Culture & Diversity

worldview

a collection of beliefs about life and the universe held by an individual or a group

transcultural nursing

a comparative study of culture to understand similarities and differences across human groups (the study of).

Transcultural nursing (cultural congruent care)

a comparative study of cultures to understand similarities (culture universal) and differences (culture specific) across human groups.

ethnicity

a shared identity related to social and cultural heritage such as values, language, geographical space, and racial characteristics

How do you achieve culturally congruent care?

cultural assessment and the application of cultural preservation, accommodation, and repatterning

How do nurses achieve culturally congruent care?

cultural assessment and the application of cultural preservation, accommodation, and repatterning.

what does cultural competence include?

cultural awareness cultural knowledge cultural skills cultural encounters cultural desires

cultural bound syndrome

interpretation and description of biological and physiological malfunctions within a culture (eg. going postal & hwa-byung)

cultural knowledge

obtaining sufficient comparative knowledge of diverse groups, including their indigenous values, health beliefs, care practices, worldview, and biocultural ecology.

cultural competence

process of acquiring specific knowledge, skills, and attitudes to ensure delivery of culturally congruent care (bridging gaps between cultural differences).

culture

the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups

acculturation

-second-culture learning that occurs when the cultures of a minority is gradually displaced by the culture of the dominant group.

rules of impression management

1.) greet patients and their visitors. 2). introduce yourself. 3.) welcome visitors and request them to introduce themselves and explain how they are related to the patient. 4.) thank visitors for coming. 5.) ask to talk with patient in private and offer to accompany visitors to waiting room. 6.) inform visitors that you will call them when you finish with patient. 7.) tell the patient your purpose. 8.) clarify if patient wants someone else such as a family member to be present. 9.) avoid asking patient questions in front of the family or spouse that will put him or her at risk with this group. 10.) ask patient with whom you will need to consult for major decisions and how to contact this person. 11.) Observe nonverbal behavior and match the degree of distance exhibited by the patient. 10.) If the patient needs an interpreter: a. Introduce yourself to the interpreter b. determine qualifications of the interpreter (1) make sure the interpreter can speak the dialect of the patient. (2) ensure gender, age, and ethnic compatibility of the interpreter with the patient's preference and topic of discussion. (3) watch for differences in educational and socioeconomic status between the patient's and interpreter. (4) orient the interpreter to your purpose and expectation (assessment of pain, intent to explain procedure to the patient).

cultural encounters

Engaging in cross-cultural interactions that provide learning of other cultures and opportunities for effective intercultural communication development

cultural pain

May be suffered by a client whose valued way of life is disregarded by practitioners.

cultural assessment

Systematic and comprehensive examination of the cultural care values, beliefs, and practices of individuals, families and communities. Gathers information that will enable the nurse to provide culturally competent care.

culturally congruent care

The goal of transcultural nursing is to provide culturally congruent care; care that fits a person's life patterns, values, and set of meanings (in line with a person's values).

cultural care accommodation or negotiation (cultural congruent care)

adapt or negotiate with others for a beneficial or satisfying health outcome

biculturism

also known as multiculturalism a person/individual identifies equally with two or more cultures

cultural awareness

an in depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people

emic worldview

an insider or native perspective (ME)

etic worldview

an outsider's perspective (ET -extra terrestrial)

asking questions (cultural assessment)

assess the insider or emic perspective of patients and interpret information during assessment. Use open-ended, focused, and contrast questions. The aim is to encourage patients to describe values, beliefs, and practices that are significant to their care that health care providers will take for granted unless otherwise uncovered.

cultural skills

being able to assess social, cultural, and biophysical factors influencing treatment and care of patients

Leininger's Sunrise Model

demonstrates the inclusiveness of culture in everyday life and helps to explain why cultural assessment needs to be comprehensive. what people believe in and practice are embedded in all things in the Sunrise Model.

major components of cultural assessment

family structure ethnohistory bicultural effects on health social organization religious and spiritual beliefs communication

census data (cultural assessment)

gather demographics from the local and regional census data and from the demographic breakdown of patients who come to the health care setting. Population demographics include the distribution of ethnic groups, education, occupations, and incidence of the most common illnesses. Example: construction workers = high incidence of hearing loss

cultural care repatterning/restructuring (cultural congruent care)

reorder, change, or greatly modify patient's lifestyles for a new, different, and beneficial health care pattern

subcultures

represent various ethnic, religious, and other groups of distinct characteristics from a dominant culture

assimilation

results in varying degrees of affiliation with a dominant culture members of an ethnocultural community are absorbed into another community and lose their unique characteristics such as language, customs, and ethnicity. adapting characteristics of dominant culture.

cultural care preservation or maintenance (cultural congruent care)

retain and/or preserve relevant care values so patients maintain their wellbeing, recover from illness, or face handicaps and/or death

enculturation

socialization into one's primary-culture as a child

ethnocentrism

tendency to hold one's own way of life as superior to that of others. causes biases and prejudices.

cultural desires

the motivation and commitment to caring that moves an individual to learn from others, accept the role as learner, and be open and accepting of cultural differences, and to build on cultural similarities

cultural competence (cultural congruent care)

the process of acquiring specific knowledge, skills, and attitudes to ensure delivery of culturally congruent care

establishing relationships (cultural assessment)

use transcultural communication skills to interpret the patient's behavior within his or her own context of meanings and to behave in a culturally congruent way.