Transcript transcultural communication

TRANSCULTURAL
COMMUNICATION
Nursing 171
INTRODUCTION
What happens when an Iranian doctor & a
Filipino nurse treat a Mexican patient?
 When a Muckleshoot patient calls a
Shaman to the hospital?
 When an Anglo nurse refuses to take
orders from a Japanese doctor?

Conflict & confusion, unless they all
have some understanding of cultural
differences
OBJECTIVES
To discuss the importance of
communication with diverse populations
 To examine cultural differences in
communication
 To describe cultural differences in verbal
and nonverbal communication
 To examine individual cultural
backgrounds and influence on health care
beliefs, values, and behavior
 To discuss the use of interpreters to
reduce the effects of language barriers

CULTURE DEFINED

Culture is a patterned behavioral response

According to anthropology, it is “The
complex whole which includes knowledge,
belief, art, morals, law, custom and any
other capabilities and habits acquired by a
member of that society”
CULTURE & RACE

According to Webster’s:
Culture is “the customary beliefs, social
forms and material traits of a racial,
religious or social group”

Race is: “a family, tribe, people, or nation
of the same stock”
CULTURE Characteristics

It is shared by all members of the same
group

It is an adaptation to environmental
conditions

It is a dynamic & ever changing process
CULTURE & VALUES

Values are perceptions of what is good or
useful

Each society has a dominant value
orientation

Cultural Norms are the rules by which
human behavior is governed
Values
Influence our perception of others
 Reflect our identity
 Are the basis for self-evaluation
 Are the foundation for personal,
professional, social, political &
philosophical issues
 Motivate behaviors
 Give meaning to life & provide self
esteem

SUBCULTURES

A group with shared characteristics not
common to all members of the larger
cultural group

Subcultures can be categorized by:
geographic region, age, sex, religion,
social class, political party, ethnic identity,
& occupational role
MINORITY GROUP

A group of people who because of physical
or cultural characteristics receive different
& unequal treatment from others

Minority group members may see
themselves as recipients of collective
discrimination and often may have
experienced prejudice by the majority
group
ETHNICITY

Ethnic is derived from “Ethnos” (nation, people),
relating to races or large groups of people classed
according to common traits & customs (Webster)

Includes the values, perceptions, feelings,
assumptions & physical characteristics associated
with an ethnic group

Ethnicity influences our sense of space, time, &
belonging

It develops through daily contact with family,
friends & associates
CULTURAL GROUPS
IN THE U.S.
The pop. of the US is ^ in ethnic, racial & cultural diversity
US census 2000:
 American Indian/Alaska Native
 Native Hawaiian 0.1%
 White 75.1%
 Latino 12.5%
 Black
12.3%
 Asian
3.6%
 Other Races 5.5%

0.9%
PREDICTIONS
 By
2050:
 European descent
 Latino
 African descent
 Asian descent
 Shortly
52.8%
24.0%
13.6%
8.2%
after 2050, white complexions
will cease to be the majority
population group in the U.S.
2005 Ethnic Groups for BSN’s*
 White
75.7%
 Black 11.7%
 Asian/Hawaiian/Pacific Islander 6.4%
 Hispanic 5.6%
 American Indian/Alaskan Native 0.7%
*Minorities greatly underrepresented especially Latinos
Source: AACN (American Association of Colleges of Nursing)
CROSS CULTURAL
COMMUNICATION
 Cross
cultural and
Intercultural are synonymous
terms and defined as
“communication between people
with different language, national
origin, race or ethnicity
PRECONCEPTIONS





Culture shapes perception
We carry our cultural expectations
(preconceptions) into all of our cross-cultural
encounters
Stereotypes and prejudices are preconceptions
There are some reasons for perceived identities,
common early experiences & values
This does not mean all cultural members are the
same as there is a wide range of individual
characteristics
ETHNOCENTRISM
 This
is the assumption of cultural
superiority (the belief that one’s
ethnic group is better than all others)
 Oppression is the result of
ethnocentrism
 Dominant culture: prevailing group
within a society
 Cultural assimilation: the absorption
of the minority into the dominant
culture
CULTURE & NURSING
Nurses must learn culturally appropriate &
competent care techniques
 When nurses consider race, ethnicity,
culture & cultural heritage, they provide
better care
 There is no “cookbook” approach
 There is much variation within different
races, cultures & ethnic groups

TRANSCULTURAL NURSING

Transcultural nursing is “a humanistic
and scientific area of formal study and
practice which is focused upon differences
and similarities among cultures with
respect to human care, health (or wellbeing), and illness based upon the
people’s cultural values, beliefs &
practices” with the ultimate goal of
culturally specific and culturally congruent
nursing care
Transcultural Assessment Model

In this model, nursing is viewed as a
culturally competent practice, which is
client centered & research focused

This model recognizes that culture
influences how clients are viewed & care
is given

Each individual is culturally unique
CULTURAL COMPETENCE
This concept takes into account
Communication
 Space
 Social organization
 Time
 Environmental control
 Biological variations

CULTURAL ASSESSMENT

Categories of information necessary for a
thorough cultural assessment
ethnic or racial background
 language & communication patterns
 cultural values & norms
 biocultural factors
 religious beliefs & practices
 health beliefs & practices

SPATIAL BEHAVIOR
The universal need for territoriality
 Meets needs for security, privacy,
autonomy and self-identity
 Proximity to others (proxemics) is the
study of human use of social & personal
space
 Physical distancing from others varies with
setting and is culturally learned

PROXEMICS

Western culture has 3 primary dimensions
of space which are:
 Intimate zone
0 inches - 18 inches
 Personal zone
18 inches - 4 feet
 Casual zone
4 feet
- 8 feet
 Public zone
8 feet - and beyond

People in the US, Canada, & Britain require
the most space whereas Latin Americans,
Japanese, & Arabs need the least
PROXEMICS




Asians generally more sensitive to personal space
Some West Indians maintain little space between
friends, whereas outsiders are expected to
maintain more distance
Touching between members of the same sex is
more common in Arabic cultures
In Latin America, a handshake is seen as cold


The embrace by hands around the shoulders is more
normal
Touching the shoulders of a Japanese man is
seen as unpardonable
HOSPTIALS
Patients need some control of their
space & rules to prevent
invasion/misuse by others
 They need a place for belongings
without fear of being bothered by
others & freedom to do things, such as
take a nap

Gestures
Know that certain hand gestures can be
misinterpreted (pointing, waving, etc.)
 Head nodding is not always a sign of
agreement (In Japan it means
attentiveness)
 Laughing/Smiling: In U.S. it is a sign of
happiness while in Asia it may indicate an
embarrassing situation, or something
unpleasant, and in Korea it means you are
unintelligent

COLORS




In North American cultures, warm colors such as
yellow, red & orange tend to stimulate creative &
happy responses
In some Asian countries, white is associated with
a funeral
In some African countries, red symbolizes
witchcraft & death
In western culture, cool colors such as blue,
green & gray tend to encourage meditation &
deliberation & discourage communication
Traditional White American Middle-Class Values
derived from the white, Anglo-Saxon protestant ethic (WASP)






Independence
Individuality
Achievement
Punctuality
Assertiveness
Future-oriented
in






Wealth
Comfort
Cleanliness
Aggression
Rationality
Mastery of one’s own fate
general, competition is valued over cooperation,
and thus a person-to-object stance is favored over a
person-to-person approach
Utilizing Translators
Professional
 Family


Often children
Sometimes same sex interpreters are
preferred
 The nurse should always speak directly to
the patient and family (not to interpreter)
 Avoid complicated Medical jargon
 Keep answers simple and concrete
