ObjectivesObjectives

After completion of this session the After completion of this session the student will be able to:student will be able to:

Define culture and related conceptsDefine culture and related conceptsDescribe the characteristics of culture.Describe the characteristics of culture.

Contrast the terms culture and sub Contrast the terms culture and sub culture.culture.

Discuss the meaning of culturally Discuss the meaning of culturally competent health care.competent health care.

Culture: culture can be defined as all Culture: culture can be defined as all the behaviors, arts, beliefs and the behaviors, arts, beliefs and institutions of population that are institutions of population that are passed down from generation to passed down from generation to generation. Culture has been called " generation. Culture has been called " the way of life for an entire society" as the way of life for an entire society" as such it includes codes of manners, such it includes codes of manners, dress, language, religion, rituals, norms dress, language, religion, rituals, norms of behavior such as law and of behavior such as law and morality ,and system of belief as well morality ,and system of belief as well as the arts and gastronomy.as the arts and gastronomy.

Tran cultural nursing: A humanistic and Tran cultural nursing: A humanistic and scientific area of formal study and scientific area of formal study and practice in nursing which is focused practice in nursing which is focused upon differences and similarities among upon differences and similarities among cultures with respect to human care, cultures with respect to human care, health, and illness based upon the health, and illness based upon the peoples cultural values, beliefs, and peoples cultural values, beliefs, and practices, and to use this knowledge to practices, and to use this knowledge to provide cultural specific or culturally provide cultural specific or culturally congruent nursing care to congruent nursing care to people(Leininger)people(Leininger)

Ethnocentrism:Ethnocentrism: Is the belief that ones own cultural practices and Is the belief that ones own cultural practices and

values are inherently correct or superior to those of values are inherently correct or superior to those of others.others.

Ethnocentric attitude can lead to the following Ethnocentric attitude can lead to the following problems:problems:

1. Prejudice: Negative preconceived opinions about 1. Prejudice: Negative preconceived opinions about others people or groups based on hearsay, others people or groups based on hearsay, perception, or emotion.perception, or emotion.

2. Stereotyping: Believing that one member of a 2. Stereotyping: Believing that one member of a cultural group will display certain behaviors or hold cultural group will display certain behaviors or hold certain attitudes (usually negative) simply because certain attitudes (usually negative) simply because he or she is a member of that cultural group).he or she is a member of that cultural group).

3.Discrimination: Differential treatment 3.Discrimination: Differential treatment based on race , class, sex, or other based on race , class, sex, or other variables rather than on individual variables rather than on individual merit.merit.

4.Stigmatization: the attribution of 4.Stigmatization: the attribution of negative characteristics or identify to negative characteristics or identify to one person or group, causing the one person or group, causing the person or group to feel rejected and , person or group to feel rejected and , alienated, from society.alienated, from society.

Characteristics of cultureCharacteristics of culture

1.Learned.1.Learned.

2.Integrated.2.Integrated.

3.Shared.3.Shared.

4.Tacit.4.Tacit.

5.Dynamic.5.Dynamic.

1. Culture is learned: Patterns 1. Culture is learned: Patterns of culture behavior are of culture behavior are acquired, not inherited. The acquired, not inherited. The way people dress, what they way people dress, what they eat, how they talk-all are eat, how they talk-all are learned.learned.

2. Culture is integrated: Rather than 2. Culture is integrated: Rather than being an assortment of various being an assortment of various customs and traits, a culture is a customs and traits, a culture is a functional, integrated whole. As in functional, integrated whole. As in any system, all parts of a culture are any system, all parts of a culture are interrelated and interdependent. interrelated and interdependent.

3. Culture is shared: Culture is the 3. Culture is shared: Culture is the product of aggregate behavior, not product of aggregate behavior, not individual habit. Certainly, individuals individual habit. Certainly, individuals practice a culture, but customs are practice a culture, but customs are phenomena shared by all members phenomena shared by all members of the group.of the group.

Culture is mostly tacit: culture Culture is mostly tacit: culture provides a guide for human provides a guide for human interaction that is mostly interaction that is mostly unexpressed and at the unconscious unexpressed and at the unconscious level, or tacit. level, or tacit.

Culture is dynamic: every culture Culture is dynamic: every culture undergoes change; none is entirely undergoes change; none is entirely static. Within every cultural group static. Within every cultural group are individuals who generate are individuals who generate innovations. More important, some innovations. More important, some members see advantages in doing members see advantages in doing things differently and are willing to things differently and are willing to adopt new practices adopt new practices

Subculture: it refer to a smaller group Subculture: it refer to a smaller group within a larger cultural group that is its own within a larger cultural group that is its own particular set of cultural values, beliefs and particular set of cultural values, beliefs and practices. A subculture is usually composed practices. A subculture is usually composed of people who have a distinct identity and of people who have a distinct identity and yet are also related to a larger cultural yet are also related to a larger cultural group. For example a family member who group. For example a family member who practices a different religious faith than practices a different religious faith than others in the family may be as uniquely others in the family may be as uniquely different from other family members as she different from other family members as she or he is like them.or he is like them.

Values, norms, beliefs, tradition and Values, norms, beliefs, tradition and taboos: All together these terms are taboos: All together these terms are constitute the essential elements of constitute the essential elements of the non-material dimension of the non-material dimension of culture.culture.

Values: these are intrinsic beliefs or Values: these are intrinsic beliefs or ideals about desirable conduct, ideals about desirable conduct, custom, and other entities. As such custom, and other entities. As such they provide the basis for each persons they provide the basis for each persons attitudes and behaviors and they assist attitudes and behaviors and they assist in establishing hierarchic of needs and in establishing hierarchic of needs and goals value orientations can be defined goals value orientations can be defined as principles that assist in the solution as principles that assist in the solution of common human problems. of common human problems.

Norms: they are expected behavior. Norms: they are expected behavior. They provide rules about standards They provide rules about standards of appropriate behavior in particular of appropriate behavior in particular situations. Norms flow from cultural situations. Norms flow from cultural values about what is important in values about what is important in various situation.various situation.

Beliefs: it is conviction based on Beliefs: it is conviction based on information held by people fro information held by people fro whish no socially acceptable means whish no socially acceptable means of validity exist, it is a conviction of validity exist, it is a conviction that is mentally accepted as true that is mentally accepted as true whether or not it based on fact. whether or not it based on fact.

Tradition: Ancient ethno-Tradition: Ancient ethno-cultural-religious, belief and cultural-religious, belief and practices handed down practices handed down through generationsthrough generations

Taboo: they are proscribes act and Taboo: they are proscribes act and thoughts to avoid actual or thoughts to avoid actual or potential harm to self and others.potential harm to self and others.

Culturally competent health care:Culturally competent health care: Cultural competence means having the Cultural competence means having the

skills, both academic and interpersonal, to skills, both academic and interpersonal, to understand and appreciate cultural understand and appreciate cultural differences and similarities within, differences and similarities within, between, and among groups.between, and among groups.

It is a process by which health care It is a process by which health care providers " continuously strives to achieve providers " continuously strives to achieve the ability to effectively work within the the ability to effectively work within the cultural context of an individual or cultural context of an individual or community from a diverse cultural or community from a diverse cultural or ethnic background.ethnic background.

Skills in cultural competence are Skills in cultural competence are relevant fro all variables to which relevant fro all variables to which differences may apply . examples differences may apply . examples include gender, race, ethnicity, include gender, race, ethnicity, language, country of origin, language, country of origin, acculturation, age, religious and acculturation, age, religious and spiritual beliefs, sexual orientation, spiritual beliefs, sexual orientation, socioeconomic class and disabilities.socioeconomic class and disabilities.

The culturally competent provider is The culturally competent provider is willing and able to draw on willing and able to draw on community-based values, traditions, community-based values, traditions, and customs and to work with and customs and to work with knowledgeable people from the knowledgeable people from the community to formulate appropriate community to formulate appropriate interventions and supports fro clients interventions and supports fro clients according to the different variables according to the different variables mentioned earlier. mentioned earlier.

History of Tran cultural nursingHistory of Tran cultural nursing::

Leininger was the founder and leader Leininger was the founder and leader of this new, specific cognitive of this new, specific cognitive specialty in nursing. Leininger took specialty in nursing. Leininger took the "culture" construct from the "culture" construct from anthropology and "care" from anthropology and "care" from nursing and reformulated these two nursing and reformulated these two dominant constructs into "culture dominant constructs into "culture care".care".

She divides the evolution of She divides the evolution of transcultural nursing into three eras:transcultural nursing into three eras:

Establishment of the field (1955-1975)Establishment of the field (1955-1975) Program and research expansion Program and research expansion

(1975-1983).(1975-1983). Establishment of transcultural nursing Establishment of transcultural nursing

worldwide (1983 to the present)worldwide (1983 to the present)