STANDARD V: HEALTH CARE PLANNING
Rationale
Healthcare planning is done in collaboration withpersons
seeking care. Based on Leininger's (1991) culture care the-
ory, nursing care planning encompasses the following three
processes or caring actions: culture care preservation, culture
care accommodation/negotiation, and culture care repattern-
ing. Culture care preservation refers to those assistive, sup-
portive, facilitative, or enabling professional actions and
decisions that help people of a particular culture to retain and/
or preserve relevant care values and practices. Culture care
accommodation/negotiation refers to those professional
actions and decisions that foster mutual (shared by nurse and
persons) adaptation toward beneficial or satisfying health
outcomes. Culture care repatterning refers to those profes-
sional actions and decisions made in collaboration withthe
client or persons seeking care that assist in modifying cultural
patterns (Leininger, 1991).
This standard also identifies ethical reasoning and skill in
ethical analysis and decision making as crucial to competent
transcultural nursing practice. Without it, the nurse is rele-
gated to the role of technician, and her or his role in preserv-
ing, accommodating, and repatterning relevant care values
and practices of persons and groups is seriously compro-
mised. RuthPurtilo (1999) defined ethics as a systematic
reflection on morality (acting in accordance withone's val-
ues) that uses special methods and approaches to examine
ethical situations. In transcultural nursing, the potential for
ethical issues to arise through clashes between and among
different groups' cultural practices and values becomes
increasingly likely. Ethical issues, therefore, must be exam-
ined in the context of professional practice as well as within
the cultural context of the persons for whom the nurse is car-
ing. Knowledge of ethical decision-making models, princi-
ples, duties, and values-clarification processes is critical to
honoring the dignity and rights of all persons involved in a
caring encounter.
Process Criteria
a. The nurse discusses with an individual, family, or community
the potential actions and choices based on their health con-
cerns and unique care preferences withthe intention of cul-
tural care preservation, cultural care accommodation/ negoti-
ation, and cultural care repatterning.
b. The nurse in collaboration with an individual, family, or com-
munity determines a plan of care that is acceptable and cultur-
ally congruent.
c. The nurse documents coestablished choices and actions to the
plan of care.
d. The nurse communicates health patterns and the health care
plan with other health professionals.
STANDARD V: HEALTH CARE PLANNINGRationaleHealthcare planning is done in collaboration withpersonsseeking care. Based on Leininger's (1991) culture care the-ory, nursing care planning encompasses the following threeprocesses or caring actions: culture care preservation, culturecare accommodation/negotiation, and culture care repattern-ing. Culture care preservation refers to those assistive, sup-portive, facilitative, or enabling professional actions anddecisions that help people of a particular culture to retain and/or preserve relevant care values and practices. Culture careaccommodation/negotiation refers to those professionalactions and decisions that foster mutual (shared by nurse andpersons) adaptation toward beneficial or satisfying healthoutcomes. Culture care repatterning refers to those profes-sional actions and decisions made in collaboration withtheclient or persons seeking care that assist in modifying culturalpatterns (Leininger, 1991).This standard also identifies ethical reasoning and skill inethical analysis and decision making as crucial to competenttranscultural nursing practice. Without it, the nurse is rele-gated to the role of technician, and her or his role in preserv-ing, accommodating, and repatterning relevant care valuesand practices of persons and groups is seriously compro-mised. RuthPurtilo (1999) defined ethics as a systematicreflection on morality (acting in accordance withone's val-ues) that uses special methods and approaches to examineethical situations. In transcultural nursing, the potential forethical issues to arise through clashes between and amongdifferent groups' cultural practices and values becomesincreasingly likely. Ethical issues, therefore, must be exam-ined in the context of professional practice as well as withinthe cultural context of the persons for whom the nurse is car-ing. Knowledge of ethical decision-making models, princi-ples, duties, and values-clarification processes is critical tohonoring the dignity and rights of all persons involved in acaring encounter.Process Criteriaa. The nurse discusses with an individual, family, or communitythe potential actions and choices based on their health con-cerns and unique care preferences withthe intention of cul-tural care preservation, cultural care accommodation/ negoti-ation, and cultural care repatterning.b. The nurse in collaboration with an individual, family, or com-munity determines a plan of care that is acceptable and cultur-ally congruent.c. The nurse documents coestablished choices and actions to theplan of care.d. The nurse communicates health patterns and the health careplan with other health professionals.
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