1. Transcultural Healthcare
Chapter 8:
Transcultural Healthcare

2. Culture, Subculture, Race, Minorities, and Ethnicity
*It is the accumulated learning for generational groups of individuals within structured or nonstructured societies.
Subcultures
These are groups within dominant cultures. They form because individuals share characteristics that belong to an identifiable group.

3. Culture, Subculture, Race, Minorities, and Ethnicity (cont.)
Large groups of humankind that share common biologic and sociologic characteristics
Racial blurring mixing has blurred the physical characteristics of individuals*
Minority
Global shifts of multiple groups of individuals who are continually revising cultures and subcultures
Ethnicity
Common heritage shared by a specific culture

4. Barriers to Culturally Competent Care
Prejudice
Belief based on preconceived notions about certain groups of people
Ethnocentrism
Belief that one’s own culture is the best and only acceptable culture
Stereotyping
Categorizing people and believing that all those belonging to a certain group are alike

5. Culturally Competent Nursing Care
The Hispanic is the fastest growing population in the US*
Cultural sensitivity
Understanding and tolerance of all cultures and lifestyles
1. born natural citizens
2. health practices
3. effects the culture has on them
Enables the nurse to
Understand more accurately and to accept the behavior of others
Provide better care by being sensitive to cultural factors involved in the client’s health or illness

6. Nursing Considerations/Cultural Assessment
Note the effect of socioeconomics: a client may divide one prescription for use by several individuals who may have similar symptoms
Ask the client if anyone else in the family needs to be aware of any healthcare situation: the client may or may not traditionally have a say in important decisions
Understand that some family members like to assist with care of the client
Educate the client and family caregivers whenever the opportunity arises

7. Box 8-3
Questions to ask:
1. what is the importance of religion, religious beliefs and religious practices
2. who makes the financial decisions? Healthcare decisions?
3. are you healthy?
4. does your heart condition affect your quality of life?

8. Values and Beliefs Beliefs
May be based on fact, fiction, or a combination of both and can be difficult to change
Values
Shape how an individual perceives right or wrong and what is desirable or valuable
Nurses must recognize that different beliefs and values exist and affect nursing.

9. Taboos and Rituals Taboos
Members of the culture cannot violate taboos without discomfort and risk of separation from the group.
Rituals
Members are often required to practice rituals for comfort, acceptance, and inclusion.
Often, taboos and rituals are associated with religious or spiritual services pertaining to healing, death, or dying.

10. Concepts of Health and Illness
Culture greatly influences an individual’s concepts of health and illness.
Each society has norms relating to the meaning of illness, how an ill person should behave, and what means should be used to assist him or her.
These also transmit to treatment and healing beliefs and practices, and attitudes toward mental illness.
Nurses must strive to accommodate clients’ healthcare beliefs and practices (as long as they are safe), even if they do not fully understand or agree with them.

11. Health and Illness Health belief systems:
1. magicoreligious-supernatural forces dominate
Scientific/biomedical
2. holistic medicine-belief that the forces of nature must be kept balanced
Yin/yang and hot/cold theories
Attitude toward mental illness
*belief that chemical changes in the brain can cause mental disorders is a relatively new concept for many cultures
*mental illness may be seen as a disgrace to the family

12. Language and Communication
The nurse and the clients may speak different languages.
Facilitate communication:
Professional interpreter
Family as interpreter
Nurse as interpreter
Personal space and touching
*Americans, Canadians, British have the largest personal space zone of all cultures
they would need private rooms, require several feet for comfort*
*Muslim-Arab woman may avoid eye contact especially with men (sign of modesty)

13. Diet and Nutrition
Cultural eating rituals vary and some religions maintain strict dietary practices.
The nurse should take into account each client’s nutrition and dietary customs as nutrition and diet constitute an important part of health and treatment of illness.

14. Elimination
People of various cultures treat the elimination of bodily wastes differently.
Many cultures consider elimination to be a private function.
Nurse need to consider that some people are unable to void or to use a bedpan or commode unless they have complete privacy.
*Arab cultures consider the left hand dirty and use it only to clean themselves after elimination

15. Death and Dying
Each cultural group has an attitude or series of beliefs about death and dying.
Nurses must respect the client’s beliefs even if they are different from their own beliefs.
Many Asian cultures consider death to be preordained, believing that when a person’s time to die has come, nothing can stop it.
Traditional Western culture tries to prevent death and to prolong life at all costs.

16. Religious and Spiritual Beliefs
The interrelationship among cultures, religious beliefs, and healthcare is very strong.
Each individual is unique and often has a mixture of belief systems, so it is important not to stereotype a client with any one religion.
With knowledge of the individual’s belief system, the client and the client’s community of significant others will be more accepting of necessary medical interventions, lifestyle changes, dietary changes, and treatment regimens.

17. Judaism Reform, Orthodox, Conservative
*KOSHER laws for food preparation
Have family bring in food for client

18. Islamic (muslims) Teachings of the Koran Pork and alcohol prohibited
Pray 5 times a day facing Mecca (east

19. Jehovah’s witnesses
NO BLOOD PRODUCTS (except maybe autologous)