Cultural considerationsfor nursing care

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

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

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

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

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!

Elements of a Cultural Assessment

1. Communication: e.g., styles, eye contact, verbal and non-verbal etc.

2. Space and personal contact: e.g., comfort levels with “personal space”, acceptability of touching another person, etc.

3. Time: very important in Western culture, not necessarily so in other cultures

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

Elements of a Cultural Assessment

6. 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

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

Acculturation and Assimilation

• Acculturation: – 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