Cultural Diversity
Culture
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-- Shared system of belies, values, and behavioral expectations
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-- Provides social structure for daily living
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-- Defines roles and interactions with others and in families and communities
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-- Culture is made of individuals
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-- Differences within the culture
Subculture
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-- Large group of people who are members of a larger cultural group (i.e. nursing is a
subculture of the healthcare system)
Groups in Society
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-- Dominant group – usually largest group
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oo group has most authority to control values and sanctions of society
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-- Minority group- smaller group
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oo A physical or cultural characteristic identifies the people as different from
dominant group
Ethnocentrism
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-- Belie that one’s ideas, belies, and practice are the best or superior, or are most preferred
to those of others
Personal Bias
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-- We all hold our own subjective world views and are influenced and shaped by our
experiences, beliefs, values, education, family, friends, peers and others.
Stereotype
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-- a widely held but fixed and oversimplified image or idea of a particular type of person or
thing.
Cultural Definitions
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-- Cultural Assimilation (acculturation)
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oo Minorities living within a dominant group lose the characteristics that made
them different.
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oo Values replaced by those of dominant culture
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-- Culture Shock
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oo The feelings a person experiences when placed in a different culture
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oo May require in psychological discomfort or disturbances
Ethnicity
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-- Sense of identification with a collective cultural group shared identity, bone, or kinship
people feel with their country of birth or place of ancestral origin, largely based on
group’s common heritage.
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-- One can belong to an ethnic group through birth or adoption of characteristics of that
group.
Race
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-- Typically based on specific characteristics
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oo Skin pigmentation, body stature, facial features, hair texture
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-- Five major categories:
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oo American Indian or Alaska native
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oo Asian
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oo Black or African American
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oo Native Hawaiian or other pacific islander
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oo white
Stereotyping
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-- The assumption that all members of a culture or ethnic group act alike.
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-- Stereotypes are preconceived and untested beliefs about people.
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-- May be positive or negative
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oo Negative includes racism, ageism, and sexism
Cultural Terminology
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--
Cultural imposition
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oo Belief that everyone should conform to the majority belief system
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Cultural blindness
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oo Ignores differences and proceeds as if they did not exist
Culture Conflict
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-- People become aware of differences and feel threatened.
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-- Response- ridiculing beliefs and traditions of others to make themselves feel more secure.
Cultural Influences on Health Care
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-- Physiologic variations
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-- Reactions to pain
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-- Mental health
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-- Gender roles
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-- Language and communication
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-- Orientation to space and time
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oo When providing nursing care that involves physical contact, you should know the
patient’s cultural personal space preferences. Sitting close to, or too far away
from, the patient may be interrupted as offensive
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-- Food and nutrition
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oo When assessing the cause of decreased appetite in patients, the nurse should
determine whether the problem may be related to culture.
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-- Family support
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-- Socioeconomic factors
Culturally Competent Nursing Care- Patient in Pain
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-- Recognize that each person holds various belies about pain and that pain is what
the patient says it is.
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-- Respect the patient’s right to respond to pain in one’s own fashion
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-- Never stereotype a patient’s culture
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-- Be sensitive to nonverbal signals of discomfort, such as holding or applying pressure to
the painful area or avoiding activities that intensify the pain.
Elements of Cultural Competence
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-- Developing self-awareness
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-- Developing knowledge and understanding of a patient’s culture
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-- Accepting and respecting cultural differences
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-- Not assuming that the health care providers beliefs and values are the same as the client’s
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-- Resisting judgmental attitudes such as “different is not as good”
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-- Being open to and comfortable with cultural encounters
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-- Accepting responsibility for one’s own cultural competency
Guidelines for providing culturally competent nursing care
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-- Develop cultural self-awareness
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-- Develop cultural knowledge
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-- Accommodate cultural practices in health care
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-- Respect culturally based family roles
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-- Avoid mandating change
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-- Seek cultural assistance
Cultural Assessment/ Areas Nurses Need to Understand
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-- Beliefs values, traditions and practices of a culture
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-- Culturally defined, health-related needs of individuals, families, and communities
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-- Culturally based belief systems of the etiology of illness and disease and those related
to health and healing
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-- Attitudes toward seeking help from health care providers
} Religious beliefs may prohibit the presence of males, including husbands, in the delivery
room. This may be observed among devout Hindus and Orthodox Jews.
} Traditional Western medicine uses medication administration as a method of
treatment.
Encourage caregivers to participate in spiritual behaviors or practices (e.g., prayer, attending
religious services) to enhance spiritual well-being when appropriate
} Different cultures may not be accustomed to American food served at hospital and
nursing home and refuse to eat how can we help??
} Orthodox Jews maintain a Kosher diet this excludes shellfish }
Buddhist belief to not move deceased patient until cold
} The Islamic religion does not prefer the use of health care professionals of the opposite
gender unless it is difficult to locate one of the same genders.
} Chinese woman usually bathed and cared for by family members post-op and/or
while hospitalized
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◦◦ May refuse breathing exercises and performing own hygienic care
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