Presentation is loading. Please wait.

Presentation is loading. Please wait.

Open with how I started this dissertation idea….

Similar presentations


Presentation on theme: "Open with how I started this dissertation idea…."— Presentation transcript:

1 Nursing Faculty Care Expressions, Patterns, and Practices Related to Teaching Culture Care
Open with how I started this dissertation idea…. Working with student diversity to address diversity in the nursing workforce AND teaching transcultural nursing. Noticed that one cannot make progress with culturally diverse nursing students and the workforce if not taught culture care. I predicted /thought that Creating a culture (environmental context) and learning to valuing similarities and differences is essential for successfully addressing diversity in the workforce AND teaching culture care… Sandra J. Mixer, PhD, RN Assistant Professor of Nursing The University of Tennessee-Knoxville SNRS 2009

2 Purpose and Goal Purpose is to discover, describe, and systematically analyze the care expressions, patterns, and practices of nursing faculty related to teaching culture care Goal is to discover faculty care that facilitates teaching students learning how to provide culturally congruent nursing care

3 Domain of Inquiry Nursing faculty care expressions, patterns, and practices related to teaching culture care within the environmental context of baccalaureate nursing programs in urban and rural universities in the Southeastern United States Study context was NURSING FACULTY Environmental context: BSN URBAN & RURAL SE United States

4 Method Grounded in culture care theory and ethnonursing qualitative research method Purposive sampling – 27 nursing faculty Leininger’s ethnonursing data analysis and qualitative criteria Open-ended interviews until saturation Informants confirmed themes & patterns 27 nursing faculty: tenured/tenure-track and clinical track. Representing urban and rural contexts

5 Leininger’s Sunrise Enabler to Discover Culture Care
Cultural & Social Structure Dimensions Cultural Values, Beliefs & Lifeways Influences Care Expressions Patterns & Practices Holistic Health / Illness / Death Focus: Individuals, Families, Groups, Communities or Institutions in Diverse Life Contexts of Generic (Folk) Care Nursing Care Practices Professional Care–Cure Practices Transcultural Care Decisions & Actions Culture Care Preservation/Maintenance Culture Care Accommodation/Negotiation Culture Care Repatterning/Restructuring Religious & Philosophical Factors Technological Factors Economic Factors Educational Factors Environmental Context, Language & Ethnohistory Worldview Kinship & Social Factors Political & Legal Factors © M. Leininger 2004 Leininger’s Sunrise Enabler to Discover Culture Care Sunrise Enabler cognitive map of the theory - Depicts an integrated holistic view of the influencing dimensions and major concepts of the theory –. The CC Theory provides a holistic means to understand the range of factors that influence nursing faculty teaching culture care. Theory traditionally used to look at different patient cultural groups, I’ve used it to look at nursing education and specifically how faculty teach culture. Culturally Congruent Care for Health, Well-being or Dying

6 Leininger’s 4 phases of ethnonursing analysis for qualitative data:
Data Analysis Leininger’s 4 phases of ethnonursing analysis for qualitative data: Collecting, describing, and documenting raw data Identification and categorization of descriptors and components Pattern and contextual analysis Major themes, research findings, theoretical formulations, and recommendations Ethnonursing method Developed by Leininger to study transcultural human care phenomena using the CCT Importance of people as knowers about human care and professional nurses’ way of knowing These phases while Similar to other qualitative methods, are specific to the ethnonursing research method (FYI) During the first phase, data analysis began on the initial day of research and continued throughout the study. Informants’ interviews were transcribed in Microsoft word and excel. The researcher was fully immersed in the data and personally transcribed most of the audio recordings. Listening to informant voices and expressions brought forth important contextual data, passion, tone, and emphasis of data. In the second phase of ethnonursing qualitative analysis, data was studied for similarities and differences and meanings were sought from recurrent components in the data. In the third phase, patterns and ideas related to teaching culture care were identified. The fourth phase involved synthesis and interpretation of data, abstracting themes from the findings. Finally, themes confirmed were used to identify nursing decisions and actions in teaching culture care. As data was analyzed, informants were contacted for additional data and clarification. Informants confirmed findings related to themes and patterns and provided valuable feedback about the accuracy of discoveries made. In all phases of analysis, findings were traced back to the raw data which was essential for an audit trail and to meet the five qualitative criteria for ethnonursing studies; credibility, confirmability, meaning-in-context, recurrent patterning, and saturation (Leininger, 2006a).

7 Data Analysis Ethnonursing Qualitative Criteria of credibility, confirmability, meaning-in-context, recurrent patterning, saturation, and transferability Research mentor – expert in theory and method Faculty were interviewed until saturation occurred. Since informants were faculty; directly ed patterns and themes. Excited to receive their confirmation. Congruent with the method. Mentor facilitated theory guiding the study from beginning to end.

8 Ethnodemographic Data
Age range: 25-71 Ethnicity: 26% Black 74% Caucasian Teaching experience: new - 40 years Nursing experience: years 11/27 doctoral degrees (2 in nursing) All limited transcultural nursing education “Black” term faculty used to describe themselves

9 Major Research Findings
Theme I Faculty care is embedded in Christian religious values, beliefs, and practices within the context of the southern United States Strong beliefs enhance faculty ability to care for students and pts/families with similar and diverse religious backgrounds Intentional about teaching students to avoid cultural imposition

10 Described faith was integral to their being and basis of caring/teaching culture care
“absolutely influences every aspect of my life… God the Father, Jesus the Son, and Holy Spirit the comforter…to do what I do every day” “I recognize we all have weaknesses and we all have forgiveness that we must ask for. The whole Christian belief. And through that I see acceptance more because as you know in nursing we see a lot, hear a lot and you see people sometimes during their best and sometimes during their worst parts of their life. And there are times you see a lot of weaknesses in human kind as well as strengths and just recognition of all that. And that’s why I try to take each person as an individual and where they’re at now and try not to judge.” Influence of faith on teaching; (Share with 1st quote) One faculty described that she comes into her teaching un-biased, “even though God is the center of my world, all students may not have similar beliefs.” She gives them the chance to explore their spirituality “whatever that might be; from whence their energy comes.” (Share with 2nd quote) Shared this sense of grace with her students as she assisted them to examine their values and beliefs toward the patients and families they cared for.

11 Taught students to be respectful in attending to religious/spiritual care. Nonjudgmental.
“Students are very spiritual when they come to us…Religiosity is big in their lives and it takes a while for students to understand that they don’t have to embrace the culture or religion of the patient, yet certainly must talk to them on their journey.” “treat every patient the same, no matter how they got to be in our care and whether we agree with their lifestyle or habits.” She further articulated, “You can’t let personal feelings get into your nursing. You just can’t.”

12 Major Research Findings
Theme II Faculty taught students culture care without an organizing conceptual framework and with differences among classroom, on-line, and clinical contexts Faculty explicitly taught culture care in clinical contexts through modeling Focused heavily on rich experiences and less so on scholarly work in TCN Assigned culturally diverse patients and families AND in both urban and rural contexts Teaching students to treat all people with respect and to address individual needs: “I’m hoping it is my example more than me telling them what to do”

13 Major Research Findings
Theme III Faculty provided generic and professional care to nursing students to maintain and promote healthy and beneficial lifeways Respect for students Mentoring Surveillance care Respect for similarities and differences Faculty were mentored and in turn valued mentoring their students Surveillance care: “listening” (including the online environment) “checking in” with students in class, via , discussion board being “approachable” – socializing/visiting with students.

14 Major Research Findings
Theme IV Care is essential for faculty health and well-being to teach culture care within the environmental context of the school of nursing / university

15 Theme IV - Patterns IVA Caring as leadership Collective caring
Respect – Love, forgiveness, and valuing family Balance tripartite faculty role Reciprocal caring Faculty mentoring of one another (co-mentoring) Each faculty member contributes to creating a health community Caring for oneself to be enabled to care about others Leadership was personal leadership as well as formal/administrative leadership Respect “we all have a unique contribution and all respect each other” Love & Forgiveness – needed to work out conflict and move forward Balancing tripartite role – laughed out loud Mentoring had a significant impact on faculty lives throughout their careers Sleep, nutrition, exercise -> role modeling to students

16 Theme IV - Patterns IVB Noncare was expressed as cultural conflict
Lack of leadership support Impact of meeting faculty tripartite role on health Tenure process Not assisting new faculty Collegial conflict Overt and covert racism Racism was expressed by both white and black faculty - Among one another white-black/black-white; black-black; and white-white

17 Leininger’s Sunrise Enabler to Discover Culture Care
Worldview Cultural & Social Structure Dimensions Cultural Values, Beliefs & Lifeways Kinship & Social Factors Political & Legal Factors Environmental Context, Language & Ethnohistory Religious & Philosophical Factors Economic Factors Influences Care Expressions Patterns & Practices Educational Factors Technological Factors Holistic Health / Illness / Death Focus: Individuals, Families, Groups, Communities or Institutions in Diverse Life Contexts of Generic (Folk) Care Nursing Care Practices Professional Care–Cure Practices The modes are the way we use this data….As teachers how is this useful to us in the real world? Transcultural Care Decisions & Actions Culture Care Preservation/Maintenance Culture Care Accommodation/Negotiation Culture Care Repatterning/Restructuring Culture Care Preservation/Maintenance Culture Care Accommodation/Negotiation Culture Care Repatterning/Restructuring Culturally Congruent Care for Health, Well-being or Dying © M. Leininger 2004

18 Culture Care Preservation/Maintenance
Maintain efforts to assist students to care for culturally diverse clients in the clinical setting Preserve faculty collective/reciprocal care for students and one another Faculty value teaching culture care and are doing so in the clinical setting

19 Culture Care Accommodation/Negotiation
Negotiate integrating culture care content into established nursing courses throughout the curriculum Introduce required and elective courses on culture care Negotiate for culturally congruent strategies to promote healthy faculty lifeways Assistance and support for balancing the faculty tripartite role INTENTIONALLY integrated

20 Culture Care Repatterning/Restructuring
Use an organizing framework for teaching culture care I recommend the culture care theory – holistic, universalities and diversities (sim/diff)

21 Care Constructs Five Decades TCN research – discovery of 175 Care Constructs from 58 cultures Care Constructs further substantiated in this study: RESPECT Praying with Listening Reciprocal care Collective care Surveillance care Over five decades of transcultural nursing research using the ethnonursing research method has led to the discovery of 175 care constructs from 58 cultures (Leininger, 2006_). These care constructs contribute to nurses understanding the meaning of care to people. Further study of care constructs facilitates discovering the epistemic roots of caring and health phenomena (Leininger, 2006-chpt 10). Care constructs discovered/listed by Leininger and further substantiated in this study. Faculty identified RESPECT as essential in teaching and modeling culturally congruent care. Leininger, 2006

22 New Care Construct Discovered
Mentoring / Co-mentoring Mentoring/co-mentoring – caring sustained over a period of time and involved faculty members making a significant impact on one another’s professional career. Faculty identified as essential in teaching and modeling culturally congruent care.

23 New Care Construct Discovered
Christian Care Informants described that within the context of their expressed Christian values and beliefs: the need to love and accept persons where they are at and facilitate movement forward. Not judge one another and forgive one another without knowing or understanding another’s circumstances. Although related to spiritual care, Christian care is a distinct care construct because informants described it as being specifically related to and evolving from their Christian values and beliefs which were taught from childhood. Faculty identified as essential in teaching and modeling culturally congruent care.

24 Nursing Implications Despite 50 years of TCN knowledge development through theory, research, and practice; there remains a lack of formal, integrated culture education in nursing The need to prepare a culturally competent workforce – challenge if faculty are not formally prepared in transcultural nursing Findings Congruent with the literature FYI: Only 8/27 = 30% of ALL informants had had ANY TCN education. And for KEY Informants – the tenured faculty usually most responsible for influencing curricular decisions only 2/10 (20%) 2/5 Urban and NO rural informants received any TCN education or workshop Scholarship…. Role modeling and experience is honoring generic care.

25 Significance of the Study
Further substantiated Leininger’s work Contributed to Practice of Nursing – understanding complex nature of teaching culture care Contributed to Discipline of Nursing – building the body of transcultural nursing education knowledge

26 Future Study Extending dissertation research
Interview - how you teach nursing students about caring and culture If you would like to be a participant, contact: Dr. Sandy Mixer extends previous research conducted with faculty in baccalaureate programs representing a small area of the southeastern United States (Mixer, 2008). This research seeks to broaden the participant pool and environmental context (e.g. diversity of faculty; geographic location; baccalaureate and graduate programs; private as well as public universities) to further explicate data essential to nursing faculty as they prepare a culturally competent workforce.


Download ppt "Open with how I started this dissertation idea…."

Similar presentations


Ads by Google