1. TRANSCULTURAL COMMUNICATION

2. INTRODUCTION  What happens when an Iranian doctor & a Filipino nurse treat a Mexican patient?  When a Navaho patient calls a medicine man to the hospital?  When an Anglo nurse refused to take orders from a Japanese doctor? conflict & confusion, unless they all have some understanding of cultural differences

3. CULTURE DEFINED  Culture is a patterned behavioral response  In 1871, Sir Edward Tylor ( an anthropologist) wrote that culture is:  “the complex whole which includes knowledge, belief, art, morals, law, custom and any other capabilities and habits acquired by man as a member of society”

4. 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”  -grouping is based on biological similarities

5. CULTURE DEFINED  Culture has 4 basic characteristics:  it is learned from birth  it is shared by all members of the same group  it is an adaptation to environmental conditions  it is a dynamic & ever changing process

6. 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

7.  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

8. SUBCULTURES  a group with shared characteristics not common to all members of the larger cultural group  subcultures are categorized by: geographic region, age, sex, religion, social class, political party, ethnic identity, & occupational role

9. MINORITY GROUP  a group of people who because of physical or cultural characteristics receive different & unequal treatment from others  minority group members see themselves as recipients of collective discrimination

10. 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

11. CULTURAL GROUPS IN THE U.S.  the population of the US is increasing in ethnic, racial & cultural diversity  US census 2000:  White 75.1% Native Hawaiian 0.1%  Black 12.3% Other Race 5.5%  Asian 3.6% Latino 12.5%  American Indian/Alaska Native 0.9%

12. PREDICTIONS  by 2050:  White52.8%  Latino 24.0%  Black 13.6%  Asian 8.2%  shortly after 2050, whites will cease to be the majority population group

13. NURSES 2002  minority nurses greatly underrepresented especially Latinos (figures for RNs)  White 86.6% (75.1)  Latino 2.0% (12.5)  Black 4.9% (12.3)  Asian 3.7% ( 3.6) (2002) (2000)

14. CROSS CULTURAL COMMUNICATION  cross cultural and intercultural are synonymous terms and s defined as “communication between people with different language, national origin, race or ethnicity

15. 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

16. ETHNOCENTRISM  -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

17. 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

18. TRANSCULTURAL NURSING  Leininger pioneered transcultural nursing as “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 well-being), and illness based upon the people’s cultural values, beliefs & practices” with the ultimate goal of culturally specific and culturally congruent nursing care

19.  Giger & Davidhizer developed a transcultural assessment model  In this medel, nursing is viewed as 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

20. CULTURAL COMPETENCE This concept takes into account  communication  space  social organization  time  environmental control  biological variations

21. CULTURAL ASSESSMENT  Categories of information necessary for a thorough cultural assessment  -ethnic or racial backgroung  -language & communication patterns  -cultural values & norms  -biocultural factors  -religious beliefs & practices  -health beliefs & practices

22. 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

23. PROXEMICS  western culture has 3 primary dimensions of space which are:  intimate zone 0-18 inches  personal zone 18inches – 3 feet  public zone 3 feet - 6 feet  people in the US, Canada, & Britain require the most space whereas Latin Americans, Japanese, & Arabs need the least

24. 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

25. 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

26. 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