ch.21

1. Define the following terms related to culture:

2. Using the statistical abstract of the United States at www.census.gov , identify the following demographic statistics:

4. Consider your own cultural background. Identify examples of material culture and non-material culture in your own culture. What values, beliefs, norms, or life practices from your culture guide your behaviors? Self- explanatory

5. What is meant by the term bicultural? Refers to the integration of two cultures within the individual. What are the challenges for a person coming from a bicultural family? Ex. Celebrating Christmas and Hanukah

6. Discuss 7 characteristics of culture. Culture is learned, taught, social, adaptive, satisfying, difficult to articulate, exists at many levels.

7. What are the differences between the indigenous health care system and the professional health care system? IHCS refers to traditional folk health care methods, such as folk medicines and other home treatments. PHCS refers to a structured system maintained by individuals who have engaged in a formal program of study.

8. Discuss Leininger’s Sunrise Model of cultural care diversity and universality. This model emphasizes that health and care are influenced by elements of the social structure, such as technology, religious and philosophical factors, kinship and social systems, cultural values, political and legal factors, economic and educational factors. What cultural factors are proposed by Leininger’s Model to influence health care decisions. Cultural, philosophical, educational, and religious factors influence the type, quality, and quantity of health care considered desirable, acceptable, or appropriate to the culture.

9. What steps are proposed by Kittler and Sucher for a nurse to improve her/his cultural sensitivity? Become aware of one own’s cultural heritage, become aware of client’s culture as described by the client, become aware from the client of adaptations made to live in a North American culture, and form a nursing care plan with the client that incorporates his or her culture.

10. Identify and describe five factors that can pose barriers to cultural sensitivity. Give an example of each. Ethnocentrism, ethnorelativity, stereotyping, prejudice, discrimination.

11. Describe nine actions a nurse can take to convey cultural sensitivity. Always address clients by last name, introduce yourself completely and acknowledging your position when meeting someone for first time, be authentic with people, use language that is culturally sensitive, find out what client knows about his/her health problems, illnesses, and treatments, do not make any assumptions about client, respect client’s values, beliefs, practices even if they differ from your own, show respect for client’s support system, make an effort to obtain client’s trust but do not be surprised if it develops slowly or not at all.

12. Describe the magico-religious health belief view. Health and illnesses are controlled by supernatural forces. Give an example of a behavior that would indicate a person’s thinking within this view. “If it is God’s will, I will recover.”

13. Describe the biomedical health belief view. Based on belief that life and life processes are controlled by physical and biochemical processes that can be manipulated by humans. Give an example of a behavior that would indicate a person’s thinking within this view. Client believes infection is caused by bacteria and will expect medical treatment.

14. Describe the holistic health belief view. Holds that the forces of nature must be maintained in balance or harmony. Give an example of a behavior that would indicate a person’s thinking within this view. Balancing “hot” and “cold” foods with “hot” and “cold” sicknesses.

15. How do family patterns reflect cultural values and beliefs? Depends on what their beliefs are. If culture believes that the male is the ultimate decision-maker and the man of the house this would be considered machismo, and woman is responsible for maintaining home and raising children. You would assume that in a medical situation involving male’s relative, you would think he would make decision.

16. How do verbal and nonverbal communication behaviors reflect cultural values and beliefs? People may assume that because Italians are very expressive they may express when they are in pain without a problem, but this is not necessarily true. People may also assume that because Chinese do not usually express their feelings will not be in pain because they don’t express it, which is definitely not true. As a nurse you must know what would be painful and always acknowledge patient not matter where they are from.

17. Describe seven considerations in using a translator when the patient and the health care provider speak different languages. Avoid asking a member of the client’s family, especially a child or spouse, to act as interpreter, be aware of gender and age differences, avoid an interpreter who is politically or socially incompatible with client, address questions to the client not to the interpreter, ask interpreter to translate as closely as possible to the words used by the nurse, speak slowly and distinctly and respectfully at the same time, observe facial expressions and body language used by client.

18. How do your own verbal and nonverbal communication behaviors reflect your own cultural values and beliefs? Self-explanatory

19. Describe nine strategies for communicating with clients from different cultures. Consider the cultural component of communication and integrate it into the relationship, encourage client to communicate cultural interpretations of health, illness, treatments, and planned care. Understand that respect for clients is crucial for effective care, use and open and attentive approach so that the client knows you are listening, relate to client in an unhurried manner, use validation techniques while communicating to check that the client understands. Try to have a nurse of the same sex as the client to discuss sexual matters. Learn key phrases in languages that are commonly spoken in the community.

20. How is the concept of space demonstrated in different cultures? Nomadic societies believe that space is not owned, western society tends to be more territorial with their space.

21. How is the concept of time demonstrated in different cultures? Some cultures value time and others do not. How might the concept of time be demonstrated differently within the same culture? Some people may be raised where time has no value but now lives in America where doctors appointmentsare important to be on time so you adapt. What time would you arrive if you received a party invitation that stated the party will start at 9:00pm? 9:30-9:45 What time would you arrive if you had a job interview scheduled for 8:00am? 7:30

22. How is food a reflection of cultural beliefs and values? You would assume if at home your utensils are chopsticks you are from an Asian descent. What foods are important to you from your cultural background? Self-explanatory. What foods are important in celebrating cultural holidays? LECHON ON NOCHE BUENA LMAOOO What foods are important in healing from a cultural perspective? Hot tea for a nervous stomach such as chamomile.

23. How is a person’s response to pain influenced by their cultural values and beliefs? If you are raised to believe that withholding one’s pain demonstrates strength in character, you will find that certain people will not show pain. Others are more expressive and cannot control the pain, therefore expressing it freely.In your own culture, is pain demonstrated openly or is expected that one should suffer quietly? CUBANS COMPLAIN ABOUT EVERYTHING LOL…But I’m a tough cookie and delivered my daughter naturally lol

24. How does culture influence one’s behaviors around childbirth and caring for children? Some cultures may believe that giving birth is a “cold” condition, therefore requiring hot foods, hot blankets, etc. Some cultures value the essence of breastfeeding over bottle-feeding.

25. How is the process of death and dying influenced by one’s cultural beliefs? Some people prefer dying peacefully in their homes versus a hospital, some ethnic groups may tell health care professionals to not disclose prognosis of a dying patient because they believe the patient should die without as much worry.

26. What questions are important to consider when conducting a cultural assessment of a patient/client? Cultural affiliation, beliefs about current illness, health care practice, illness belief and care practice, family life and support system.

27. What is the relationship between the nurse’s cultural values and beliefs and the patient/client’s cultural values and beliefs? If client’s views reveal that certain behaviors would not affect the client’s condition adversely, then the nurse incorporates these views in planning care. If the client’s views can lead to har,ful behaviors, then the nurse attempts to shift the client’s perspectives to the scientific view. Whose cultural values and beliefs take priority in the health care relationship? The client’s.