Culture and Ethnicity
 Values, beliefs, norms & practices of a
particular group
 Learned and shared
 Guide thinking, decisions, & actions in a
patterned way
Concepts of Culture and Ethnicity
 Culture – a set of values, beliefs & traditions that are held
by a specific social group and handed down from
generation to generation
 Subculture – made up of people with a distinct identity, but
who have certain ethnic, occupational or physical
characteristics that are found in the larger culture
 Dominant group – the group within the culture that has the
authority to control the value system.
 Minority group – usually has some physical or cultural
characteristic that identifies the people within it as different
“Despite being technically
competent, a nurse can be
incompetent, formulating
unworkable interventions because
of an unwillingness or inability to
understand the culturally different
patient.” (West, 1994, .232)
“Having knowledge of a culture before trying
to help a client and family is analogous to a
nurse or a physician having basic
knowledge of anatomy and physiology
before doing physical assessment or
attempting to meet a patient’s
physical needs.” Madeleine Leininger
 The sense of
identification that a
cultural group
collectively has, largely
based on the group’s
common heritage.
 Race – Subculture of
people characterized
by specific
 Culture Assimilation
– AKA acculturation
– When minority groups living within the dominant
group loose the cultural characteristics that
make them different.
– Stereotyping – involves assigning
characteristics to a group of people without
considering specific individuality.
 Cultural Imposition – the belief that
everyone should conform to the majority
belief system.
 Cultural conflict – when one ridicules others
beliefs and traditions in an effort to make his
or her own values more secure
Cultural and Ethnic Influences on
Health Care
 Gender Roles – It is important to
know who is the dominant figure
in a family
 Language and Communication
– Some clients may not be able
to speak the English Language
 Orientation to Space and time –
personal space
 Food and Nutrition
 Socioeconomic
 The culture of povertythe highest risk
families are headed by
one income single
females, fixed income
elderly and future
generations of those
living in poverty
 Feelings of despair, resignation
& fatalism
 Day to day attitude toward life
with no hope for the future
 Unemployment and need for
financial or government aid
 Use of escape values such as
alcohol and drugs
 Unstable family structure with
abusiveness and abandonment
 Decline in self respect and
retreat from community
Effects of Poverty on Health Care
 Lack of affordable and adequate housing
 Crowded living conditions
 The sick usually experience more
 Recovery time is longer
 Less likely to regain their preillness level of
 Lack of access to health care insurance
Family Support
 Some cultures have large extended families
and are unable to share private information
with anyone outside the family.
 Some cultures have great respect for elderly
and will not consider institutional care
Physical and Mental Health
 Physiologic Characteristics
– Keloid formation – overgrowth of connective
tissue that occurs during healing process of
injury, surgery—African heritage
– Lactose intolerance - lack of lactase to break
down lactose during digestion - Hispanic,
African, Chinese, Thai.
– Sickle Cell Anemia – sickle shaped red blood
cells. Most common in African or
Mediterranean ethnic background.
Tay Sacks Disease – a gene for a hereditary disorder – have
very short life span – Eastern European, Jewish descent.
G6PD deficiency – enzyme deficiency. Red blood cells have
no cell membrane they are easily destroyed , which leads
to anemia and increased billirubin levels. - 10% of African
American population
Thalassemia – genetic disorder effecting the Hgb in RBC
function. Mediterranean, Asian, and African origin.
Sarcoidosis – formation of multiple tubercles or nodules on
various parts of the body - African American population.
Gout – An increase of uric acid in the blood -males especially
from Puerto Rican or Filipino descent.
Psychological Characteristics
 In most situations an
individual will relate the
behavior of another person
to the individual’s own
familiar culture.
 It is important to remember
that what may seem
perfectly reasonable &
important to a client may
seem ridiculous and
irrelevant to a nurse. The
reverse perception may
also exist.
Culture Shock
 Feelings an individual
experiences when
placed in a different
and often strange
culture and may result
in psychological
discomfort or
Cultural Imposition and
 Cultural Imposition. – the
tendency for health
personnel to impose their
beliefs practices and
values of other cultures,
because they believe that
their ideas are superior.
 Ethnocentrism – the belief
that one’s own ideas,
beliefs and practices are
the best and superior.
Providing Transcultural Care
 Major Theme – Focus
on caring practices of
various cultures
 Nursing Role –
Understand the client’s
needs and to adapt
care to meet those
Cultural Assessment
 Identify factors that effect behavior by
cultural assessment
– Values, religion, dietary practices, family lines of
authority, family life patterns and beliefs and
practices related to health and illness
– See guidelines on pp 47 & 52
– See table 3-1 on page 48-51
Reaction to Pain
 Reactions are
culturally prescribed
……….. Let’s discuss
Different Health Practices
Folk Healers
less expensive, more
accessible and more
understanding of
cultural needs . Speak
the client’s language
Traditional Folk Medicine
Transcultural Nursing
 Nursing care planned and implemented in a way
that is sensitive to the needs of individuals,
families, and groups representing diverse cultural
 The culture of health care: Assess:
the cultural background
expectations and beliefs about healthcare
Cultural context of the encounter
Degree of agreement between the 2 persons set of
beliefs and values

Culture and Ethnicity