HA PRELIMS WEEK 5

CULTURE

-            Totality of socially transmitted behaviors, beliefs, and values guiding worldview.

ETHNICITY

-            A group sharing common characteristics not shared by others.

ETHNOCENTRISM

Perception that one's own worldview is superior to others.

STERIOTYPING

Erroneous belief that all people of a group are alike.

CULTURAL COMPETENCE

-            is a continuous process, summarized by ASKED:

COMPONENT	DESCRIPTION
Awareness	Self-examination of one’s own cultural beliefs and biases
Skill	Ability to perform cultural assessments
Knowledge	Understanding different cultural practices and health beliefs
Encounters	Direct interaction with diverse populations
Desire	Genuine motivation to engage in cultural competence

AWARENESS
SKILL
KNOWLEDGE
ENCOUNTERS
DESIRE

ASKED: CULTURAL COMPETENCE

AWARENESS

Self-examination of one’s own cultural beliefs and biases

SKILL

Ability to perform cultural assessments

KNOWLEDGE

Understanding different cultural practices and health beliefs

ENCOUNTERS

Direct interaction with diverse populations

DESIRE

Genuine motivation to engage in cultural competence

COMMUNICATION
SPACE (PERSONAL ZONES)
SOCIAL ORGANIZATION
TIME ORIENTATION

ENVIRONMENTAL CONTROL

BIOLOGICAL VARIATIONS AND SYNDROMES

6 CULTURAL PHENOMENA

COMMUNICATION

-            Verbal Communication: Includes language spoken, tone of voice, and the appropriate use of interpreters. 

-            Non-Verbal Communication:

ASPECT	CULTURAL MEANING
Eye Contact	Direct eye contact = honesty (Western); Avoidance = respect (Asian/Native American)
Silence	Respect (Native American); Discomfort (Western cultures)
Touch	Varies widely; some cultures view the head as sacred

-            Nursing rule: Always ask permission before touching, especially the head. 

SPACE (PERSONAL ZONES)

-            Closer Contact: Middle Eastern, Latin American, Southern European.

-            More Distant: Asian, Northern European, North American.

o   Nursing Implication: Always explain procedures before entering the intimate zone (0-18 inches).

SOCIAL ORGANIZATION

-            Family Structure:

o   Patriarchal: Father leads

o   Matriarchal: Mother leads

o   Egalitarian: Shared leadership

-            Family Value: In Hispanic and Asian cultures, family interest often outweighs individual interest.

TIME ORIENTATION

ORIENTATION	CHARACTERISTICS	NURSING IMPACT
Past-Oriented	Values tradition (e.g., Asian cultures)	May resist new treatments
Present-Oriented	Focus on “here and now” (some African American/Hispanic)	May neglect prevention
Future-Oriented	Emphasizes planning & prevention (Western)	Strict schedule adherence

PAST ORIENTED

Values tradition (e.g., Asian cultures)

May resist new treatments

PRESENT ORIENTED

Focus on “here and now” (some African American/Hispanic)

May neglect prevention

FUTURE ORIENTED

Emphasizes planning & prevention (Western)

Strict schedule adherence

ENVIRONMENTAL CONTROL

-            Locus of Control: Internal ("I control my health") vs. External ("It is God's will/Fate").

-            Health Belief Systems:

o   Biomedical: Germ theory.

o   Magico-Religious: Spirits, blessings, punishments.

o   Holistic: Balance (Yin/Yang, Hot/Cold).

BIOMEDICAL

GEM THEORY

MAGICO-RELIGIOUS

SPIRITS, BLESSINGS, PUNISHMENTS

HOLISTIC

BALANCE (YIN YANG)

BIOLOGICAL VARIATIONS AND SYNDROMES

-            Recognizes that genetics and culture influence disease patterns and responses to treatment.

SYNDROME	GROUP	DESCRIPTION
Susto	Latin American	"Soul Loss" from fright; anxiety, insomnia, depression
Empacho	Latin American	Food stuck in stomach; treated by rubbing stomach
Mal Ojo	Latin American	"Evil Eye" from admiration/jealousy; fever, vomiting
Wind Illness	Asian	Cold/Wind enters body; treated by coining/cupping
Ghost Sickness	Navajo	Preoccupation with death; bad dreams, weakness

SUSTO

Latin American

"Soul Loss" from fright; anxiety, insomnia, depression

EMPACHO

Latin American

Food stuck in stomach; treated by rubbing stomach

MAL OJO

Latin American

"Evil Eye" from admiration/jealousy; fever, vomiting

WIND ILLNESS

Asian

Cold/Wind enters body; treated by coining/cupping

GHOST SICKNESS

Navajo

Preoccupation with death; bad dreams, weakness

TRADITIONAL HEALERS

CULTURE	HEALERS	PRACTICES
Asian	Herbalists, Chinese practitioners	Yin/Yang balance, hot/cold foods, acupuncture, cupping, moxibustion
African	"Granny", "Old Lady", Hougan	Herbs, roots, rituals, talismans
Hispanic	Curandero/a, Yerbero, Partera	Hot/Cold balance, herbs, amulets, prayers
Native American	Shamans, Medicine Men	Respect for nature, masks, herbs, sand paintings

SPIRITUALITY

-            A broad search for meaning and purpose in life. It seeks to understand life's ultimate questions in relation to the sacred. It is essential to human existence.

RELIGION

-            An organized system of beliefs, rituals, worship, and rules shared by a group (e.g., Catholicism, Islam).

SPIRITUAL DISTRESS

-            A disturbance in the belief system that provides strength, hope, and meaning.

FICA SPIRITUAL HISTORY TOOL

LETTER	FOCUS	SAMPLE QUESTIONS
F – Faith	Beliefs	“Do you consider yourself spiritual or religious?”
I – Importance	Influence	“Does your faith influence your self-care?”
C – Community	Support	“Are you part of a spiritual community?”
A – Address	Care Integration	“How would you like me to address this in your care?”

FAITH
IMPORTANCE
COMMUNITY
ADDRESS

FICA

RESPECT

Support practices (dietary restrictions, prayer, privacy)

PRESENCE

Listen without imposing beliefs

REFERRAL

Chaplain, priest, imam, rabbi when appropriate

JEHOVAH’S WITNESSES

• No blood transfusions (whole blood, components)

• May accept volume expanders

• No food with blood (e.g., dinuguan)

ISLAM

• Diet: Halal; no pork, no alcohol

• Fasting: Ramadan (dawn to sunset)

• Prayer: 5 times/day facing Mecca

• Modesty: Prefer same-gender caregivers

• Hygiene: Right hand for eating

JUDAISM

• Diet: Kosher; no pork or shellfish; no mixing meat and milk

• Sabbath: Friday sunset to Saturday sunset

• Circumcision: 8th day (Bris)

HINDUISM

• Mostly vegetarian

• Beef strictly forbidden

• Belief in karma (cause-and-effect of illness)

• Prefer running water for hygiene

BUDDHISM

• Many are vegetarian

• Value clarity of mind; may refuse strong analgesics

• Peace is essential at end of life

MORMONISM

• No alcohol, tobacco, coffee, or tea

• Sacred undergarments (avoid removal)

CATHOLICISM

• Sacraments: Anointing of the Sick, Eucharist

• No meat on Fridays during Lent

• Family planning: natural methods only