Our Lady of Lourdes College Foundation Learning Module

College of Nursing NCM 101

Instructor: Jay O. Malanyaon Health Assessment

Module: Culture and Health

OVERVIEW

LEARNING OUTCOMES

LEARNING EXPERIENCES AND SELF ASSESSMENT ACTIVITY

Context and Health

Understanding or being aware of the client context is essential in performing and effective health
assessment.
 Every client is part of a:
 Cultural context
 Family context
 Community context
 All of these affect the client’s health
 In turn,
 Family
 Community
 Person’s spirituality
 Are affected by the individual’s health status

A. Culture
 Is composed of all verbal and behavioral systems that transmit meaning which includes arts,
beliefs, values, customs, life ways and other product of human work.
 Is learned; transmitted from one generation to the next
 Is shared
 Is associated with adaptation to the environment
 Is universal; may vary but humans cannot exist without culture.
 There are many variations of beliefs and practices and these variations are defined as normal.
 There maybe may be biologic variations such as Mongolian spots / nail streak skinned infants.
 The mechanism that cause humans to vary biologically are genetics and environment and the
interactions of the two.
 Gene variations cause obvious differences such as eye color and genetic disease such as Trisomy
21.
 The genetic background of the client affects the genetic-based characteristics seen.

Selected physical variations

Surface variations – e.g. secretions – variations in apocrine and eccrine sweat secretions and apocrine
 Our Lady of Lourdes College Foundation Learning Module
College of Nursing NCM 101
Instructor: Jay O. Malanyaon Health Assessment

Module: Culture and Health

secretions of ear wax based on genetic traits (Asian and Native American have dry ear wax and blacks
have wet ear wax.)
Anatomic variations – lower extremity venous valves vary between Caucasians and blacks Africans.
Blacks account for the lower prevalence of varicose veins.
Developmental variation – maturity differences appear to be related to both genetics and environment.
African American infants and children tend to be ahead of other American groups in motor development.
Biochemical variations and differential disease susceptibility – drug metabolism differences, lactose
intolerance and malaria-related conditions.
Cultural competence- nurse must develop skill in many areas of cultural competence
The level of competence of the caregiver affects the level of accuracy of the assessment findings

Five process of cultural competence:

Cultural desire
Cultural awareness

Stages of cultural awareness

Unconscious incompetence
Conscious incompetence
Conscious competence
Unconscious competence
Cultural knowledge
Cultural Skill
Cultural encounters

Do’s and Don’ts for cultural encounters:

1. Develop cultural habit –the desire to effectively build relationships with people from different
cultural background.
2. Recognize hat intra-ethnic variation exits among all cultural and ethnic groups. – differences
with ethnic groups
3. Remember that cultural competence is a journey, not a destination; a process not an event;
and a state of becoming, not of being.
4. Become sensitive to nonverbal cues and communication. Be aware that some nonverbal
communication may be insulting to specific cultures.
5. Remember that ethnicity is only one aspect of cultural diversity. Geographic location, gender,
age, socioeconomic status, religious affiliation and occupation are few of the variables that
constitute a distinct cultural group.
6. Keep in mind that, when conflict exists between two people, each should examine whether
the source of conflict is self-generated.
7. Engage in many direct cultural encounters; seek out evaluative feedback on cross-cultural
interactions. Be receptive to constructive criticism, and avoid becoming defensive.
8. Appreciate differences, but build on similarities. When people recognize and value
differences, they will realize that they are more alike than different.
9. Remember that communication is inevitable. One cannot communicate. Culturally sensitive
communication, however, requires not only many cultural encounters but also cultural
knowledge, cultural skill and an awareness of the role one’s own cultural values play in
 Our Lady of Lourdes College Foundation Learning Module
College of Nursing NCM 101
Instructor: Jay O. Malanyaon Health Assessment

Module: Culture and Health

communicating.
Don’ts
1. Do not assume that because someone looks and behaves much the same as you do that there are
no cultural differences or barriers to communication.
2. Avoid relying solely on textbooks and other written materials for information on cultural groups.
Direct cross-cultural interactions will help a person to gain accurate information on cultural
group.
3. Never assume that you understand any verbal communication unless you are familiar with a
particular culture.
4. Do not personalize all negative communications. Some culture may respond to you based on
“what you represent” and not necessarily on who you truly are. Make a genuine good first
impression of who you truly are.
5. Avoid judging others based on your cultural values and rules. People live by different rules and
priorities that are valid according to their cultural beliefs.
6. Do not be content with just respecting and understanding another culture’s view of the world.
Have a serious commitment to internalize and incorporate selected values, practices, beliefs,
lifestyles and problem-solving skills of another culture into one’s own world view.

B. Spirituality
 Spirituality and religious practices affect health in both psychological and physiological ways.
Psychological well-being is often associated with spiritual well-being, while psychological
problems often result from spiritual dissonance. Religious practices can have profound effects on
health.

C. Family
 The family’s beliefs about health, illness and related behaviors, and the meaning health and
illness have for the family tends to affect each member’s behaviors.
 The family’s psychological and spiritual health and the family’s beliefs about what are acceptable
gender and generation roles affect the members’ approach to prevention and illness care. The
family has a profound effect on the health status of its members.

D. Community
 To assess a client, be it a single person, family or community, the nurse must maintain a
perspective of the system. The nurse will need to assess how the community is affecting the
client, the health and illness of the client and the community itself.
 It is important for the nurse to assess the effect of community on then client to complete an
effective assessment.