MZC1© 2005 by Lippincott Williams & Wilkins Unit I: Foundations of Community Health Chapter 4 Transcultural Nursing in the Community

MZC2© 2005 by Lippincott Williams & Wilkins Objectives: Upon mastery of this chapter, you should be able to: Define and explain the concept of culture. Discuss the meaning of cultural diversity and its significance for community health nursing. Describe the meaning and effects of ethnocentrism on community health nursing practice.

MZC3© 2005 by Lippincott Williams & Wilkins Objectives: Identify five characteristics shared by all cultures. Contrast the health-related values, beliefs, and practices of selected culturally diverse populations with those of the dominant U. S. culture. Conduct a cultural assessment. Apply transcultural nursing principles in community health nursing practice.

MZC4© 2005 by Lippincott Williams & Wilkins Define the Concept of Culture “The act of developing the intellectual and moral faculties especially by education” (Merriam-Webster OnLine)Merriam-Webster OnLine Culture is the knowledge people use to design their own actions and, in turn, to interpret others’ behavior (Spradley & McCurdy, 2000)

MZC5© 2005 by Lippincott Williams & Wilkins Other Definitions Race refers to biologically designated groups of people whose distinguishing features, such as skin color, are inherited An ethnic group is a collection of people who have common origins and a shared culture and identity; they may share a common geographic origin, race, language, religion, traditions, values, and food preferences (Spector, 2000)

MZC6© 2005 by Lippincott Williams & Wilkins Explain the Concept of Culture Culture is learned. It is beliefs, values, and behavior that are shared by members of a society. It provides a design or “map” for living. It tells people what is acceptable or unacceptable in a given situation. It dictates what to do, say, or believe.

MZC7© 2005 by Lippincott Williams & Wilkins Meaning and Significance of Cultural Diversity Cultural diversity (also called cultural plurality) means that a variety of cultural patterns coexist within a designated geographic area 100 different ethnic groups in the US (2000) Sub-cultures and microcultures have special customs that affect everyday life Major shifts are occurring in group demographics

MZC8© 2005 by Lippincott Williams & Wilkins Meaning and Effects of Ethnocentrism The belief and feeling that one ’ s own culture is best It causes people to believe that their way of doing things is right and to judge others ’ methods as inferior, ignorant, or irrational developmental progression along a continuum

MZC9© 2005 by Lippincott Williams & Wilkins Five Characteristics Shared by All Cultures Learned Integrated Shared Tacit Dynamic

MZC10© 2005 by Lippincott Williams & Wilkins Health-Related Values Biomedical View Magicoreligious View Holistic View Folk Medicine and Home Remedies Herbalism Prescription and Over-the-Counter Drugs

MZC11© 2005 by Lippincott Williams & Wilkins Complementary Therapies and Self-Care Practices Diet therapies (cancer diets, juice diets, fasting) Gastrointestinal treatments (coffee enemas, high colonic enemas) Balance and exercise activities (t’ai-chi, yoga) Sensory exposure (aromatherapy, music therapy, light therapy) Therapeutic manipulation (acupuncture, acupressure, reflexology)

MZC12© 2005 by Lippincott Williams & Wilkins Steps of a Cultural Assessment Tables 4–7 (p. 86) Ethnic or racial background Language and communication patterns Cultural values and norms Biocultural factors Religious beliefs and practices Health beliefs and practices Table 4–8 (p. 87) Self-care Assessment in Chapter 23 (p. 534)

MZC13© 2005 by Lippincott Williams & Wilkins Application of Transcultural Nursing Principles Develop Cultural Self-Awareness Cultivate Cultural Sensitivity Assess the Client Group ’ s Culture Show Respect and Patience While Learning About Other Cultures Examine Culturally Derived Health Practices

MZC14© 2005 by Lippincott Williams & Wilkins Case Study: Unit I #4 documents/CaseStudies/u1c4.asp Do you believe that the residents of Adams County have different health care needs based on their cultural differences? If you do believe this, what needs might you assess clients for? What services might you provide as a community health nurse based on the assessed needs? How many of the needs found are related to other factors that may or may not be culturally related?

MZC15© 2005 by Lippincott Williams & Wilkins Internet Resources Minority Health Website US Census Immigration Assistance Section Cultural Competence Compendium

MZC16© 2005 by Lippincott Williams & Wilkins Internet Resources Culture and Diversity Section Minority Health (in left bar) Multicultural Health Communication Service Health Fact Sheets in multiple languages tm tm Asian & Pacific Health

MZC17© 2005 by Lippincott Williams & Wilkins Clinical Activities

MZC18© 2005 by Lippincott Williams & Wilkins Contact Information