| Understanding Various Cultural Practices and Applying Them to Nursing Care | Transcultural Nursing |
| A nation, community, or broad group of people who establish particular aims, beliefs, or standards of living | Society |
| Set of learned values, beliefs, customs and practices that are shared by a group and passed from one generation to another | Culture |
| Having characteristics that make it distinguishable from another group | Subculture |
| Generalized expectation about forms of behavior, an individual, or a group | Stereotype |
| A fixed concept of how all members of an ethnic group act or think | Ethnic Stereotype |
| The belief that ones cultural practices and beliefs should be the standard | Ethnocentrism |
| The awareness of ones own cultural beliefs and practices and their relation to those of others | Cultural awareness |
| A group of people who share biologic physical characteristics and hereditary factors | Race |
| A group of people who share a common social and cultural heritage based on shared tradition, national origin and physical and biologic characteristics | Ethnicity |
| Women make decisions about health care, provide care and discipline | Matriarchy |
| This is culturally related | Touch |
| Men make decisions about health care, provide care and discipline | Patriarchy |
| 4 Common characteristics of all cultures | 1)Culture is learned, beginning at birth, through language and socialization.
2)Culture is dynamic and everchanging and may act as a stabilizer for a culture.
3)Members of the same cultural group may share patterns that are present in every culture such as communication, means of economic and physical survival, social customs and mores, and religious systems.
4)Culture is an adaptation to specific factors or conditions in a specific location. When people are removed from that location, their customs continue even though they are no longer called for in the new setting |
| 8 Reasons for which variations within a cultural group occur | 1)Age
2)Amount and type of interaction between age groups
3)Degree to which values in current country are adopted
4)Dialect or language spoken
5)Gender identity roles
6)Geographic location of country of origin or current residence
7)Religion
8)Socioeconomic background |
| Common interview questions for cultural assessment(16) | 1)Who will make decisions about your treatment?
2)Who is the person in the family who must be involved with health care decisions?
3)Will members of your community be asked to help with making decisions about your care?
4)Can you describe what is wrong?
5)What do you thin has caused your problem?
6)Why do you think this has happened at this time?
7)Why did it happen to you?
8)Why did it affect your(body part)?
9)How long have you had this problem?
10)Why did you come for help now?
11)What do you think will help to resolve your problem?
12)Who else do you think can help you?
13)Have you gone to this person for help?(If so what did the person do?)
14Did this treatment help?
15)What results do you hope to get from your care?
16)How will your illness affect your family? |
| Cultural Data Necessary to Collect Through Interview(8) | 1)What language is used?(How well do they understand English? Do they need a translator?)
2)What cultural practices have the potential to interfere with receiving health care?
3)Differences in health care beliefs
4)Difficulty with care being performed by members of the opposite sex
5)Modesty and privacy concerns
6)Personal space practices
7)Use of folk medicines or treatments
8)What dietary practices have the potential to interfere with treatment for this illness? |
| Differences between race and ethnicity | Race is related to biologic factors such as physical characteristics and hereditary factors, while ethnicity refers to a group who shares a common social and cultural heritage based on shared traditions, national origin, and physical and biologic characteristics |
| Strategies for communication with patient from different cultures(12) | 1)Take time to establish patient-nurse relationship and comfort level
2)Ask questions in a calm unhurried manner. Rephrase and ask again if patient answer is inconsistent with prior information
3)Observe cultural differences in communication and honor those differences
4)Ask patient about the meaning of health and illness and their understanding of treatments and planned care. Investigate how the illness is likely to affect their life, relationships, and self-concept. Find out what patients consider the cause of their illness and how they prefer to manage the illness
5)Listen to the patients perception of their needs and respect them
6)Listen actively and attentively(Try not to anticipate patient responses)
7)Talk to Patients in an unhurried manner that considers social and cultural amenities
8)Give patients time to answer
9)Use validation techniques to verify that the patient understands(Be cautious of head nodding and smiles may indicate wanting to please the nurse and not necessarily understanding
10)Sexual concerns may be difficult for patients to discuss(Consider nurse of same gender to facilitate communication
11)Use alternative communication methods such as phrase books, an interpreter or pictures for non-english speaking patients
12)Learn key phrases of languages that are commonly spoken in your community |
| Biomedical Health Belief System | Life is regulated by physical processes and may be manipulated by mechanical means. Health is absence of disease or signs and symptoms of disease. Disease is an alteration of the structure and function of the body.
Disease has a specific cause, onset, course and treatment and is cause by trauma, pathogens, chemical imbalance or failure of body parts.
Treatment focuses on the use of physical and chemical intervention |
| Folk Health Belief System | (Third World)Classifies illness or diseases as natural or unnatural. Natural illnesses occur within the world as god made it and intended. Unnatural implies events that interrupt Gods plan and may represent evil. They have no predictability and are beyond the control of mortals.
Treatment is done by carrying out rituals or repentance or giving in to the supernatural forces wishes |
| Holistic Health Belief System | Religious experiences are based on the cultural beliefs and may include thing such as blessings from spiritual leaders, apparitions of dead relatives and miracle cures. Healing powers may be ascribed to animate or inanimate objects. Religion dictates social, moral and dietary practices designed to assist an individual in maintaining a healthy balance and in playing a vital role in illness prevention.
Treatment is designed to restore balance with physical, social, and metaphysical worlds. It may extend beyond treating the person to treating the environment(eg decreasing pollution, preventing world hunger) |
| Alternative/Complementary Belief System | Use of nonmedical forms of therapy to treat an illness.(eg acupuncture, aromatherapy, meditation). Most do so without informing their health provider. Treatments address the whole patient as viewing symptoms as means of the body to communicate to the mind that something must be changed, removed or added to ones life. Mind and body are seen as a unit |
| Fasting during this holiday for the jewish faith | Yom Kippur |
| 3-6 feet is acceptable for this culture | Western culture |
| Silence indicates respect in this culture | Asian culture |
| Eye contact indicates rudeness or agression | Some Asian and Native American cultures |
| Views time as elastic | Mexican American |
| Health practice believed by western culture | Biomedical Health Belief System |
| Chinese-Americans focus on this type of health practice | Holistic Health Belief System |
| Ramadan is practiced by these religious members | Muslim Americans |
| Male family members are usually consulted before care decision are made | Mexican American |
| Taking care of family members brings honor to the family | Chinese-American |
| Decision making is done by the family unit not the individual | Muslim American |
| Extremely family oriented(More that just father, mother and children) | American Indian |
| High incidence of lactose intolerance, so milk intake is low | African American |
| Diet is low in fat and sugar due to cooking methods | Chinese American |
| Fasting during daylight hours is practiced during Ramadan | Muslim American |
| Any intervention to hasten death is forbidden | Muslim American and American Indian |
| Eldest son is responsible for all arrangements for the deceased | Chinese American |
| Personal space and comfort tends to be close | African American |
| Sustained eye contact is considered rude, immodest or dangerous | Mexican American |
| Women and children are susceptible to the mal ojo so avoid eye contact | Mexican American |
| Uncomfortable with face to face sitting, side to side or at right angles to converse | Chinese American |
| Women do not usually shake hands with men | Muslim American |
| Biomedical belief system mixed with folk | Mexican American |
| Holistic belief system is primary influence | Chinese American |
| Highly diverse belief system, many adhere to biomedical | African American |
| Sacred myths and legends guide health belief system | American Indian |
| Women prefer to keep head, arms and legs covered | Muslim American |
| Touch is often used | Mexican American |
| Predisposition for Diabetes Mellitus | American Indians |
| Commonly Matriarchal society | African American |
| Commonly Patriarchal Society | Mexican American |
| Commonly inappropriate for husband to be in birth room | Mexican American |
| Follow Kosher dietary laws(No leavened products during passover) | Judaism |
| Do not permit use of blood transfusions | Jehovahs Witness |
| Women are considered impure during menstruation and following birthing and may not be touched by husband | Judaism |
| T/F: You can have more than on race but only one ethnicity | False: You may only have one race even if mixed race. You may however have multiple ethnicities |
| T/F: Use of medical terminology potentiates risk of miscommunication | True |
| Sickle Cell Anemia prone | African Ancestry |
| Have belief that adjusting diet for hot or cold foods can treat illness | Chinese, Korean, Vietnamese, Mexican and Puerto Rican |
| Why may nursing diagnosis and patient problems have limitations in culturally diverse patients? | Because they are based on the biomedical health belief system |
| Patient decision making and health seeking behavior is directed by a different health belief system. Nurse also has knowledge deficit if care plan and nursing interventions are based solely on nurse's own health plan | Insufficient Knowledge |
| Ability to understand each other is the problem; Communication is not impaired. Patients sometimes seem unable to speak normally when they attempts to respond to someone speaking another language. Non verbal communication is likely to become more significant | Compromised Verbal Communication |
| Patient is very possibly following acceptable guidelines for health maintenance in his or her culture. Nurse expects person to change behavior to meet nurse's cultural view. | Impaired Health Maintenance |
| Patient makes decisions based on a health belief system that is different from the nurses. Concept of time possibly delays implementation. Religious beliefs sometimes affect adherence to biomedical treatment regimens. Perhaps others in the patients cultural context counsel the patient to follow alternative health practices | Noncooperation |
| Eye contact indicates openness, interest, attentiveness and honesty | United States |
| Eye contact indicates rudeness and invasion of privacy | Asian and American Indian |
| Eye contact indicates hostility and aggressiveness | Appalachian |
| Punctuality is high priority | US, Japan and Northern European |
| Flexible concepts of time | Eastern cultures |
| Present Oriented Cultures | African American, Hispanic and American Indian |
| Believe in laying on of hands as form of healing. Sometimes speak in tongues during prayer | Pentecostal |
| More than 27 different groups in the US | Baptist |
| Do not practice infant baptism. Open communion every Sunday | Disciples of Christ |
| Autopsy commonly declined. Coffee, tea, tobacco and alcohol declined. Generally do not seek medical care(May use services of a surgeon to set a bone but decline drugs) | Christian Science |
| Anointing the sick for physical or spiritual uplift is held in high regard of the church. | Church of Brethren |
| Only natural birthing means recommended unless life of the woman is at stake. Abstinence from tobacco, caffeine, alcohol practiced. Encourage intake of fruits vegetables, grains and herbs. A sacred undergarment may be worn at all times that is only removed in case of emergency situations. | Mormons |
| Use of alcohol and tobacco is forbidden. Stillborn infants are buried. Believe in divine healing but not the exclusion of medical treatment | Church of Nazarene |
| Infants must be baptized within 40 days of birth. Fasting from meat and dairy products required Wednesdays and Fridays during Lent and other holy holidays(Exempt if detrimental to health). Last rites are essential and to be given by ordained priest before death. Christmas is celebrated January 7 and New Years is January 17 | Eastern Orthodox |
| Some abstain from meat on Fridays. Others fast before receiving the Eucharist but is not mandatory. | Episcopal(Anglican) |
| Baby is bathed immediately after birth(Before being given to the mother). Call to prayer is whispered in the childs ears so the first sounds heard are of the faith. Women are not allowed to make health decisions for themselves. It is mandatory for the husband to be present. Consumption of pork or alcohol is forbidden. All permissible meat must be blessed and killed in a special way. Daytime fasting is practiced. The koran is not to be touched by anyone ritually unclean and nothing is to be place on top of it. May wear taviz(black strings with words of koran attached). These should remain dry and intact | Islam |
| Blood Transfusion is forbidden followers do respect physicians and accept alternatives to blood transfusion. | Jehovahs Witness |
| Babies are named by the father, 8 days after birth when circumcision is done. Women considered impure during menstruation and following birthing. The husband may not come in physical contact with her during this time. Men do not touch any woman except his wife daughters and mother. Defines death as occurring when respiration and circulation are irreversibly stopped. Advocate strict use of life support. Believe that visiting of the family and friends is a religious duty before death(Someone should be with them as their soul leaves the body). Body must be untouched for 8-30 minutes. | Judaism |
| 10 Different Branches | Lutheran |
| 12 Different Groups | Mennonite |
| 20 Different Groups | Methodist |
| The name of the infant is recorded in official book at a religious meeting | Quaker |
| Believe in "the sacrament". Believe that unbaptized children are cut off from heaven. Contraceptives prohibited. Fast during ash wednesday and lent. Rosaries and medals bearing images of saints are often pinned to hospital gown or pillow or kept at bedside. | Roman Catholic |
| Use of alcohol, caffeine, tobacco or drugs prohibited. Most are vegetarian. Sabbath is observed on Saturday. Believe homosexual or lesbian orientation may be "corrected". | Seventh Day Adventist |
| Sunday mornings are used to honor Mrs. Moon as true parents and members get up at 5 AM bow before a picture of the moons three times and vow to do what is needed to help the reverend accomplish his mission on Earth. All marriages must be solemnized by Reverend Moon | Unification Church |
| Cremation is preferred. Womens choice to abortion is strongly supported | Unitarian Universalist Association |
| Funerals are celebrations of life. actively supports diversity and acceptance. | Unity Church |
