culture nur 210 m.sharpe, rn, msn, np. culture §collection of beliefs, values, behaviors, rituals,...
TRANSCRIPT
Culture
NUR 210
M.Sharpe, RN, MSN, NP
CULTURE
Collection of beliefs, values, behaviors, rituals, habits shared by a group of people and passed from one generation to the next
• LEARNED FROM BIRTH
• SHARED BY ALL MEMBERS
• MOLDED BY ENVIRONMENT
• SUBCULTURES
Common Characteristics
Universality
Uniqueness
Stability
Changeability
Unconsciousness
Variability
Ethnocentrism
The belief that one’s cultural, ethnic, or professional group is superior to that of others
Stereotyping
Exaggerated beliefs and images that are popularly depicted in the mass media, folklore, and general conversation.
Cultural Blindness
Failure to acknowledge cultural differences
Cultural Shock
Immobilization due to cultural differences
Cultural Diversity
Myth of the “melting pot” is being displaced with a sense of identity among various ethnic groups
Acculturation
The changes of one’s cultural patterns to those of the host society (assumed to take 3 generations in the US)
Racism
Belief that people can be classified on the basis of biophysical traits that indicate innate inferior or superiority PrejudicePrejudice: unfavorable attitudes toward an
individual or group of people based on unfavorable attitudes toward that group
DiscriminationDiscrimination: differential treatment of an individual or a group based on unfavorable attitudes toward the group
Transcultural Assessment Model
CommunicationSpaceSocial organizationTimeEnvironmental controlBiological variations
AFRICIAN AMERICANS
MORTALITY Life Expectancy Strokes Heart Disease Infant Mortality Homicide HIV/AIDS
Health Problems R/T:
Economic status poverty discrimination social and psychological barriers
Hereditary
Communication
Dialect and language usageModes of behaviorFrench, Spanish, Creole
Space
Close Personal Space
Social Organization
Strong church affiliations within communityFailure to assimilate
choice segregation
Family System female headed household large networks
Time
May be present or future oriented, depends on assimilation into dominant culture.
Environmental Control
HeterogeneousReligious
prayer and magic
Folk Medicine Internal remedies External remedies
Biological VariationsPallorErythemaCyanosisEcchymosisJuandiceKeloidsPigmentary disordersPseudofolliculitisMelasma
Biological Variations
Lactose intoleranceSickle cell anemia
Genetically inherited
AlcoholismHypertensionCancer of esophagus and stomach
HISPANICS
Second largest emerging majority groupFastest growing population
Mexican Puerto Rican Cuban Other Latin American origin
Communication
Language barrier: 50 dialects Spanish or Portuguese
Small talkVerbal expression: elaborate and indirectEye contact
Space
Tactile touch, handshakes, embrace
Physical presence family
Time
Present
Current activity rather than with planning ahead to be on time
Environmental Control
Health is state of harmony and balance maintain by diet and keeping four humors in
balance• blood
• phlegm
• black bile
• yellow bile
Illness as body imbalance
Illness that are “hot”are treated with a “cold” substance
Hot foods cannot be combined, they are to be eaten with cold foods
Hot and cold do not refer to temperature, but are a description of a particular substance itself.
Have to ask the client, varies from person to person
Curanderismo
A medical system with historic roots that combine Aztec, Spanish, sprititualistic, homeopathic, and scientific elements
Cuandero(a): holistic healer and religious figure
Social Organization
Nuclear familiesLarge, extended family networksStrong church affiliations within
communityCommunity social organizations
Dislocation of Parts of Body
Empacho
Caida de la mollera
Mal ojo
Susto
Disease and Health Conditions
Higher rates of obesity and DMLower rates of CVDCommunicable diseases
Respiratory: TB GI: diarrhea, Hep. C Skin disorders HIV
Implications
Reduce access to care barriersReduce communication barriersHealth promotion messages and health care
more effective when delivered within their social frame of reference
Focus on problems seen as problems by the community
Involve the community
ASIAN AMERICANS
Chinese (16%)Filipinos (13%)Japanese ((10%)Asian Indian (9%)Korean (7%)Other Asian groups (45%)
Communication
Many languages Written verses OralCommunicate RESPECTLimit use of touchAvoid eye contactNonverbalSelf-control
Asian American Space
Intimate zone confined to private settings
Noncontact people
Social Organization
Respect traditionsFamily roles well definedRole reversal Religion
Buddhism Confudianism Taoism
Time
Emphasis on the pastTime as cycles, events, occurrences
Environmental Control
Cultural health practices Naturalistic Supernaturalistic Metaphysical
Biological Variations
Cancer stomach, esophagus, liver
DM: diet, lifestyleCVD: increase with change in diet
NATIVE AMERICANS
10 different tribes in USCherokee and Navajo are largest
Communication
No common language (tribal language)
Touch
Disrespectful to engage in direct eye contact
Use of silence and body language
Space
Difficult adjusting to unfamiliar spaces
Value personal space
Social Organization
Family oriented
Matriarchal society in some tribes
Guided by supernatural
Time
Present orientedTime is casual, and relative to present tasks
that need to be done in a present time frame
Environmental Control
Native American Healers harmony with the environment symbolic and sacred items
Biological Variations
DM: major health problemSTDSuicideAlcoholism
different enzyme to metabolize alcohol which acts quicker and therefore consume more alcohol
ARAB AMERICANS
Major Religion: MuslimMajor Language: ArabicHealth Care Beliefs
health promotion important women hold inferior social position same sex health care providers
Communication
For a women, direct eye contact is limited to other women or family members
Males may touch only those women who are in family
Handshakes are continued for a lengthy period
Educated Saudis respect direct eye contact
Social Organization
Husband is the family leader
Extended families live together
The Saudi mother is revered
Time
Time has little meaning except in business
Social rituals continue while appts. go by attended
Arab Americans Health
DMSyphilisLeprosyCholeraRickets and malnutritionAIDS
MIDDLE ANGLO AMERICANSEnvironmental ControlModern, Western health care delivery
Remaining traditional beliefs
Folk medicine
Biological Variations
Breast cancerHeart diseaseDM
Social Organization
Nuclear familiesExtended familiesJudeo-Christian religionsCommunity and social organizations
Communication
National languages
Many learned English rapidly as immigrants
Verbal, rather than nonverbal
Space
Noncontact people aloof and distant
Southern countries closer contact and touch
Time Orientation
Future over present