Ethnic and Cultural

Considerations
Chapter 3

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 Ethnic/Cultural Considerations
• Many cultures in United States: continuum of
change in behaviors/beliefs
• Culture dynamic/changing: human interaction
– Culture: shared beliefs, values, behaviors that
define right/wrong, abnormal/inappropriate
• Ethnic/cultural diversity creates challenges
– Caring for ethnic individuals: not force
compliance, work with belief/value system
– Challenge: when cultures/languages different

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 Ethnic/Cultural Considerations
• Not responsible for knowing health
beliefs/practices/values of all groups
• Are responsible for asking about beliefs, etc.,
which is essential for individualize care
• May come from major racial/cultural groups or
unrecognized cultural groups
• Improve cultural awareness: ask questions
about unique beliefs/practices/values

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 Ethnic/Cultural Considerations

• Culture: all the socially transmitted behavioral

patterns, arts, beliefs, knowledge, values,
morals, customs, lifeways, and characteristics of
a population that influences their worldview
• Ethnicity: social group within a cultural/social
system who share common cultural/social
heritage

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 Ethnic/Cultural Considerations

• Race: genetic in origin and includes

physical characteristics
– All humans share genetic code more than
99% identical
– Individuals from same racial group not
necessarily the same culture

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 Ethnic/Cultural Considerations
• National standards (14) to ensure
equitable/effective treatment (DHSS/OMH)
– Culturally/linguistically appropriate services
• Three themes: nurses affected by standard 1
– Improving cultural awareness
• Develop sensitivity
• Don’t stereotype
• Develop template for assessment

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 Become Culturally Competent
• Ability to communicate among/between cultures
• Demonstrate skill in interacting/understanding
people of other cultures
• Culturally competent nurse
– Allows clients to explain meaning of illness
– Respects concepts of time, space, contact
– Respects physical/social activities
– Respects systems of social organization/provides
environmental control

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 Don’t Stereotype
• Uniqueness of each individual
• Cultural heritage equals “roots”: helps to
explain activities and beliefs
– Differences exist within cultures/groups
• Beliefs/attitudes in United States have
been shaped by stereotyped images and
misinformation
• Each one deserving of personalized
assessment
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 Develop a Template for
Assessment
Focused interview to get data about health
beliefs/practices that reflect culture
• Introductory questions (where born; identified
culture)
• Primary language/method of communication
– Language spoken/think in/translate in mind?
– Speak, read, write English?
– Special communication rituals; customs that influence
nonverbal/verbal communication; signs of respect?
– Entering and exiting situations?

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 Develop a Template for
Assessment
Focused interview (cont.)
• Personal beliefs about health/illness?
– Definition of/have control over health; if not,
who?
– Practices/rituals to improve health;
alternative healing methods?
– Consult who when ill?
– Rituals/practices needed to treat problem?
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 Develop a Template for
Assessment
• Personal beliefs (cont.)
– Attitudes/uncomfortable health topics to
discuss?
– Family health decisions made by whom?
– Modesty during exam?
– Health care members do what to
keep/become healthy?

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 Develop a Template for
Assessment
• Religious influences/special rituals
– Belong to particular religion?
– Look to whom for guidance/support?
– Special religious practices for support
when ill?
– Important rituals/practices?

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 Develop a Template for
Assessment
• Roles of individuals in family
– Who makes decisions?
– Family composition (generations/number)?
– Marriage customs/divorce and separation?
– Role/attitude toward children?
– How/who does punishment?
– Celebrations for important events?
– Special beliefs regarding practices and events
related to childbearing?

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 Develop a Template for
Assessment

• Dietary practices
– Main type of diet?
– Foods that are forbidden/required for
rite/ceremony?
– Who prepares food?
– Special preparation?
– Beliefs related to food, e.g., cause/cure of
illness?
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 Remember:
• Be sensitive
• Ask questions
• Gather specific information
• Don’t stereotype
• Don’t assume that care used for one individual
of culture is appropriate for another individual of
same/similar culture
• Regardless of culture/race, each one unique;
take time to get to know
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