1. Cultural Considerations Across the Lifespan and in Health and Illness
Chapter 3
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Culture
A set of learned values, beliefs, customs, and behaviors shared by a common social group
Passed down through generations of family
Can affect foods, parenting styles, health, discipline measures
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Cultural Sensitivity
Observing and demonstrating knowledge of culturally appropriate verbal language, body language, use of personal space, and gestures of respect toward family members
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Cultural Competence
Awareness of, acceptance of, and respect for beliefs, values, traditions, and practices that are different from one’s own
Important to remember to adapt care to include the culture of the patient
Cultural stereotyping
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5. Critical Thinking Question 1
What practices may be influenced by a person’s culture? Do you think all people of the same culture have the same practices?
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Beliefs
Cultural teachings of practices and values handed down for generations
Determine how one behaves and responds to daily life and health-care practices
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Values
Deep feelings about what is right or wrong, good or bad
Most times learned in childhood by age 10
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Ethnicity
A cultural pattern shared by people with the same cultural heritage:
Language
Preferred diet
Specific customs
Family roles
Religious beliefs
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Cultural Awareness
Recognizing the history of patients’ ancestry or culture and how their customs influence the handling of problems, issues, or teachings
Ethnocentricity
Acculturation
See Table 3-1.
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Cultural Care
Cultural interventions
Communication
Personal space
Review Table 3-1 on page 29
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Culture and Pregnancy
The culture of a pregnant woman may strongly influence the pregnancy and birthing experience.
Discuss the ways different cultures may influence this time period
Pregnancy and labor considered cold conditions; will want to balance out with hot accomodations
Effleurage
The PrimaBella
See Figure 3-1.
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Culture and the Child
Cultural practices can influence the timing of developmental stages
For example a culture that believes in authoritarian style of parenting will curb the initiative development of a child
What are some cultures that might display this type of parenting?
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13. Culture and the Adolescent
Independence in adolescents is not valued equally by all cultures.
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Culture and the Adult
Views of women
Marriage
Birth control
Health care
Abortion
Menopause
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15. Culture and the Older Adult
A positive attitude toward life and health is encouraged for older adults in most cultures.
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16. Culture and Health Beliefs
Balances between hot and cold
Yang (light, heat, or dryness) and yin (darkness, cold, or wetness)
Harmony in body, mind, and spirit
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17. Culture and Illness
Specific holidays may involve some restriction of activity
Sacrament of Last Rites
Declining medications or psychotherapy
Declining blood transfusions or medications containing blood products
Sacred undergarments
Illness is the result of sins committed in a previous life or for the atonement of sins in the present life
“Sick persons’ role”

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Culture and Death
Self-Determination Act of 1991
In most Western cultures, a high value is placed on individual life
In many non-Western cultures, the welfare of the family is primary, and life-and-death decisions are made by group approval
Judaism-somebody with them, buried within 24 hrs, dressed in shroud, no metal objects in coffin; Hindu-priest places a thread around the neck or waist; Native American-dying person surrounded by positive celebratory atmosphere; Hmong-well dressed at time of death, all metal objects must be removed from the body, no metal can touch the body
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Culture and Teaching
The myriad of cultures creates an opportunity for misunderstandings and misinterpretations of health-care teachings
Questions should be phrased in a neutral fashion
Asian, Native American, Muslim-consider direct eye contact disrespectful; Hispanic-extended eye contact as possible evil eye; Asians-do not touch the head considered sacred and disrespectful to touch it, would ask for permission before doing so; Native American, Chinese, and Japanese suggest silence as a sign of respect for another person and in Russians silence suggest agreement on topic being discussed
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Culture and Food
Many cultures and religions include certain foods as an integral part of holiday celebrations and may also restrict the consumption of other foods
Mormons do not consume alcohol or caffeine
Hindu prohibit meat
Jewish do not mix dairy and meat in same meal
Islamic prohibits pork, need to take care about medications gelatins some have pork products
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21. Complementary and Alternative Therapies and Culture
Growing desire for control of one's own body and health-care decisions
Desire for consideration of family, cultural beliefs, and values
Alternative medicine
Complementary medicine
Every patient should be assessed for CAM therapy use
Modalities can include acupuncture, acupressure, massage, guided imagery, energy healing among some of many others
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22. Critical Thinking Question 2
Why is it important for the nurse to determine any alternative or complementary medicines the patient may be using and how should it be included in the plan of care?
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23. The Government’s Role in Promoting Culturally Competent Care
National Center for Complementary and Alternative Medicine (NCCAM)-study effectiveness of CAM therapies and documents findings in medical journals
United States Department of Health and Human Services Office of Minority Health and Cross Cultural Health Care
Agency for Healthcare Research and Quality (AHRQ)-promotes cultural competence
U.S. Office of Minority Health-promotes culturally and linguistically appropriate health services
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Outcomes
Understanding culture as related to health care will:
Improve services and health-care outcomes.
Enhance cost effectiveness of health care.
Reduce errors caused by misunderstandings.
Assist in reaching Healthy People 2020 goals.
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