2.1 Concepts in Culture
- Culture consists of the characteristic beliefs, values, customs, behaviors, and artifacts shared by a particular group of people. Conversely, race is used to group people by certain physical or geographical characteristics, and it is a social construct.
- Culturally sensitive nurses recognize and respect their patients’ diverse backgrounds and tailor care to meet each person’s specific needs and preferences. Although they recognize that generalizations about cultural groups may be valid and used to guide practice, they avoid stereotypes (widely held but oversimplified assumptions about groups).
- Cultural competence is the ability of health-care professionals to provide effective care to patients from diverse cultural backgrounds. It has become a focus in nursing practice, reflecting the growing recognition of the influence of culture on health care. Embracing cultural competence as an ongoing journey is crucial for nurses to provide patient-centered care in an increasingly multicultural society.
- Cultural humility takes cultural competence a step further. It is an attitude of openness, self-reflection, and lifelong learning regarding cultural differences. Cultural humility enhances equitable care, promotes social justice, and works toward reducing health-care disparities by asking nurses to recognize and challenge their own biases, practice respectful and nonjudgmental attitudes, and strive for equitable and patient-centered care.
- There are many reasons for nurses to deliver culturally sensitive care, including improved communication and increased trust between patients and caregivers, improved outcomes for patients, and a reduction of health disparities in society.
2.2 Cultural Assessment
- Completing a cultural assessment helps the nurse identify unique needs the patient may have.
- Giger and Davidhizar’s Transcultural Assessment Model provides a best practice on how to conduct a comprehensive and culturally sensitive assessment by collecting data on the impact of cultural factors on health beliefs, health care–seeking behaviors, and treatment preferences.
- Factors such as language barriers, nonverbal cues, culturally appropriate communication styles, understanding cultural perspectives on time, and the perception of illness are important to include in a cultural assessment and care.
- Cultural assessment can illuminate differences in concepts of time, space, communication, social organization, environmental control, and biological variations.
- Leininger’s Cultural Care Diversity and Universality Theory emphasizes the importance of cultural factors in providing effective and culturally competent care. Her Sunrise Model helps nurses recognize culturally specific needs and the necessity for collaboration between the nurse and patient to accommodate those needs. This is culturally congruent care.
- Josepha Campinha-Bacote’s Process of Cultural Competemility in the Delivery of Healthcare Services combines the ideas of “competence” and “humility” to create the concept of competemility. This encourages health-care providers to self-reflect on questions aimed at providing care that transcends cultural competence and addresses personal biases.
- A cultural assessment identifies the patient’s health beliefs and practices to help the nurse provide individualized care, improve communication, and foster trust. In addition, a cultural assessment complies with legal and ethical standards, promotes interdisciplinary collaboration, and addresses health disparities.
2.3 Health Equity and Disparities
- Health equity is the condition in which all people have a fair opportunity to achieve optimal health and receive appropriate, high-quality care regardless of their social or demographic characteristics. Health disparities are differences in health outcomes and access to health care between different population groups.
- Social determinants of health are the conditions in which individuals are born, live, work, and age. They impact access to and the ability to afford health care, safety and security, nutritional status, lifestyle choices, stress levels, and health literacy, to name a few.
- Factors that impact health include nutrition, holidays observances, educational beliefs, and risk factors for illness.
- Nurses can help decrease health-care disparities through culturally competent patient care, supporting their organization with increasing health-care access, and supporting legislation that addresses health-care disparities in the community.