Cultural Assessment - Transcultural Nursing

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.