CULTURAL DIVERSITY AND NURSING

1. CULTURAL DIVERSITY AND NURSING

2. Objectives: • Define key terms. • Describe the characteristics and components of culture. • Discuss the impact of cultural beliefs on illness and health. • Compare and contrast diverse health beliefs of major cultural groups in the United States. • Describe cultural differences in relation to time and space. • Identify nutritional preferences held by various cultural groups. • Identify the general beliefs that account for the differences among religions. • Describe the way that the nurse’s religious beliefs or lack thereof can influence nursing care. • Discuss the nurse's role in meeting the spiritual needs of the client and family. • Analyze personal values and cultural beliefs. • Perform a cultural assessment

3. Content: I. Introduction • Culture II. Ethnicity and Race • Ethnicity • Race III. Cultural Diversity • Ethnocentrism • Oppression • Stereotyping • Dominant cuture • Minority group • Acculturation • Cultural assimilation

4. Content: IV. Culture’s Components V. Culture’s Characteristics and Conflicts VI. Cultural Influences on Health Care Beliefs and Practices • Cultural sensitivity • Definition of Health • Etiology • Health promotion and protection • Practitioners and Remedies

5. Content: VII. Beliefs of Select Cultural Groups • European American • African American • Hispanic American • Asian American • Native American VIII. Cultural and Racial influences on client care • Communication • Orientation to space and time • Social Organization • Family structure • Gender roles Religion • Spiritual Needs and spiritual care

6. Content: IX. Biological Variation X. Cultural Aspects and the Nursing Process XI. Nutrition XII. Natural Folk Medicine XIII. Health and Illness XIV. Alternative Therapies

7. INTRODUCTION • Every aspect of a person’s life is influenced by that person’s culture. • Because nurses provide health care to culturally diverse client populations in various settings, knowledge of culturally relevant information is essential for delivery of competent nursing care.

8. CULTURE • An integrated, dynamic structure of knowledge, attitudes, behaviors, beliefs, ideas, habits, customs, languages, values, symbols, rituals, and ceremonies unique to a particular group of people. • This structure provides the group of people with a general design for living.

9. CULTURE • Shared system of beliefs, values, and behavioral expectations • Provides social structure for daily living • Defines roles and interactions with others and in families and communities • Apparent in the attitudes and institutions unique to the culture

10. Tell whether the following statement is true or false. Culture includes the beliefs, habits, likes and dislikes, and customs and rituals learned from one’s family. A. True B. False

11. ETHNICITY AND RACE • Ethnicity–a cultural group’s perception of itself, or a group identity. • Race–a group of people with biological similarities. Typically based on specific characteristics • Skin pigmentation, body stature, facial features, hair texture • Five major categories: • American Indian or Alaska Native • Asian • Black or African American • Native Hawaiian or Other Pacific Islander • White

12. CULTURAL DIVERSITY ALSO INCLUDES … • Ethnocentrism–the assumption of cultural superiority and inability to accept another culture’s ways. • Oppression–when the rules, values and ideals of one group are imposed on another group.

13. CULTURAL DIVERSITY ALSO INCLUDES … (continued) • Stereotyping–belief that people in same ethnic, racial, or cultural group act the same way, share same beliefs, attitudes. • Dominant culture–the group whose values prevail within a given society. • Minority group–constituting less than a numerical majority of the population.

14. CULTURAL DIVERSITY ALSO INCLUDES … (continued) • Acculturation–the process of learning beliefs, norms, and behavioral expectations of a group. • Cultural assimilation–members of a minority group are absorbed by the dominant culture, taking on the characteristics of the dominant culture.

15. Which of the following occurs when a minority group, living with a dominant group, begins to blend in and lose the characteristics that made them distinct? A. Cultural imposition B. Cultural conflict C. Cultural assimilation D. Cultural shock

16. CULTURE’S COMPONENTS • Perception of self and the individual: refers to personal identity, respect for individuals, and value. • Motivation–explains the methods and value of achievement. • Activity–identifies the ways people organize and value work.

17. CULTURE’S COMPONENTS (continued) • Social relations–explains the structure and importance of friendships, gender roles, and class. • Perception of the world–indicates the explanation of religious beliefs and life events.

18. CULTURE’S CHARACTERISTICS • Culture is not inherited or innate, rather, it is integrated throughout all the interrelated components, motivations, activities, world views, relationships, and individuality are affected by consistent patterns of behavior and form a cohesive whole.

19. CULTURE’S CHARACTERISTICS (continued) • Culture is learned. • Culture is shared. • Culture is dynamic (constantly changing). • Culture is tacit (unspoken). Everyone in the cultural group understands acceptable behavior.

20. INFLUENCES ON HEALTH CARE BELIEFS AND PRACTICES • Cultural values define human responses to illness and will determine whether an individual seeks professional care when ill and complies with prescribed treatment. • Clients tend to define wellness and illness in the context of their own culture.

21. PRACTITIONERS AND REMEDIES • Variety in health/illness care providers is a natural extension of: • Culturally diverse concepts of etiology. • Definitions of health and illness.

22. PRACTITIONERS AND REMEDIES (continued) • Nurses must be able to: • Relate care and treatment to the client’s cultural context. • Incorporate informal caregivers, healers, and other members of the client’s support system as allies in treatment.

23. BELIEFS OF SELECT CULTURAL GROUPS • European Americans • African Americans • Hispanic Americans • Asian Americans • Native Americans

24. EUROPEAN AMERICANS • Traditional healers: nurse, physician. • Healing practices: exercise, medications, modified diets, amulets, religious healing rituals.

25. AFRICAN AMERICANS • Traditional healers: elderly women healers, “community mother” or “granny,”“root doctor,” voodoo healer, spiritualist. • Healing practices: herbs, roots, oils, poultices, rituals, talismans.

26. HISPANIC AMERICANS • Traditional healers: curandero, espiritualista, yerbero, brujo, sobadora, santiguadora. • Healing practices: hot and cold foods, herbal teas, prayers and religious medals, massage, azabache, “three baths” ritual.

27. ASIAN AMERICANS • Traditional healers: herbalist, physician. • Healing practices: hot and cold foods, herbs, soups, cupping, pinching, and rubbing, meditation, acupuncture, acupressure, tiger balm, energy to restore balance between yin and yang.

28. NATIVE AMERICANS • Traditional healers: shaman, medicine man/woman. • Healing practices: plants and herbs, medicine bundle or bag, sweet grass burned to purify the ill person, estafiate (dried leaves) tea, the Blessingway ceremony, sand paintings.

29. CULTURAL AND RACIAL INFLUENCES ON CLIENT CARE Can be viewed through: • Communication • Orientation to space and time • Social organization • Biological variations

30. COMMUNICATION • Not everyone shares the same language. • This can lead to misunderstanding and frustration. • Alternative methods include gestures and flash cards. • Family members may be able to assist. • Interpreters may be used.

31. ORIENTATION TO TIME AND SPACE • The distance that a person prefers to maintain from another is determined by one’s culture. • Individual’s orientation to time may affect: • Promptness, attendance at appointments. • Compliance with self-medication schedules. • Reporting the onset of illness.

32. SOCIAL ORGANIZATION Refers to the ways that cultural groups determine rules of acceptable behavior and roles of individual members and includes: • Family structure. • Gender roles. • Religion.

33. BIOLOGICAL VARIATION • Distinguishes one racial or cultural group from another. • Includes variations in hair texture, eye shape, skin color, thickness of lips, and body structure. • Also includes enzymatic differences and susceptibility to disease.

34. CULTURAL ASPECTS OF NURSING PROCESS–ASSESSMENT • Culturally sensitive nursing care begins with examination of own culture, beliefs. • It is followed by an assessment of the client’s cultural beliefs and background. • Even if we cannot understand or accept particular cultural practices, it is important to show respect for them.

35. NURSING DIAGNOSIS • Any nursing diagnosis may be appropriate for a client of any cultural group.

36. PLANNING/OUTCOME IDENTIFICATION • Cultural variables must be taken into consideration when establishing goals and planning interventions. • Care will be most effective when client and family are active participants in planning care, and cultural preferences are respected.

37. IMPLEMENTATION • Interventions should be carried out in a manner that respects, as much as possible, client’s preferences and desires. • When client does not speak or understand the native language well, nurse should arrange to have interpreter present to explain procedures and tests.

38. EVALUATION • Should include feedback from client and family to determine their reaction to the interventions. • Nurses should perform self-evaluations to identify their attitudes toward caring for clients from diverse cultures.

39. CULTURALLY APPROPRIATE CARE • Respect clients for their beliefs. • Be sensitive to behaviors and practices different from your own. • Accommodate differences if they are not detrimental to the client’s health. • Listen for cues from client that relay unique ethnic beliefs about disease.