TRANSCULTURAL

NURSING
Done by:
Hawraa Ali
Fatima Ebrahim
Zahraa moh’d
Sara al buraik
Walaa essam
Ahmed mahdi
Hamad kawan
 Objectives
By the end of this presentation you will be able to :

1. Recognize the meaning of culture and other Key Terms:

o Race
o Ethnic group
o Ethnicity
o Cultural diversity
o Subcultures
o Micro cultures
o Ethno relativism
o Ethnocentrisms
 The Meaning of Culture

 Beliefs, values, and behavior shared by members of a

society; they provide a design or “roadmap” for
living.
 According to Giger and Davidhizar, (2008,p.3)“A
patterned behavioral response that develops over time
as a result of imprinting the mind through social and
religious structures and intellectual and artistic
manifestations”
 Can culture impact your neurobiology?

Culture is a way of organizing and thinking about life , It gives people a sense
of security about their behavior and help them to act.
It provides the underlying values and beliefs on which people’s behavior is
based..
It might influence a person’s response to authority figures, dictates religious
beliefs and practices, and shapes child rearing.
All individual members believe and act based on what they have learned
within the specific culture.
 Race

Refer to the biologically designated groups of people whose

distinguishing features, such as skin color, are inherited.
 Ethnic group

Is a collection of people who have common origins and a shared

culture and identity; they may share a common geographic origin,
race, language, religion, traditions, values, and food preferences
(Spector, 2009).

6
 Ethnicity
Group of qualities that mark ones association with a particular
ethnic group or “who share cultural and/or physical characteristics
including one or more of the following: history, political system,
religion, language, geographical origin, traditions, myths,
behaviors, foods, genetic similarities, and physical features
(Ethnicity Online, 2010).
 Cultural diversity
Also called cultural plurality” means that variety of cultural
patterns coexisting within a designated geographic area”.

Factors some times contributing to cultural diversity:

• Immigration over the years have contributed to cultural
diversity.
• Refugees from other countries.

21-Feb-19 8
 Sub culture
Relatively large aggregates of people within a society sharing
separate distinguishing characteristics.
e.g.
Ethnicity: Arab Christians and Arab Muslims , African American ,
Hispanic American.
Occupations: Farmers, Physicians.
Religion: Catholics, Muslims
 Cont.

• Geographic area: New Englanders , Southerners.

• Age: Elderly, school- age children.

• Gender: Men, women.

• Sexual preference : gay , lesbian.

 Other terms- Micro cultures

Microcultures: They are “systems of cultural knowledge

characteristic of subgroups within larger societies. Members of
micro culture usually share much of what they know which
everyone in greater society but possess a special cultural
knowledge that is unique to the subgroup”
 Micro cultures

• Some of their beliefs and practices -like food they eat, the language they speak at
home, ideas about sickness and healing remain the important part of everyday
life.

Eg. Indian American , Mexican Americans, Irish Americans, Swedish Americans etc.
 Other terms- Ethnocentrism

“ is the belief and feeling that one’s own culture is best. It reflect our tendency
to judge others peoples belief and behavior using values of our own native
culture”

Ethnocentrism block effective communication, how?

By creating biases and misconception about human behavior.
https://youtu.be/BSb4jdBI688
 Other terms -Ethnorelativism
Seeing all behavior in a cultural context. Some people may stop progressing and
remain stagnated at one step and the others may move backward on the
continuum.
https://play.kahoot.it/v2/?quizId=bea77944-6732-4711-9bdd-ebbf2a0da4
7f
Ethnocultural Health Care
Practices
Fatema Ebrahim Mohamed
Objectives:
• By the end of this presentation, we will
1. Discuss how various geographic or ethnocultural groups view health
care.
Biomedical view
Magicoreligious view
Holistic view

2. Discuss select folk medicines, home remedies and complementary

therapy.
 Introduction:
Biomedical
Views
• Beliefs bout the causes and effects
of illness, health practices and
Ethnocultural Magicoreligious
health – seeking behaviors are all views Views

influence by a persons, a group, or

community’s perception. Holistic Views

Biomedical view

• It relies on scientific principles and see disease and injuries as life

events controlled by physical and biochemical processes that can be
manipulated through medication, surgery, other treatment.

• e.g.: elements such as bacteria , fungi or viruses are causes of illness.

Magicoreligious view

• Religious beliefs, an individual’s

spirituality and how these factors
interface with feeling of wellness.

• Some cultures
Disease occur as a result of ‘ committing
sins’ or going against God’s will’.
Holistic view

• Being in harmonious balance.

• To be healthy, all facet of individual’s nature ( physical, mental,

emotional and spiritual) must be balance.
Folk medication and home remedies

• Folk medication: is a body of preserved treatment practices that has been

handed down verbally from generation to generation. ( traditional medication)

• It exists today as the first line of treatment for many individuals.

• E.g.: taping coins over a newborn’s umbilical area to prevent hernia.

Folk medication and home remedies
• Home remedies: are individualized caregiving practices that are
passed down within families.

• E.g.: margadoosh for stomachache in children.

activity
Complementary therapies
• Also called alternative medication or alternative therapies are practices
used to complement medication and nursing care to promote comfort,
health and well being. The range of therapies include:

 therapies ( cancer diets, juice diets, fasting)

Treatment ( coffee enemas, high colonic enemas)
Exercise activities (yoga)
Exposure ( aroma therapy, music therapy)
Manipulation ( acupuncture, acupressure, reflexology)
Integrated health care

• Is defined as the combination of complementary therapies with

biomedical and western health care.
 Consumers need to be well informed regarding efficacy and safety of complementary therapies and how
they can complement other treatment
e.g.: music therapy to promote relaxation
To sum up..
1. ethnocultural groups view health care.
Biomedical view
Magicoreligious view
Holistic view

2. Define folk medicines, home remedies and complementary therapy.

The Objective
2- Discuss the characteristics of culture:
Learned culture
Integrated culture
Shared culture
1-Learned culture

The patterns of behavior are not

1-Learned culture
1-Patterns of cultural behavior are acquired (not inherited).
1-Learned culture

2- Enculturation: the process that

3-The process and results of the
individuals learn their group's
learning of culture are different for
culture, through experience,
each person.
observation, and instruction.
 1-Integrated culture

2-Various components of culture, e.g.

1-Culture is holism and all parts of culture
its religious beliefs perform separate
are interrelated, interdependent and
functions but come into relative
interconnected.
harmony with each other to form an
operating and cohesive role.
4-Shared culture

1-To learn a language, behavior, or

tradition often involves interacting with
other people. Thus, culture is
largely shared.
4-Shared culture

1-The most important element among culture is the value.

Value: it is principles or standards of behavior.

2-Other members of the same culture frequently influence health behaviors and
sometimes difficult to change unhealthy behavior.
Summary
The Objective
1. Explain the concepts of Tacit and
Dynamic Cultures.
2. Discuss the health problems and
beliefs of the native American
culture and the African American
culture.
5- Culture is Tacit
5. A culture that’s unexpressed and at the unconscious level.
 6- Culture is Dynamic
6- Each culture is in a dynamic state of adding or removing components, functional aspects are retained,
less functional ones are eliminated
Cultural Community
Native American Indians, Eskemo Communities:
Native Americans have their own health care system HIS. Constitute 2.4% of the GenPop.
 Health Problems:
 Children: 1. SIDS 2.Obesity 3.type 2 diabetes. 4. intentional and unintentional injuries (Motor Vehicle Accidents).
 Adults: 1.Diabetes. 2-TB. 3.Obisity 4. Alcoholism.
 Why?
 Poor Sanitation. Overcrowded Housing. Low immunization levels. Low tolerance for alcohol.

 Health Beliefs and Practices:

 They prefer to seek a medicine man.
 Depend on natural and spiritual healing.
 Believe the earth is a living organism that deserves respect
so does the body.
 Purification Rituals. (Immersing in Water..)
 Herbs and plants for healing
 Oppression and racism has caused mistrust that he nurse
has to overcome.
Cultural Community cont.
African American/ Blacks Communities:
1/3 of African American around the age of 18 Years. They make up 15.4% of GenPop.
 Health Problems:
 Cardiovascular disease. Cancer. Stroke.DM. Cirrhosis
 Why?
 Stress. Discrimination. Poverty. Lack of education. High rates of teen pregnancy.in adequate housing.
HIV. Inadequate health care.

 Health Beliefs and Practices:

 Religion.
 Evil is sickness and that is punishment for a bad deed.
 Take natural remedies and ointments.
 Healing is through devotion to god.
 Wearing talisman and copper to ward off evil.
 Black magic going back to ansestrial times.
Summary
Objectives :
By the end of this prestation you will be able to :

1- identify population characteristics, health problems, health beliefs

and practice for Asian culture .

2- identify population characteristics, health problems, health beliefs

and practice for Hispanic culture

3- identify population characteristics, health problems, health beliefs

and practice for arab population and muslims.
Asian American
 Population characteristics and culture

- 16 million Asian and pacific islander were living in the united states .
Representing 5.3% of the population.

- Each group represent a distinct culture with its own unique challenges for
community health nurse

- each Asian culture is distinct in language, values and customs.

- This culture share some general traits

 Health problems
: Leading cause of death

cancer-
heart disease-
stroke-

: Health problems

Malnutrition - Arthritis -
TB - Parasitic infestation -
Mental illness - Chronic disease associated with -
Cancer - aging
Respirotry infections - -
 Health beliefs and practices
Many beliefs in yin(cold) and yang(hot)
A balance between yin a yang result in “qi” the desired state of harmony.

Western medicine “hot”

Eastern folk medicine and herbal treatments “cold”
(some groups practice both for balance )

- some Groups (Filipinos ) view illness as an act of god and pray healing

- Many have traditional healer (depend on the culture ) ; acupuncturists herbalists, herp
pharmacist.
- Most Asian exercise traditional self care practices ; herbal medicines, type of acupuncture ,
massage.
- Southeast Asian practice dermabrasive techniques; coining, cupping, pinching, rubbing,
burning
Hispanic American
 Population characteristics and culture
The subgroups of Hispanics vary by their patterns of geographic distribution in the united
status

47 million Hispanics in the united states , 15% of the population

Are the fastest growing and largest ethnic group in the united states

Uses Spanish as its common and primary language

They have lower achievement of high school diploma compared with whites

Hispanic have the highest uninsured rate of any racial/ethnic group with 32.1% not coverd
by any health insurance

Families have generally patriarchal

 Health problems
Leading cause of death :

- Cancer
- Stroke
- Diabetes
- Heart disease

Health problems:
- TB
- Hypertension
- Obesity
- COPD
- Liver disease
- AIDs
- Pneumonia
- Gastroenteritis
 Health beliefs and practice

Catholicism is the dominant religion.

Hispanics believe that illness maybe a form of castigo or
punishment from god . Ex: solito

Latino culture belief witchcraft and evil eye are supernatural causes
of illness that cannot be treated by anglo or western medicine

”empacho” a stomachache in children that occurs after a traumatic

event. Is treated with herbal mixture made into teas.

They use (hot and cold) categories of food influence their diet
during illness.
Arab culture and
Muslims
The number of people from Arabic countries in the US is small, but because of the
terrorist and the wars in the middle east the number increased.

4 million people of Arab descent live in the US

Arabs are largely Christians or Muslims , some are Jews or Druze.

 Population characteristics and culture
The belief and practices of people cannot be encompassed into the culture .
More liberal in following traditional (not all countries ).
Arab are mostly value western medicine, trust American health care worker and do not
seek medical care.

Several practice are unfamiliar to most Americans

Modesty is one of the core values for Arabs it is expressed by both gender, although
more evidently by female

All sexual contacts outside the marital bond are considered illegal.

The practice of female genital mutilation , which mistakenly related to the Islamic
religion.
 Health problems

Life style related :

1- poor nutritional practices (obesity)
2- smoking
3- lack of physical exercise

-Oral cancers ( chewing tobacco )

- Malaria
- TB
- Hepatitis
- Parasitic infection

Pregnancy can be complicated by genital mutilation which result in infection and difficult
deliveries
 Health beliefs and practices

Muslims believe in predestination.

”Sharaf” or honor , is an important concept in Arab beliefs ( drug addiction, mental

illness, unwed pregnancy) of a family member bring the shame the family.

When someone do something good or an achievement that honor reflect all the family.
Cleanliness is paramount and ritualistic .

Muslims fast during Ramadan from sunrise to sunset.

Muslims pray several time a day , home visit should be planned to not interrupted
prayers.
 Guideline for nurses working with all immigrant groups

1- make no assumption about a client’s understanding of health

care issues

2- permit more time for interviewing; allow time to evaluate beliefs

and provide appropriate interventions

3- provide educational program to correct any misconception

about health issues; this can occur in clinics, mosques or schools

4- provide an appropriate interpreter to improve communication

with immigrants who do not speak English well.
Transcultural community
health nursing
principles
Objectives :
- Recognize the importance of transcultural nursing.

- Identify the transcultural community health nursing principles.

Transcultural nursing :
is provide culturally sensitive nursing services to people of deferent
ethnic and racial background.

Importance ?!
The nurse must avoid ethnocentric attitudes and understand cultural
differences when serving and working with others. So, its important
to develop knowledge and skills in serving multicultural clients.
Principles :
- develop cultural self awareness.
- Cultivate cultural sensitivity.
- Assess the client groups culture.
- Show respect while learning about other cultures.
- Examine culturally derived health practices.
Develop cultural self awareness:
Cultural self awareness is recognizing the values, beliefs and practices
that makes up ones own culture.

Self awareness is important for the nurse because :

- - The nurses become sensitive to the impact of culturally based
responses.
- - Help the nurse to understand the importance of culture for others.
Cultivate cultural sensitivity :
After developing self awareness , the second step is to recognize the
differences between cultures and develop culture sensitivity.

To do that , the nurse need to understand the clients point of view by

listening, observing and gradually learning about other cultures.

Building a trusting relationship by showing interest and concerns is the

main step to allow sharing concerns and beliefs.
•Thank you
Objectives
By the end of this presentation you will be able to

1- differentiate between different types of transcultural health

nursing principles.
Asses Clients
Group’s Culture
•To learn client’s culture like beliefs, values and
ideas
•E.I some culture does not eats meats or drinks
milk.

•Instead of making assumptions and judging

client’s behavior the nurse first must learn about
the culture that guides that behavior
Giger and Davidhizar
Transcultural Assessment Model
• Ethnic or racial background
• Language and communication patterns
• Cultural values and norms
• Bicultural factors
• Health beliefs and practices
Respect and patience
• Respect is the first behavior

• Minority Group part of population that differs

from the majority and often receives different
and unequal treatment.
• Cultural relativism: recognize and respecting
alternative viewpoints and understanding
values, beliefs and practices within their cultire
content
Culturally Derived
Health practices
• Scrutiny of the client group’s cultural practices
as the effect group’s health status.

• E.i some practices are beneficial in the

psychological and physical health but some
times it might be harmful for their health.