CULTURAL CONCERNS IN NURSING

Presented by:Jade Kaniowski, Lacey Kelley, Heather Kyle, Laura Lindsey, Kimberly Peters

Cultural Concerns in Nursing

Being aware of or inquiring about a person's cultural or religious beliefs with respect to medical care can help nurses avoid causing cultural pain to patients. These concerns must be a priority when caring for patients and must be respected in order to gain a patient’s trust and to be able to holistically care for them. Caring for patients not only focuses on the physical aspect of health, but must also include the mind and spirit as well.

Culture

Shared system of beliefs, values, and behavioral expectations that provide social structure for daily living.

Cultural Diversity

It is the cultural variety and differences that exist in the world, a society or an institution. It is having a group of diverse people in one place. People working or living together that have different cultures.

Cultural Sensitivity

Being aware that cultural differences and similarities exist and that they can have an effect of behavior, values and learning. It also means to be aware and tolerant of these differences and acknowledging them when interacting with others.

Stereotyping

Categorizing individuals or groups of people into an oversimplified or standardized image or idea. It’s when you assume that a belief or characteristic is shared by all in one class, culture or ethic group.

Cultural bias

To give an advantage to one cultural over another. To ignore the differences between cultures and impose understanding based on the study of one culture to other cultures. To think one culture has precedence of the other.

Cultural Influences on Healthcare

• Physiologic Characteristics

• Psychological Characteristics

• Reactions to Pain

• Gender roles

• Language and communication

• Orientation to space and time

• Food and nutrition

• Socioeconomic Factors

Physiologic Characteristics

Certain racial groups are more prone to specific diseases and conditions.

Examples include:• Keloids• Lactase deficiency and lactose intolerance• Sickle cell anemia

Psychological Characteristics

In most situations, a person interprets the behaviors of another person in terms of her or his own familiar culture.

Reactions to PainHealthcare researchers have discovered that many of the expressions and behaviors exhibited by people in pain are culturally prescribed. Nursing care for patients in pain should be individualized, but important culture-sensitive considerations include the following:

• Recognize that culture is an important component of individuality and that each person holds various beliefs about pain

• Respect the patient’s right to respond to pain in whatever manner is culturally and individually appropriate

• Never stereotype a patient’s perceptions or responses to pain based on the persons culture

Gender roles

In many cultures either the man or woman is the dominant figure and generally makes decisions for the family.

Knowing who is the dominant member of the family is an important consideration when planning nursing care.

Language and communication

• To avoid misinterpretation of questions and answers, it is important to use an interpreter who understands the healthcare system.

• When caring for culturally and ethnically diverse patients it is important to perform a transcultural assessment of communication.

Orientation to space and time

• Personal space is the area around a person regarded as part of the person. This area, individualized to each person and to different cultures and ethnic groups, is the area others should not intrude during personal interactions.

• Different cultures vary in being future, present, or past oriented.

Food and nutrition

Food preferences and how foods are prepared are often related to culture. Patients in a hospital or long term care often do not have a choice in foods. This can be a cause for weight and health changes in a patient.

Socioeconomic Factors

Research suggests that both physical and mental health are associated with Socioeconomic status(SES). In particular, studies suggest that lower SES is linked to poorer health outcomes. Poor health may in turn decrease an individual’s capacity to work, thus reducing their ability to improve their SES.

CULTURALLY COMPETENT NURSING CARE

Providing culturally competent care means that care is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups from a diverse populations within society.

• Cultural assessment

• Guidelines for care

Cultural assessment

When caring for patients from a different culture, it is important to find out how they want to be treated based on their cultural values and beliefs. An effective way to identify specific factors that influence a patient’s behavior is to perform a cultural assessment.

Guidelines for Care

Cultural competency is a process and takes time. It involves developing awareness, acquiring knowledge, and practicing skills. As defined by Campinha-Bacote (2003), the nurses should answer the following questions when caring for culturally diverse patients:

• Am I aware of my personal biases and prejudices toward cultural groups different from mine?

• Do I have the skill to conduct a cultural assessment in a sensitive manner?

• Do I have knowledge of the patient’s worldview?• How many encounters have I had with patients from diverse

cultural backgrounds?• What is my genuine desire to be culturally competent?

Links to Learn More…

• http://www.culturediversity.org/index.html

• http://www.apa.org/about/gr/issues/socioeconomic/ses-health.aspx

• http://www.barnesjewish.org/about/diversity

References

Fernandez, V. M., & Fernandez, K. M. (2011, November 05). Transcultural nursing: Basic concepts and case studies. Retrieved from http://www.culturediversity.org/index.html

Davidhizar, R., & Giger, J. (2004). A review of the literature on care of clients in pain who are culturally diverse. International Nursing Review, 51(1), 47-55.

Paniagua, C. T., & Taylor, R. E. (2008). The Cultural Lens of Genomics. Online Journal Of Issues In Nursing, 13(1), 2.

Parikh, A. (2008). Cultural assessment manual. Retrieved from http://www.dbhds.virginia.gov/2008CLC/documents/clc-Trn-AmieParikh-revis-cult-assess.pdf

http://www.apa.org/about/gr/issues/socioeconomic/ses-health.aspx

Lillis, C., & Taylor, C. R. (2008). Fundamentals of nursing, the art and science of nursing care. (6th ed.). New York, NY: Lippincott Williams & Wilkind.