Transcultural Concepts in Nursing Care

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Part Three Healthcare Systems

and the clients in their care. Today, the need for nurses to provide culturally relevant care is greater than ever. Currently, the focus of com munity nursing is on efforts aimed at the promo tion, protection, and preservation of the public’s health (Rector, 2022). This often involves health education to individuals, families, and commu nity groups. Health education should be struc tured in such a way to appeal to people from different subcultures. Subcultures are aggregates of people who establish certain rules of behavior, values, and living patterns that are different from mainstream culture. Leininger described subcul tures as having “distinctive patterns of living with sets of rules, special values and practices that are different from the dominant culture” (Leininger, 1995, p. 60). There can also be diversity within each subculture. Hispanic culture as a group is very broad and includes Mexican Americans, Puerto Ricans, Dominicans, Cubans, and Central and South Americans. There is diversity within each of these groups as well. Certain geographic areas of the country, such as Appalachia, are examples of areas where dis tinct subcultures can be identified. Persons born and reared in the southern states or in New York City can often be identified as members of a dis tinct subculture by their dialect and mannerisms.

The United States used to be described as a “melt ing pot” culture, indicating that new arrivals gave up their former languages, customs, and values to become Americans. This concept may not be appropriate, however. A more accurate metaphor for the American population is a rich and complex tapestry of colors, backgrounds, and interests. One subculture that has retained many aspects of their traditional culture is the Hmong people from Southeast Asia. They came to the United States in the 1970s as refugees after the Vietnam War. The large Hmong community in Fresno, CA, sponsors a New Year’s Day Celebration that is attended by as many as 100,000 Hmong from all over the United States (Fig. 11-2). Refugee and Immigrant Populations Migration affects the health and well-being of communities, regardless of the cause (weather, war, or lack of resources). The United Nations reports global displacement at an all-time high, representing 1% of the world’s population, over 100 million people (United Nations, 2022). Communities from which individuals emigrate as well as those communities that accept immi grants are profoundly affected by human migra tion patterns. Therefore, it is important for

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Figure 11-2. The Hmong New Year’s Celebration in Fresno, CA, is attended by 100,000 Hmong. In this photo, several Hmong admire the merchandise in a booth selling traditional clothes.