CULTURAL
DIVERSITY
AND NURSING
 Define key terms.
 Describe the characteristics
 Identify the general beliefs
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and components of culture.
Discuss the impact of cultural
beliefs on illness and health.
Compare and contrast diverse
health beliefs of major
cultural groups in the United
States.
Describe cultural differences
in relation to time and space.
Identify nutritional
preferences held by various
cultural groups.
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that account for the
differences among religions.
Describe the way that the
nurse’s religious beliefs or
lack thereof can influence
nursing care.
Discuss the nurse's role in
meeting the spiritual needs of
the client and family.
Analyze personal values and
cultural beliefs.
Perform a cultural assessment
I. Introduction
 Culture
II. Ethnicity and Race
 Ethnicity
 Race
III. Cultural Diversity
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Ethnocentrism
Oppression
Stereotyping
Dominant cuture
Minority group
Acculturation
Cultural assimilation
IV. Culture’s Components
V. Culture’s Characteristics and Conflicts
VI. Cultural Influences on Health Care Beliefs and
Practices
 Cultural sensitivity
 Definition of Health
 Etiology
 Health promotion and protection
 Practitioners and Remedies
VII. Beliefs of Select Cultural Groups
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European American
African American
Hispanic American
Asian American
Native American
VIII. Cultural and Racial influences on client care
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Communication
Orientation to space and time
Social Organization
Family structure
Gender roles Religion
Spiritual Needs and spiritual care
IX. Biological Variation
X. Cultural Aspects and the Nursing
Process
XI. Nutrition
XII. Natural Folk Medicine
XIII. Health and Illness
XIV. Alternative Therapies
 Every aspect of a person’s life is influenced by that
person’s culture.
 Because nurses provide health care to culturally
diverse client populations in various settings,
knowledge of culturally relevant information is
essential for delivery of competent nursing care.
 An integrated, dynamic structure of knowledge,
attitudes, behaviors, beliefs, ideas, habits,
customs, languages, values, symbols, rituals, and
ceremonies unique to a particular group of people.
 This structure provides the group of people with a
general design for living.
 Shared system of beliefs, values, and
behavioral expectations
 Provides social structure for daily living
 Defines roles and interactions with others
and in families and communities
 Apparent in the attitudes and institutions
unique to the culture
Tell whether the following statement is true
or false.
Culture includes the beliefs, habits, likes
and dislikes, and customs and rituals
learned from one’s family.
A. True
B. False
 Ethnicity–a cultural group’s perception of itself, or a group
identity.
 Race–a group of people with biological similarities.
Typically based on specific characteristics
 Skin pigmentation, body stature, facial
features, hair texture
 Five major categories:
 American Indian or Alaska Native
 Asian
 Black or African American
 Native Hawaiian or Other Pacific Islander
 White
 Ethnocentrism–the assumption of cultural superiority
and inability to accept another culture’s ways.
 Oppression–when the rules, values and ideals of one
group are imposed on another group.
 Stereotyping–belief that people in same ethnic, racial,
or cultural group act the same way, share same beliefs,
attitudes.
 Dominant culture–the group whose values prevail
within a given society.
 Minority group–constituting less than a numerical
majority of the population.
 Acculturation–the process of learning beliefs, norms,
and behavioral expectations of a group.
 Cultural assimilation–members of a minority group
are absorbed by the dominant culture, taking on the
characteristics of the dominant culture.
Which of the following occurs when a
minority group, living with a dominant group,
begins to blend in and lose the characteristics
that made them distinct?
A. Cultural imposition
B. Cultural conflict
C. Cultural assimilation
D. Cultural shock
1.
2.
3.
Perception of self and the individual: refers to
personal identity, respect for individuals, and value.
Motivation–explains the methods and value of
achievement.
Activity–identifies the ways people organize and
value work.
4.
5.
Social relations–explains the structure and
importance of friendships, gender roles, and class.
Perception of the world–indicates the explanation
of religious beliefs and life events.
1.
Culture is not inherited or innate, rather, it is
integrated throughout all the interrelated
components, motivations, activities, world views,
relationships, and individuality are affected by
consistent patterns of behavior and form a cohesive
whole.
2.
3.
4.
5.
Culture is learned.
Culture is shared.
Culture is dynamic (constantly changing).
Culture is tacit (unspoken). Everyone in the
cultural group understands acceptable behavior.
 Cultural values define human responses to illness and
will determine whether an individual seeks
professional care when ill and complies with
prescribed treatment.
 Clients tend to define wellness and illness in the
context of their own culture.
 Variety in health/illness care providers is a
natural extension of:
 Culturally diverse concepts of etiology.
 Definitions of health and illness.
 Nurses must be able to:
 Relate care and treatment to the client’s cultural
context.
 Incorporate informal caregivers, healers, and other
members of the client’s support system as allies in
treatment.
 European Americans
 African Americans
 Hispanic Americans
 Asian Americans
 Native Americans
 Traditional healers: nurse, physician.
 Healing practices: exercise, medications, modified
diets, amulets, religious healing rituals.
 Traditional healers: elderly women healers,
“community mother” or “granny,” “root doctor,”
voodoo healer, spiritualist.
 Healing practices: herbs, roots, oils, poultices,
rituals, talismans.
 Traditional healers: curandero, espiritualista,
yerbero, brujo, sobadora, santiguadora.
 Healing practices: hot and cold foods, herbal teas,
prayers and religious medals, massage, azabache,
“three baths” ritual.
 Traditional healers: herbalist, physician.
 Healing practices: hot and cold foods, herbs, soups,
cupping, pinching, and rubbing, meditation,
acupuncture, acupressure, tiger balm, energy to
restore balance between yin and yang.
 Traditional healers: shaman, medicine
man/woman.
 Healing practices: plants and herbs, medicine
bundle or bag, sweet grass burned to purify the ill
person, estafiate (dried leaves) tea, the
Blessingway ceremony, sand paintings.
Can be viewed through:
 Communication
 Orientation to space and time
 Social organization
 Biological variations
 Not everyone shares the same language.
 This can lead to misunderstanding and frustration.
 Alternative methods include gestures and flash cards.
 Family members may be able to assist.
 Interpreters may be used.
 The distance that a person prefers to maintain from
another is determined by one’s culture.
 Individual’s orientation to time may affect:
 Promptness, attendance at appointments.
 Compliance with self-medication schedules.
 Reporting the onset of illness.
Refers to the ways that cultural groups determine rules
of acceptable behavior and roles of individual
members and includes:
 Family structure.
 Gender roles.
 Religion.
 Distinguishes one racial or cultural group from
another.
 Includes variations in hair texture, eye shape, skin
color, thickness of lips, and body structure.
 Also includes enzymatic differences and susceptibility
to disease.
 Culturally sensitive nursing care begins with
examination of own culture, beliefs.
 It is followed by an assessment of the client’s cultural
beliefs and background.
 Even if we cannot understand or accept particular
cultural practices, it is important to show respect for
them.
 Any nursing diagnosis may be appropriate for a
client of any cultural group.
 Cultural variables must be taken into consideration
when establishing goals and planning interventions.
 Care will be most effective when client and family are
active participants in planning care, and cultural
preferences are respected.
 Interventions should be carried out in a manner that
respects, as much as possible, client’s preferences
and desires.
 When client does not speak or understand the native
language well, nurse should arrange to have
interpreter present to explain procedures and tests.
 Should include feedback from client and family to
determine their reaction to the interventions.
 Nurses should perform self-evaluations to identify
their attitudes toward caring for clients from diverse
cultures.
 Respect clients for their beliefs.
 Be sensitive to behaviors and practices different from
your own.
 Accommodate differences if they are not detrimental
to the client’s health.
 Listen for cues from client that relay unique ethnic
beliefs about disease.