Culture and Global Health

Online Module
NUR 215
Fall 2007
Why study culture in nursing?

Cultural minority populations

1990’s = 26%
2010 = 30%
2050 = 50%
 Culture
The collection of beliefs, values,
behaviors, and practices shared by a
group of people and passed from one
generation to the next.

– Learned from birth

– Molded by environment
– Guides thinking, decisions, and actions
 Ethnocentrism
The belief that one’s cultural, ethnic, or
professional group is superior to that of
others.
 Stereotyping
An expectation that all
people within the same
racial, ethnic, or cultural
group act alike and share
the same beliefs and
attitudes.

Usually results in labeling.

Acculturation vs. Assimilation
Acculturation is the process of adapting to
and adopting a new culture.

Assimilation results when an individual

gives up his or her ethnic identity in favor
of the dominant culture.
 Cultural Competence
The process through which the nurse
provides care that is appropriate to the
client’s cultural context.

The goal is to make healthcare more

efficient and more effective.
 Transcultural Nursing
Focuses on the study and analysis of
different cultures and subcultures with
respect to cultural care, health beliefs and
health practices, with the goal of providing
health care within the context of the
client’s culture.

Leininger, M. (1978). Transcultural nursing: Concepts, theories, and practice.

New York:Wiley.
 Organizing Phenomena of
Culture
Communication
Space
Social organization
Time
Environmental control
Biological variations
.
 Communication
The way by which one person interacts
with another through written or oral
language, gestures, facial expressions,
and body language.
Culture influences how feelings are
expressed and the type of verbal and non-
verbal expressions that are appropriate.
Language, silence, eye contact
 Communication
With verbal communication, problems may
occur because words have different
meanings within different cultural contexts.

Nonverbal communication consists of

body language, the use of silence, and
eye contact.
 Space
Culture usually determines the amount of
social distance tolerated by a person.

Diverse groups also have varying norms

for use of touch. Touch may be perceived
as invasive by clients from some cultures.
 Time Orientation
Past or Present or Future oriented
If past oriented, may value tradition and
the way they have always done things.
May be reluctant to try new procedures.
If present oriented, tend to focus on the
here and now. May be relatively
unconcerned with the future, deal with it
when it comes.
 Social Organization
Refers to the ways in which groups
determine rules of acceptable behavior
and roles of individual members.

Family may assume greater importance

than the individual in many cultures.
– Example: In Native American tribes, the
extended family is the basic family structure.
 Social Organization
Gender roles vary according to cultural
context. Some cultures have very distinct
roles for male vs. female.

Religious beliefs also influence a person’s

response to major events such as birth,
illness, and death.
 Environmental Control
Refers to the relationships between people
and nature and to a person’s perceived
ability to control activities of nature

Definition of Health
Causative Factors of Illness
 Biologic Variations

Dietary Practices/Preferences

Increased Susceptibility to disease

 Application of Cultural
Phenomena to Nursing Care

See Culture Group

Handout on website.
Providing Culturally Sensitive Care
Self-Awareness – Need to recognize own
stereotypes, biases, and prejudgments
about clients who are culturally different.
Nonjudgmental Attitude is essential in
providing culturally sensitive care.
Education must be relevant to client’s
needs and provided in culturally sensitive
manner.
Culturally Sensitive Teaching
Guidelines

See Cultural Teaching

Handout on website.
Global Health Organizations
United Nations (UN)
World Health Organization (WHO)
United Nation’s Children’s Fund (UNICEF)
International Council of Nurses (ICN)
 United Nations (UN)
To maintain international peace and
security
To foster international cooperation in
solving economic, social, cultural, and
humanitarian problems and in promoting
respect for human rights and fundamental
freedoms
To be a center for harmonizing the actions
of nations in attaining these common ends
 WHO
Four major functions:
1. To give worldwide guidance in the field of
health
2. To set global standards for health
3. To cooperate with governments in
strengthening national health programs
4. To develop and transfer appropriate health
technology, information and standards
 UNICEF
Primary objective is to provide support for
the world’s most disadvantaged children
without discrimination
Major focus is worldwide problem of
malnutrition
 ICN
Goals:
– Bring nurses together worldwide
– Advance nurses and nursing worldwide
– Influence health policy

www.icn.ch/abouticn.htm (ICN’s Mission,

Vision, and Vision for the Future of Nursing
Statements)
Complete the following quiz
to turn in as evidence of
module completion.
See link
For Culture QUIZ
On website.