Culture

• Unconscious Incompetence

  Not aware that one lacks cultural knowledge

  • Not aware that cultural difference exists
• Conscious Incompetence


  Aware that one lacks knowledge about another culture

  Aware that cultural difference exists

  • Doesn’t know how to communicate with a client from a different culture
• Conscious Competence


  Consciously (actively) learning about a client’s culture

  Providing culturally relevant interventions

  Aware of differences between cultures

  • Able to interact effectively (despite this)
• Unconscious Competence

  Able to automatically provide culturally congruent care to clients from different cultures

  • Experienced with a variety of cultural groups
• Cultural Skill

  • Ability to collect relevant cultural data regarding client’s health history and presenting problem
  • Accurately performing a physical assessment
  • Application of cultural knowledge
• Cultural Knowledge

  Process of seeking and obtaining sound educational foundation

  Concerning the various worldviews of different cultures

  • Immersion vs reading
• Cultural Encounters

  Process that allows healthcare providers to engage directly in cross-cultural interactions

  • Actual experience = knowledge and awareness
• Cultural Desire

  • Motivation:
  • To engage in intercultural encounters
  • To acquire cultural competence
• LATIN

  Ataque de nervois

  Results from stressful event and build up of anger over time.

  • Shouting, crying, trembling, verbal or physical aggression, sense of heat in chest rising to head
• LATIN

  Empacho

  • Especially in young children Soft foods believed to adhere to stomach wall
  • Abdominal fullness, stomachange, diarrhea with pain, vomiting
  • Confirmed by rolling egg over stomach and egg appears to stick to an area
• Mal de ojo (Evil Eye)

  • Children, infants at greatest risk
  • Women more at risk than men
  • Cause often thought to be a stranger’s touch or attention. Sudden onset of fitful sleep, crying without apparent cause, diarrhea, vomiting, and fever
• Mal puesto/Brujeria


  • Belief that illnesses are supernatural in origin (witchcraft, voodoo, evil spirits, or evil person)
  • Anxiety, gastrointestinal complaints, fear of being poisoned or killed
• Susto

  • Spanish for “fright”
  • Caused by natural (cultural stressors) or supernatural (sorcery or witnessing supernatural phenomenon)
  • Nervousness, anorexia, insomnia, listlessness, fatigue, muscle tics, diarrhea
• Caida de la mollera

  • Mexican term for “fallen fontanel”
  • Caused by midwife failing to press on palate after delivery Falling on the head
  • Removing the nipple from baby’s mouth inappropriately
  • Failing to put on a cap on newborn’shead
  • Crying, fever, vomiting, diarrhea are indicators of this condition
  • Similarity to dehydration
• Falling/Blacking out

  • Sudden collapse preceded by dizziness, spinning sensation
  • Eyes may remain open but unable to see
  • May hear and understand what is happening around them but unable to interact
• Rootwork


  Belief that illnesses are supernatural in origin (witchcraft, voodoo, evil spirits, or evil person)

  • Anxiety, gastrointestinal complaints, fear of being poisoned or killed
• Spell

  • Communicates directly with dead relatives or spirits
  • Often with distinct personality changes
  • Not considered pathologic in culture of origin
• High Blood

  • Slang term for high blood pressure
  • Also for thick or excessive blood that rises in the body
  • Often believed to be caused by overly rich foods
• Low blood

  enough or weak blood caused by diet
• Bad Blood

  • Blood contaminated
  • Often refers to sexually transmitted infections
• Bouffee Deliriante (haiti)

  • Panic disorder with sudden agitated outbursts
  • Aggressive behavior
  • Confusion, excitemenmt
  • May have hallucinations or paranoia
• Hi-wa tick (Mohave)

  Unwanted separation from a loved one

  • Insomnia, depression, loss of appetite, suicide
• Ghost sickness (Navajo)

  • Feelings of danger, confusion, futility, suffocation, bad dreams, fainting,dizziness, hallucinations, loss of consciousness and Possible preoccupation with death or someone who died
• Pibloktoq/Arctic hysteria (Greenland Eskimos)

  • Abrupt onset
  • Extreme excitement of up to 30 minutes
  • Followed by convulsive seizures and coma lasting 12 hours with amnesia of event
  • Withdrawn or mildly irritable for hours or days before attack
  • During attack, may tear off clothing, break furniture, shout obscenities, eat feces, run out into snow, do other irrational or dangerous acts
• Wacinko (Oglala Sioux)

  • Often reaction to disappointment or interpersonal problems
  • Anger, withdrawal, mutism, immotibility. Often leads to attempted suicide
• Zar

  • Experience of spirit possessionLaughing, shouting, weeping, singing, hitting head against wall
  • May be apathetic, withdraw, refuse food, unable to carry out daily tasks
  • May develop long-term relationships with possessing spirit
  • Not considered pathologic in the culture
• Amok (Malaysia)

  Occurs among males (20-45 years old) after perceived or slightly insult

  • Aggressive outbursts, violent, o rhomicidal, aimed at people or objects, often with ideas persecution
  • Amnesia, exhaustion, finally returns to previous state
• Koro (Malaysia, SEA)

  • Fear that genitalia will retract into the body
  • Possible leading to death
  • Causes vary, including inappropriate sex,mass cases from belief that eating swine flu-vaccinated pok is a cause
  • Similar to conditions in China, Thailand, and other areas
• Latah (Malaysia)

  • Occurs after traumatic episode or surprise
  • Exaggerated startle response (usually in women)
  • Screaming, cursing,dancing, hysterical laughter, may imitate people, hypersuggestibility
• Taijin KyoFusho (Japan)

  • Dread of offending or hurting others
  • By behavior or physical condition such as body odor
  • Social phobia
• Shen kui (China)

  • Similar conditions that result from belief that semen (or “vital signs”) is being lost
  • Anxiety, panic, sexual complaints, fatigue, weakness, loss of appetite,guilt, sexual dysfunction, with no physical findings
• Wind illness (Asia)

  Fear of wind or cold exposure

  Causing loss pof YANG energy
• Anorexia nervosa

  • Associated with intense fear of obesity
  • Severely restricted food and calorie intake
• Bulimia nervosa

  • Associated with intense fever of obesity
  • Binge-eating and self-induced vomiting
  • Use of laxatives or diuretics