DWETN 5 interactional model and Culture

• CULTURE ENCOUNTER -It refers to a situation in which a person from one culture meets or briefly interacts with a person from another culture

  CULTURE ENCOUNTER It refers to a situation in which a person from one culture meets or briefly interacts uation in which a person from one culture meets or briefly interacts

  CULTURE ENCOUNTER -It refers to a situation in which a person from one culture meets or briefly interacts with a person from another culture
• A nurse having brief encounters with people from another culture or a client seldom grasps and understands strangers and their cultural lifeways. Nor does one then become an “expert” or an authority about a culture
• Nurses in the past and today who have had such brief encounters such as giving tours or traveling abroad without cultural background knowledge. Some publish, give lectures, and declare themselves as “cultural experts” of designated cultures. This often leads to “cultural backlash” and ethical problems when local cultures discover their culture was not presented accurately or understood following such brief encounters
• ENCULTURATION It refers to the process by which one learns to take on or live by a particular culture with its specific values, beliefs, and practices
• Nurses are enculturated within the nursing profession by learning the norms (rules of behavior), values, and other expectations of the nursing culture. Nurses become enculturated into local hospitals, community agencies, and other health services to accept and maintain practice expectations. Some clients may become enculturated to a hospital, especially if they stay in the institution over a long period of time such as with chronic illnesses or disabilities
• ACCULTURATION It refers to the process by which an individual or group from Culture A learns how to take on many (but not all) values, behaviors, norms, and lifeways of Culture
• Acculturated individuals generally reflect that they have taken on or adopted the lifeways and values of another culture by their actions and other expressions.
• An individual from Culture A may still retain and use some traditional values and practices from the old culture, but this does not interfere with taking on new culture norms. One generally becomes attracted to another culture for various reasons and almost unintentionally learns to take on the lifeways of the new culture in dress, talk, and daily living. This person or family becomes acculturated
• SOCIALIZATION It refers to the social process whereby an individual or group from a particular culture learns how to function within the larger society (or country), that is to know how to interact appropriately with others and how to survive, work, and live in relative harmony within a society
• Socialization is different from acculturation. The goal of socialization is to learn how to adapt to and function in a large society with its dominant values, ethos, or national lifeways. It is not necessarily becoming acculturated to a particular local culture or another culture. It requires becoming an acceptable member of the dominant and larger society
• ASSIMILATION It refers to the way an individual or group from one culture very selectively and usually intentionally selects certain features of another culture without necessarily taking on many or all attributes of lifeways that would declare one to be acculturated
• Assimilation is different from becoming fully acculturated or enculturated to another culture. The individual generally may be attracted to certain features, values, material goods or lifeways of a culture, but does not adopt the total lifeways of another
• Culture refers to the learned, shared, and transmitted knowledge of values, beliefs, and lifeways of a ​articular group that are generally transmitted i​ntergenerationally and influence thinking, decisions, and actions in patterned or in certain ways (Leininger & McFarland, 2002)
• Culture can be understood as “a particular way of life, which expresses certain meanings and values not only in art and learning, but also in institutions and ordinary behavior” or “is a set of assumptions people simply accept without questions a they interact with each other”
• What is DIVERSITY? It is Variety​ and Difference
• CULTURAL DIVERSITY

  ● Race ● Disability ● Age ● Religion ● Ethnic heritage ● Socioeconomic status ● Sexual orientation ● Education status ● National origin and physical characteristics
• Cultural Diversity ● Refers to the variations and differences among and between cultural groups resulting from differences in ifeways, language, values, norms, and other cultural

  aspects (Leininger & McFarland, 2002)
• A nurse who is culturally competent has the knowledge and skills to adapt nursing care to cultural similarities and differences.
• 5 aspects of Cultural Diversity

  ● Health Insurance and health care access ● Racial and ethnic minority communities ● Mental health ● Elderly ● Bariatric/obesity
• Cultural universals refer to the commonalities among human beings or humanity that reveal the similarities or dominant features of humans. Universality refers to the nature of a being or an object that is held as common or universally found in the world as part of humanity.
• Example of culture universality - Language and cognition - Society - Marriage - Myth, ritual, and aesthetics - Not to kill or do no harm - Technology
• The purpose of the theory (Diversity and Universality) is to discover similarities and differences about care and culture and to explain the relationship and reasons for the findings
• Discovering commonalities and differences in life ways, values, and rules among cultures is essential for nurses in our multicultural world.
• Cultural Care Theory of Diversity and Universality can be applied in:

  ● Encouraging patients to discuss their background and experiences with health care system. ● Demonstrate open mindedness. ● Teaching nurses how to approach patients of different cultures.
• The applications to nursing care ​are numerous but are based on what is known and how much a nurse is willing to learn about the patient’s culture. However, it is an important theory aimed at improving healthcare.
• Benefits of Cultural Care Theory of Diversity and Universality

  ● Brings awareness of how the patient’s culture affects their experiences, illness, suffering, and even death. ● Helps strengthen relationships between nurses and

  patients.

  ● Keeps the nurses open-minded to different treatments

  ● Helps the nurses understand how their own culture

  affects their care.
• Racism is a belief that race is a fundamental determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race.
• Racism is derived from the concept of race
• Racism can lead to vicious labelling of people with unsupported accusations, overt violence, cultural backlash, and often prolonged alienation and legal suits between groups or individuals
• All nurses and health professionals need to address racism and discrimination problems and to discover the sources, reasons, and various factors leading to or aggravating racism
• Learning about cultural differences in values, beliefs, patterns, and lifeways and understanding the why of these differences is crucial.
• What can nurses do to address Racism?

  ● Acknowledge the inequities. ● Evaluate your own thoughts and feelings. ● Support systemic change. ● Take a patient-centered approach.
• Prejudice refers to preconceived ideas, beliefs, or opinions about an individual, group, or culture that limit a full and accurate understanding of the individual, culture, gender, event or situation
• Patient Prejudice Toward Providers or PPTP is dynamic where physicians, nurses, and other healthcare workers are treated with bias and discrimination based on their gender, ethnicity, faith tradition, or country of origin
• Nurses Prejudice Toward Patients is where patients are treated with bias and discrimination based on their illnesses, gender, ethnicity, faith tradition, or country of origin.
• Discrimination refers to overt or covert ways of limiting opportunities, choices, or l​ife experiences of others based on feelings or on racial biases. Discrimination in nursing involves unfair or unjustified treatment that can harm individuals careers and their health.
• Discrimination among Nurses Nurses may experience acts of discrimination from other nurses who hold ignorant or prejudiced attitudes and beliefs about one or several of their personal characteristics. They may make injurious assumptions about their skill level or knowledge as a nurse based on factors such as their age, country of origin, or gender.
• Discrimination Involving Nurses & Patients. Nurses may hold stereotypes about patients that impact the care they deliver, while patients may hold prejudicial views about nurses that cause them to mistreat those charged with their care.
• Implicit biases in nursing can lead to a host of unfortunate outcomes for patients such as the following:

  - Insufficient patient assessments - Incorrect diagnoses

  - Inappropriate treatment decisions

  - Decreased time spent inpatient care

  - Inadequate patient follow-up after discharge
• Additionally, numerous studies have found that patients who perceive discrimination in their treatment often disengage from healthcare and treatment in some of the following ways: - They delay getting prescriptions or medical care - They are less likely to adhere to medical recommendations. - They use preventive services less. - They miss more appointments.