KOMUNIKASI

DALAM KONTEKS BUDAYA

Oleh: Imas Rafiyah, S.Kp., MNS

Magister Peminatan Keperawatan Jiwa Fakultas Keperawatan Universitas Padjadjaran

Tujuan

Konsep dasar komunikasi dan budaya

Komunikasi western dan eastern
Komunikasi berbagai suku di Indonesia
Berkomunikasi dengan klien dengan latar belakang
berbeda
Pengembangan kemampuan seseorang dalam
berkomunikasi

DEFINISI DAN KONSEP

KOMUNIKASI DAN BUDAYA

KOMUNIKASI

BUDAYA

Cara hidup yang berkembang dan dianut oleh

sekelompok orang serta berlangsung dari generasi
ke generasi
Membentuk persepsi dan perilaku

BUDAYA
Bersifat kompleks meliputi
pengetahuan, keyakinan, seni,
moral, hukum, adat, dan
kemampuan serta kebiasaan
lainnya yang didapat
manusia sebagai anggota
masyarakat
(Tylor dikutip dalam Frisch & Frisch,
2007)

BUDAYA

Transmits meaning
Dipelajari
Disebarkan
Ever-changing
Dialogical
Mendefiniskan nilai-nilai
Mendefiniskan norma:
peran, hubungan
hak-hak dan kewajiban;
kepercayaan dan praktek atau perilaku

(Tylor dikutip dalam Frisch & Frisch, 2007)

KOMUNIKASI ANTAR BUDAYA

Komunikasi yang terjadi di antara orangorang yang memiliki kebudayaan yang
berbeda

BENTUK KOMUNIKASI ANTAR BUDAYA

Komunikasi antara
kelompok agama yang
berbeda
Komunikasi antara subkultur
yang berbeda.
Komunikasi antara kultur
yang dominan.
Komunikasi antara jenis
kelamin yang berbeda

KOMUNIKASI
WESTERN DAN EASTERN

The difference between traditional and

western society (Okasha, 2007)
Traditional society

extended family,
family and group oriented,
status is determined by age and position
in the family,
extensive knowledge of distance
relationship,
decision making dependent on the family,
external locus of control,
respect on the decision of the elderly,
family who care for their members illness,
dependence in God in health and
disease

Eastern society

nuclear family and individual

oriented,
status achieved by own effort,
restrictive only to close family,
decision making was
determined by oneself,
internal locus of control,
dependent of oneself in
health and disease,
tend to search care from
health service.

KOMUNIKASI BERBAGAI SUKU

DI INDONESIA

Suku Bangsa di Indonesia

1.

2.
3.

4.
5.

6.
7.
8.

By ethnicity there are approximately 300 ethnic group and by mother

tongue they can be grouped in eight largest ethnicity including:
Javanese (52.1%) in Central and east Java,
Sundanese (19.3%) in West Java,
Minang (3.5%) in West Sumatra,
Maduranese (2.9%) in Madura island,
Banjar (2.4%) in Kalimantan,
Batak (2.3%) in North Sumatra,
Buginese (1.8%) in South Sulawesi, and
Balinese (1.7%) in Bali.

Five recognized religions in Indonesia including Islam (87%), Protestant

(6.5%), Catholic (3.6%), Hindu (1.5%), and Buddhism (data not available)
(Hidayat, 2002).

Suku Sunda

Close relationship among neighboring families (Guines

as cited in Zevalkink et al., 1999).
Believe on value silih asih, silih asah, silih asuh, it
means that people should care, love and guide each
other (Suryani, n.d).
Social activities that are commonly done by women,
those are volunteer for public health center, Islamic
organization or pengajian, and rotating saving
association or arisan. These activities can be the
activities for making relationship or making relax
(Niehof, 1998).

Budaya Sunda
Good health, economic security, and the well being of
loved ones, are considered enough for satisfaction.
illness is caused by inner imbalance that influence
functioning of the mind. They describe inner as hawa
nafsu (climate of feeling),this climate is influenced by up
and down feeling rhythm, for example, anger is caused
by hot feeling
Muslim-Sundanese believes to ulama (Islamic religious
functionaries) as local healers
(Horikoshi-Koe, 1979).

Budaya Sunda

mother is mostly primary caregiver for children.

(Adimihardja & Utja as cited in Zevalkink et al., 1999)
People help to others, particularly mother to her
children and it should be given voluntarily (Suryani, n.d).
Economic stress is also found in most Sundanese family.
Instable income and permanent job are rare in
Sundanese families(Chase-Lansdale & Owen, Gecas,
Greenberger, ONeill & Nagel as cited in Zevalkink et
al., 1999).

BERKOMUNIKASI DENGAN KLIEN

DENGAN LATAR BELAKANG BERBEDA

Nursing theory
MADELEINE LEININGERS CULTURE CARE: DIVERSITY
AND UNIVERSALITY THEORY

Pentingnya Memahami Budaya dalam

Komunikasi Keperawatan

Era globalisasi----banyak klien dari budaya

berbeda
Memahami klien-----membangun trust
Mengidentifikasi cultural need klien
Mencapai tujuan asuhan keperawatan dengan
cultural strategies

Intercultural caring (Wickberg & Eriksson, 2008)

Patients and nurses with different cultural

backgrounds meet in nursing care that is not always
experienced as caring.
The patients expectations might not be met
Nurses feel frustrated when language problems,
different cultural values and beliefs and lack of
support and resources interfere with nursing care
The world is becoming more multicultural, and there
are patients from different cultures in almost all
countries.

SETTING
KLINIK

KOMUNITAS

Pengkajian Terkait Budaya

Suku bangsa, jenis kelamin, usia, agama, pendidikan, status ekonomi

Komunikasi: verbal dan non verbal
Bahasa
Pakaian dan penampilan
Makanan dan kebiasaan makan
Waktu
Penghargaan dan pengakuan
Hubungan
Nilai dan norma
Rasa kenyamanan diri dan ruang
Proses mental dan belajar
Kepercayaan dan sikap

Hambatan Komunikasi Terkait Budaya

Bahasa
Kebiasaan dan pola perilaku
Persepsi
Stereotip budaya

Cultural Miscommunication

Vokal
Pakaian
Gesture
Kontak mata
Jarak
Sentuhan
Diam
Perilaku sosial
Orientasi waktu

Patients Transcultural Needs and

Carers Ethical Responses (Dogan, Tschudin, Hot &zkan)

This study was carried out in Gttingen, Germany.

Fifty Turkish people (described as patients) were asked about the
care they had received from German health care personnel, and 50
German nurses and 50 German physiotherapists were questioned
about care they had given to Turkish patients.
Significant findings were the needs of the Turkish patients for good
communication, physical contact and understanding of their culturebased expressions of illness.
The German nurses and physiotherapists expressed the need for
language barriers to be minimized and for education in the specific
culture of Turkish patients.
Suggestions for better transcultural health care paradigms are made
for relating to patients from different cultures

Student nurses experiences of communication in

cross-cultural care encounters (Jirwe, Gerrwish, emami, 2010)

Aim : To explore student nurses experiences of communication in cross-cultural care encounters.

Methods: Semi-structured interviews were undertaken a purposive sample of 10 final year
students from one university in Sweden: five participants were from a Swedish background
and five from an immigrant background.
Four themes were identified: conceptualizing cross-cultural care encounters, difficulties in
communication, communication strategies and factors influencing communication.
Cross-cultural care encounters involved patients from a different immigrant background to the
nurse.
Student nurses experienced particular difficulties communicating with patients with whom they
did not share a common language. This led to care becoming mechanistic and impersonal.
They were fearful of making mistakes and lacked skills and confidence in questioning patients.
Various strategies were used to overcome communication barriers including the use of relatives
to interpret, nonverbal communication, gestures and artefacts.
Other factors which influenced communication included the students attitude, cultural
knowledge acquired through education and life experience.

Tips Komunikasi Efektif

Pengetahuan perawat tentang budaya sendiri dan

budaya lainnya
Hindari stereotiping terhadap klien
Kaji secara individual

(Frisch & Frisch, 2007)

PENGEMBANGAN KEMAMPUAN SESEORANG

DALAM BERKOMUNIKASI

Cultural Competency

Cultural competence is defined as a set of congruent

behaviors, attitudes, policies, and structures that come
together in a system or agency or among professionals
and enables the system, agency, or professionals to
work effectively in cross cultural situations (Cross &
colleagues in Flaskerud, 2007)
In these descriptions, skills, attitudes, and values are
spelled out in three areas: cultural knowledge, cultural
sensitivity, and collaboration with the community to be
served.
(Flaskerud, 2007).

Cultural Competency

Cultural knowledge means actively learning about

the communityits ethnicities, languages, origins,
immigration or migration history, acculturation level,
economy, sources of income, family and social
structures and roles, value systems and beliefs,
education levels and literacy, geography, and
ecologic environment.
(Flaskerud, 2007).

Cultural Competency

Cultural sensitivity includes an ethic or a moral

imperative to value and respect the beliefs, norms,
and practices of the people to be served.
This begins with an awareness of our own cultural
beliefs and practices and moves toward being nonjudgmental and respectful in dealing with people
whose culture is different than our own.
Culturally sensitive professionals possess capacities
for warmth, empathy, and genuineness.
(Flaskerud, 2007).

Cultural Competency in Nursing

Cultural desire: want to be competent

Cultural awareness : self exploration

Cultural skill: ability to collect data

Cultural encompasses: professioanl face to face
interaction

SUATU
PROSES
Frisch & Frisch, 2007)

Daftar Pustaka

Dogan, H., Tschudin, V., Hot, I., & Ozkan, I. (2009). Patients transcultural needs and carers ethical responses. Nursing Ethics.
16(6), p. 683-696
Flaskerud, J., H. (2007). Cultural competence: What is it?. Issues in Mental Health Nursing, 28:121123.
Hidayat, R., S. (2002, December). Women in Indonesia: Between ethnicity and
meeting of Women in Asia: Issues and Concerns, Chennai.

religiosity. Seminar conducted at the

Horikoshi-Roe, H. (1979). Mental illness as a cultural phenomenon: Public tolerance

moslem Sundanese in West Java.
Indonesia, 28, 121-138.

and theurapeutic process among the

Jirwe, M., Gerrwish, , K., & Emami, A. (2010). Student nurses experiences of communication in cross-cultural care encounters.
Scanadian Journal of Caring Sciencies, 24; 436-444.
Niehof, A. (1998). The changing lives of Indonesian women: Contained emancipation under pressure. Leiden, 2, 236-258.
Okasha, A. (2007). The individual versus the family: An Islamic and traditional
societies perspective. In J. Cox., A. V.
Campbell, & B. Fulford (Eds.),
Medicine of the person (pp. 110-124). Philadelphia, PA: Jessica Kingsley.
Suryani, E. (n.d). Pandangan hidup orang sunda. Retrieved January, 18, 2011 from
content/uploads/publikasi_dosen/
Adat&PandanganHidupOrangSunda.pdf.

http://resources.unpad.ac.id/unpad-

Wickberg, A. & Eriksson, K. (2008). Intercultural caring an abductive model. Scanadian Journal of Caring Sciencies 22;
485496

Zevalkink, J., Riksen-Walraven, J. M., & Lieshout, C. F. M. Van. (1999). Attachment

Development, 8(1), 21-40.

in Indonesian caregiving context. Social

TUGAS

Mahasiswa ditugaskan melakukan literatur review

tentang aplikasi praktek komunikasi terapeutik
yang peka budaya
Tugas dipresentasikan di kelas minggu depan.

TERIMAKASIH