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    Cultural Assessment

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    MARY ANN PANGAN
    The document discusses Giger and Davidhizar's transcultural assessment model for providing culturally competent nursing care. It examines key cultural phenomena like communication, space, and time across different ethnic groups including Anglo-American, Mexican-American, Haitian-American, African American, and North American Indian cultures. Traditional and folk healers from various cultures are also reviewed. The document concludes with discussing biocultural variations in physical examinations and Leininger's three modalities for clinical decision making: cultural preservation, accommodation, and repatterning.

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    Cultural Assessment

    Uploaded by

    MARY ANN PANGAN
    106 views50 pages
    The document discusses Giger and Davidhizar's transcultural assessment model for providing culturally competent nursing care. It examines key cultural phenomena like communication, space, and time across different ethnic groups including Anglo-American, Mexican-American, Haitian-American, African American, and North American Indian cultures. Traditional and folk healers from various cultures are also reviewed. The document concludes with discussing biocultural variations in physical examinations and Leininger's three modalities for clinical decision making: cultural preservation, accommodation, and repatterning.

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    CULTURAL ASSESSMENT

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    The document discusses Giger and Davidhizar's transcultural assessment model for providing culturally competent nursing care. It examines key cultural phenomena like communication, space, and time across different ethnic groups including Anglo-American, Mexican-American, Haitian-American, African American, and North American Indian cultures. Traditional and folk healers from various cultures are also reviewed. The document concludes with discussing biocultural variations in physical examinations and Leininger's three modalities for clinical decision making: cultural preservation, accommodation, and repatterning.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    106 views50 pages

    Cultural Assessment

    Uploaded by

    MARY ANN PANGAN
    The document discusses Giger and Davidhizar's transcultural assessment model for providing culturally competent nursing care. It examines key cultural phenomena like communication, space, and time across different ethnic groups including Anglo-American, Mexican-American, Haitian-American, African American, and North American Indian cultures. Traditional and folk healers from various cultures are also reviewed. The document concludes with discussing biocultural variations in physical examinations and Leininger's three modalities for clinical decision making: cultural preservation, accommodation, and repatterning.

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    CULTURAL ASSESSMENT

    TOPICS
    • Giger and Davidhazer Model
    • Cultural Values and Cultural Care Meanings and
    Actions
    • Folk, Indigenous and Traditional Healers
    • Biocultural Variations in Health and Illness
    • Biocultural Differences in the Physical Examination
    GIGER AND DAVIDHIZAR’S
    TRANSCULTURAL ASSESSMENT
    MODEL
    GIGER AND DAVIDHIZAR’S TRANSCULTURAL ASSESSMENT MODEL

    • Is viewed as a culturally competent practice field that is


    client centered and research focused.

    • To deliver culturally sensitive care, the nurse must


    remember that everyone is unique and a product of past
    experiences, beliefs, and vales that have been learned
    and passed down from one generation to the next.
    SIX CULTURAL PHENOMENA
    • 1. Communication
    • 2. Space
    • 3. Social Organization
    • 4. Time
    • 5. Environmental Control
    • 6. Biological variations
    CULTURAL VALUES AND CARE
    MEANINGS AND ACTIONS
    ANGLO AMERICAN CULTURE (MAINLY U.S MIDDLE AND UPPER CLASS

    A) CULTURE VALUES
    • Individualism
    • Independence and freedom
    • Competition and achievement
    • Materialism
    • Technology dependent
    • Instant time and actions
    ANGLO AMERICAN CULTURE (MAINLY U.S MIDDLE AND UPPER CLASS

    • Youth and beauty


    • Equal sex rights
    • Leisure time highly valued possible
    • Reliance on scientific facts and numbers
    • Less respect for authority and the elderly
    • Generosity in time of crisis
    ANGLO AMERICAN CULTURE (MAINLY U.S MIDDLE AND UPPER CLASS

    B. CULTURE CARE MEANINGS AND ACTION MODES:


    • Stress alleviation by:
    – Physical means
    – Emotional means
    • Personalized acts
    – Doing special things
    – Giving individual attention
    ANGLO AMERICAN CULTURE (MAINLY U.S MIDDLE AND UPPER CLASS

    B. CULTURE CARE MEANINGS AND ACTION MODES:


    • Self reliance by:
    – Reliance on self
    – Becoming as independent
    – Reliance on technology
    • Health instruction
    – Teach us hot “to do” this care for self
    – Give us the “medical” facts
    MEXICAN AMERICAN CULTURE
    A) CULTURAL VALUES:
    • Extended family valued
    • Interdependence with kin and social activities
    • Patriarchal (Machismo)
    • Exact time less valued
    • High respect for authority and the elderly
    • Religion valued (many Roman Catholics)
    MEXICAN AMERICAN CULTURE
    A) CULTURAL VALUES:
    • Native foods for well being
    • Traditional folk-care healers for folk illnesses
    • Belief in hot-cold theory
    MEXICAN AMERICAN CULTURE
    B) CULTURAL CARE MEANINGS AND ACTION MODES:
    • Succorance (direct family aid)
    • Involvement with extended family
    • Filial love/loving
    • Respect for authority
    • Mother as care decision maker
    • Protective male care
    MEXICAN AMERICAN CULTURE
    B) CULTURAL CARE MEANINGS AND ACTION MODES:
    • Acceptance of God’s will
    • Use of folk-care practices
    • Healing with foods
    • Touching
    HAITIAN AMERICAN CULTURE
    A) CULTURAL VALUES:
    • Extended family as support system
    • Religion – God’s will must prevail
    • Reliance on folk foods and treatments
    • Belief in hot-cold theory
    • Male decision maker and direct caregivers
    • Reliance on native language
    HAITIAN AMERICAN CULTURE
    B) CULTURAL CARE MEANING AND ACTION MODES:
    • Involve family for support
    • Respect
    • Trust
    • Succorance
    • Touching
    • Reassurance
    HAITIAN AMERICAN CULTURE
    B) CULTURAL CARE MEANING AND ACTION MODES:
    • Spiritual healing
    • Use of folk food, care rituals
    • Avoid evil eye and witches
    • Speak the language
    AFRICAN AMERICAN CULTURE
    A) CULTURAL VALUES:
    • Extended family networks
    • Religion valued (many are Baptists)
    • Interdependence with “blacks”
    • Daily survival
    • Technology valued e.g. radio, car
    • Folk foods
    • Folk healing modes
    • Music and physical activities
    AFRICAN AMERICAN CULTURE
    B) CULTURAL CARE MEANINGS AND ACTION MODES:
    • Concern for my “brothers and sisters”
    • Being involved
    • Giving presence (physical)
    • Family support and “get together”
    • Touching appropriately
    • Reliance on folk home remedies
    • Rely on “Jesus to save us” with prayers and songs
    NORTH – AMERICAN INDIAN CULTURE
    A) CULTURAL VALUES:
    • Harmony between land, people, and environment
    • Reciprocity with “Mother earth”
    • Spiritual inspiration (spirit guidance)
    • Folk healers (shamans)
    • Practice culture rituals and taboos
    • Rhythmicity of life with nature
    • Authority of tribal elders
    • Pride in cultural heritage and “nations”
    • Respect and value for children
    NORTH – AMERICAN INDIAN CULTURE
    A) CULTURAL CARE MEANINGS AND ACTION MODES:
    • Establishing harmony between people and environment with reciprocity
    • Actively listening
    • Using periods of silence (Great Spirit” guidance)
    • Rhythmic timing (nature, land and people) in harmony
    • Respect for native folk healers, carers, and curers.
    • Maintaining reciprocity (replenish what is taken from Mother Earth)
    • Preserving cultural rituals and taboos
    • Respect for elders and children.
    HEALERS AND THEIR
    SCOPE OF PRACTICE
    I. CULTURE/FOLK PRACTITIONER
    A. HISPANIC
    • Family Member
    • Curandero
    • Espiritualista or spiritualist
    • Yerbero
    • Sabador
    I. CULTURE/FOLK PRACTITIONER
    B. BLACK
    • Old lady
    • Spiritualist
    • Voodoo priest or priestess or Hougan
    I. CULTURE/FOLK PRACTITIONER
    C. CHINESE
    • Herbalist
    • Acupuncturist
    I. CULTURE/FOLK PRACTITIONER
    D. AMISH
    • Braucher or Baruch-doctor
    • Lay midwives
    I. CULTURE/FOLK PRACTITIONER
    E. GREEK
    • Magissa, “magician”, boneseetters
    • Priest (Orthodox)
    I. CULTURE/FOLK PRACTITIONER
    F. NATIVE AMERICANS
    • Shaman
    • Crystal gazer hand trembler (Navajo)
    BIOCULTURAL DIFFERENCE IN
    THE PHYSICAL EXAMINATION
    BIOCULTURAL DIFFERENCE IN THE
    PHYSICAL EXAMINATION

    1. GENERAL APPEARANCE
    a. Physical appearance (age, gender, level of consciousness,
    facial features and skin color)
    b. Body structure (stature, nutrition, symmetry, posture,
    position and overall body build or contour)
    c. Assessment of mobility (gait and ROM)
    d. Behavior (facial expression, mood and affect, fluency of
    speech, ability to communicate ideas, grooming)
    BIOCULTURAL DIFFERENCE IN THE
    PHYSICAL EXAMINATION

    1. GENERAL APPEARANCE
    • Client’s dress for the following groups:
    1. Amish (solid colors, use of snaps or pins instead of
    buttons, bonnets cover the heads of the women)
    2. India – wear saris
    3. Arab- Muslim men - wear kafias (cloth headdress)
    and long robes
    BIOCULTURAL DIFFERENCE IN THE
    PHYSICAL EXAMINATION
    1. GENERAL APPEARANCE
    • Client’s dress for the following groups:
    4. Church of Jesus Christ of Latter-Day Saints (Mormons)
    Wear special white underwear called temple garments.
    2. SKIN
    • Mongolian spots
    • Jaundice
    • Pallor
    • Erythema
    • Petechiae
    BIOCULTURAL DIFFERENCE IN THE
    PHYSICAL EXAMINATION

    3. SECRETIONS
    • Most Asians and native Americans have mild to absent body
    odor
    • White and African Americans tend to have a strong body odor.
    4. HAIR
    • African Americans – fragile and long and straight, thick and
    kinky.
    • Asians – straight and silky hair.
    BIOCULTURAL DIFFERENCE IN THE
    PHYSICAL EXAMINATION

    5. EYES
    • African Americans – brown eyes
    • Scandinavian – blue eyes
    6. MUSCOLOSKELETAL SYTEM
    • African Americans – Long bones narrower and denser
    than the whites
    • Asians – is below than the white Americans.
    BIOCULTURAL DIFFERENCE IN THE
    PHYSICAL EXAMINATION

    7. Laboratory Tests
    • African Americans – brown eyes
    • Scandinavian – blue eyes
    6. MUSCOLOSKELETAL SYTEM
    • African Americans – Long bones narrower and denser
    than the whites
    • Asians – is below than the white Americans.
    CLINICAL DECISION MAKING AND
    NURSING ACTIONS
    • According to Leininger suggest 3 major modalities to
    guide nursing judgement:
    1. Cultural preservation – refers to “assistive,
    supporting, facilitative or enabling professional actions
    and decisions that help people of culture to retain or
    preserve relevant care values.
    CLINICAL DECISION MAKING AND
    NURSING ACTIONS
    • According to Leininger suggest 3 major modalities to
    guide nursing judgement:
    2. Cultural care accommodation and/or negotiation–
    refers to “those assistive, supporting, facilitative or
    enabling creative professional actions and decisions that
    help people of a designated culture to adapt to or
    negotiate to, or satisfying health outcome with
    professional careproviders.
    QUESTIONS?
    CLINICAL DECISION MAKING AND
    NURSING ACTIONS
    • According to Leininger suggest 3 major modalities to
    guide nursing judgement:
    3. Cultural care repatterning and/or restructuring– refers
    to “those assistive, supporting, facilitative or enabling
    creative professional actions and decisions that help
    people of a designated culture to reorder, change or
    greatly modify their lifeways for new while respecting the
    clients cultural values and beliefs.

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