Fundamentals of Nursing Practice - Lecture
Module #22 Student Activity Sheet
Name: _________________________________________________________
Class number: _______
Section: ____________ Schedule: ___________________________________
Date: _______________
Lesson title: CULTURE, VALUES AND PRACTICES IN
RELATION TO HEALTH CARE
Learning Targets:
At the end of the module, students will be able to:
1. Describe cultural influences on health and illness;
2. Explain how the many facets of culture affect a health care
provider's ability to provide culturally congruent care;
3. Describe health disparities and social determinants of health;
4. Describe steps toward developing cultural competence;
5. Describe the relationship between cultural competence and
patient-centered care;
6. Use cultural assessment to plan culturally competent care;
7. Discuss research findings applicable to culturally competent
care; and,
8. Discuss research finding applicable to equity-focused quality
improvement.
Materials:
Electronic gadget, pen, & notebook
References:
Potter, P. A., Perry, A.G., et al. (2021).
Fundamentals of nursing (10th ed.).
Singapore: Elsevier.
A. LESSON PREVIEW/REVIEW
Let us have a quick review of what you have learned from the previous session. Kindly answer the posted task on the
space provided. You may use the back page of this sheet, if necessary. Here is the task:
Discuss what you have learned with regards to career opportunities in nursing field and relate your personal choice as you
graduate and have your license to practice the profession.
B. MAIN LESSON
CULTURAL AWARENESS
 In the US, many individuals face greater obstacles to good health on the basis of racial or ethnic group; religion;
socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or
gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.
 Culture relates to all of these factors.
 Research findings reveal differences in rates of cancer, diabetes, infant mortality, organ transplantation, and many
other health conditions because of cultural factors.
This document is the property of PHINMA EDUCATION
Fundamentals of Nursing Practice - Lecture
Module #22 Student Activity Sheet
Name: _________________________________________________________
Class number: _______
Section: ____________ Schedule: ___________________________________
Date: _______________
Health Disparities
 Health disparity o
A particular type of health difference that is closely linked with social, economic,
and/or environmental disadvantage (USDHHS, 2015)
 Social determinants of health o The conditions in which people are born, grow, live, work, and age, shaped by
the distribution of money, power, and resources at global, national, and local levels (WHO, 2013)
Health Disparities and Health Care
 Health care disparities o
Differences among populations in the availability,
accessibility, and quality of health care services
 Addressing health care disparities: New standards o
Focus on cultural competency,
health literacy, and patient- and family-centered care
o Recognize that valuing each patient’s unique needs improves the overall safety and quality of care
and helps to eliminate health disparities. Culture
 Norms, values, and traditions
 Ethnicity, race, nationality, and language
 Gender, sexual orientation, location, class, and immigration status
 Intersectionality o Belonging simultaneously to multiple social groups
 Oppression o A system of advantages and disadvantages tied to our membership in social
groups
Culturally Congruent Care
 Transcultural nursing o a comparative study of cultures to understand their
similarities and differences
 Culturally congruent care o
Care that fits a person’s life patterns, values,
and system of meaning
Meaning of Disease and Illness
 Culture affects how an individual defines the meaning of illness
 Illness: The way that individuals and families react to disease
 Disease: Malfunctioning biological or psychological processes
Cultural Competency
 Defined as the enabling of health care providers to deliver services that are
respectful of and responsive to the health beliefs, practices, and cultural
and linguistic needs of diverse patients.
 Culturally competent organizations: o
Value diversity
o Conduct a cultural self-assessment
o Manage the dynamics of difference
o Institutionalize cultural knowledge o
Adapt to diversity
1. Respecting a patient’s health beliefs and understanding the effect of the patient’s beliefs on health care delivery
2. Shifting a model of understanding a patient’s experience from a disease happening in the patient’s organ systems to
that of an illness occurring in the context of culture
3. Ability to elicit a patient’s explanation of an illness and its causes
This document is the property of PHINMA EDUCATION
Fundamentals of Nursing Practice - Lecture
Module #22 Student Activity Sheet
Name: _________________________________________________________
Class number: _______
Section: ____________ Schedule: ___________________________________
Date: _______________
4. Ability to explain to a patient the health care provider’s perspective on the illness and its perceived causes
5. Being able to negotiate a mutually agreeable, safe, and effective treatment plan
 Expanding the original focus on interpersonal skills, many of the current approaches to cultural competency now
also focus on:
o All marginalized groups and not just immigrants o
Prejudice, stereotyping, and social determinants of health
o The health system, communities, and institutions.


Campinha-Bacote:
o
Cultural
awareness o Cultural
knowledge o
Cultural
skills
Blanchet and Pepin o Building a relationship
with the other o Working outside the usual
practice framework o Reinventing practice in
action
o
Cultural
encounters o Cultural
desire
Patient Centered Care
 Landmark reports o Crossing the Quality Chasm (IOM, 2001) o Unequal Treatment (Smedley et al., 2003)
 Cultural competence vs. patient-centered care o Each emphasizes different aspects of quality o Patientcenteredness provides individualized care and restores an emphasis on personal relationships o Cultural
competence aims to increase health equity and reduce disparities by concentrating on people of color and other
disadvantaged populations Cultural Awareness
 Bias: a predisposition to see people or things in a certain light, either positive or negative.
 Becoming more self-aware of your biases and attitudes about human behavior is the first step in providing
patientcentered care.
This document is the property of PHINMA EDUCATION
Fundamentals of Nursing Practice - Lecture
Module #22 Student Activity Sheet
Name: _________________________________________________________
Class number: _______
Section: ____________ Schedule: ___________________________________
Date: _______________
Cultural Knowledge —World Views
 World view: Emic & Etic
 Avoid stereotyping
 Treat the individual
 See every patient encounter as cross-cultural
 Iceberg analogy: most aspects of a person’s worldview are hidden
 Conduct a cultural assessment
This document is the property of PHINMA EDUCATION
Fundamentals of Nursing Practice - Lecture
Module #22 Student Activity Sheet
Name: _________________________________________________________
Class number: _______
Section: ____________ Schedule: ___________________________________
Date: _______________
Skills and Interventions: Cultural assessment
 Cultural assessment model o Open-ended, focused, and contrasted questions o Explanatory model o Trust
 Mnemonics o LEARN: Listen, Explain, Acknowledge, Recommend, Negotiate
o RESPECT: Rapport, Empathy, Support, Partnership, Explanations, Cultural Competence,
Trust o
ETHNIC: Explanation, Treatment, Healers, Negotiate, Intervention, Collaboration o
C-LARA: Calm, Listen, Affirm, Respond, Add
 Linguistic competence
 Health literacy
 Teach back
Cultural Encounters
 Are interventions that involve a nurse directly interacting with patients from culturally diverse backgrounds 
Have the potential for conflict
 Enable new forms of community and collective identity
 Provide the opportunity to show compassion
Cultural Desire
 The motivation of a healthcare professional to “want to”—not “have to”—engage in the process of becoming
culturally competent
 Health care organizations are increasingly integrating cultural competence principles into everyday organizational
processes and practices
This document is the property of PHINMA EDUCATION
Fundamentals of Nursing Practice - Lecture
Module #22 Student Activity Sheet
Name: _________________________________________________________
Class number: _______
Section: ____________ Schedule: ___________________________________
Date: _______________
Core Measures
 Key quality indicators that help health care institutions improve performance, increase accountability, and reduce
costs
 Consistent with national health priorities
 Intended to reduce health disparities
\
C. LESSON WRAP-UP
Thinking about Learning
CAT 3-2-1
This strategy provides a structure for you to record your own comprehension and summarize your learning. Let us see
your progress in this chapter!
Three things you learned:
1.
_______________________________________________________________________________________
This document is the property of PHINMA EDUCATION
Fundamentals of Nursing Practice - Lecture
Module #22 Student Activity Sheet
Name: _________________________________________________________
Class number: _______
Section: ____________ Schedule: ___________________________________
Date: _______________
2.
_______________________________________________________________________________________
3.
_______________________________________________________________________________________
Two things that you’d like to learn more about:
1. __________________________________________________________________________________________
2. __________________________________________________________________________________________
One question you still have:
1. __________________________________________________________________________________________
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