NUR430: TRANSCULTURAL

NURSING
By:
DR. Christian Makafui Boso
School of Nursing and Midwifery, UCC
Unit IX: Barriers to Cultural
Sensitivity in Nursing
 SESSION OBJECTIVES
At the end of this lecture, the students will be able to:
1. Understand the relevance of cultural sensitivity to nursing
2. Identify the common barriers to cultural sensitivity in nursing
3. Overcome barriers to cultural sensitivity
4. Provide culturally sensitive care to patients regardless of their
background
 Introduction
❑ Developing cultural sensitivity is crucial for
providing high-quality, patient-centered care.
❑ However, nurses may face various barriers that
hinder their ability to be culturally sensitive.
 Defining Cultural Sensitivity
❑ Cultural sensitivity Cultural sensitivity refers to the knowledge,
awareness, and acceptance of other cultures and cultural
identities.
❑ This includes cultural awareness, respect and adaptation
❑ Awareness
➢ Understanding one's own cultural beliefs, values, and biases, as well as
those of others.
❑ Respect
➢ Appreciating and valuing the unique cultural differences of patients and
their families.
❑ Adaptation
➢ Adjusting care practices to meet the specific cultural needs of each
patient.
 Barriers to cultural sensitivity
❑ Language barriers
❑ Cultural differences
❑ Lack of cultural awareness and competence
❑ Organizational barriers
❑ Structural barriers
❑ Individual factors
❑ Stereotyping
❑ Ethnocentrism
❑ Implicit bias
 Barriers to cultural sensitivity
❑ Language barriers
➢ Lack of access to professional interpreter services and
➢ inability of patients to communicate effectively with healthcare providers
➢ hinder the delivery of culturally competent care. (Grandpierre et al., 2018)
❑ Cultural differences in health beliefs and practices:
➢ different cultural views on health, illness, and treatment can lead to mistrust
and poor adherence. (Fenkl & Purnell, 2019)
❑ Lack of cultural awareness and competence among healthcare
providers:
➢ Providers may lack understanding of diverse cultural backgrounds, customs,
and communication styles
➢This makes it difficult to provide care that is sensitive to patients' needs
(Grandpierre et al., 2018)
 Barriers to cultural sensitivity
❑ Organizational barriers:
➢Healthcare systems may lack diversity in leadership and staff, fail to
provide culturally appropriate resources which disadvantages culturally
diverse patients (Handtke et al., 2019)
❑ Structural barriers: long wait times, and problems with
referrals can impact culturally diverse patient populations
(Grandpierre)
❑ Individual factors: Low health literacy, fear of stigma among
diverse patients can create additional barriers to accessing
culturally competent care.
 Barriers to cultural sensitivity
❑ Stereotyping:
➢ Viewing one's own culture as superior and using it as the
standard to judge other cultures.
❑ Stereotyping
➢ Oversimplified, generalized beliefs about a particular cultural
group that can lead to prejudice and discrimination.
❑ Impact
➢ Ethnocentrism and stereotyping can hinder effective
communication, trust, and the provision of culturally sensitive
care.
 Barriers to cultural sensitivity: Biases
❑ To be biased means to have a tendency or inclination that
affects one's ability to make impartial or objective decisions
(Popovic & Huecker, 2023).
❑ It involves factors such as subjectivity and prejudice.
❑ There two main types of biases:
➢ Explicit biases: easy to recognize and dealt with
➢ Implicit or unconscious biases: difficult to identify
 Implicit biases
❑ Implicit biases are the attitudes or stereotypes that affect our
understanding, actions, and decisions in an unconscious manner
(ThinkCulturalHealth.hhs.gov).
❑ They are more subtle and pervasive.
❑ Sub-types include:
➢ Halo Effect
➢ Confirmation Bias
➢ Affinity Bias (Similarity Bias)
➢ Anchoring Bias
➢ Bandwagon Effect
➢ Status Quo Bias
➢ Stereotyping
 Implicit bias
❑ Halo Effect: Halo effect occurs when the perception of one positive
quality leads to the perception of other positive qualities in a person
or object.
➢ Example: If a person is physically attractive, others may also perceive them
as intelligent and competent.
❑ Confirmation Bias: the tendency to search for, interpret, and
remember information in a way that confirms one's preexisting
beliefs or hypotheses.
➢ Example: If someone believes a particular diet is effective, they may focus
on studies that support this view while ignoring contrary evidence.
 Implicit Bias
❑ Affinity Bias (Similarity Bias): he tendency to favor people who
are similar to ourselves in terms of background, interests, and
experiences.
➢ Example: In a hiring process, a manager might prefer a
candidate who shares the same hobbies or attended the same
university.
❑ Anchoring Bias: The tendency to rely too heavily on the first piece
of information encountered (the "anchor") when making decisions.
➢ Example: In negotiations, the initial offer can set the standard
for the rest of the negotiation.
 Implicit bias
❑ Bandwagon Effect: The tendency to adopt a belief or behavior
because it is popular or because others are doing it.
➢Example: People are more likely to support a political candidate
if they see that many others are doing the same.
❑ Status Quo Bias: The preference for the current state
of affairs and the resistance to change.
➢ Example: People might continue using a familiar
product even when a better alternative is available.
❑ Stereotyping: Attributing specific characteristics, attributes, or
behaviors to an entire group of people, often based on
oversimplified or generalized beliefs
➢ Example: Assuming that all elderly people are bad with technology.
 Explicit bias
❑ Explicit biases are conscious attitudes or beliefs about certain
groups of people.
❑ It includes
➢ Racial Bias
➢ Gender Bias
➢ Age Bias
➢ Religious Bias
➢ Sexual Orientation Bias
➢ Disability Bias
➢ Ethnic Bias
➢ Socioeconomic Bias
➢ Nationality Bias
➢ Political Bias
 Strategies for Improving Cultural
Sensitivity
❑ Self-reflection
➢ Nurses should engage in ongoing self-assessment to
identify their own cultural biases and areas for improvement.
❑ Continuous Learning
➢ Seek out opportunities for cultural sensitivity training,
workshops, and educational resources to enhance knowledge
and skills.
❑Organizational Support
➢ Advocate for institutional policies and resources that
promote cultural diversity, inclusivity, and sensitivity.
 Conclusion

❑ Overcoming barriers to cultural sensitivity is essential for

providing high-quality, patient-centered nursing care.
❑ By addressing issues such as ethnocentrism, language
barriers, and organizational challenges, nurses can create a
more inclusive and culturally responsive healthcare
environment.
 References
Grandpierre, V., Fitzpatrick, E., Thomas, R., Mendonca, O., Sikora, L., & Potter, B.
(2019). Barriers and facilitators to cultural competence in early hearing loss
services: A qualitative analysis. CANADIAN JOURNAL OF SPEECH-LANGUAGE
PATHOLOGY & AUDIOLOGY
Purnell, L. D., & Fenkl, E. A. (2019). Handbook for culturally competent care. Springer
International Publishing.
Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare–A
scoping review of strategies implemented in healthcare organizations and a
model of culturally competent healthcare provision. PloS one, 14(7), e0219971.
Sterniuk, et al. (2023). Social and Ethical Issues in Various Medical Procedures. In
2023 Progress in Applied Electrical Engineering (PAEE) (pp. 1-9). IEEE.