Family Hierarchy as the Top Priority in Nursing

Background Information: What a Nurse Must Know about Pacific Islanders

There is no secret that the U.S. environment can be characterized by an incredible cultural diversity. As a result, the nursing approaches towards a specific concern within a certain community must be based on the cultural and ethnic background of the people inhabiting it. In order to address the needs of Pacific Islanders properly, a nursing specialist must take the aforementioned specifics of the culture into account.

Psychological, environmental and psychosocial factors

The close connection between the members of the Pacific Islands community, particularly, the links between the family members, and the resulting hierarchy, is often viewed as a major obstacle to the efficient nursing interventions.

Beliefs of Pacific Islanders and health practices

When it comes to defining the features of the beliefs that control the lives of the target population, one must mention that the local residents believe in the highest power immensely. Though the confessions that the local residents belong to are quite diverse, ranging from Christian (Catholicism and United Methodist Church for the most part) to pagan (Kester, 2013, p. 147), the local people still are highly religious and pious.

Barriers to competent health care

Because of the emphasis on the authority of the male family members, female patients of the Pacific Island origins may face a range of obstacles to efficient nursing. Combined with the nearly Puritan and rather old-fashioned image of a woman in the specified culture, the mind frame of Pacific Islanders may not allow even for a medical examination for a breast cancer (Friedlaender et al., 2008).

Ethical dilemmas to deal with

Though altering the attitude towards nursing services among the Pacific Islanders is crucial to the provision of the specified services and the following health status of the local resident, it is also necessary to respect the culture and the identity of the target population, thus, avoiding a culture clash.

The Culture of Pacific Islanders through the Lens of a Culturally Competent Model

Giger and Davidhizar’s Transcultural Assessment Model

In order to address the issue, one will need to consider Giger and Davidhizar’s Transcultural Assessment Model. The specified model will help approach the needs of the target population, at the same time avoiding the threat of a culture clash by integrating “communication, space, social organization, time, environmental control and biologic variations” (Dayer-Berenson, 2010, p. 22) – the six element that pretty much define the success of a nursing intervention.

Reasons for model selection: clarification

The choice of the model in question was predetermined by the necessity to improve the communication process between the nursing specialists and the target population. By definition, the model in question creates the environment, in which a culturally discordant care should be provided (Karabdudak, Tas & Baskabbal, 2013).

Model application and its effects on Pacific Islanders

It is assumed that the model suggested above will help address the needs of the Pacific Islanders to the fullest degree. The Transcultural Assessment Model allows for a mild and at the same time efficient intervention into the target group by establishing trust-based relationships between the patient and the nursing specialist. As a result, it becomes possible to convince the patient deviate from the traditional cultural patterns for the sake of addressing a certain health concern (Aczon-Armstrong, 2013).

Plan of care: the needs of the target population

Health care needs: tuberculosis and cancer

According to the latest reports Pacific Islanders are facing the issues related to tuberculosis infraction and cancer development Speaking of the latter, breast cancer rates have increased significantly among Pacific Islanders. The lack of awareness on the issues in question combined with the unwillingness to allow women to have regular breast examinations leads to the grows in the number of patients and the subsequent increase of death toll among Pacific Islanders.

Interdisciplinary approach

As far as the awareness issues are concerned, it will be required to incorporate the local community resources, including nursing centers and other related facilities. The latter two will be responsible for providing the target demographics with booklets, in which the basic information on the topic of cancer and tuberculosis (prevention, symptoms and contact details) are listed.

Other health care professionals

Apart from nursing staff, several healthcare professionals will be required to create the premises for a successful intervention. Specifically, doctors and surgeons will be needed.

Implementation of the Intervention: Preventing Possible Issues in Treatment

Defining two culturally sensitive strategies

Seeing that the language concerns and the gender issues seem to cause the greatest amount of problems for nurses when addressing the needs of Pacific Islanders, the corresponding culturally sensitive strategies can be suggested for implementing the nursing plan. In other words, it is highly recommendable that the nursing staff should be gender-matched with the patients (Tung & Barnes, 2014) and that interpreters should be hired for rendering the information from patients to nurses and vice versa.

Reasons for choosing the strategies

The reasons for choosing the strategies in question are quite obvious. As it has been stressed above, the moral and ethical principles of Pacific Islanders are very rigid. Therefore, a rather strong set of convincing arguments will be required to persuade tem use the services provided. The strategies listed above, in their turn, will help establish a proper contact between the nursing specialists and the target demographics.

Overcoming the identified barriers

The communication barrier may be addressed with the help of two very efficient methods. First and most obvious, it is crucial to make sure that there is no language barrier. In other words, the services of an interpreter are required. Alternatively, the nursing staff and the patients may communicate with the help of a pidgin language. Next, it is required that the significance of communication between nurses and patients should be enhanced among the latter, thus, convincing them to use nursing services.

Evaluation: Defining the Success of the Approach towards Cultural Issues with Pacific Islanders

A tool for evaluating the efficacy of the plan: series of tests and surveys

In order to evaluate the efficacy of the plan detailed above, a series of surveys and tests must be carried out. The target population will be provided with a survey prior to and after the change mentioned above. A comparative analysis of the results will show the progress made.

Implementation and data collection: embracing the entire target population

The survey will be distributed to the target population by the nursing staff. As far as the booklets are concerned, every patient will receive one. More to the point, the patients will be provided with access to the information resources concerning cancer and tuberculosis. Afterwards another survey will be conducted in the same manner. At the end of the research, the results will be compared and both qualitative and quantitative data will be retrieved.

Conclusion: Culture Clash as One of the Greatest Concerns for a Nursing Specialist

There is no need to stress the fact that cultural conflicts make one of the most significant obstacles towards providing people with nursing services. However, by choosing a proper model for change and implementing it correctly, one is most likely to attain rather impressive results. Though at present, tuberculosis and breast cancer rates are significant among Pacific Islanders, raising awareness among the later will help convince them to use the nursing services offered to them.

Reference List

Aczon-Armstrong, M. (2013). Depression and chronic illness: Asian/Pacific Islander adults in Hawaii. Issues in Mental Health Nursing, 34(3), pp. 169–179.

Dayer-Berenson, L. (2010). Cultural competencies for nurses: Impact on health and illness. New York, NY: Jones & Bartlett Publishers.

Friedlaender, J. S., Friedlaender, S. D., Reed, F. A., Kidd, K. K., Kidd, J. R., Chambers, G. K., … & Weber, J. L. (2008). The genetic structure of Pacific Islanders. PLoS Genetics, 4(1), pp. 1–9.

Karabdudak, S. S., Tas, F. & Baskabbal, Z. (2013). Giger and Davidhizar’s Transcultural Assessment Model: A case study in Turkey. Health Science Journal, 7(3), pp. 342–345.

Kester, M. (2013). Remembering Iosepa: History, place, and religion in the American West. Oxford, UK: Oxford University Press.

Tung, W.-C. & Barnes, M. (2014). Heart diseases among Native Hawaiians and Pacific Islanders. Journal of immigrant and minority health. Center for Minority Public Health, 12(2), 173–178.

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