Chapter 8 Transcultural Healthcare

1. Chapter 8Transcultural Healthcare

2. Culture, Subculture, Race, Minorities, and Ethnicity • *Culture • It is the accumulated learning for generational groups of individuals within structured or nonstructured societies. • Subcultures • These are groups within dominant cultures. They form because individuals share characteristics that belong to an identifiable group. • Demographic growth of specific cultures

3. Culture, Subculture, Race, Minorities, and Ethnicity (cont’d) • Race • Large groups of humankind that share common biological and sociological characteristics • Racial mixing has blurred the physical characteristics of individuals • Hispanics are the fastest growing group in the US • Minority • Global shifts of multiple groups of individuals who are continually revising cultures and subcultures • *Ethnicity • Common heritage shared by a specific culture

4. *Barriers to Culturally Competent Care • Prejudice • Belief based on preconceived notions about certain groups of people • Ethnocentrism • Belief that one’s own culture is the best and only acceptable culture • Stereotyping • Categorizing people and believing that all those belonging to a certain group are alike

5. Culturally Competent Nursing Care • Cultural sensitivity • Understanding and tolerance of all cultures and lifestyles • Enables the nurse to • Understand more accurately and to accept the behavior of others • Provide better care, being sensitive to cultural factors involved in the client’s health or illness • SEE BOX 8-2

6. Nursing Considerations • Effect of socioeconomics where a client may divide one prescription for use by several individuals who may have similar symptoms • Consider asking the client if anyone else in the family needs to be aware of any healthcare situation, as the client may or may not traditionally have a say in important decisions. • Understand that some family members like to assist with care of the client. • Educate the client and family caregivers whenever the opportunity arises.

7. Values and Beliefs • Beliefs • May be based on fact, fiction, or a combination of both • Values • Shape how an individual perceives right or wrong and what is desirable or valuable • Nurses must recognize that different beliefs and values exist and affect nursing.

8. Taboos and Rituals • Taboos • Members of the culture cannot violate taboos without discomfort and risk of separation from the group. • Rituals • Members are often required to practice rituals for comfort, acceptance, and inclusion. • Often, taboos and rituals are associated with religious or spiritual services pertaining to healing, death, or dying. • SEE TABLE 8-2

9. Concepts of Health and Illness • Culture greatly influences an individual’s concepts of health and illness. • Each society has norms relating to the meaning of illness, how an ill person should behave, and what means should be used to assist him or her. • These also transmit to treatment and healing beliefs and practices, and attitudes toward mental illness. • Nurses must strive to accommodate clients’ healthcare beliefs and practices (as long as they are safe), even if they do not fully understand or agree with them.

10. *Health Belief Systems • Magicoreligious • Scientific/biomedical • Holistic medicine • Yin/yang

11. Language and Communication • The nurse and the clients may speak different languages. • Facilitate communication: • Professional interpreter • Female for a female pt. • Family as interpreter • Nurse as interpreter • Do not imply your judgement

12. *Personal space and touching • Personal space –comfort zone • In middle east, maintaining such a large space would be considered rejecting and insulting • In Asian cultures, touching a child on the head is a sign of disrespect and is believed to cause illness

13. Diet and Nutrition • Cultural eating rituals vary and some religions maintain strict dietary practices. • The nurse should take into account each client’s nutrition and dietary customs as nutrition and diet constitute an important part of health and treatment of illness.

14. Elimination • People of various cultures treat the elimination of bodily wastes differently. • *Many cultures consider elimination to be a private function, and some people are unable to void or to use a bedpan or commode unless they have complete privacy, which the nurse should consider.

15. Death and Dying • Each cultural group has an attitude or series of beliefs about death and dying. • The nurse must respect the client’s belief even if it different from their own belief. • Many Asian cultures consider death to be preordained, believing that when a person’s time to die has come, nothing can stop it. • Traditional Western culture tries to prevent death and to prolong life at all costs.

16. Religious and Spiritual Beliefs • The interrelationship among cultures, religious beliefs, and healthcare is very strong. • Each individual is unique and often has a mixture of belief systems, so it is important not to stereotype a client with any one religion. • With knowledge of the individual’s belief system, the client and the client’s community of significant others will be more accepting of necessary medical interventions, lifestyle changes, dietary changes, and treatment regimens.

17. Common Philosophies of Mental Illness inDifferent Cultures • *Mental illness is not accepted in all cultures as a consequence of biological disease. • The belief that chemical changes in the brain can cause mental disorders is a relatively new concept for many cultures. • Some cultures consider mental disorders a disgrace to the individual and to the family. • Some individuals believe in a curse or “evil eye.” • Western medicine traditionally considers this type of belief a deviation.

18. Cultural Aspects of Eye Contact • Eye contact can give important cues about clients. This action is culturally influenced. • In most European-based cultures, direct eye contact is considered normal. • In Native American, Arab, and some Southeast Asian cultures, members believe that looking a person in the eye during conversation is improper and impolite. • Facial expressions may be totally absent. The nurse must take care not to misinterpret these nonverbal cues.

19. Religious customs • Judaism • Kosher laws • Tao • To know and live a natural life • Islam • Pray 5 times a day facing Mecca • Do not believe in faith healing and do not baptize infants • Procedures for washing and shrouding the body by a imam