1. Objectives
After completion of this session the student will be able to:
Define culture and related concepts
Describe the characteristics of culture.
Contrast the terms culture and sub culture.
Discuss the meaning of culturally competent health care.

2. Culture: culture can be defined as all the behaviors, arts, beliefs and institutions of population that are passed down from generation to generation. Culture has been called " the way of life for an entire society" as such it includes codes of manners, dress, language, religion, rituals, norms of behavior such as law and morality ,and system of belief as well as the arts and gastronomy.

3. Tran cultural nursing: A humanistic and scientific area of formal study and practice in nursing which is focused upon differences and similarities among cultures with respect to human care, health, and illness based upon the peoples cultural values, beliefs, and practices, and to use this knowledge to provide cultural specific or culturally congruent nursing care to people(Leininger)

4. Ethnocentrism:
Is the belief that ones own cultural practices and values are inherently correct or superior to those of others.
Ethnocentric attitude can lead to the following problems:
1. Prejudice: Negative preconceived opinions about others people or groups based on hearsay, perception, or emotion.
2. Stereotyping: Believing that one member of a cultural group will display certain behaviors or hold certain attitudes (usually negative) simply because he or she is a member of that cultural group).

5. 3.Discrimination: Differential treatment based on race , class, sex, or other variables rather than on individual merit.
4.Stigmatization: the attribution of negative characteristics or identify to one person or group, causing the person or group to feel rejected and , alienated, from society.

6. Characteristics of culture
1.Learned.
2.Integrated.
3.Shared.
4.Tacit.
5.Dynamic.

7. 1. Culture is learned: Patterns of culture behavior are acquired, not inherited. The way people dress, what they eat, how they talk-all are learned.

8. 2. Culture is integrated: Rather than being an assortment of various customs and traits, a culture is a functional, integrated whole. As in any system, all parts of a culture are interrelated and interdependent.

9. 3. Culture is shared: Culture is the product of aggregate behavior, not individual habit. Certainly, individuals practice a culture, but customs are phenomena shared by all members of the group.

10. Culture is mostly tacit: culture provides a guide for human interaction that is mostly unexpressed and at the unconscious level, or tacit.

11. Culture is dynamic: every culture undergoes change; none is entirely static. Within every cultural group are individuals who generate innovations. More important, some members see advantages in doing things differently and are willing to adopt new practices

12. Subculture: it refer to a smaller group within a larger cultural group that is its own particular set of cultural values, beliefs and practices. A subculture is usually composed of people who have a distinct identity and yet are also related to a larger cultural group. For example a family member who practices a different religious faith than others in the family may be as uniquely different from other family members as she or he is like them.

13. Values, norms, beliefs, tradition and taboos: All together these terms are constitute the essential elements of the non-material dimension of culture.

14. Values: these are intrinsic beliefs or ideals about desirable conduct, custom, and other entities. As such they provide the basis for each persons attitudes and behaviors and they assist in establishing hierarchic of needs and goals value orientations can be defined as principles that assist in the solution of common human problems.

15. Norms: they are expected behavior
Norms: they are expected behavior. They provide rules about standards of appropriate behavior in particular situations. Norms flow from cultural values about what is important in various situation.

16. Beliefs: it is conviction based on information held by people fro whish no socially acceptable means of validity exist, it is a conviction that is mentally accepted as true whether or not it based on fact.

17. Tradition: Ancient ethno-cultural-religious, belief and practices handed down through generations

18. Taboo: they are proscribes act and thoughts to avoid actual or potential harm to self and others.

19. Culturally competent health care:
Cultural competence means having the skills, both academic and interpersonal, to understand and appreciate cultural differences and similarities within, between, and among groups.
It is a process by which health care providers " continuously strives to achieve the ability to effectively work within the cultural context of an individual or community from a diverse cultural or ethnic background.

20. Skills in cultural competence are relevant fro all variables to which differences may apply . examples include gender, race, ethnicity, language, country of origin, acculturation, age, religious and spiritual beliefs, sexual orientation, socioeconomic class and disabilities.

21. The culturally competent provider is willing and able to draw on community-based values, traditions, and customs and to work with knowledgeable people from the community to formulate appropriate interventions and supports fro clients according to the different variables mentioned earlier.

22. History of Tran cultural nursing:
Leininger was the founder and leader of this new, specific cognitive specialty in nursing. Leininger took the "culture" construct from anthropology and "care" from nursing and reformulated these two dominant constructs into "culture care".

23. She divides the evolution of transcultural nursing into three eras:
Establishment of the field ( )
Program and research expansion ( ).
Establishment of transcultural nursing worldwide (1983 to the present)