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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
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LEARNED FROM BIRTH
SHARED BY ALL MEMBERS
MOLDED BY ENVIRONMENT
SUBCULTURES
Common Characteristics
 Universality
 Changeability
 Uniqueness
 Unconsciousness
 Stability
 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
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Prejudice: unfavorable attitudes toward an
individual or group of people based on
unfavorable attitudes toward that group
Discrimination: differential treatment of an
individual or a group based on unfavorable
attitudes toward the group
Transcultural Assessment Model
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Communication
Space
Social organization
Time
Environmental control
Biological variations
AFRICIAN AMERICANS
 MORTALITY
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Life Expectancy
Strokes
Heart Disease
Infant Mortality
Homicide
HIV/AIDS
Health Problems R/T:
 Economic status
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poverty
discrimination
social and psychological barriers
 Hereditary
Communication
 Dialect and language usage
 Modes of behavior
 French, Spanish, Creole
Space
 Close Personal Space
Social Organization
 Strong church affiliations within community
 Failure to assimilate
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choice
segregation
 Family System
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female headed household
large networks
Time
 May be present or future oriented, depends
on assimilation into dominant culture.
Environmental Control
 Heterogeneous
 Religious
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prayer and magic
 Folk Medicine
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Internal remedies
External remedies
Biological Variations
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Pallor
Erythema
Cyanosis
Ecchymosis
Juandice
Keloids
Pigmentary disorders
Pseudofolliculitis
Melasma
Biological Variations
 Lactose intolerance
 Sickle cell anemia
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Genetically inherited
 Alcoholism
 Hypertension
 Cancer of esophagus and stomach
HISPANICS
 Second largest emerging majority group
 Fastest growing population
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Mexican
Puerto Rican
Cuban
Other Latin American origin
Communication
 Language barrier: 50 dialects
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Spanish or Portuguese
 Small talk
 Verbal expression: elaborate and indirect
 Eye contact
Space
 Tactile
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touch, handshakes, embrace
 Physical presence
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family
Time
 Present
 Current activity rather than with planning
ahead to be on time
Environmental Control
 Health is state of harmony and balance
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maintain by diet and keeping four humors in
balance
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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
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Nuclear families
Large, extended family networks
Strong church affiliations within community
Community social organizations
Dislocation of Parts of Body
 Empacho
 Caida de la mollera
 Mal ojo
 Susto
Disease and Health Conditions
 Higher rates of obesity and DM
 Lower rates of CVD
 Communicable diseases
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Respiratory: TB
GI: diarrhea, Hep. C
Skin disorders
HIV
Implications
 Reduce access to care barriers
 Reduce communication barriers
 Health 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
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Chinese (16%)
Filipinos (13%)
Japanese ((10%)
Asian Indian (9%)
Korean (7%)
Other Asian groups (45%)
Communication
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Many languages
Written verses Oral
Communicate RESPECT
Limit use of touch
Avoid eye contact
Nonverbal
Self-control
Asian American Space
 Intimate zone confined to private settings
 Noncontact people
Social Organization
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Respect traditions
Family roles well defined
Role reversal
Religion
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Buddhism
Confudianism
Taoism
Time
 Emphasis on the past
 Time as cycles, events, occurrences
Environmental Control
 Cultural health practices
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Naturalistic
Supernaturalistic
Metaphysical
Biological Variations
 Cancer
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stomach, esophagus, liver
 DM: diet, lifestyle
 CVD: increase with change in diet
NATIVE AMERICANS
 10 different tribes in US
 Cherokee 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 oriented
 Time is casual, and relative to present tasks
that need to be done in a present time frame
Environmental Control
 Native American Healers
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harmony with the environment
symbolic and sacred items
Biological Variations
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DM: major health problem
STD
Suicide
Alcoholism
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different enzyme to metabolize alcohol which
acts quicker and therefore consume more
alcohol
ARAB AMERICANS
 Major Religion: Muslim
 Major Language: Arabic
 Health Care Beliefs
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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
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DM
Syphilis
Leprosy
Cholera
Rickets and malnutrition
AIDS
MIDDLE ANGLO
AMERICANS
Environmental Control
 Modern, Western health care delivery
 Remaining traditional beliefs
 Folk medicine
Biological Variations
 Breast cancer
 Heart disease
 DM
Social Organization
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Nuclear families
Extended families
Judeo-Christian religions
Community and social organizations
Communication
 National languages
 Many learned English rapidly as immigrants
 Verbal, rather than nonverbal
Space
 Noncontact people
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aloof and distant
 Southern countries
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closer contact and touch
Time Orientation
 Future over present