Culture

• Nursing care


  Holistic and encompasses the client's perspectives on health, which are greatly influenced by the client's culture. Each person is born into a culture influenced by the place of birth and the family of origin.
• Culturally responsive care


  Care that is centered on the client's cultural point of view and integrates the client's values and beliefs into the plan of care.

  
• Culturally responsive care


  • The nurse must first develop self-awareness of his or her own culture, attitudes, and beliefs, and examine the biases and assumptions he or she holds about different cultures.
  • The nurse needs to gain the necessary knowledge and skills to create an environment where trust can be developed with the client.
• Culture


  The "thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups"
• Subculture


  Usually composed of people who have a distinct identity and yet are related to a larger cultural group. Examples include occupational groups (e.g., nurses), societal groups (e.g., feminists), and ethnic groups (e.g., Cajuns).
• Multicultural


  Used to describe a person who has multiple patterns of identification or crosses several cultures, lifestyles, and sets of values.
• Diversity


  The fact or state of being different. Factors include sex, age, culture, ethnicity, socioeconomic status, educational attainment, religious affiliation, and so on.
• Race


  A term with many definitions, often used interchangeably with the terms ethnicity and culture.
• Ethnicity


  A term often interchangeably used with race. Ethnicity may be viewed as a relationship among individuals who believe that they have distinctive characteristics that make them a group.
• Nationality


  Sometimes used interchangeably with ethnicity or citizenship. Generally refers to the sovereign state or country where an individual has membership, which may be through birth, through inheritance (parents), or through naturalization.
• Religion


  A system of beliefs, practices, and ethical values about divine or superhuman power worshipped as the creator(s) and ruler(s) of the universe. The practice of religion is revealed in numerous denominations, organizations, sects, and cults.
• Ethnocentrism


  The belief in the superiority of one's own culture and lifestyle. Other viewpoints are not only considered different, but also wrong or of lesser importance.
• Prejudice


  A preconceived notion or judgment that is not based on sufficient knowledge; it may be favorable or unfavorable. Unfavorable prejudice may lead to stereotyping and discriminatory behavior toward groups of people.
• Racism


  Assumptions held about racial groups, including the belief that races are biologically discrete and exclusive groups that are inherently unequal and ranked hierarchically. Cultural behaviors are viewed as inherited and exclusive to each group and form the basis of judging persons based on their racial classification.
• Discrimination


  The negative treatment of individuals or groups on the basis of their race, ethnicity, gender, or other group membership. It occurs when rights and opportunities are denied for arbitrary or prejudicial reasons.
• Generalizations


  Statements about common cultural patterns that may not hold true at the individual level, and should serve only as openings for individuals to better understand each other.
• Stereotyping


  Making the assumption that an individual reflects all characteristics associated with being a member of a group.
• Health disparities


  The differences in care experienced by one population compared with another population, including differences in quality of care and access to care.
• Determinants of health


  • Social determinants (e.g. gender, socioeconomic status, employment status, educational attainment, food security status, availability of housing and transportation, racism, health system access and quality)
  • Behavioral determinants (e.g. patterns of overweight and obesity, exercise norms, use of illicit drugs, tobacco, or alcohol)
  • Environmental determinants (e.g. lead exposure, asthma triggers, workplace safety factors, unsafe or polluted living conditions)
  • Biological and genetic determinants (e.g. family history of heart disease, inherited conditions such as hemophilia and cystic fibrosis)
• Cultural competence


  The ongoing process in which the health care professional continuously strives to achieve the ability and availability to work effectively within the cultural context of the patient (individual, family, community). It has five constructs: cultural desire, cultural awareness, cultural knowledge, cultural skills, and cultural encounters.

  
• Health traditions model


  A model predicated on the concept of holistic health that describes what people do from a traditional perspective to maintain, protect, and restore health. It includes traditional methods related to the body (physical), mind (cognitive and emotional), and spirit (positive and negative learned spiritual practices and teachings).
• Symbolic examples of health traditions

  • Thousand-year-old eggs (traditional foods to maintain physical health in China)
  • Enjoyment of nature (universal way of maintaining mental health)
  • Islamic prayer (way of maintaining spiritual health in East Jerusalem)
  • Red string (worn to protect physical health in Bethlehem, Israel)
  • Eye symbol (worn or hung in home to protect mental health in Cuba)
  • Thunderbird (worn for spiritual protection and good luck in Hopi Nation)
  • Herbal remedies (used to restore physical health in Africa)
  • Tiger balm (used in massage therapy to restore health in various cultures)
• Symbolic examples


  • Thousand-year-old eggs (China)
  • Enjoyment of nature (universal)
  • Islamic prayer (East Jerusalem)
  • Red string (Tomb of Rachel, Bethlehem, Israel)
  • Eye (Cuba)
  • Thunderbird (Hopi Nation)
  • Herbal remedy (Africa)
  • Tiger balm (Singapore)
  • Rosary beads (Italy)
• Magico-religious health belief


  Health and illness are controlled by supernatural forces. Illness is the result of "being bad" or opposing the creator(s)' will.
• Scientific/biomedical health belief


  Life is controlled by physical and biochemical processes that can be manipulated by humans. Illness is caused by germs, viruses, bacteria, or a breakdown of the body.
• Holistic health belief


  The forces of nature must be maintained in balance or harmony. When the natural balance or harmony is disturbed, illness results.
• Sociocultural forces influence the client's health status and health care behavior
• Folk medicine


  Beliefs and practices relating to illness prevention and healing that derive from cultural traditions rather than from modern medicine's scientific base
• Family


  • The basic unit of society, but the concept is complex and influenced by personal and social values. There is no agreed-on definition of family and there is great diversity in family types and structures.
• Communication and culture


  Communication transmits culture from one generation to the next, and knowledge about the culture within and outside the group.
• Verbal communication


  Includes vocabulary, grammatical structure, voice qualities, intonation, rhythm, speed, pronunciation, and silence.
• Translator


  Converts written material from one language into another.
• Interpreter


  Transforms the message expressed in a spoken or signed source language into its equivalent in a target language, so that the interpreted message has the potential of eliciting the same response in the listener as the original message. Also serves as a cultural broker.
• Nonverbal communication


  • Includes the use of silence, touch, eye movement, facial expressions, and body posture.
• Space orientation


  The relationship between the individual's own body and objects and individuals within that space, which is learned and influenced by culture.
• Time orientation


  An individual's focus on the past, the present, or the future, with one orientation more likely to dominate.
• Nutritional patterns


  Most cultures have staple foods that are plentiful or readily accessible in the environment.
• LEARN model


  1. Listen actively with empathy

  2. Explain what you think you heard/ask for clarification

  3. Acknowledge the importance of what is said and what it means

  4. Recommend inclusive strategies

  5. Negotiate the plan of care by collaborating with the client and others
• The 4 C's of culture

  1. What do you call your problem?

  2. What do you think caused your problem?

  3. How do you cope with your condition?

  4. What are your concerns regarding the condition and/or recommended treatment?
• The nursing diagnoses developed by NANDA International are focused on nursing care provided in the United States and are based on European-centric cultural beliefs.