Introduction

As awareness of transcultural health care has increased, so has the use of the term cultural competence. For the beginning nursing student, Giger and Davidhizar provide a clear, understandable definition. They view cultural competence as a dynamic, fluid, continuous process, whereby an individual, system, or health care agency finds meaningful and useful care delivery strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behaviors of those to whom they render care. The culturally competent nurse has six topics to assess for the client: (1) communication, (2) time, (3) space, (4) social organization, (5) environmental control, and (6) biological variations. It is these elements that make up Giger and Davidhizars transcultural assessment model. The Giger and Davidhizars model will be described in relation to the Mexican-American culture to put it into context.

CommunicationCommunication is a key component of each individual culture. While some cultures may emphasize non-verbal communication, and others express verbal communication, it is important to know which is emphasized in each culture, as it is a vital part of the nursing assessment. For the Mexican-American client, their voice quality is strong, and resonant. Use of silence is usually infrequent and brief. The use of nonverbal communication is dominant within this culture; hands are used to exaggerate expression. Direct eye contact is used when communicating. They are tactile in relationships, and usually accepts touch without difficulty. Nursing implications for communicating with a Mexican-American client would include the use of welcoming facial expressions, sitting in front of the patient, and conversing directly to the client. There are more than 50 dialects within the Mexican culture, while the Spanish language makes up 66% of the foreign-languages used in the United States. For this reason, it is also important for the nurse to take this into consideration and make use of a translator when necessary.

TimeTime is very important aspect of interpersonal communication. Cultural groups can be past, present, or future oriented. Those individuals who focus on the past, attempt to provide tradition and have little motivation for formulating future goals 10,13. Other individuals are present-time orientated and if the present task is viewed as the most important, the people in the culture tend to be unappreciative of the past and do not plan for the future. Individuals with futuretime orientation plan and organize present activities to achieve future goals. Preventive health care needs some future-time orientation because preventive actions are motivated by a future reward. Also cultures relate to time in terms of clock time vs. social time. Some groups relate on the basis of social time.

Time is an imperative part of interpersonal communication. Different cultural groups are either past, present, or future oriented. Those people who concentrate on the past, endeavor to give custom and have little inspiration for defining future objectives 10,13. Different people are present-time orientated and if the present errand is seen as the most vital, the individuals in the society have a tendency to be unappreciative of the past and try not to anticipate what's to come. People with future time introduction plan and sort out present exercises to accomplish future objectives. Preventive

health awareness needs some future-time introduction

since preventive activities are persuaded by a

future prize. Additionally societies identify with time in

terms of clock time versus social time. A few gatherings

relate on the premise of social time.Space

Social Organization

Environmental Control

Biological Variations

Conclusion