Culture and Global HealthCulture and Global HealthOnline ModuleOnline Module

NUR 215NUR 215Fall 2007Fall 2007

Why study culture in nursing?Why study culture in nursing?

Cultural minority populationsCultural minority populations

1990’s = 26%1990’s = 26%

2010 = 30%2010 = 30%

2050 = 50%2050 = 50%

CultureCulture

The collection of beliefs, values, The collection of beliefs, values, behaviors, and practices shared by a behaviors, and practices shared by a group of people and passed from one group of people and passed from one generation to the next.generation to the next.

– Learned from birthLearned from birth– Molded by environmentMolded by environment– Guides thinking, decisions, and actionsGuides thinking, decisions, and actions

EthnocentrismEthnocentrism

The belief that one’s cultural, ethnic, or The belief that one’s cultural, ethnic, or professional group is superior to that of professional group is superior to that of others.others.

StereotypingStereotyping

An expectation that all An expectation that all people within the same people within the same racial, ethnic, or cultural racial, ethnic, or cultural group act alike and share group act alike and share the same beliefs and the same beliefs and attitudes.attitudes.

Usually results in labeling.Usually results in labeling.

Acculturation vs. AssimilationAcculturation vs. Assimilation

Acculturation is the process of adapting to Acculturation is the process of adapting to and adopting a new culture.and adopting a new culture.

Assimilation results when an individual Assimilation results when an individual gives up his or her ethnic identity in favor gives up his or her ethnic identity in favor of the dominant culture.of the dominant culture.

Cultural CompetenceCultural Competence

The process through which the nurse The process through which the nurse provides care that is appropriate to the provides care that is appropriate to the client’s cultural context.client’s cultural context.

The goal is to make healthcare more The goal is to make healthcare more efficient and more effective.efficient and more effective.

Transcultural NursingTranscultural Nursing

Focuses on the study and analysis of Focuses on the study and analysis of different cultures and subcultures with different cultures and subcultures with respect to cultural care, health beliefs and respect to cultural care, health beliefs and health practices, with the goal of providing health practices, with the goal of providing health care within the context of the health care within the context of the client’s culture.client’s culture.

Leininger, M. (1978). Leininger, M. (1978). Transcultural nursing: Concepts, theories, and practice.Transcultural nursing: Concepts, theories, and practice. New York:Wiley.New York:Wiley.

Organizing Phenomena ofOrganizing Phenomena ofCultureCulture

CommunicationCommunicationSpaceSpaceSocial organizationSocial organizationTimeTimeEnvironmental controlEnvironmental controlBiological variationsBiological variations

..

CommunicationCommunication

The way by which one person interacts The way by which one person interacts with another through written or oral with another through written or oral language, gestures, facial expressions, language, gestures, facial expressions, and body language.and body language.

Culture influences how feelings are Culture influences how feelings are expressed and the type of verbal and non-expressed and the type of verbal and non-verbal expressions that are appropriate.verbal expressions that are appropriate.

Language, silence, eye contactLanguage, silence, eye contact

CommunicationCommunication

With verbal communication, problems may With verbal communication, problems may occur because words have different occur because words have different meanings within different cultural contexts.meanings within different cultural contexts.

Nonverbal communication consists of Nonverbal communication consists of body language, the use of silence, and body language, the use of silence, and eye contact.eye contact.

SpaceSpace

Culture usually determines the amount of Culture usually determines the amount of social distance tolerated by a person.social distance tolerated by a person.

Diverse groups also have varying norms Diverse groups also have varying norms for use of touch. Touch may be perceived for use of touch. Touch may be perceived as invasive by clients from some cultures.as invasive by clients from some cultures.

Time OrientationTime Orientation

Past or Present or Future orientedPast or Present or Future oriented

If past oriented, may value tradition and If past oriented, may value tradition and the way they have always done things. the way they have always done things. May be reluctant to try new procedures.May be reluctant to try new procedures.

If present oriented, tend to focus on the If present oriented, tend to focus on the here and now. May be relatively here and now. May be relatively unconcerned with the future, deal with it unconcerned with the future, deal with it when it comes.when it comes.

Social OrganizationSocial Organization

Refers to the ways in which groups Refers to the ways in which groups determine rules of acceptable behavior determine rules of acceptable behavior and roles of individual members.and roles of individual members.

Family may assume greater importance Family may assume greater importance than the individual in many cultures. than the individual in many cultures. – Example: In Native American tribes, the Example: In Native American tribes, the

extended family is the basic family structure.extended family is the basic family structure.

Social OrganizationSocial Organization

Gender roles vary according to cultural Gender roles vary according to cultural context. Some cultures have very distinct context. Some cultures have very distinct roles for male vs. female.roles for male vs. female.

Religious beliefs also influence a person’s Religious beliefs also influence a person’s response to major events such as birth, response to major events such as birth, illness, and death.illness, and death.

Environmental ControlEnvironmental Control

Refers to the relationships between people Refers to the relationships between people and nature and to a person’s perceived and nature and to a person’s perceived ability to control activities of natureability to control activities of nature

Definition of HealthDefinition of Health

Causative Factors of IllnessCausative Factors of Illness

Biologic VariationsBiologic Variations

Dietary Practices/PreferencesDietary Practices/Preferences

Increased Susceptibility to diseaseIncreased Susceptibility to disease

Application of Cultural Application of Cultural Phenomena to Nursing CarePhenomena to Nursing Care

See Culture GroupSee Culture Group

Handout on website.Handout on website.

Providing Culturally Sensitive CareProviding Culturally Sensitive Care

Self-Awareness – Need to recognize own Self-Awareness – Need to recognize own stereotypes, biases, and prejudgments stereotypes, biases, and prejudgments about clients who are culturally different.about clients who are culturally different.

Nonjudgmental Attitude is essential in Nonjudgmental Attitude is essential in providing culturally sensitive care.providing culturally sensitive care.

Education must be relevant to client’s Education must be relevant to client’s needs and provided in culturally sensitive needs and provided in culturally sensitive manner.manner.

Culturally Sensitive Teaching Culturally Sensitive Teaching GuidelinesGuidelines

See Cultural TeachingSee Cultural Teaching

Handout on website.Handout on website.

Global Health OrganizationsGlobal Health Organizations

United Nations (UN)United Nations (UN)

World Health Organization (WHO)World Health Organization (WHO)

United Nation’s Children’s Fund (UNICEF)United Nation’s Children’s Fund (UNICEF)

International Council of Nurses (ICN)International Council of Nurses (ICN)

United Nations (UN)United Nations (UN)

To maintain international peace and To maintain international peace and securitysecurityTo foster international cooperation in To foster international cooperation in solving economic, social, cultural, and solving economic, social, cultural, and humanitarian problems and in promoting humanitarian problems and in promoting respect for human rights and fundamental respect for human rights and fundamental freedomsfreedomsTo be a center for harmonizing the actions To be a center for harmonizing the actions of nations in attaining these common endsof nations in attaining these common ends

WHOWHO

Four major functions:Four major functions:1.1. To give worldwide guidance in the field of To give worldwide guidance in the field of

healthhealth

2.2. To set global standards for healthTo set global standards for health

3.3. To cooperate with governments in To cooperate with governments in strengthening national health programsstrengthening national health programs

4.4. To develop and transfer appropriate health To develop and transfer appropriate health technology, information and standardstechnology, information and standards

UNICEFUNICEF

Primary objective is to provide support for Primary objective is to provide support for the world’s most disadvantaged children the world’s most disadvantaged children without discriminationwithout discrimination

Major focus is worldwide problem of Major focus is worldwide problem of malnutritionmalnutrition

ICNICN

Goals:Goals:– Bring nurses together worldwideBring nurses together worldwide– Advance nurses and nursing worldwideAdvance nurses and nursing worldwide– Influence health policyInfluence health policy

www.icn.ch/abouticn.htmwww.icn.ch/abouticn.htm (ICN’s Mission, (ICN’s Mission, Vision, and Vision for the Future of Nursing Vision, and Vision for the Future of Nursing Statements)Statements)

Complete the following quiz Complete the following quiz to turn in as evidence of to turn in as evidence of

module completionmodule completion..

See linkSee link

For Culture QUIZFor Culture QUIZ

On website.On website.