Cultural considerations for nursing care

Cultural Considerations Necessary for holistic assessment Culture incorporates customs, beliefs, values and attitudes shared by a group of people and passed down through generations Disparities in health status exist among different cultural groups

Transcultural Nursing Roots in early 1900s; public health nurses cared for immigrants from Europe who came from many different cultural backgrounds Madeleine Leininger (1940s) saw importance of nursing care that was based on a client’s culture (unique values, beliefs, practices and life ways) First nurse to have PhD in anthropology Josepha Campinha-Bacote (2002) developed the model for process of developing cultural competence

Cultural Awareness Involves self-examination and in-depth exploration of one’s own beliefs and values as they influence behavior (e.g. understanding your own cultural background, influences, and biases) Cultural awareness is necessary in order to provide culturally competent care

Cultural blindness & ethnocentrism Cultural blindness: occurs when nurse doesn’t recognize his/her own beliefs and practices, nor the beliefs and practices of others Ethnocentrism: The idea that one’s own ways are the only or the best way to behave or do things

Cultural Knowledge Information about organizational elements of diverse cultures and ethnic groups; emphasis is on learning about the client’s worldview from an emic (native) perspective Etic: The professional or outsider’s views and values about a phenomenon Nurses can’t know all there is to know about a culture, but they need to know where and how to get information about different cultures!

Elements of a Cultural Assessment Communication: e.g., styles, eye contact, verbal and non-verbal etc. Space and personal contact: e.g., comfort levels with “personal space”, acceptability of touching another person, etc. Time: very important in Western culture, not necessarily so in other cultures

Elements of a Cultural Assessment 4. Social organization: family patterns cultural values can determine communication within family and attitudes towards children and older people religious beliefs decision-making 5. Biologic variations: e.g., disease incidence in certain groups sickle cell, Tay-Sachs, lactose intolerance, etc. differences in responses to drugs herbal remedies

Elements of a Cultural Assessment Environmental control: refers to relationship between environment and health Magico-religious: illness as a supernatural phenomenon, e.g., “evil spirits” Biomedical: disease/illness caused by microorganisms or malfunction of the body Humoral: looks for balance or harmony with nature; e.g., healthy body is characterized by evenly distributed warmth; illness results when the body is attacked by an increase or decrease in hot or cold

AVOID STEREOTYPING Individual families may have their own roles, beliefs, and practices that differ from the larger cultural group Younger family members may be more acculturated to Western patterns than are older family members There are also many regional variations

Acculturation and Assimilation learning the ways to exist in a new culture learning to drive, going to school, using public transportation interacting in an environment unlike that of home country Assimilation: when individuals or groups identify more strongly with the dominant culture in values, activities, and daily living happens often when children grow up in dominant culture