Culture and Ethnicity Ismaila
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CULTURE AND ETHNICITY
ISMAILA SANYANGRN, BSC, MBA
3RD FEBRUARY, 2012
AIUWA
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OUTLINE The concept of culture
Culture and nursing
Ethnicity
Transcultural nursing
Major concepts (leninger,1991)
Applications to nursing
Health practices in different cultures
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Having knowledge of a culture before trying to help a
client and family is analogous to a nurse or a
physician having basic knowledge of anatomy andphysiology before doing physical assessment or
attempting to meet a patients
physical needs. Madeleine Leininger
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THE CONCEPTOF CULTURE Set of values, beliefs and traditions, that are held by a specific
group of people and handed down from generation to generation.
Culture is also beliefs, habits, likes, dislikes, customs and ritualslearn from ones family.
Culture is the learned, shared and transmitted values, beliefs,norms and life way practices of a particular group that guidethinking, decisions, and actions in patterned ways.
Culture is learned by each generation through both formal andinformal life experiences.
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THE CONCEPTOF CULTURE
(CTD)Language is primary through means of
transmitting culture.
The practices of particular culture often arisebecause of the group's social and physical
environment.
Culture practice and beliefs are adapted over
time but they mainly remain constant as long as
they satisfy needs.
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THE CONCEPTOF CULTURE
(CTD)Cultural Identify the sense of being part of an ethnic group
or culture
Culture-universals commonalities of values, norms ofbehavior, and life patterns that are similar among differentcultures.
Culture-specifies values, beliefs, and patterns of behaviorthat tend to be unique to a designate culture.
Material culture refers to objects (dress, art, religiousarti1acts)
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THE CONCEPTOF CULTURE
(CTD)Non-material culture refers to beliefs customs,
languages, social institutions.
Subculture composed of people who have a distinctidentity but are related to a larger cultural group.
Bicultural a person who crosses two cultures,
lifestyles, and sets of values.
Diversityrefers to the fact or state of being different.Diversity can occur between cultures and within acultural group.
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THE CONCEPTOF CULTURE
(CTD)Acculturation People of a minority group tend to
assume the attitudes, values, beliefs, findpractices of the dominant society resulting in a
blended cultural pattern.
Cultural shock the state of being disoriented orunable to respond to a different cultural
environment because of its sudden strangeness,unfamiliarity, and incompatibility to the stranger'sperceptions and expectations at is differentiatedfrom others by symbolic markers (cultures,biology, territory, religion).
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THE CONCEPTOF CULTURE
(CTD)Cultural awareness It is an in-depth self-examination of one's own background, recognizing
biases and prejudices and assumptions about other
peopleCultural Imposition the belief that everyone
should conform to the majority belief system.
Cultural conflict when one ridicules others beliefs
and traditions in an effort to make his or her ownvalues more secure
Ethnocentrism the belief that ones own ideas,
beliefs and practices are the best and superior
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CULTURE AND NURSINGCulturally congruent care care that fits the
people's valued life patterns and set of meanings -
which is generated from the people themselves,rather than based on predetermined criteria.
Culturally competent care is the ability of the
practitioner to bridge cultural gaps in caring, work
with cultural differences and enable clients andfamilies to achieve meaningful and supportive
caring.
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ETHNICITYEthnicity the sense of identification that a cultural
group collectively has, largely based on the groups
common heritage.Ethnic groups share a common social and cultural
heritage that is passed on to successive generations.,
Ethnic identity refers to a subjective perspective of
the person's heritage and to a sense of belonging to a
group that is distinguishable from other groups.
Race the classification of people according to shared
biologic characteristics, genetic markers, or features.
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TRANSCULTURAL NURSINGMadeleine Leininger is considered as the founder of the
theory of transcultural nursing.
Her theory has now developed as a discipline in nursing.
Evolution of her theory can be understood from herbooks: Culture Care Diversity and Universality(1991)
Transcultural Nursing(1995)
Transcultural Nursing(2002)
Transcultural nursing theory is also known as CultureCare theory.
Theoretical framework is depicted in her model called theSunrise Model (1997).
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TRANSCULTURAL NURSING
(CTD)y Transcultural nursing is a comparative study of
cultures to understand similarities (culture
universal) and difference (culture-specific) acrosshuman groups (Leininger, 1991
y Despite being technically competent, a nurse can beincompetent, formulating unworkable interventions because of
an unwillingness or inability to understand the culturallydifferent patient. (West, 1994, .232)
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MAJOR CONCEPTS LEININGER
(1991) Illness and wellness are shaped by a various factors
including perception and coping skills, as well as thesocial level of the patient.
Cultural competence is an important component ofnursing.
Culture influences all spheres of human life. It defineshealth, illness, and the search for relief from disease ordistress.
Religious and Cultural knowledge is an importantingredient in health care.
The health concepts held by many cultural groups mayresult in people choosing not to seek modern medicaltreatment procedures.
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MAJOR CONCEPTS LEININGER
(1991) (CTD)Health care provider need to be flexible in the design of
programs, policies, and services to meet the needs andconcerns of the culturally diverse population, groups that
are likely to be encountered.
Most cases of lay illness have multiple causalities andmay require several different approaches to diagnosis,treatment, and cure including folk and Western medicalinterventions..
The use of traditional or alternate models of health caredelivery is widely varied and may come into conflict withWestern models of health care practice
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MAJOR CONCEPTS LEININGER
(1991) (CTD)Culture guides behavior into acceptable ways for
the people in a specific group as such culture
originates and develops within the socialstructure through inter personal interactions.
For a nurse to successfully provide care for a
client of a different cultural or ethnic to
background, effective intercultural
communication must take place.
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APPLICATION TO NURSINGTo develop understanding, respect and
appreciation for the individuality and diversity of
patients beliefs, values, spirituality and cultureregarding illness, its meaning, cause, treatment,
and outcome.
To encourage in developing and maintaining aprogram of physical, emotional and spiritual self-
care.
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HEALTH PRACTICES IN
DIFFERENT CULTURESUse of Protective Objects. Protective objects can
be worn or carried or hung in the home- charmsworn on a string or chain around the neck, wrist, or
waist to protect the wearer from the evil eye or evilspirits.
Use of Substances It is believed that certian foodsubstances can be ingested to prevent illness.
E.g. eating raw garlic or onion to prevent illness orwear them on the body or hang them in the home.
Religious Practices Burning of candles, rituals ofredemption etc..
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HEALTH PRACTICES IN
DIFFERENT CULTURESTraditional RemediesThe use of folk or traditional
medicine is seen among people from all walks of life
and cultural ethnic back ground.HealersWithin a given community, specific people
are known to have the power to heal.
Immigration Immigrant groups have their own
cultural attitudes ranging beliefs and practicesregarding these areas.
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ROLEOF NURSEDetermine the client's cultural heritage and
language skills.
Determine if any of his health beliefs relate to thecause of the illness or to the problem.
Collect information that any home remedies the
person is taking to treat the symptoms.
Nurses should evaluate their attitudes toward
ethnic nursing care.
Self-evaluation helps the nurse to become more
comfortable when providing care to clients from
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ROLE OF NURSEy Understand the influence of culture, race ðnicity
on the development of social emotional relationship,
child rearing practices & attitude toward health.y Collect informationabout the socioeconomic status of
the family and its influence on their health promotionand wellness
y
Identifiy the religious practices of the family and theirinfluence on health promotion belief in families.
y Understanding of the general characteristics of themajor ethnic groups, but always individualize care
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ROLEOF NURSEThe nursing diagnosis for clients should include potential
problems in their interaction with the health care system
and problems involving the effects of culture.
The planning and implementation of nursing interventions
should be adapted as much as possible to the client's
cultural background.
Evaluation should include the nurse's self-evaluation of
attitudes and emotions toward providing nursing care toclients from diverse sociocultural backgrounds.
Self-evaluation by the nurse is crucial as he or she
increases skills for interaction. .
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CULTURAL AND ETHNIC
INFLUENCES ON HEALTHCAREGender Roles It is important to know who is the
dominant figure in a family
Language and Communication Some clients maynot be able to speak the English Language
Food and Nutrition
Socioeconomic
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CULTURAL AND ETHNIC
INFLUENCES ON HEALTHCARETay Sacks Disease a gene for a hereditary
disorder have very short life span EasternEuropean, Jewish descent.
G6PD deficiency enzyme deficiency. Redblood cells have no cell membrane they areeasily destroyed , which leads to anemia andincreased billirubin levels. - 10% of African
American population
Thalassemia genetic disorder effecting the Hgbin RBC function. Mediterranean, Asian, and
African origin.
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INFLUENCES ON HEALTHCARE
(CTD)
Sarcoidosis formation of multiple tubercles or
nodules on various parts of the body - AfricanAmerican population.
Gout An increase of uric acid in the blood -males especially from Puerto Rican or Filipino
descentAnemia in pregnancy
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TRANSCULTURAL NURSING
STANDARDSA task force of the Expert Panel forGlobal Nursing
and Health of the American Academy of Nursing,along with members of the Transcultural Nursing
Society, developed a set of standards for culturalcompetence in nursing practice. The aim of thisproject was to define standards that can beuniversally applied by nurses around the world in the
areas of clinical practice, research, education, andadministration, especially by nurses involved indirect patientcare.
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TRANSCULTURAL NURSING
STANDARDS (CTD)Standard 1. Social Justice
Standard 2. Critical Reflection
Standard 3. Knowledge of CulturesStandard 4. Culturally Competent Practice
Standard 5. Cultural Competence in
HealthCare Systems and Organizations
Standard 6. Patient Advocacy and Empowerment
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TRANSCULTURAL NURSING
STANDARDS (CTD)Standard 7. MulticulturalWorkforce
Standard 8. Education and Training in
Culturally Competent CareStandard 9. Cross Cultural Communication
Standard 10. Cross Cultural Leadership
Standard 11. Policy Development
Standard 12. Evidence-Based Practice and Research
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yTHANK YOU FOR YOUR ATTENTION