SECTION IV. TRANSCULTURAL FACTORS INFLUENCING NURSING CARE

Transcultural nursing refers to the nursing care of all patients, taking into consideration their religious and sociocultural backgrounds. There are many variables to consider in giving nursing care to a person of a race, religion, or culture different from your own. Respect for the patient, however, is something all aspects of transcultural nursing have in common.

• Nutrition and dietary practices.

• Beliefs about illness, its causes and cures.

• Disorders specific to a particular group, such as the high incidence of sickle cell anemia among the Blacks.

• Specific anatomical characteristics (e.g, stature, skin tone, hair texture).

• Religious beliefs about illness and death.

Some of the factors are:

• Cultural background of the nurse; differences and similarities between the patient and the nurse.

• Definition of health and illness accepted by a specific culture; concepts relating to the causes of illness and injury.

• Folk medicine practices.

• Attitudes toward health care, relationships, and interactions (e.g., personal space, eye contact).

• Economic level of the patient and family (socioeconomic status).

• Environmental factors and related disorders (e.g., ghetto living, lead poisoning).

• Specific names and terms related to the illness or disorder (e.g.,"bad blood," "mal ojo"); use of slang.

• Language differences between the health care staff and the patient and family.

• Modesty and concept of the human body.

• Reactions to pain, aging, and death.

• Attitudes about childbirth, abortion, sexual expression, children born to unmarried parents, and homosexuality.

• Attitudes about mental illness and retardation.

• Diets in relation to religious and cultural practices; dietary taboos.

• Attitudes about physical appearance and obesity; adaptation to special therapeutic diets.

• Importance of religion and religious practices.

• Religious practices in illness and death; specific prohibitions.

• Group identity; importance and type of family structure; cohesiveness within the group; traditional roles of men and women.

• "Visibility" of ethnic background (that is, Black, Oriental).

• Disorders specific to a cultural group (that is, Tay-Sachs, sickle cell anemia).

• Attitudes about school; educational level and aspirations of most members of the group.

• Predominant occupations within the group; role models.

• "Americanization" of younger members.

• Numbers of people belonging to that group in the same geographic area as the health care facility.

• Prejudices within a cultural group relating to other members of the same group.

• Stereotypes about other cultural/ethnic groups.

• Mixed families (mixed races, religions, or cultural backgrounds).

Japanese Shintoist.

• Man is inherently good.

• Illness is caused when the person comes into contact with pollutants, such as blood or a corpse.

Native Americans. Native Americans follow these three concepts:

• Prevention.

• Treatment.

• Health maintenance.

The person's health is defined in terms of the person's relationship with nature and the universe.

Blacks and Raza/Latino cultures have long used roots, potions, and herbs for treating illnesses.

Filipinos and Raza/Latino groups believe that:

• Hotness and coldness, wetness and dryness, must be balanced to be healthy.

• Certain illnesses are hot or cold, wet or dry.

• Certain foods and medications, classified as hot or cold, are added or subtracted to bring about a balance of humors or to fight off "hot" or "cold" illnesses.

Copper bracelets are worn by some groups as a preventive or cure for arthritis.

• The nurse should take into consideration the needs of people who practice folk healing. The folk healer (curandero in Spanish) should be allowed to see the patient.

• South Americans often wear chains to drive away evil spirits. The nurse should not remove these unless it is absolutely necessary.

• Native American women are not likely to seek early prenatal care. They believe that pregnancy is a natural, normal process; a clinic or a hospital is associated with illness.

• Many Latino patients believe that it is dangerous to bathe immediately after delivery. The nurse must remember this during postpartum care.

• Many cultural groups, such as Native Americans and Southeast Asians, believe that it is improper or impolite to look someone in the eye when speaking to him/her.