Giger and Davidhizar Cultural Model

Giger and Davidhizar Cultural Model

This is a guideline and template. Please do not use it as a final turn-in paper.

This paper explores published articles, and the book, Transcultural nursing: assessment & Intervention, written by the authors of the Transcultural Assessment Model, Joyce Giger and Ruth Davidhizar, (Philadelphia: Elsevier Health Sciences, 2004). The Giger and Davidhizar

model is used by nurses to assess intervention strategies based on six cultural phenomena that are to be applied to every patient in any culture: communication, space, social organization, time, environmental control and biological variations. The purpose of this paper is to describe and explain the Assessment Model and how it might be used in actual situations with persons of differing cultures by presenting a few brief practical examples. The paper concludes with an explanation of why I chose this particular model to study.

Giger and Davidhizar Cultural Model

Introduction

Today, in the United States, we have a society which has a combination of cultures, ethnicities, races, and beliefs. It is imperative that our health care systems be able to approach and resolve health issues with the different cultures through an understanding of the factors which determine the individual's health and sickness behaviors. If nurses and doctors do not have knowledge of these factors, health behaviors may be misjudged or ignored.

The Giger and Davidhizar Transcultural Assessment Model focuses on six criteria they believe greatly impact proper trans-cultural assessment and care. As we will see, the importance of this model is that it allows nurses, in particular, to clearly understand and apply their knowledge of the differences in health behaviors between various cultures to the end of providing optimum care for all (AAN, n.d.).

Explanation of the Model

The six factors that must be understood and that comprise the Giger -- Davidhizar assessment model are as follows:

Communication makes the world go around. Without it, different cultures and societies are "blind" so-to-speak. Imagine trying to nurse a person back to health without being able to communicate or understand what ailments the person has. How would you understand the amount of pain, where it is located, what all of their symptoms are, or how much a certain medication or treatment helps them? You wouldn't.

If a person provides healthcare, it is easy to see why they must be able to understand the way different cultures communicate to them and what they are communicating.

Touch, as we all know, is also a form of communication that a nurse must understand between cultures. To some it means friendship -- and to others it is an affront. But, again, it communicates just like words do. And some Asian cultures will not look anyone directly in the eye, particularly if that person is nurse or doctor, because their culture believes that the nurse and doctor are elevated in status above their own. It is crucial that the nurse respect that culture and not confront them about it. Just knowing of that belief should increase the level of communication.

Space is a not-so-obvious factor with good healthcare assessment. Think "personal" space and what it means to you. With some cultures, you can't be "in their face" or even physically close for too long or it "communicates" something negative. People from Quebec, Canada, for example, are particular about a certain amount of physical space between them and you. They also do not want you to become too familiar or friendly (close) to them. They may not accept friendly teasing or joking as an individual from the U.S. might, and their modesty may be highly sensitive to some of the more "intimate" forms of care. (Giger & Davidhizar, 2004, p. 596-597).

The social organization of a culture is important. For instance, an African-American family tends to be matriarchal and it is upon her advice that a family member may be getting healthcare. But a nurse must also know that she can't leave the patriarchal figure out of the decision-making process. Also, these families tend to have large support networks of relatives, etc. This can be both positive and negative. A large support network can provide a great many different opinions, and this can be stressful, and dangerous. So, the nurse will have to earn their trust so they respect her or his decisions as to healthcare.

Time is understood in different ways by different cultures. In many cultures time is more

"expandable" and flexible than in others. So the nurse has to understand, when giving directions as to medications or other therapies, what that culture's definition of "three times a day" or "first thing in the morning," etc. means to them. And explanations of which directions are flexible and which are not are critical -- and might be life or death. They may nod their heads but have their own ideas about what change the dressing "frequently" means.

Time also has to do with tradition. Many countries are oriented to the past and value the "old" ways. China and England come to mind. A nurse may find that these cultures may not be so acceptable of "new" technologies or "cutting-edge" procedures.

Environmental Control deals with an individual's beliefs about illness and disease and their health prevention practices and ideas. It also has to do with their values and whether or not they feel at the mercy of "nature." For instance, according to studies, Hispanics are more likely than Caucasians to say that pain had "ruined their life." And in these same cultures, like the Chinese, asking another for help may be considered a lack of respect. That applies to nursing in the fact that requesting pain medication from a clinician (nurse) is believed to be disrespectful of the nurse's time, so they may go without unless asked about the need for the medication by the nurse or doctor (Hart, Davidhizar, & Davidhizar, 2005).

Biological Variations include susceptibility to disease, nutrition, and inherited genes. These, and others, may have a significant impact on the individual's level of pain sensitivity.

There is a gene that has been discovered that can make a person more or less sensitive to pain.

There is no doubt that this would be important information for the nurse to be aware of as she and the doctor apply treatments, medications, etc. To a patient who could think an injection is extremely painful because to her or him -- it is. And, on the other hand, it is important to know that, in some cultures, admitting to pain is abhorrent. So, "does that hurt?" could cause a health practitioner to apply unnecessary force or even injury to one from those cultures who may be sitting there smiling at them while experiencing severe pain but not admitting it.

Conclusion

Assessment of a person's health is a very important part of being a nurse. The doctor may perform the exam, but it is usually the nurse who spends more time with the patient and may sit with them to interview or do an evaluation of the past and present health.

There is nothing more crucial than understanding who is sitting there across the table or lying in that hospital bed, and why she or he has the beliefs that might seem so strange to some.