Nursing Leadership &
Management
Patricia Kelly-Heidenthal
0-7668-2508-6
Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company
Chapter 24
Cultural Diversity and
Spirituality
Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company
Objectives
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Upon completion of this chapter, the reader should be
able to:
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Define culture.
Discuss the U.S. population composition.
Identify key cultural theorists.
Discuss how culturally competent care can best be
delivered.
• Integrate understanding and respect for spiritual and
religious beliefs of different peoples.
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Definitions
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Culture refers to the behaviors, norms, belief sets,
values, and folkways of a specific group.
Ethnicity is a component of cultural identity; people
often describe themselves as being from a certain
group of society, perhaps within a larger community.
Ethnocentrism is the belief that one’s own culture or
ethnic group is better than all other groups.
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Definitions
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Values are those standards with which a society is
maintained.
Acculturation is the process by which one adjusts and
adapts to another culture by altering one’s own
cultural behaviors.
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Defining U.S. Diversity
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The United States is a nation of immigrants.
America’s ethnic profile is changing.
Hispanic, African-American, and Asian populations
are growing.
Health care provider racial and ethnic diversity:
• Studies show that the racial and ethnic composition of the
health care industry does not reflect the national trend;
however, the recent nursing shortage has resulted in an
increase of foreign-born nurses in the United States.
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Diversity Awareness
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Increase in diversity awareness began in the 1980s.
The six primary diversity characteristics include:
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Age
Race
Ethnicity/culture
Sexual/affectional orientation
Gender
Physical abilities
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Nursing Organizations
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The AACN defines the study of cultural competency
and cultural awareness as one of the core
competencies required of a baccalaureate nursing
graduate in the 21st century.
The Expert Panel on Culturally Competent Nursing
Care was convened in 1992 to develop and present
recommendations for the care of the culturally diverse
patient.
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PEW Recommendations
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Ensure that cultural sensitivity awareness be an active
part of the training of all health professionals.
Place concerted effort on the recruitment of diverse
students and providers.
Providers must develop the ability to administer
culturally sensitive care to a diverse society
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Cultural Nursing Theories
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Cultural competence is care that is sensitive to issues
related to culture, race, gender, and sexual
orientation.
Ethnosensitive care is the ability to appreciate values
and behaviors within the context of specific cultural
norms and to apply this ability to practice.
Transcultural nursing is concerned with providing
care that matches the patient’s expectations and
cultural belief set.
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Cultural Nursing Models
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Sunrise model
Transcultural assessment model
Campinha-Bacote model
Spector
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Providing Care in a Culturally
Competent Manner
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Understanding the health care provider’s culture
Understanding the patient’s culture
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Creating an Environment of Acceptance
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Actively seek an understanding of one another’s
cultures.
Understand nonverbal communication patterns.
Understand meanings behind communications.
Know how to respond in a culturally competent
manner.
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Creating an Environment of Acceptance
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Do not label one culture as preferable to another, or
treat one culture as the majority culture.
Develop an environment in which people can ask
questions and receive accurate answers.
Have work groups or teams composed of people with
differing cultural backgrounds and abilities.
Confront, acknowledge, and work with prejudices and
prejudgments so that effective communication can
occur.
Model respectful behavior.
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Managing a Culturally Diverse Team
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When problem-solving, include a variety of team
members from different cultural backgrounds,
experiences, and abilities.
Understand how individual team members respond to
conflict, and what their expectations are for the final
result.
Focus on the cultural differences and build an
appreciation for what everyone can contribute.
Do not assume all members of a certain group respond
in the same manner.
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Managing a Culturally Diverse Team
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Value everyone’s differences and recognize their
similarities.
Pay close attention to both verbal and nonverbal
communications for cultural cues.
Ask for clarification. Do not assume.
Alter your assumptions about others based on their
membership in certain groups.
Assist those who are not of the majority cultural group
to be successful. Include the informal networking and
the organization’s culture as starting points.
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Spirituality and Nursing Care
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Nurses are taught to look at patients holistically, and
to include psychological and spiritual factors in the
healing process.
People who are sick will often seek comfort from
religious or spiritual beliefs.
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Spirituality and Religion: Definitions
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Spirituality refers to a belief in a higher power, an
awareness of life and its meaning, the centering of a
person with purpose in life. It involves relationships
with a higher being, with self, and with world around
the individual.
Religion is an organized and public belief system of
worship and practices that generally have a focus of a
god or supernatural power. It generally offers an
arrangement of symbols and rituals that are
meaningful and understood by followers.
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Spiritual Distress
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Spiritual distress includes questioning the purpose of
life and its meaning, refusing to participate in one’s
usual religious practices, and seeking unusual
assistance rather than the usual spiritual or religious
support.
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Spiritual Assessment
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There is increasing interest in the role that spirituality
and religion play in a person’s physical health and
well-being.
An integral part of a patient’s initial assessment
should include data about the patient’s spiritual and
religious beliefs.
Several tools exist for spiritual assessment.
Spiritual care needs to be individualized, with the
patient given the opportunity to participate
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Religious Beliefs Related to Health Care
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What are health-related beliefs of these major
religions?
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Buddhism
Christianity
Hinduism
Judaism
Islam
Atheism
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