patients before placing them in the same area. Despite coming from the same country, a poor and wealthy client with Haitian experience may find that sharing a room in a hospital is unpleasant.

There is an important influence of cultural factors on health and healthcare behavior in social organizations. Reproductive behavior is influenced by fundamental norms, such as the desire to have a large family and the outdated roles of men and women. Several Haitians use different names at different clinics since their legal status is either questionable, such as that of entrants, or undesirable, such as undocumented immigrants. Due to the lack of access to patient records, this practice causes confusion among healthcare providers and results in people "falling through the cracks.". As a result,

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some Haitian patients lose continuity of care. Several intake procedures may be conducted on the same client, resulting in a delay in health care services.

Researchers have found that immigrant Haitian mothers believe that little can be done to prevent childhood diseases considered medically preventable in the United States. Due to a lack of education or belief in preventive healthcare, many Haitian mothers have to the principles and practices of Haitian folk medicine. There are significant suggestions for the health instruction of parents and children. Nursing was found to be the most effective method of teaching health. Understanding, practicality, reinforcement of parenting skills, and an opportunity for questions are all qualities that make teaching valuable (Nurse Key, 2019).

2. Transcultural Nursing and Health Care in Taiwan Nursing educators in Taiwan must address and effectively manage trans-cultural healthcare issues due to Taiwan's multicultural population. It has been noted that there has been a longstanding lack of self-reflection on cultural problems resulting in a health gap between community nursing and Taiwan's Indigenous populations. As Taiwan's immigrant communities have grown from Southeast Asia, Mainland China, and elsewhere, the community healthcare landscape has become more complex.

Among Taiwanese values are challenging work, patience, humility, friendliness, and respect for others. Their primary economic resource is their extended family, which is initiative-taking. Most of them dislike loud, showy, and unrefined behavior. Anyone who brings shame to his or her family ("loss of face") brings shame to the entire community (Wu, & Yen, 2012).

There is a keen sense of closeness and extended family among Taiwanese families. Despite marriage, most Taiwanese people remain close to their parents. Westerners are often surprised by the degree of support Taiwanese parents give their grown-up children. Parents often decide which subject their children should study at university or purchase houses for their children. In many households, three or more generations live together. Most families still expect the oldest son to carry his wife to live with them in the house in which he grew up. However, some newlyweds have few options due to the high cost of housing in major cities and the low salaries of Taiwanese professionals.

To show respect to those older than oneself, it is important to offer food and joss paper to the ancestors and to show respect to one's parents and grandparents. Elder siblings are expected to defer to their younger siblings. Twins are often considered older siblings throughout their lives, even if one was born moments earlier.

In Chinese culture, descendants are both loved and dreaded; daughters are expected to marry and make offerings to their husbands' ancestors; their descendants may be intentionally harmed. Many households have shrines dedicated to ancestors, sometimes located in the living room and upstairs ( Life of Taiwan, 2022).

Welcome and meeting

1. At the first conference, the permission of the head or a minor bow is considered polite. A handshake is reserved for male friends.

2. It is important to make an introduction. Please do not introduce yourself. It would be more appropriate if a third party introduced you. It is an innovative idea to wait for the host to introduce you at a party or business meeting.

Communication through body language

1. Touching anyone on top of their head, particularly a baby, is not advisable.

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2. Public displays of affection for the other sex are not permitted.

3. It is never a promising idea to move an object with your feet or point at an object with your feet. Dirty feet are considered unclean.

4. When sitting, place your firsthand your lap.

5. Rather than crossing their legs, men should place both feet on the ground.

6. It is considered rude to put your arm around another's shoulder, wink, and point with your index finger. The hand should be open when pointing.

7. A palm facing outward in front of the face and moving back and forth indicates a negative response.

8. A gesture of respect would be to place the right hand over the left fist and raise both hands to the heart when greeting the elderly.

References

Framingham State College (2008). Haiti. (s. f.). https://www.framingham.edu/Assets/uploads/academics/colleges/science-technology-engineering- and-mathematics/food-and-nutrition/_documents/haiti.pdf

Gonzalo, A. B. (2021b, agosto 19). Madeleine Leininger: Transcultural Nursing Theory. Nurseslabs. https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/

Taiwan’s Culture and Festivals | Life of Taiwan Tours. (2018, 7 junio). Life of Taiwan. https://lifeoftaiwan.com/about-taiwan/culture-festivals/

Themes, U. (2019, 29 diciembre). Haitian Americans. Nurse Key. https://nursekey.com/haitian- americans/

Leininger’s Culture Care Theory. (2020, 21 julio). Nursing Theory. https://nursing-theory.org/theories- and-models/leininger-culture-care-theory.php

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