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Chapter: Medical Surgical Nursing: Perspectives in Transcultural Nursing

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Cultural Assessment - Transcultural Nursing

Cultural nursing assessment refers to a systematic appraisal or ex-amination of individuals, families, groups, and communities in terms of their cultural beliefs, values, and practices.

Cultural Assessment

Cultural nursing assessment refers to a systematic appraisal or ex-amination of individuals, families, groups, and communities in terms of their cultural beliefs, values, and practices. The purpose of such an assessment is to provide culturally competent care (Giger & Davidhizar, 1999). In an effort to establish a database for determining a patient’s cultural background, nurses have de-veloped cultural assessment tools or modified existing assessment tools (Spector, 2000; Leininger, 2001) to ensure that transcul-tural considerations are included in the plan of care. Giger and Davidhizar’s (1999) model has been used to design nursing care from health promotion to nursing skills activities (Giger & Davidhizar, 1999; Smith-Temple & Johnson, 2002). The infor-mation presented in this and the following general guide-lines can be used to direct the nurse’s assessment of culture and its influence on a patient’s health beliefs and practices.

 

          What is the patient’s country of origin? How long has the patient lived in this country? What is the primary language and literacy level?

          What is the patient’s ethnic background? Does he or she identify strongly with others from the same cultural back-ground?

 

·      What is the patient’s religion, and how important is it to his or her daily life?

 

·      Does the patient participate in cultural activities such as dressing in traditional clothing and observing traditional holidays and festivals?

 

·      Are there any food preferences or restrictions?

 

·       What are the patient’s communication styles? Is eye contact avoided? How much physical distance is maintained? Is the patient open and verbal about symptoms?

 

·      Who is the head of the family, and is he or she involved in decision making about the patient?

·      What does the patient do to maintain his or her health?

 

·       What does the patient think caused the current problem?

 

·       Has the advice of traditional healers been sought?

 

·       Have complementary therapies been utilized?

 

·      What kind of treatment does the patient think will help? What are the most important results he or she hopes to get from this treatment?

·      Are there religious rituals related to health, sickness, or death that the patient observes?

 

Additional Cultural Considerations: Know Thyself

Because the nurse–patient interaction is the focal point of nurs-ing, nurses should consider their own cultural orientation when conducting assessment of the patient and the patient’s family and friends.

 

          Know your own cultural attitudes, values, beliefs, and practices.

          Regardless of “good intention,” everyone has cultural “bag-gage” that ultimately results in ethnocentrism.

          In general, it is easier to understand those whose cultural heritage is similar to our own, while viewing those who are unlike us as strange and different.

          Maintain a broad, open attitude. Expect the unexpected. Enjoy surprises.

          Avoid seeing all people as alike; that is, avoid cultural stereo-types, such as “all Chinese like rice” or “all Italians eat spaghetti.”

          Try to understand the reasons for any behavior by discussing commonalities and differences.

          If a patient has said or done something that you do not un-derstand, ask for clarification. Be a good listener. Most pa-tients will respond positively to questions that arise from a genuine concern for and interest in them.

          If at all possible, speak the patient’s language (even simple greetings and social courtesies will be appreciated). Avoid feigning an accent or using words that are ordinarily not part of your vocabulary.

          Be yourself. There are no right or wrong ways to learn about cultural diversity.

 

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