TRANSCULTURAL NURSING
 They honor and value loyalty to
FINALS
Cultural Practices of Different Races
ASIANS
 Body build is petite, thin
Communication
 Languages include Chinese, Japanese,
Korean, Vietnamese, and English
 Silence is valued
 Especially the Chinese
 Filipinos are loud
 Know personal space
 Eye contact may be considered
inappropriate or disrespectful
 Koreans and the majority of Asians
practice this
 This means that when you look at
their eyes you are at their
level/overpowering them
 Look slightly below (bridge of the
nose or lips)
 Filipinos have no problem with eye
contact
 Criticisms or disagreements are not
exposed verbally
 Head nodding does not necessarily mean
agreement
 The word “no” may be interpreted as
disrespect for others
Time Orientation and Personal Space
 Time orientation reflects respect for
the past but includes emphasis on the
present and the future
 Asians respect and value time
 When you say that you will be going
back at a specific time, go back to
that time
 Usually, members do not touch others
during conversations
 Ask permission first if needed
 Touching is unacceptable with members
of the opposite sex
 Male nurses are assigned to male
patients and female nurses are
assigned to female patients
 The head is considered to be sacred
 When you touch someone’s head it
means disrespectful
Social Roles
 Large extended family networks
common
 Family-oriented people
immediate and extended family
 The family unit is structured and
hierarchical
 Most Asians practice patriarchal
families
 Men have the power and authority
 They are the breadwinners, makes
decisions for the family
 Women are expected to be obedient to
men
 Education is viewed as important
 Religions include Taoism (Buddhism),
Islam, and Christianity
 Social organizations are strong within
the community
Health and Illness
 Health is a state of physical and
spiritual harmony with nature and
balance between positive and energy
forces
 Chinese: yin (femaleness, darkness,
earth) and yang (heaven, light,
maleness)
 A healthy body is viewed as a gift from
the ancestors
 illness is viewed as an imbalance
between the positive and negative
energy
 Yin foods are cold and yang foods are
hot
 Fever: yin foods (balance)
 Illness to attributed to prolonged
sitting, lying, or overexertion
 Moderate work is the standard
 Filipinos
 albularyo, tapal
 Usog (bati): laway is life; “puwera
usog” for countereffect
 Tuko: placed inside a fishnet
Health Risks
 Hypertension
 Asians like meat and salty foods
 Heart diseases
 Diabetes (fond of sweets)
 Cancer (colorectal cancer d/t spicy and
raw foods)
 Lactose intolerance
 Blood disorders: Thalassemia
Interventions
 Avoid physical closeness and excessive
are
touching
 Unless necessary e.g., performing
procedures
  But inform the client that you will  Members believe illness can be
be touching a body part prevented by nutritious meals, rest,
 Limit eye contact and cleanliness (body & environment)
 Avoid gesturing with hands
Health Risks
 If possible, a female client prefers
female health care providers and male  Sickle-cell anemia (crescent-shaped
nurses to a male client RBCs)
 Be flexible in scheduling care  Hypertension
 They do not want rigidity when  Heart disease
scheduling care (Asians do not like  Stroke
structure)  Cancers except for skin cancer d/t
 Alternative modes of healing may melanin
include herbs, acupuncture, restoration  Lactose intolerance
of balance with foods, massage, and  Diabetes mellitus
offering of prayers and incense
 Encourage family involvement in the Interventions
care of the patient  Recognize the presence of many
individual subgroup variations
AFRICANS  Build a relationship based on trust
 Clarify the meaning of the client’s
Communication verbal and non-verbal behavior
 Members are competent in standard  They do not like rigid scheduling of
English care, be flexible in scheduling
 Head nodding does not necessarily mean  Encourage family involvement in care
agreement
 Alternative modes of healing may
 Direct eye contact may be interpreted include herbs, prayers, and laying of
as rudeness or aggressive behavior hands
 Be observant when it comes to their
nonverbal cues EUROPEANS
 Nonverbal cues are important because  Body build is large and broad
they are not expressive
 Personal questions asked on initial Communication
contact with a person may be viewed as  Languages include national languages
intrusive and English
 Explain well the importance of  Silence can be used to show respect or
health history taking and why disrespect for another, depending on
certain information is asked the situation
 Eye contact is viewed as indicating
Time Orientation and Personal Space
trustworthiness
 Members may be late for an appointment
because relationships and events may be Time Orientation and Personal Space
deemed more important than being on
 Members are future-oriented
time
 Time is valued
 Members are comfortable with close
personal space when interacting with  Fast workers
family and friends  Always on time
 Gets impatient when a person is not
Social Roles on time
 Large extended family networks are  Waiting is a waste of time
important  Members may be aloof and tend to avoid
 Many households are headed by single- physical contact
parent women  When a patient requests to be alone,
 Religious beliefs and church respect the decision
affiliations are sources of strength  Handshakes may be used for formal
greetings
Health and Illness
 Religious beliefs profoundly affect Social Roles
ideas about health and illness  The nuclear family is the basic unit
 The elderly are placed in nursing
homes
 The man is the dominant figure  Members are comfortable with close
 But it depends on the variation of proximity with family and friends,
culture acquaintances
 Religion includes Judeo-Christian  Allow visitors unless
beliefs contraindicated
 Community social organizations are  Involve family members in decision
important making in regards to their care
 Members are very tactile and use
Health and Illness embraces and handshakes
 Health is usually viewed as an absence  Embraces are used for greeting
of disease or illness (clinical model)  Value physical presence of others
 Members tend to be stoical when  Politeness and modesty are essential
expressing physical concerns
 Does not show or express emotions Social Roles
and physical pains  The nuclear family is the basic unit
 Members primarily rely on modern  But still takes high regard to the
western health care delivery system extended family
 Value large extended family networks
Health Risks
 Needs of the family take precedence
 Diabetes mellitus (they are fond of over individual family members’ needs
carbohydrates) (family oriented)
 Cancer  Men are the decision-makers
 Heart disease  They are the breadwinners
 Injury (physical d/t work)  Women are homemakers and caretakers
 Religions include Catholicism,
Interventions
Evangelicalism, Jehovah’s Witness, and
 Monitor and assess client’s body Mormons
language
 Social organizations and church
 They do not express if they feel affiliations are strong within the
pain community
 Respect client’s personal space
 Europeans are usually aloof Health and Illness
 Health may be a reward from God
HISPANIC AMERICANS  Health is also a sign of good luck
 Health results from a state of balance
Communication between “hot and cold” forces and “wet
 Languages include Spanish and and dry” forces
Portuguese  Illness may be viewed as a result of
 Members tend to be verbally expressive God’s punishment for sins
 But value confidentiality  Members may adhere to folk medicine
 Avoiding eye contact with a person in traditions
authority indicates respect and
attentiveness Health Risks
 To signify authority  Lactose intolerance
 Direct confrontation is disrespectful  Diabetes mellitus
and the expression of negative feelings  Parasites (diet is usually raw foods)
is impolite  Hypertension
 Dramatic body language is used to  Heart disease
express emotion or pain
 Gestures, facial expressions are Interventions
used to express emotions and pain  Allow time for the client to discuss
 Observe their body language treatment options with family members
 Protect privacy
Time Orientation and Personal Space
 Offer to call clergy because of the
 Members are oriented more to the significance of religious practices
present related to illness
 Members may be late for an appointment  Ask if it would be all right to touch a
because relationships and events are child before examining him or her
valued more than being on time
 Be flexible in scheduling care  Community social organizations are
 do not want rigidity/structured care important
 be lenient
 Herbs, consultation with lay healers
(alternative modes of healing)
Health and Illness
 Diet between hot and cold foods
 Health is a state of harmony between
should be balanced
the person, the family, and the
 Religious medals for faster healing environment
 Prayers as part of the healing  A healthy relationship with the
process family
 If there is a conflict between the
NATIVE AMERICANS
family, they are not healthy
Communication  Should be a healthy environment as
well
 Languages include English, Navajo, and
other tribal languages  Individual, family, and people
surrounding you should be balanced
 Silence indicates respect for the
speaker  Illness is caused by supernatural
forces and disequilibrium between
 Do not interrupt the speaker
person and environment
 Let them speak first
 The conflict between the people and
 Members speak in a low tone of voice the environment
and expect others to be attentive
 An imbalance between the person,
 Value listening and attentiveness family, and the environment results
 A high tone of voice is a sign of in illness
disrespect, aggressiveness, rudeness  Traditional health and illness beliefs
 Eye contact is viewed as a sign of may continue to be observed, including
disrespect natural and religious folk medicine
 Body language is important tradition

Time Orientation and Personal Space Health Risks

 Oriented more to present
 Personal space is important
 Ask permission to knock, touching
body parts
 Members will lightly touch another
person’s hand during greetings
 Vigorous handshakes are not allowed
 Massage is used for the newborn infant
to promote bonding between infant and
mother
 Some tribes may prohibit touching of a
dead body
Social Roles
 Members are family-oriented
 The basic family unit is the extended
family
 Elders are honored
 Grandparents are viewed as family
leaders
 They teach children to respect this
tradition
 The father does all the work outside
the home, and the mother assumes
responsibility for domestic duties
 Sacred myths and legends provide
spiritual guidance
 Alcohol abuse
 Injury
 Heart disease
 Diabetes mellitus
 Tuberculosis
 Arthritis
 Lactose intolerance
 Gallbladder disease
 American Eskimos are susceptible to
glaucoma
Interventions
 Clarify communication
 Understand that the client may be
attentive even when eye contact is
absent
 Be attentive to own use of body
language
 Obtain input from members of extended
family
 Encourage the client to personalize
space in which health care is delivered
 Alternative modes of healing include
herbs, restoration of balance between
the person and the universe, and
consultation with traditional healers