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CULTURALLY
COMPETENTE CARE
ETNOSEMIOTICS OF NURSES IN THE INFECTIOLOGY SERVICE
FRANCISCO RAFAEL DE ARAÚJO RODRIGUES MARCOS PAULO DE OLIVEIRA LIMA EDITE LOPES DA SILVA
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DATA SHEET edition: title:
edições Ex-Libris (Sitio do Livro Seal) CULTURALY COMPETENT CARE
Etnosemiotics of Nurses in the Infectiology Service authors: Francisco Rafael de Araújo Rodrigues Marcos Paulo de Oliveira Lima Edite Lopes da Silva translation: Prof. Teresa Marinho pagination: cover:
Alda Teixeira Patrícia Andrade
1st edition Lisbon, November 2015 isbn: 978-989-8714-57-2 legal deposit: 398298/15 © Francisco Rafael de Araújo Rodrigues Marcos Paulo de Oliveira Lima Edite Lopes da Silva
publishing and comercialization:
www.sitiodolivro.pt
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CULTURALLY COMPETENT CARE ETNOSEMIOTICS OF NURSES IN THE INFECTIOLOGY SERVICE
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SUMMARY PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
CHAPTER I – CULTURALLY COMPETENT CARE . . . . . . . . . . . . . . . 15
CHAPTER II – METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Study draft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Data Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Ethical Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
CHAPTER III – NARRATIVE CONSTRUCTION . . . . . . . . . . . . . . . . . 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Experiencing care and care focus. . . . . . . . . . . . . . . . . . . . . . . . . . 27 Positive expectations with care . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Negative expectations with care . . . . . . . . . . . . . . . . . . . . . . . . . . 29 The physical environment and the representative environment . . . . . . 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Recognizing (him/herself) as a nurse in the social context . . . . . . . . . 32 The nurse perceiving (him/herself) as a cultural facilitator. . . . . . . . . 33 Performing care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 The in luence of inter and intra cultural indicators in care . . . . . . . . . 36 Strategies and tactics in care . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
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CHAPTER IV – PRACTICE IMPLICATIONS . . . . . . . . . . . . . . . . . . . 39
CHAPTER V – FINAL CONSIDERATIONS . . . . . . . . . . . . . . . . . . . . 49
REFERENCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 BIOGRAPHIES OF AUTHORS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
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We thank the nurses that accepted participating in this study.
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PREFACE The cultural competences are values socially shared based upon a culture, which are moralizing and generate behaviors that guide health practice towards the processes of health transition and disease enable a culturally sensitive and congruent care. This review considers the impact that the act of caring mobilizes intentional deeds grounded on humanitarian and ethical features, on cultural awareness, on communication and knowledge skills over speci ic intra and intercultural decisive topics. LetĂcia Amaral I am a report from Federal University of CearĂĄ, Brazil
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INTRODUCTION Cultural Competence in nursing refers to the understanding of social meaning and to the cultural in luence upon beliefs about health and people’s behavior, having as foundation the awareness acquired by nurses on population lifestyles. This assumption embodies a framework which helps to understand the lived experiences full of values socially shared based upon a culture, on the identi ication of crucial elements, which are moralizing and generate behaviors that guide health practice. Hence, this context aimed to understand the meaning of culturally able nursing care performed by nurses in the infectiology service. The study is descriptive and exploratory. After the free and clear consent twenty-seven nurses accepted participating in this study through semi-structured interviews. The participants worked in two well-known service for infectology: in Portugal and other service in Cabo Verde. Interviews were analyzed following Bardins’ (2011) content analysis. Three categories were selected: Experiencing care; The nurse caring and The nurse interacting. Culturally able nursing care in the infectiology service should not be understood through the sole reading of the above categories, as togetherness among them is essential to under-
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CULTURALLY COMPETENT CARE
stand the topic within the nurses’ lives who participated in the research. Caring was described through actions triggered not only by practical abilities but also via expressed behavioral competencies, in the sense of professional care and human being support targeting the acquisition of capacity and wellness. Nurse knows that it is urgent to understand multiple worlds’ insights, popular knowledge and values as facilitating agents in the way of rendering care nursing. Nurse plays the role of a cultural facilitator able to ind suitable tactics aiming a most sensitive care to con ined patients’ needs. Nevertheless, cultural ability in the care nursing enables individuals’ cultural identity maintenance and shortens cultural rules on the rendered services. To meet this objective it is important that the act of caring mobilizes intentional deeds grounded on humanitarian and ethical features, on cultural awareness, on communication and knowledge skills over speci ic inter and intercultural decisive topics. The existing conditions of speci ic particularities and the understanding ability of human detailed responses towards the processes of health transition and disease enable a culturally sensitive and congruent care.
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CHAPTER I
CULTURALLY COMPETENT CARE
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2 CAPĂ?TULO II Culturally Competent Care & Cuidado Culturalmente Competente.indd 100
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CUIDADO CULTURALMENTE COMPETENTE
ǡ Ǧ Ǧ ǣ ϐ Ǧ Ǥ
ʹͳ
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CUIDADO CULTURALMENTE COMPETENTE
ȋ ǡ ǡ ǡ Ƭ ǡ ʹͲͲͻȌǤ ǡ Ǧ ǡ Ǧ ǡ À ȋ ǡ ʹͲͳͳȌǤ ǡ À ǡ ± ϐ ǡ ǡ ǡ Ǧ Ǥ × À ǡ ï Ǧ Ǧ Ù × Ǥ ǡ Ǧ ǣ ϐ Ǧ ǫ ǡ Ǧ ² ǫ ϐ Ǧ ± Ù ǡ Ù Ǧ ǡ ϐ ǡ ǡ Ǥ
ʹͲ
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Ǧ ǡ ȋ Ȁ Ȍ Ǥ Ƭ ȋʹͲͲʹȌǡ ϐ ² Ǥ ǡ ǡ ȋ × Ȍ ï À Ù ȋ ǡ ʹͲͲȌǤ × Ǧ À ǡ ȋʹͲͳͲȌ ï ² ǡ Ǧ ȋ Ǧ ϐÀ ǡ Ȍ Ǥ ï Ù ȋ Ƭ ǡ ʹͲͲͺǢ Ƭ ǡ ʹͲͲͺȌǤ ² Ǧ ϐ ² Ǧ ï ǡ ² Ǧ × Ù Ǥ Ǧ Ǧ± Ǧ ± ï
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CAPĂ?TULO I Culturally Competent Care & Cuidado Culturalmente Competente.indd 106
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CUIDADO CULTURALMENTE COMPETENTE
Ǧ ï Ǧ À Ǥ
ͳͷ
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CUIDADO CULTURALMENTE COMPETENTE
ǡ Ǥ Ǧ ± Ǧ ϐ Ǧ Ǥ Ù ² ² Ǧ ǡ ϐ Ǥ Ǧ Ù ǡ Ǧ Ǥ À Ù Ǥ ǡ ² Ǧ Ù Ǥ ϐ ± Ǧ Ù ± ǡ ² ǡ Ǧ Àϐ Ǥ Ù ² Ǧ ͳͶ
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INTRODUÇÃO ² Ǧ ϐ ² ï Ǧ ǡ ² × Ù Ǥ Ǧ ² Ǧ ǡ ϐ ǡ ϐ ï Ǥ ǡ Ǧ ǣ ϐ Ǥ ± × Ǥ Ǧ ʹ ǡ × Ǥ Ǧ ² Ǧ Ǥ Ǧ ï ȋʹͲͳͳȌǤ Ǧ Ͳ͵ ǣ ǡ ǡ Ǥ
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PREFÁCIO ² ǡ Ù Ǧ ï ï Ǥ Ǧ Ù ǡ ± ǡ ǡ Ǧ Àϐ ǡ À Ǥ Letícia Amaral ǡ
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ĔĘ ĆĚęĔėĊĘ Nós agradecemos aos enfermeiros que aceitaram participar deste estudo. Culturally Competent Care & Cuidado Culturalmente Competente.indd 114
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ϐ ² Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ͷͳ ± Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ͷʹ CAPÍTULO IV – IMPLICAÇÕES PRÁTICAS Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ͷͷ CAPÍTULO V – CONSIDERAÇÕES FINAIS Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͷͷ
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ÍNDICE
Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͳͳ
.! Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͳ͵ CAPÍTULO I – CUIDADO CULTURALMENTE COMPETENTEǤ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͳ CAPÍTULO II – MÉTODOǤ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ʹ͵ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ʹͷ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ʹͷ Ù Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ʹ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ʹ ± Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ʹͺ CAPÍTULO III – CONSTRUÇÃO DA NARRATIVAǤ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ʹͻ
ěĎěĊēĈĎĆēĉĔ Ĕ ĈĚĎĉĆė Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͵ͳ ² Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͵ͳ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͵͵ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͵Ͷ ϐÀ × Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͵ͷ
Ĕ ĊēċĊėĒĊĎėĔ ĈĚĎĉĆēĉĔ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͵ Ǧ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͵ Ǧ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͵ͺ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ ͶͲ
Ĕ ĊēċĊėĒĊĎėĔ ĎēęĊėĆČĎēĉĔ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ǥ Ͷͳ
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ċėĆēĈĎĘĈĔ ėĆċĆĊđ ĉĊ ĆėĆŎÄ?Ä” ėĔĉėĎČĚĊĘ ĒĆėĈĔĘ ĕĆĚđĔ ĉĊ ĔđĎěĊĎėĆ đĎĒĆ ĊĉĎęĊ đĔĕĊĘ ĉĆ ĘĎđěĆ
CUIDADO CULTURALMENTE COMPETENTE V .
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FICHA TÉCNICA edição: título: autores:
revisão:
edições Ex-Libris (Chancela Sitio do Livro) CUIDADO CULTURALMENTE COMPETENTE
Etnossemiótica dos Enfermeiros em Serviço de Infeciologia Francisco Rafael de Araújo Rodrigues Marcos Paulo de Oliveira Lima Edite Lopes da Silva Professora Luana Monteiro
paginação: Alda Teixeira capa: Patrícia Andrade
1.ª Edição Lisboa, novembro 2015 isbn: 978-989-8714-57-2 depósito legal: 398298/15 © Francisco Rafael de Araújo Rodrigues Marcos Paulo de Oliveira Lima Edite Lopes da Silva
publicação e comercialização:
www.sitiodolivro.pt
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CUIDADO
CULTURALMENTE COMPETENTE ETNOSSEMIÓTICA DOS ENFERMEIROS EM SERVIÇO DE INFECIOLOGIA
F
R
A
R
RANCISCO AFAEL DE RAÚJO ODRIGUES MARCOS PAULO DE OLIVEIRA LIMA EDITE LOPES DA SILVA
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