Cultural Considerations

a set of beliefs, values, and assumptions about life that are widely held among a group of people and that are transmitted across generations
What is culture?

a biological designation whereby group members share features (e.g., skin color, bone structure, genetic traits such as blood groupings
What is race?

Shared feeling of people hood among a group of individuals; a common trait such as heritage, race, culture, language.
What is ethnicity?

Ethnicity individuals share similar cultural patterns such as family structure, beliefs and dietary habits.
What is the difference between culture vs. Ethnicity?

not a citizen but allowed to both live and work in the U.S.
What is a legal immigrant?

(undocumented or illegal aliens) may have crossed the border illegally or legal permission expired; eligible only for emergency medical services
What is an unauthorized immigrant?

admitted to US for a specific purpose (work, education, diplomats)
What is a non-immigrant?

persons seeking asylum
What is a refugee?

Constraints on provision of health care
Language barriers
Differences in social, religious, and cultural backgrounds
Use of traditional healing or folk health care practices
Providers may lack knowledge about high-risk diseases in the specific immigrant groups.
What are some health issues for immigrants?

Health related beliefs/practices
Religious rituals/death and dying beliefs
Use of Complementary/Alternative Therapy (CAM)
Family dynamics
What makes delivering nursing care in a culturally diverse community setting/home different than the acute care setting?

egocentrism, stereotyping, cultural imposition, prejudice/racism, cultural conflict, culture shock
What inhibits developing cultural competence?

Ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences
What is stereotyping?

emotional manifestations of deeply held beliefs (stereotypes) about a group
What is prejudice?

form of prejudice; judging others as inferior
What is racism?

The belief that one’s own cultural group determines the standards that another group’s behavior is judged
What is egocentrism?

Imposing your own cultural beliefs, values, practices on individuals from another culture
What is cultural imposition?

Arises when we are unable to respond appropriately to another individual’s cultural practice because of unfamiliarity with the practice
What is cultural conflict?

Uncomfortable feelings experienced when trying to understand or adapt to cultural group whose beliefs and values are radically different from our own
What is culture shock?

A combination of culturally congruent behaviors, practice attitudes, and polices that allow nurses to work effectively in cross-cultural situations
What is cultural competence?

Care is designed for the specific client
Care is based on the uniqueness of the person’s culture and includes cultural norms and values
Care includes self-empowerment strategies to facilitate client decision making to health behavior
Care is provided with sensitivity and is based on the cultural uniqueness of clients
What are the four principles of cultural competence?

Know your biases, prejudices and ethnocentric tendencies
How do you become culturally aware?

know cultural features of your community)
What is cultural knowledge?

Use of appropriate eye contact, space, touch, family structure, environmental control, time
What are cultural skills?

Incorporate skills with Interactions-communicate using appropriate language/literacy & being open to learning from client
How to have a competent cultural encounter?

Feeling the moral and ethical responsibility and desire to provide culturally competent care
What is cultural desire?

Cultural preservation- Mixing biomedicine with Cultural practices
Cultural Accommodation- Support cultural practices that are not harmful
Cultural Repatterning- Repattern only harmful practices
Cultural Brokering- Negotiating/compromising/
advocating to ensure clients receive culturally appropriate care
What are the dimensions of cultural competence?

Home burial of Placenta
Example of cultural accommodation?

The nurse arranges a meeting with migrant farmers @ 4am to discuss health promotion
Example of cultural brokering?

Respecting an adult clients use of acupuncture/cupping/coining/moxibustion in combination with traditional practices
Example of cultural preservation?

The nurse explores ways to lower sodium content when a Greek client with CHF (requiring a low sodium diet) eats too much salty feta cheese and olives, requiring frequent hospitalizations for pulmonary edema
Example of cultural repatterning?

Space, time, environmental influences, verbal/nonverbal communication, social organization, biological variations
Cultural assessment considerations?

Eye contact
Written materials
Examples of nonverbal communications?

Nurses should be able to distinguish between culture and socioeconomic issues and not misinterpret behavior as having a cultural origin, when in fact it should be attributed to socioeconomics.
What is important for a nurse to consider with culture and socioeconomic status?

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