Transcultural Concepts in Nursing Care


Chapter 11 Culture, Family, and Community

Basic Principles of Cultural Assessments BOX 11-4

1. All cultures must be viewed in the con text in which they have developed.

a leader, for example, might be the pastor of an African American church in the rural south or a member of the tribal council for a Native American tribe. The nurse must also be sensitive to cultural differences in leadership styles. For example, African American pastors may not speak in favor of the health education program from their pulpit, choosing instead to work through more informal networks. Zuniga et al., 2018 found that many African Americans rely on spirituality and/or reli gious practices when they are ill, and in general, a health program that has the support of the church pastor would be viewed favorably by the church community. In addition to local community and religious leaders, it is important to involve those who are most affected by the specific health prob lem in the planning process. Those involved in planning and participating in the health program’s activities should likewise participate in its evalu ation. Forming partnerships and building coali tions is the key to success in community-based health programs (Ervin & Flagg, 2022). biomedical model and the other end firmly anchored within the individual culture. The more widely disparate the differences between the biomedical model and the beliefs within the cultural group, the greater the potential for encountering resistance to biomedical interventions. 3. There is such a phenomenon as intracultural variation. Not every member of a cultural group displays all the behaviors that are associated with that group. For instance, not every Central American or Mexican American client will adhere to hot/ cold theories of illness or disease. It is only by careful appraisal of the assessment data, and validation of the nurse’s assessment with the client and family, that culturally competent care can be provided (Ellis & Purnell, 2021).

of health occurs in the context of everyday lives rather than in the doctor’s office or in a hospital. The range of cultural, historical, and social influ ences on health maintenance and promotion is considerable. Major cultural considerations must be addressed before health maintenance and pro motion programs are implemented for culturally diverse groups. To illustrate this, Evidence-Based Practice 11-4 describes a study that sought to understand what matters to Chinese older adults in relation to well-being, quality of life, and life satisfaction. A core theme (Cultural Foundations) emerged that informed the categorical themes and involved participants maintaining some ele ments of their homeland and traditional culture while facing different challenges in a new country. Cultural competence in community settings begins with anticipatory planning. In addressing cultural traditions and values, it is important to involve local community leaders and others who are members of the cultural group to promote the acceptance of health promotion programs. Such Cultural practices develop as a “logical” or understandable response to a particular human problem, and the setting as well as the problem must be considered. This is one reason why environmental and/or contextual data are so important. 2. The meaning and purpose of the behav ior must be interpreted within the context of the specific culture. For example, a Guatemalan client’s refusal to take a “hot” medication with a cold liquid is understandable if the nurse is aware that many Central American and Mexican American clients adhere to hot/cold theories of illness causation. There is often a range or spectrum of illness beliefs, with one end encompassing illnesses defined within the

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