1. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

2. Population Diversity The United States is becoming more diverse. Health disparities among ethnic and racial minorities continue to increase. Racial and ethnic minorities often experience poor access to care.

3. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Understanding Cultural Concepts CultureSubculturesEthnicity Emic worldview Etic worldviewEnculturation AcculturationAssimilationBiculturalism

4. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Cultural Concepts Culturally congruent care Fits the person’s valued life patterns and set of meanings Requires specific knowledge, skills, and attitudes in the delivery of culturally congruent care Cultural conflicts Ethnocentrism Cultural imposition

5. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Cultural Context of Health and Caring Health, illness, and caring have meanings that are unique to each culture. Every culture provides a context according to which groups interpret and define experiences relevant to birth, illness, and death.

6. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Cultural Healing Modalities and Healers Chinese and Southeast Asians Herbalist, acupuncturist, fortune teller, shaman Asian Indians Ayurvedic practitioner Native Americans Shaman

7. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Healers African American “Granny midwife,” spiritualist, voodoo practitioner, hougan (male), mambo (female) Hispanics Cuarandero/a, yerbero, sabador, espiritsta, santero/a

8. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Culture and Life Transitions Rights of passage Pregnancy Childbirth Newborn Postpartum period Grief and loss

9. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Cultural Assessment A systematic and comprehensive examination of the cultural care values, beliefs, and practices of individuals, families, and communities Gathers information that will enable the nurse to provide culturally competent care

10. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Selected Components of Cultural Assessment Ethnic heritage and ethnohistory Biocultural history Social organization Religious and spiritual beliefs Communication patterns Time orientation Caring beliefs and practices Experiences with professional health care

11. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Decisions Action modes of professional decisions or actions: Cultural care preservation or maintenance Cultural care accommodation or negotiation Cultural care repatterning or restructuring