Culture, Family, and

Community

Presented By Group 5
Meet
The
MARA, ALEAGIEN MARIKIT, ALJANE
Group ROSE CUYOS

MELGAR, MARY NIADAS, ORJALEZA,

JEAN LAMOSTE NICEFORO FLURAMIE

PACE, JOFEL PONCE, KETH

PRANZA NICOLE
 Competent Nursing Care in Community Setting
Nurses practice in many settings:

Community worksites Schools Physician's office

Healthcare program public health

sites
Clinic Churches departments
 Competent Nursing Care in Community Setting

Cultural data

are prerequisite to
successful nursing
important in the care of intervention in community
clients nursing.

Cultural competence requires that the nurse understand the

family lifestyle and value system, as well as those
cultural forces that are powerful determinants of health-
related behaviors.
A Transcultural Framework

COMMUNITY-BASED NURSING PRACTICE

Focus
Community
(Client)

Effective community nursing practice must

reflect accurate knowledge of the causes and
distribution of health problems and of effective
interventions that are congruent with
the values and goals of the community.
 SOCIO-ECOLOGICAL APPROACH

can be used by the

COLLECT
community nurse to:

ORGANIZE

ANALYZE INFORMATION

Socio-ecological approach emphasizes

that health promotion should focus not only
on intrapersonal behavioral factors but
also on the multiple-level factors that
influence the specific behavior in question.
 Identify subcultures and devising specialized
community-based interventions

TRANSCULTURAL FRAMEWORK

helps the nurse to to devise community-

identify subcultures based interventions Interventions that are successful in one
within the larger that are specific to subgroup may fail with another subgroup of
community community health and the same community, and often, the failure
can be attributed to cultural differences or
nursing goals.
barriers that arise because of these
differences. Often, the community location of
a diverse subculture reflects distinctive
aspects of the cultural group.
 Identify the Values and Cultural Norms of a
Community
helps the nurse to
TRANSCULTURAL FRAMEWORK identify the values and
cultural norms of a
community
VALUES

are universal
features of all culture
serve as the community’s
acceptance and use of health
their types and expression vary widely, resources
even within the same community group’s participation in community-
based intervention programs to data
and collaborate with clients and
serve as the families to establish mutually
foundation for: acceptable goals for nursing care,
 Cultural Issues in Community Nursing Practice

Language

Diverse Client
Groups

Cultural Differences differences in health status or in

the distribution of health
resources between different
population groups, arising from
the social conditions in which
people are born, grow, live, work
and age.
Health Inequalities

Cultural Influences on Individuals and

Families

Values Norms

Beliefs Behavior

Cultural influences that

have profound effect on
health
 Cultural Influences on Individuals and
Families
The community nurse should carefully examine the following when assessing
individuals and families:

1. Family roles, typical family households and structure, and dynamics in the family,
particularly communication patterns and decision making.
2. Health beliefs and practices related to disease causation, treatment of illness,
and the use of indigenous healers or folk practitioners and other
alternative/complementary therapies.
3. Patterns of daily living, including work, school, and leisure activities.
4. Social networks, including friends, neighbors, kin, and significant others, and how
they influence health and illness.
5. Ethnic, cultural, or national identity of client and family, for example,
identification with a particular group, including language.
 Cultural Influences on Individuals and
Families

6. Nutritional practices and how they relate to cultural factors and health
7. Religious preferences and influences on wellbeing, health maintenance, and
illness, as well as the impact religion.
might have on daily living and taboos or restrictions arising from religious beliefs
that might influence health status or care.
8. Culturally appropriate behavior styles, including what is manifested during
anger, competition, and cooperation, as well as relationships with health care
professionals, relationships between genders, and relations with other groups in
the community.
 Subcultures or Diversity within
Communities

Lillian Wald, an early nurse leader,

founder of public health nursing, focused
on caring for diverse groups within the
community.

Home care was provided to inner city residents, particularly

recently arrived immigrants. Nurses who were not from the
same cultural background as their clients, deal with cultural
differences between themselves and the persons in their care.
(Degazon, 2012)
 The focus of community nursing is on diversity in the U.S across and within
subcultures.
Subcultures
Subcultures are values and
norms distinct from those of the
majority and are held by a group
within a wider society. In the
United States, subcultures might
include hippies, Goths, fans of
hip hop or heavy metal and even
bikers - the examples are
endless. One area of particular
interest has to do with deviant
subcultures.
"Distinctive patterns of living
with sets of rules, special values,
and practices that are different
from the dominant culture"
(Leininger, 1995, p.60).
There can be diversity within
each subculture.
Ex. Hispanic culture as a group
includes Mexican American,
Puerto Ricans, Dominicans,
Cubans, and Central and South
Americans.
 Refugee and Immigrant Population

Immigrants
An immigrant is someone from a
foreign country who relocates to live in
another country. They may or may not
be citizens. Immigrants move by choice
and due to promise of a better life.
The main reasons include better
economic conditions, education and
family reasons. However, they still have
a choice to return to their own country
at any time.
Refugee
Refugees are forced to
relocate for reasons such as
natural disasters, fear of
MOVER persecution or suffered
persecution due to at least one
of the following: race, religion,
nationality, membership of a
particular social group or
political opinion.

Many persons come to the United States, Canada, and Western Europe without the proper
documentation. In the United States, they usually referred to as "undocumented" migrants,
"illegal immigrants," or "illegal aliens."
"Illegal"
"Alien"

Show respect for the

undocumented immigrant as a
human being.
Be open-minded and aware of
these experiences.
Planning Nursing Care for Refugee Families and
Communities
Important Factors to Assess:
Length of time since the client and family left their country of origin

The different locations (countries/refugee camps) and no. of years spent

prior to resettlement.
Language spoken in the home and language skill in English.

Nonverbal communication style

Religious practices
Ethnic affiliation or identity
Family roles and how they are influenced by the resettlement experience.

Social support or networks, especially relatives/family members in the new

country
Maintenance of Traditional Cultural Values and
Practices

An important aspect of
transcultural nursing is the
collection of cultural data and the
assessment of traditional values
and practices and how they are
maintained over time.
How immigrants and refugees adapt and change over time in
a new country?

Assimilation
It refers to the degree to which
immigrants GIVE UP their CULTURE of
ORIGIN and TAKE ON the
characteristics of the NEW CULTURE.
Integration
A better term to describe the experience.
Acculturation
Acculturation is a process of cultural
contact and exchange through which a
person or group comes to adopt
certain values and practices of a
culture that is not originally their own,
to a greater or lesser extent. The
result is that the original culture of the
person or group remains, but it is

changed by this process.

It implies that an immigrant or refugee
incorporates certain aspects of the new
culture into his/her lifestyle, such as
language and food, while still maintaining
his/her cultural tradition and values.
 Assessment of Culturally Diverse Communities

A cultural assessment is a systematic way to identify the beliefs, values, meanings, and
behaviors of people while considering their history, life experiences, and social and physical
environments.

Goal
to obtain accurate information from the patient that will allow the nurse to formulate a
mutually acceptable and culturally relevant treatment plan for each patient problem

In a brief cultural assessment, you should ask about

ethnic background family patterns eating patterns

religious preference food preferences health practices

 Assessment of Culturally Diverse Communities
A community nursing assessment is a process by which the nurse collects data about the
community in order to identify factors which may influence the deaths and illnesses of the
population, to formulate a community health nursing diagnosis and develop and implement
community health nursing interventions and strategies.

Goal
Improvement in the health status of a group of people.

Community nursing assessment requires:

Gathering relevant data Interpreting the data

(including problem analysis
and prioritization)
Identifying and implementing intervention activities for
community health
BASIC PRINCIPLES OF CULTURAL ASSESSMENT

The meaning and purpose

All cultures must be viewed of the behavior must be
in the context in which they interpreted within the
have developed. context of the specific
culture.

There is such a phenomenon as intracultural variation.

 Take-away Questions

1. As a nurse working in a diverse community, how would you

deal with the discomfort brought on by individual/family
beliefs that are difficult to negotiate?

2. In your own opinion, how can you, as a nurse, provide

culturally competent care within the community?

3. What are the impacts of transcultural/socio-ecological

approach in the delivery of nursing care?
 Thank You

Do you have any questions of us?