culture nur 210 m.sharpe, rn, msn, np. culture §collection of beliefs, values, behaviors, rituals,...

Culture

NUR 210

M.Sharpe, RN, MSN, NP

CULTURE

Collection of beliefs, values, behaviors, rituals, habits shared by a group of people and passed from one generation to the next

• LEARNED FROM BIRTH

• SHARED BY ALL MEMBERS

• MOLDED BY ENVIRONMENT

• SUBCULTURES

Common Characteristics

Universality

Uniqueness

Stability

Changeability

Unconsciousness

Variability

Ethnocentrism

The belief that one’s cultural, ethnic, or professional group is superior to that of others

Stereotyping

Exaggerated beliefs and images that are popularly depicted in the mass media, folklore, and general conversation.

Cultural Blindness

Failure to acknowledge cultural differences

Cultural Shock

Immobilization due to cultural differences

Cultural Diversity

Myth of the “melting pot” is being displaced with a sense of identity among various ethnic groups

Acculturation

The changes of one’s cultural patterns to those of the host society (assumed to take 3 generations in the US)

Racism

Belief that people can be classified on the basis of biophysical traits that indicate innate inferior or superiority PrejudicePrejudice: unfavorable attitudes toward an

individual or group of people based on unfavorable attitudes toward that group

DiscriminationDiscrimination: differential treatment of an individual or a group based on unfavorable attitudes toward the group

Transcultural Assessment Model

CommunicationSpaceSocial organizationTimeEnvironmental controlBiological variations

AFRICIAN AMERICANS

MORTALITY Life Expectancy Strokes Heart Disease Infant Mortality Homicide HIV/AIDS

Health Problems R/T:

Economic status poverty discrimination social and psychological barriers

Hereditary

Communication

Dialect and language usageModes of behaviorFrench, Spanish, Creole

Space

Close Personal Space

Social Organization

Strong church affiliations within communityFailure to assimilate

choice segregation

Family System female headed household large networks

Time

May be present or future oriented, depends on assimilation into dominant culture.

Environmental Control

HeterogeneousReligious

prayer and magic

Folk Medicine Internal remedies External remedies

Biological VariationsPallorErythemaCyanosisEcchymosisJuandiceKeloidsPigmentary disordersPseudofolliculitisMelasma

Biological Variations

Lactose intoleranceSickle cell anemia

Genetically inherited

AlcoholismHypertensionCancer of esophagus and stomach

HISPANICS

Second largest emerging majority groupFastest growing population

Mexican Puerto Rican Cuban Other Latin American origin

Communication

Language barrier: 50 dialects Spanish or Portuguese

Small talkVerbal expression: elaborate and indirectEye contact

Space

Tactile touch, handshakes, embrace

Physical presence family

Time

Present

Current activity rather than with planning ahead to be on time

Environmental Control

Health is state of harmony and balance maintain by diet and keeping four humors in

balance• blood

• phlegm

• black bile

• yellow bile

Illness as body imbalance

Illness that are “hot”are treated with a “cold” substance

Hot foods cannot be combined, they are to be eaten with cold foods

Hot and cold do not refer to temperature, but are a description of a particular substance itself.

Have to ask the client, varies from person to person

Curanderismo

A medical system with historic roots that combine Aztec, Spanish, sprititualistic, homeopathic, and scientific elements

Cuandero(a): holistic healer and religious figure

Social Organization

Nuclear familiesLarge, extended family networksStrong church affiliations within

communityCommunity social organizations

Dislocation of Parts of Body

Empacho

Caida de la mollera

Mal ojo

Susto

Disease and Health Conditions

Higher rates of obesity and DMLower rates of CVDCommunicable diseases

Respiratory: TB GI: diarrhea, Hep. C Skin disorders HIV

Implications

Reduce access to care barriersReduce communication barriersHealth promotion messages and health care

more effective when delivered within their social frame of reference

Focus on problems seen as problems by the community

Involve the community

ASIAN AMERICANS

Chinese (16%)Filipinos (13%)Japanese ((10%)Asian Indian (9%)Korean (7%)Other Asian groups (45%)

Communication

Many languages Written verses OralCommunicate RESPECTLimit use of touchAvoid eye contactNonverbalSelf-control

Asian American Space

Intimate zone confined to private settings

Noncontact people

Social Organization

Respect traditionsFamily roles well definedRole reversal Religion

Buddhism Confudianism Taoism

Time

Emphasis on the pastTime as cycles, events, occurrences

Environmental Control

Cultural health practices Naturalistic Supernaturalistic Metaphysical

Biological Variations

Cancer stomach, esophagus, liver

DM: diet, lifestyleCVD: increase with change in diet

NATIVE AMERICANS

10 different tribes in USCherokee and Navajo are largest

Communication

No common language (tribal language)

Touch

Disrespectful to engage in direct eye contact

Use of silence and body language

Space

Difficult adjusting to unfamiliar spaces

Value personal space

Social Organization

Family oriented

Matriarchal society in some tribes

Guided by supernatural

Time

Present orientedTime is casual, and relative to present tasks

that need to be done in a present time frame

Environmental Control

Native American Healers harmony with the environment symbolic and sacred items

Biological Variations

DM: major health problemSTDSuicideAlcoholism

different enzyme to metabolize alcohol which acts quicker and therefore consume more alcohol

ARAB AMERICANS

Major Religion: MuslimMajor Language: ArabicHealth Care Beliefs

health promotion important women hold inferior social position same sex health care providers

Communication

For a women, direct eye contact is limited to other women or family members

Males may touch only those women who are in family

Handshakes are continued for a lengthy period

Educated Saudis respect direct eye contact

Social Organization

Husband is the family leader

Extended families live together

The Saudi mother is revered

Time

Time has little meaning except in business

Social rituals continue while appts. go by attended

Arab Americans Health

DMSyphilisLeprosyCholeraRickets and malnutritionAIDS

MIDDLE ANGLO AMERICANSEnvironmental ControlModern, Western health care delivery

Remaining traditional beliefs

Folk medicine

Biological Variations

Breast cancerHeart diseaseDM

Social Organization

Nuclear familiesExtended familiesJudeo-Christian religionsCommunity and social organizations

Communication

National languages

Many learned English rapidly as immigrants

Verbal, rather than nonverbal

Space

Noncontact people aloof and distant

Southern countries closer contact and touch

Time Orientation

Future over present