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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
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LEARNED FROM BIRTH
SHARED BY ALL MEMBERS
MOLDED BY ENVIRONMENT
SUBCULTURES
Common Characteristics
Universality
Changeability
Uniqueness
Unconsciousness
Stability
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
Prejudice: unfavorable attitudes toward an
individual or group of people based on
unfavorable attitudes toward that group
Discrimination: differential treatment of an
individual or a group based on unfavorable
attitudes toward the group
Transcultural Assessment Model
Communication
Space
Social organization
Time
Environmental control
Biological 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 usage
Modes of behavior
French, Spanish, Creole
Space
Close Personal Space
Social Organization
Strong church affiliations within community
Failure 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
Heterogeneous
Religious
prayer and magic
Folk Medicine
Internal remedies
External remedies
Biological Variations
Pallor
Erythema
Cyanosis
Ecchymosis
Juandice
Keloids
Pigmentary disorders
Pseudofolliculitis
Melasma
Biological Variations
Lactose intolerance
Sickle cell anemia
Genetically inherited
Alcoholism
Hypertension
Cancer of esophagus and stomach
HISPANICS
Second largest emerging majority group
Fastest growing population
Mexican
Puerto Rican
Cuban
Other Latin American origin
Communication
Language barrier: 50 dialects
Spanish or Portuguese
Small talk
Verbal expression: elaborate and indirect
Eye 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
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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 families
Large, extended family networks
Strong church affiliations within community
Community social organizations
Dislocation of Parts of Body
Empacho
Caida de la mollera
Mal ojo
Susto
Disease and Health Conditions
Higher rates of obesity and DM
Lower rates of CVD
Communicable diseases
Respiratory: TB
GI: diarrhea, Hep. C
Skin disorders
HIV
Implications
Reduce access to care barriers
Reduce communication barriers
Health 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 Oral
Communicate RESPECT
Limit use of touch
Avoid eye contact
Nonverbal
Self-control
Asian American Space
Intimate zone confined to private settings
Noncontact people
Social Organization
Respect traditions
Family roles well defined
Role reversal
Religion
Buddhism
Confudianism
Taoism
Time
Emphasis on the past
Time as cycles, events, occurrences
Environmental Control
Cultural health practices
Naturalistic
Supernaturalistic
Metaphysical
Biological Variations
Cancer
stomach, esophagus, liver
DM: diet, lifestyle
CVD: increase with change in diet
NATIVE AMERICANS
10 different tribes in US
Cherokee 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 oriented
Time 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 problem
STD
Suicide
Alcoholism
different enzyme to metabolize alcohol which
acts quicker and therefore consume more
alcohol
ARAB AMERICANS
Major Religion: Muslim
Major Language: Arabic
Health 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
DM
Syphilis
Leprosy
Cholera
Rickets and malnutrition
AIDS
MIDDLE ANGLO
AMERICANS
Environmental Control
Modern, Western health care delivery
Remaining traditional beliefs
Folk medicine
Biological Variations
Breast cancer
Heart disease
DM
Social Organization
Nuclear families
Extended families
Judeo-Christian religions
Community 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