Nursing Fundamentals: Chapter 5 Cultural Diversity

Cultural diversity

- Culture is learned through life experiences from one generation to the next. - Culture helps to define identity within specific groups of people. - Culture can be seen in attitudes and institutions of certain populations. - Language is the primary way that people share their culture.

Values

Beliefs and attitudes that are important to a person

Hispanic culture

Believes in the hot/cold theory of disease; treat cold diseases with hot food and hot diseases with cold food E.g. soup, hot tea, and toast

Personal space

It is most appropriate to ask the client what he prefers in regard to personal space. If the nurse needs to invade the client's personal space, it is important to discuss the matter. It is not appropriate to back away without assessing preference. It may make the client feel judged if the nurse asks him why he is backing away. Moving closer to the client just perpetuates the problem.

Cultural norm

Knowing a cultural norm does not enable one to predict a person's response. Generalizing about cultural norms in contemporary societies is inappropriate because people belong to more than one subcultural group and are influenced uniquely by multiple and diverse groups. Exceptions to cultural norms always exist. Therefore the nurse needs to approach each person as an individual.

Ethnicity

People are often born into an ethnic group, or ethnicity develops by immersion in a community. People of the same ethnicity often speak similar dialects and share similar values. Ethnicity and race are terms used interchangeably; however, they are not the same thing. Race refers specifically to physical characteristics. Ethnicity refers to a common bond of kinship with country of origin.

Health disparities

Persistent gaps between the health status of minorities and non-minorities Despite continued advances in health care and technology, racial and ethnic minorities continue to have higher rates of disease, disability and premature death than non-minorities.

Race

Physical characteristics; biologic differences

Poverty

Poverty has long been a barrier to adequate health care. If clients cannot access health care, it does not matter if they have affordable housing, health insurance, or the need for financial assistance. It is not possible to create a plan of care with client involvement without adequate support and access to care.

Pride in ethnicity

Pride in one's ethnicity is demonstrated by valuing certain physical characteristics, giving children ethnic names, wearing unique items of clothing, appreciating folk music and dance, and eating native dishes.

Professionalism

The nurse can demonstrate professionalism and culturally appropriate care by addressing clients by their last names and introducing himself or herself. He or she should follow-up thoroughly with requests, respect the client's privacy, and ask open-ended rather than direct questions until trust has been established.

Ethnocentrism

Viewing one's own culture as the only correct standard by which to view people of other cultures Belief that one's personal heritage is superior to others

Ageism

A form of stereotyping. E.g. A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, "All these young nurses think they can come in late and leave early."

Spirituality

Ask the client if a spiritual leader is desired, which is observant of the client's preferences. The nurse should not generalize that a Latino client is Roman Catholic, nor should the nurse refrain from inquiring about spiritual needs.

Asian culture

Clients who are Asian feel more comfortable when the nurse keeps an arm's length distance. Direct eye contact with clients who are Asian is considered offensive. The nurse would not expect the client to touch during conversation, and the nurse would not sit close to the client.

Cultural competence

Cultural competence can be shown by actively learning about culture through attending a conference.

Muslim culture

Modesty is very important in the Muslim culture. Care providers should be of the same sex when possible, and the nurse should avoid touching clients of the opposite sex.

Appalachian culture

The Appalachian culture is very family oriented, and many members are skeptical of modern health care. The request for the client's family to leave most likely frightened the client. Asking the client how to make him more comfortable is the best option. Asking him why he thinks he needs to leave is judgmental, implying he has no real reason to leave.

A new client comes to the primary care clinic and asks for help treating head lice. The nurse assesses that the client lives in low-income housing, and nine other people live with her in a one-bedroom apartment. Which of the following is a primary nursing concern? a) The client does not have running water. b) The client has no hope for the future. c) The client does not have air-conditioning. d) The client receives government assistance.

The client does not have running water. The priority in this poverty situation is the lack of running water. The already challenging task of eradicating head lice in a crowded living space is worsened by the lack of running water. The feelings of hopelessness need to be addressed, but the need for water is the first priority.

Mandated change

When clients are forced to participate in care that conflicts with their values, feelings of guilt and abandonment are likely. These feelings may deepen and threaten the client's well-being. E.g. A nurse convinces a client who is a Jehovah's Witness that receiving blood products is more important than the legalistic components of religion. What client reaction may be expected following this mandated change? The client states, "I feel like I abandoned my religion."

Cultural blindness

When cultural differences are ignored

Cultural assimilation

When one begins to assume some characteristics of a culture outside of one's own

Cultural imposition

When one pushes his beliefs onto another person

Culture shock

When the culture one has learned differs from the culture in one's environment, the acute reaction is called culture shock, and a person can become disoriented and stressed.