Culture

• Culture


  A set of learned values, beliefs, customs, and practices that are shared by a group and are passed from one generation to another
• Subculture


  Cultural group within larger culture with slightly different or additional traditions and cultural ideas
• Subculture of healthcare


  Physicians are socialized to work independently, nurses are socialized to work more as a team
• Americans


  • An American that grew up in the mountains of Appalachia has different cultural practices than a person that grew up in New York City
• All members of a culture do not exhibit the same behaviors
• Variations within cultural groups

  • Age
  • Religion
  • Dialect or language spoken
  • Gender identity and roles
  • Socioeconomic background
  • Geographic location of country of origin or current residence
  • Amount and type of interaction between younger and older generations
  • Degree to which values in current country are adopted
• Stereotype


  Generalized expectation about forms of behavior, an individual, or a group
• Ethnic stereotype


  Fixed concept of how all members of an ethnic group act or think

  
• Ethnocentrism


  Believing that one's own cultural values and behaviors are best
• Cultural competence


  • Awareness of own beliefs
  • Exercise compassion and respect in regards to others
  • Identify the cultural mix in your own community
  • Generalize, rather than stereotype
  • Exploring your personal cultural identity
• Transcultural nursing


  Study began in 1950s by Dr. Madeleine Leininger, meeting holistic needs of client must include cultural considerations
• Nursing areas influenced by culture

  • Treatment methods
  • Responses to illness and death
  • Childbirth
  • Diet and nutrition
• Race


  Group of people who share biologic physical characteristics and hereditary factors
• Ethnicity


  Based on cultural characteristics, less defined than race, includes factors like nationality, regional culture, ancestry, and language
• Important not to make assumptions about a patient's belief or practice based on name, skin color, or language
• Communication


  • Nurse and patient must understand each other
  • Do not assume patient/family understand
  • Keep questions brief and simple
  • Call for professional interpreter
  • Nurse is responsible for providing information to patient
  • Different cultural groups interpret different meanings for same words
• Meanings of silence in different cultures

  • Lack of understanding
  • Stubbornness
  • Apprehension
  • Discomfort
  • Agreement
  • Disagreement
  • Respect
  • Disdain
• Nonverbal communication


  • Cultural variations influence nonverbal communication and interpretation of body language
  • Cultures differ on acceptable touch
  • Some cultures more comfortable with touching or maintaining eye contact
  • Personal space needs vary
• Meanings of eye contact in different cultures


  • US: Maintaining eye contact indicates openness, interest, attentiveness, and honesty. Lack of eye contact can indicate shyness, humility, guilt, embarrassment, rudeness, thoughtlessness, or dishonesty.
  • Asians and American Indians: Sustained eye contact can be seen as impolite or an invasion of privacy.
  • East Indian cultures: Avoid eye contact with people of lower or higher socioeconomic classes.
  • Appalachian: Sustained eye contact can be seen as hostility or aggressiveness.
• Space and time


  • Different comfort areas for personal space, Western culture more comfortable with 3-6 feet during conversation
  • Different meanings of time in various cultures, Northern European and US give high priority to being on time, Eastern cultures more flexible, Asians spend time getting to know someone and view abrupt endings as rude, Mexican-Americans focus on current activity rather than previously planned activities
• Social organization


  Socially acquired, not genetically inherited, can be patriarchal (men make most decisions) or matriarchal (women make decisions about health care, provide care, and discipline)
• Religious beliefs and healthcare


  • Entwined with cultural beliefs, some religions expect members to adhere, nursing care affected by religious beliefs and practices

  
• Health belief systems


  • Biomedical
  • Folk
  • Holistic
  • Alternative or complementary

  
• Biological variations


  • Cultural groups identified by characteristics like body structure, skin color, hair color and texture, family history of disease, dietary practices
• Cultural practices of specific groups

  • Mexican Americans
  • African Americans
  • Chinese Americans
  • Muslim Americans
  • American Indians
• Cultural competency


  • Health belief system
  • Language
  • Communication
  • Family roles
  • Birth rites
  • Death rites
  • Dietary practices