1. Cultural considerations for nursing care

2. 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

3. 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

4. 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

5. 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

6. 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!

7. 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

8. 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

9. 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

10. 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

11. 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