KOMUNIKASI

DALAM KONTEKS BUDAYA

Oleh: Imas Rafiyah, S.Kp., MNS

Magister Peminatan Keperawatan Jiwa Fakultas Keperawatan Universitas Padjadjaran

Tujuan

Konsep dasar komunikasi dan budaya

Komunikasi western dan eastern

Komunikasi berbagai suku di Indonesia

Berkomunikasi dengan klien dengan latar belakang

berbeda

Pengembangan kemampuan seseorang dalam

berkomunikasi

DEFINISI DAN KONSEP

KOMUNIKASI DAN BUDAYA

KOMUNIKASI

BUDAYA

Cara hidup yang berkembang dan dianut oleh

sekelompok orang serta berlangsung dari generasi

ke generasi

Membentuk persepsi dan perilaku

BUDAYA

Bersifat kompleks meliputi

pengetahuan, keyakinan, seni,

moral, hukum, adat, dan

kemampuan serta kebiasaan

lainnya yang didapat

manusia sebagai anggota

masyarakat

(Tylor dikutip dalam Frisch & Frisch,

2007)

BUDAYA

Transmits meaning

Dipelajari

Disebarkan

Ever-changing

Dialogical

Mendefiniskan nilai-nilai

Mendefiniskan norma:

peran, hubungan

hak-hak dan kewajiban;

kepercayaan dan praktek atau perilaku

(Tylor dikutip dalam Frisch & Frisch, 2007)

KOMUNIKASI ANTAR BUDAYA

Komunikasi yang terjadi di antara orang-

orang yang memiliki kebudayaan yang

berbeda

BENTUK KOMUNIKASI ANTAR BUDAYA

Komunikasi antara

kelompok agama yang

berbeda

Komunikasi antara subkultur

yang berbeda.

Komunikasi antara kultur

yang dominan.

Komunikasi antara jenis

kelamin yang berbeda

KOMUNIKASI

WESTERN DAN EASTERN

The difference between traditional and

western society (Okasha, 2007)

extended family,

family and group oriented,

status is determined by age and position in the family,

extensive knowledge of distance relationship,

decision making dependent on the family,

external locus of control,

respect on the decision of the elderly,

family who care for their member‘s illness,

dependence in God in health and disease

nuclear family and individual oriented,

status achieved by own effort,

restrictive only to close family,

decision making was determined by oneself,

internal locus of control,

dependent of oneself in health and disease,

tend to search care from health service.

Traditional society Eastern society

KOMUNIKASI BERBAGAI SUKU

DI INDONESIA

Suku Bangsa di Indonesia

By ethnicity there are approximately 300 ethnic group and by mother tongue they can be grouped in eight largest ethnicity including:

1. Javanese (52.1%) in Central and east Java,

2. Sundanese (19.3%) in West Java,

3. Minang (3.5%) in West Sumatra,

4. Maduranese (2.9%) in Madura island,

5. Banjar (2.4%) in Kalimantan,

6. Batak (2.3%) in North Sumatra,

7. Buginese (1.8%) in South Sulawesi, and

8. Balinese (1.7%) in Bali.

Five recognized religions in Indonesia including Islam (87%), Protestant (6.5%), Catholic (3.6%), Hindu (1.5%), and Buddhism (data not available)

(Hidayat, 2002).

Suku Sunda

Close relationship among neighboring families (Guinesas cited in Zevalkink et al., 1999).

Believe on value ―silih asih, silih asah, silih asuh‖, it means that people should care, love and guide each other (Suryani, n.d).

Social activities that are commonly done by women, those are volunteer for public health center, Islamic organization or ―pengajian‖, and rotating saving association or ―arisan‖. These activities can be the activities for making relationship or making relax (Niehof, 1998).

Budaya Sunda

Good health, economic security, and the well being of

loved ones, are considered enough for satisfaction.

illness is caused by inner imbalance that influence

functioning of the mind. They describe ―inner‖ as hawa

nafsu (climate of feeling),this climate is influenced by up

and down feeling rhythm, for example, anger is caused

by hot feeling

Muslim-Sundanese believes to ―ulama” (Islamic religious

functionaries) as local healers

(Horikoshi-Koe, 1979).

Budaya Sunda

mother is mostly primary caregiver for children.

(Adimihardja & Utja as cited in Zevalkink et al., 1999)

People help to others, particularly mother to her

children and it should be given voluntarily (Suryani, n.d).

Economic stress is also found in most Sundanese family.

Instable income and permanent job are rare in

Sundanese families(Chase-Lansdale & Owen, Gecas,

Greenberger, O‘Neill & Nagel as cited in Zevalkink et

al., 1999).

BERKOMUNIKASI DENGAN KLIEN

DENGAN LATAR BELAKANG BERBEDA

Nursing theory

MADELEINE LEININGER‘S CULTURE CARE: DIVERSITY

AND UNIVERSALITY THEORY

Pentingnya Memahami Budaya dalam

Komunikasi Keperawatan

Era globalisasi----banyak klien dari budaya

berbeda

Memahami klien-----membangun trust

Mengidentifikasi cultural need klien

Mencapai tujuan asuhan keperawatan dengan

cultural strategies

Intercultural caring (Wickberg & Eriksson, 2008)

Patients and nurses with different cultural backgrounds meet in nursing care that is not always experienced as caring.

The patients‘ expectations might not be met

Nurses feel frustrated when language problems, different cultural values and beliefs and lack of support and resources interfere with nursing care

The world is becoming more multicultural, and there are patients from different cultures in almost allcountries.

SETTING

KLINIK KOMUNITAS

Pengkajian Terkait Budaya

Suku bangsa, jenis kelamin, usia, agama, pendidikan, status ekonomi

Komunikasi: verbal dan non verbal

Bahasa

Pakaian dan penampilan

Makanan dan kebiasaan makan

Waktu

Penghargaan dan pengakuan

Hubungan

Nilai dan norma

Rasa kenyamanan diri dan ruang

Proses mental dan belajar

Kepercayaan dan sikap

Hambatan Komunikasi Terkait Budaya

Bahasa

Kebiasaan dan pola perilaku

Persepsi

Stereotip budaya

Cultural Miscommunication

Vokal

Pakaian

Gesture

Kontak mata

Jarak

Sentuhan

Diam

Perilaku sosial

Orientasi waktu

Patients’ Transcultural Needs and

Carers’ Ethical Responses (Dogan, Tschudin, Hot &Özkan)

This study was carried out in Göttingen, Germany.

Fifty Turkish people (described as patients) were asked about the care they had received from German health care personnel, and 50 German nurses and 50 German physiotherapists were questioned about care they had given to Turkish patients.

Significant findings were the needs of the Turkish patients for goodcommunication, physical contact and understanding of their culture-based expressions of illness.

The German nurses and physiotherapists expressed the need for language barriers to be minimized and for education in the specific culture of Turkish patients.

Suggestions for better transcultural health care paradigms are made for relating to patients from different cultures

Student nurses’ experiences of communication in

cross-cultural care encounters (Jirwe, Gerrwish, emami, 2010)

Aim : To explore student nurses‘ experiences of communication in cross-cultural care encounters.

Methods: Semi-structured interviews were undertaken a purposive sample of 10 final year students from one university in Sweden: five participants were from a Swedish background and five from an immigrant background.

Four themes were identified: conceptualizing cross-cultural care encounters, difficulties in communication, communication strategies and factors influencing communication. ‗

Cross-cultural care encounters involved patients from a different immigrant background to the nurse.

Student nurses experienced particular difficulties communicating with patients with whom they did not share a common language. This led to care becoming mechanistic and impersonal.

They were fearful of making mistakes and lacked skills and confidence in questioning patients.

Various strategies were used to overcome communication barriers including the use of relatives to interpret, nonverbal communication, gestures and artefacts.

Other factors which influenced communication included the student‘s attitude, cultural knowledge acquired through education and life experience.

Tips Komunikasi Efektif

Pengetahuan perawat tentang budaya sendiri dan

budaya lainnya

Hindari stereotiping terhadap klien

Kaji secara individual

(Frisch & Frisch, 2007)

PENGEMBANGAN KEMAMPUAN SESEORANG

DALAM BERKOMUNIKASI

Cultural Competency

Cultural competence is defined as a set of congruentbehaviors, attitudes, policies, and structures that come together in a system or agency or among professionals and enables the system, agency, or professionals to work effectively in cross cultural situations (Cross & colleagues in Flaskerud, 2007)

In these descriptions, skills, attitudes, and values are spelled out in three areas: cultural knowledge, cultural sensitivity, and collaboration with the community to be served.

(Flaskerud, 2007).

Cultural Competency

Cultural knowledge means actively learning about

the community—its ethnicities, languages, origins,

immigration or migration history, acculturation level,

economy, sources of income, family and social

structures and roles, value systems and beliefs,

education levels and literacy, geography, and

ecologic environment.

(Flaskerud, 2007).

Cultural Competency

Cultural sensitivity includes an ethic or a moral imperative to value and respect the beliefs, norms, and practices of the people to be served.

This begins with an awareness of our own cultural beliefs and practices and moves toward being non-judgmental and respectful in dealing with people whose culture is different than our own.

Culturally sensitive professionals possess capacities for warmth, empathy, and genuineness.

(Flaskerud, 2007).

Cultural Competency in Nursing

Cultural desire: want to be competent

Cultural awareness : self exploration

Cultural skill: ability to collect data

Cultural encompasses: professioanl face to face

interaction

SUATU PROSESFrisch & Frisch, 2007)

Daftar Pustaka

Dogan, H., Tschudin, V., Hot, I., & Ozkan, I. (2009). Patients‘ transcultural needs and carers‘ ethical responses. Nursing Ethics.

16(6), p. 683-696

Flaskerud, J., H. (2007). Cultural competence: What is it?. Issues in Mental Health Nursing, 28:121–123.

Hidayat, R., S. (2002, December). Women in Indonesia: Between ethnicity and religiosity. Seminar conducted at the

meeting of Women in Asia: Issues and Concerns, Chennai.

Horikoshi-Roe, H. (1979). Mental illness as a cultural phenomenon: Public tolerance and theurapeutic process among the

moslem Sundanese in West Java. Indonesia, 28, 121-138.

Jirwe, M., Gerrwish, , K., & Emami, A. (2010). Student nurses‘ experiences of communication in cross-cultural care encounters.

Scanadian Journal of Caring Sciencies, 24; 436-444.

Niehof, A. (1998). The changing lives of Indonesian women: Contained emancipation under pressure. Leiden, 2, 236-258.

Okasha, A. (2007). The individual versus the family: An Islamic and traditional societies perspective. In J. Cox., A. V.

Campbell, & B. Fulford (Eds.), Medicine of the person (pp. 110-124). Philadelphia, PA: Jessica Kingsley.

Suryani, E. (n.d). Pandangan hidup orang sunda. Retrieved January, 18, 2011 from http://resources.unpad.ac.id/unpad-

content/uploads/publikasi_dosen/ Adat&PandanganHidupOrangSunda.pdf.

Wickberg, A. & Eriksson, K. (2008). Intercultural caring – an abductive model. Scanadian Journal of Caring Sciencies 22;

485–496

Zevalkink, J., Riksen-Walraven, J. M., & Lieshout, C. F. M. Van. (1999). Attachment in Indonesian caregiving context. Social

Development, 8(1), 21-40.

TUGAS

Mahasiswa ditugaskan melakukan literatur review

tentang aplikasi praktek komunikasi terapeutik

yang peka budaya

Tugas dipresentasikan di kelas minggu depan.

TERIMAKASIH