1. Chapter 10: Cultural Diversity and Values

2. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Chapter Highlights
Culture in community settings
Cross-cultural nursing
Cultural competence and related concepts
How culture affects health
Cultural health assessment
Copyright © 2016 Wolters Kluwer • All Rights Reserved

3. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false? Culture is static, private, and inherited.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

4. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
False Rationale: Culture is dynamic, shared, and learned.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

5. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Culture and Nursing
Culture—knowledge, values, practices, customs, and beliefs of a group
Properties of culture
Dynamic, not static
Shared, not private
Learned, not inherited
Copyright © 2016 Wolters Kluwer • All Rights Reserved

6. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false? Cultural competence is an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

7. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
True
Rationale: Cultural competence is an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities. For community health nurses, it necessitates familiarizing oneself with cultures that are represented in the communities they serve.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

8. Cross-cultural Nursing
Cross-cultural or transcultural nursing—any nursing encounter in which the client and nurse are from different cultures
Cultural competence—considering cultural aspects of health, illness, and treatment for each client or community, as well as doing so at each stage of the nursing process
Copyright © 2016 Wolters Kluwer • All Rights Reserved

9. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false? Advocates for groups that have been sociopolitically marginalized promote “cultural safety,” the ideal of considering cultural aspects of groups while working against assimilationism and repression.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

10. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
True Rationale: Advocates for groups that have been sociopolitically marginalized promote “cultural safety,” the ideal of considering cultural aspects of groups while working against assimilationism and repression.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

11. Institutional Cultural Competence
For community and public health agencies to be culturally competent, they must
Have a defined set of values and principles and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally
Copyright © 2016 Wolters Kluwer • All Rights Reserved

12. Institutional Cultural Competence (cont.)
Have the capacity to
Value diversity
Conduct self-assessment
Manage the dynamics of difference
Acquire and institutionalize cultural knowledge
Adapt to diversity and the cultural contexts of the communities they serve
Copyright © 2016 Wolters Kluwer • All Rights Reserved

13. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false? Cultural humility is an acknowledgment that our own beliefs are inherently better than those of our clients.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

14. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
False Rationale: Cultural humility is an acknowledgment that everyone’s views are culturally influenced, that our own are not inherently better than those of our clients, and that our clients can teach us.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

15. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Cultural Safety
Culturally appropriate health services to disadvantaged groups while stressing dignity and avoiding institutional racism, assimilationism, and repressive practices
Copyright © 2016 Wolters Kluwer • All Rights Reserved

16. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Cultural Humility
Ask open-ended questions about beliefs and practices of the client and family.
Ask about traditions. What does the client think may have caused an illness, and how has the client already tried to address it?
Copyright © 2016 Wolters Kluwer • All Rights Reserved

17. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false? Ethnocentrism can be defined as an assumption that everyone shares your cultural values, or an opinion that your culture is superior to others.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

18. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
True Rationale: Ethnocentrism can be defined as an assumption that everyone shares your cultural values, or an opinion that your culture is superior to others.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

19. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Ethnocentrism
Assumption that others believe and behave as the dominant culture does, or the belief that the dominant culture is superior to others
Copyright © 2016 Wolters Kluwer • All Rights Reserved

20. Copyright © 2016 Wolters Kluwer • All Rights Reserved
Subculture
Group sharing some practices, language, or other characteristics in common, within a larger society that does not share those characteristics
Copyright © 2016 Wolters Kluwer • All Rights Reserved

21. Western Biomedicine as “Cultured”
The first imperative of cultural competence is to be competent in one’s own cultural heritage.
Copyright © 2016 Wolters Kluwer • All Rights Reserved

22. Aspects of Culture Directly Affecting Health and Health Care
Attribution of illness
Diet
Verbal communication
Nonverbal communication
Eye contact
Personal space
Style of communication
Copyright © 2016 Wolters Kluwer • All Rights Reserved

23. Aspects of Culture Directly Affecting Health and Health Care (cont.)
Time orientation
Roles
Religion
Folk medicine
Copyright © 2016 Wolters Kluwer • All Rights Reserved

24. Cultural Health Assessment
Individual clinicians
Healthcare organizations
Copyright © 2016 Wolters Kluwer • All Rights Reserved