Online Companion: Fundamentals of Nursing Standards and Practice 2E

Chapter Summary

Chapter 16 discusses the various concepts related to culture, the importance of diversity in American society, the influence of culture on health and transcultural nursing. Culture in social terms is a structure of knowledge, behaviors, and values that provide a group of people with a "blueprint" or a general design for living. Differences exist among cultural groups and among individuals within a single culture. However, all cultures exhibit some common characteristics: culture is learned and taught, is shared, is social in nature, and is adaptive and ever-changing. The dominant culture of the United States has European origins and some of the dominant beliefs are these: achievement and success, individualism, independence and self-reliance, reliance on technology, material comfort, competition and youth and beauty. Minority groups, because of their cultural or physical characteristics, are labeled and treated differently from others in the society. The United States is becoming an increasingly multicultural and multilingual society. Native Americans, African Americans, Asian Americans, and Hispanic Americans are four cultural groups that have shown significant growth in America. Diversity among cultural groups regarding behavior and expectations influences health care.

Every culture organizes itself around six phenomena; these must be considered when providing culturally sensitive care. These phenomena include: communication, personal space, orientation to time, social organization (role of the family, gender roles, religion),environmental control (different beliefs about sources of health and illness), and biologic variations. Chapter 16provides a comparison of the dominant culture and the significant minority culture ideas on these six phenomena. The three types of family patterns: linear, collateral and individualist are contrasted in Chapter 16. The nurse is recommended to use the following approaches when collaborating with families: be nonjudgmental, respect others' beliefs and values, recognize families as significant sources of support for the client, and value the families' participation in caregiving. The folk medicine traditions of the significant subcultures in the United States, their traditional healers and healing practices are presented. The effects of biologic variations in cultural subgroups on drug metabolism are described in this chapter.

In Chapter 16, the challenge of delivering health care services to certain vulnerable populations is explored. People in minority groups experiences some diseases at much higher rates than white Americans. Nineteen percent of American children live in families with incomes below the poverty line. Childhood poverty is associated with long-lasting negative effects on health. The homeless population is at greater risk for illness and injuries. Access to basic health care services is limited because the homeless lach health insurance coverage.

The nurse delivers culturally competent care by acknowledging and accepting cultural differences in clients and understanding culture-specific responses to illness. The nurse includes the client's cultural heritage, food preferences, social networks, and health care beliefs in the assessment of the client. The nurse reflects on personal responses to cultural differences, facilitates the client's choices, gains cultural knowledge and communicates effectively in every step of nursing process.