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Basic Nursing: Foundations of

Skills & Concepts

Chapter 12
Culture and Nursing

Nurses provide health care to culturally

diverse client populations in a variety of

Knowledge of culturally relevant

information is vital in the delivery of
competent nursing care.

Dynamic and integrated structures of

Knowledge, beliefs, behaviors,
ideas,attitudes, values, habits,
customs, languages, symbols,
rituals, ceremonies, and
practices that are unique to a
particular group of people.

A cultural groups perception of itself, or

a group identity.

The grouping of people based on

biological similarities.
Cultural Diversity

The differences among people that

result from racial, ethnic, and cultural
Important Terms in
Cultural Diversity

Ethnocentrism: assumption of cultural superiority

Oppression: result of ethnocentrism
Stereotyping: the belief that all members of a cultural
group act alike
Dominant culture: prevailing group within a given
Minority group: those of fewer numbers
Cultural assimilation: the absorption of the minority
into the dominant culture
Components of Cultural

Culture is composed of beliefs about:

Activity - how people organize and value work.
Social relations - structure of friendships, gender
roles and class.
Motivation - the value and methods of achievement.
Perception of the world - interpretation of life events
and religious beliefs.
Perception of self - refers to personal identity, value,
and respect for individuals.
Characteristics of Cultural

Culture is learned
Culture is not inherited or innate, but integrated
throughout all interrelated components
Culture is shared by all who belong to the cultural
Culture is tacit (unspoken) and understood by all in
the cultural group
Culture is dynamic
Cultural & Health Care

How different cultures view the following

variables affects health care in
significant ways.
Definition of health: what is it?
Etiology: what are the origins of disease?
Health Promotion and Protection: how is health
achieved and maintained?
Practitioners and Remedies: who and what can heal
a person?
Cultural Roots

Unlike opinions, preferences, and

attitudes, which can change, cultural
characteristics are deeply rooted and
difficult to change.

Clients reflect their cultural and ethnic

heritage every time they interact with
the world around them.
Cultural & Racial Influences on
Client Care

Culture and race influence client care in

the areas of:


Orientation to Space and Time

Social Organization

Language differences can lead to misunderstandings

and frustration.

Alternative methods of communication, such as flash

cards and gestures, may have to be used.

Family members or staff interpreters may also be

necessary to intercede.
Orientation to Space and Time

Issues around personal space and

future orientation vary from culture to
culture and impact the effective delivery
of health care.
Social Organization

Social organization refers to how different

cultural groups determine rules of
acceptable behavior. Examples include:
Family Structure.
Gender Roles.

Culture is influenced by religion, which

in turn affects beliefs and practices
about health and illness.

Spiritual and religious beliefs are

important in many peoples lives. They
can influence lifestyle, attitudes, and
feelings about illness and death.
Biological Variation

Biological variations distinguish one cultural or racial

group from another.

Biological variations include skin color, hair texture,

body structure, eye shape, etc.

Enzymatic differences account for diverse responses

of some groups to dietary therapy and drugs.
Cultural Aspects
& The Nursing Process

Cultural aspects affect all significant

areas of the nursing process:
assessment, nursing diagnosis,
planning/outcome identification,
implementation, and evaluation. Some
areas are more affected than others.
Personal Cultural Assessment

Five areas to be examined in assessing

ones own culture and the influence it
may have on personal beliefs about
health care are:
Influences from own ethnic/racial background.
Typical verbal and non-communication patterns.
Cultural values and norms.
Religious beliefs and practices.
Health beliefs and practices.
Client Cultural Assessment

Six categories of information necessary

for a comprehensive cultural
assessment of a client are:
Ethnic or racial background.
Language and communication patterns.
Cultural values and norms.
Biocultural factors.
Religious beliefs and practices.
Health beliefs and practices.
Culturally Appropriate Care

Respect clients for their different beliefs.

Be sensitive to behaviors and practices different from
your own.
Accommodate differences if they are not detrimental
to health.
Listen for cues in the clients conversation that relay
a unique ethnic belief about etiology, transmission,
prevention, etc.
Teach positive health habits if clients practices are
deleterious to good health.