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Copyright © 2016 Wolters Kluwer • All Rights Reserved
Chapter 10: Cultural Diversity and Values
2Copyright © 2016 Wolters Kluwer • All Rights Reserved
Chapter Highlights
• Culture in community settings• Cross-cultural nursing • Cultural competence and related
concepts• How culture affects health• Cultural health assessment
3Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false?Culture is static, private, and inherited.
4Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
FalseRationale: Culture is dynamic, shared, and learned.
5Copyright © 2016 Wolters Kluwer • All Rights Reserved
Culture and Nursing
• Culture—knowledge, values, practices, customs, and beliefs of a group
• Properties of culture– Dynamic, not static– Shared, not private– Learned, not inherited
6Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false?Cultural competence is an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities.
7Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
TrueRationale: Cultural competence is an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities. For community health nurses, it necessitates familiarizing oneself with cultures that are represented in the communities they serve.
8Copyright © 2016 Wolters Kluwer • All Rights Reserved
Cross-cultural Nursing
• Cross-cultural or transcultural nursing—any nursing encounter in which the client and nurse are from different cultures
• Cultural competence—considering cultural aspects of health, illness, and treatment for each client or community, as well as doing so at each stage of the nursing process
9Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false?Advocates for groups that have been sociopolitically marginalized promote “cultural safety,” the ideal of considering cultural aspects of groups while working against assimilationism and repression.
10Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
TrueRationale: Advocates for groups that have been sociopolitically marginalized promote “cultural safety,” the ideal of considering cultural aspects of groups while working against assimilationism and repression.
11Copyright © 2016 Wolters Kluwer • All Rights Reserved
Institutional Cultural Competence
• For community and public health agencies to be culturally competent, they must– Have a defined set of values and principles and
demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally
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Institutional Cultural Competence (cont.)
– Have the capacity to • Value diversity• Conduct self-assessment• Manage the dynamics of difference• Acquire and institutionalize cultural knowledge• Adapt to diversity and the cultural contexts of the
communities they serve
13Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false?Cultural humility is an acknowledgment that our own beliefs are inherently better than those of our clients.
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Answer
FalseRationale: Cultural humility is an acknowledgment that everyone’s views are culturally influenced, that our own are not inherently better than those of our clients, and that our clients can teach us.
15Copyright © 2016 Wolters Kluwer • All Rights Reserved
Cultural Safety
Culturally appropriate health services to disadvantaged groups while stressing dignity and avoiding institutional racism, assimilationism, and repressive practices
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Cultural Humility
• Ask open-ended questions about beliefs and practices of the client and family.
• Ask about traditions. What does the client think may have caused an illness, and how has the client already tried to address it?
17Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false?Ethnocentrism can be defined as an assumption that everyone shares your cultural values, or an opinion that your culture is superior to others.
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Answer
TrueRationale: Ethnocentrism can be defined as an assumption that everyone shares your cultural values, or an opinion that your culture is superior to others.
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Ethnocentrism
Assumption that others believe and behave as the dominant culture does, or the belief that the dominant culture is superior to others
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Subculture
• Group sharing some practices, language, or other characteristics in common, within a larger society that does not share those characteristics
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Western Biomedicine as “Cultured”
• The first imperative of cultural competence is to be competent in one’s own cultural heritage.
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• Attribution of illness• Diet• Verbal communication• Nonverbal communication– Eye contact– Personal space– Style of communication
Aspects of Culture Directly Affecting Health and Health Care
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• Time orientation• Roles• Religion• Folk medicine
Aspects of Culture Directly Affecting Health and Health Care (cont.)
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Cultural Health Assessment
• Individual clinicians• Healthcare organizations