Transcultural Concepts in Nursing Care

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Part Three Healthcare Systems

and co-occurring concepts. These concepts are Comfort, Communication, Connection, and Care. Hispanic patients had more trust in their providers when patient–provider dialogues with personable discussions (omit occurred) before clinical affairs were discussed. This study was conducted with Hispanic patients and cannot be generalized to other populations. Many factors influence the likelihood that cli ents, families, and communities will maintain tra ditional health beliefs and practices. For example, the length of time a person lives in the new host country will influence factors such as language and the use of media (e.g., radio, television, and computers). Teenagers may quickly adjust to American culture and begin to use a smartphone or an iPad and use the translation services on these devices to communicate with each other or their new American friends. The ability to understand and communicate with members of the majority culture is crucial to beginning to feel comfortable. 1. Length of time in the new host country. 2. Size of the ethnic or cultural group with which an individual identifies and interacts. 3. Age of the individual. As a general rule, children acculturate more rapidly than do adults or seniors. 4. Ability to speak English and communicate with members of the majority culture. Language spoken in the home among family members. 5. Economic status. For example, if an immigrant woman who has a work visa works outside the home, she may learn English more quickly than if she remains within the household and speaks only Spanish with her family members. 6. Educational status. In general, higher levels of education lead to faster acculturation.

Generally, children acculturate more quickly because they are exposed to their peer group at school and they learn cultural characteristics through that association. The need to work out side the household often exposes women from traditional cultures to others of the majority cul ture; thus, they learn English more quickly than if they remain isolated at home. When individuals from other cultures seek healthcare in their host country, they become familiar with its health care system. This does not necessarily mean that they adhere to all health advice, but contact with the system decreases anxiety and confusion, and individuals are more likely to seek care again. In addition, if individuals or groups have distin guishing ethnic characteristics, such as skin color, they may be more isolated because of discrimi nation and thus retain traditional values, beliefs, and practices over a longer time. Some factors that influence the likelihood that clients, families, and communities will maintain traditional health beliefs and practices are shown in Box 11-2. 7. Health status of family members. If individuals and their families seek healthcare in their host country, they begin to “learn the system.” This does not mean that they accept all of the health advice, but contacts with the system should decrease anxiety and confusion. 8. Distinguishing ethnic characteristics, such as skin color. These individuals may be more isolated because of discrimination and thus may retain traditional values related to health beliefs and behavior. 9. Rigidity or flexibility of the host society. This refers to the extent to which the host society is willing to allow members of different ethnic groups, along with their traditions, beliefs, and practices, into their structure, culture, and identity.

Some Factors Influencing Traditional Beliefs and Practices BOX 11-2

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