Assessment Notes

1. Culture should not be used to stereotype individuals because all individuals are unique. Culture, however, is an integral part of all people and contributes to their uniqueness.
2. Physical, psychosocial, and cultural characteristics are not the same. In other words, one cannot assume that individuals from similar cultural backgrounds have the same physical, psychosocial, and cultural beliefs.
3. Understanding various cultural characteristics however, may help the nurse practitioner in providing individualized care to clients.
4. Individual's life experiences, including cultural backgrounds, influence health promotion and maintenance practices as well as reactions to illness.
5. Assessment of cultural practices is an integral part of the health history.
6. Value orientations, health beliefs and practices, dietary considerations, family aspects, communication practices, and religion are, among others, relevant in assessing cultural practices. (Seidel, Ball, Dains, & Benedict, 1995, pp. 39-51).
   Students may wish to consult Seidel et al. for detailed information about these and other cultural practices and assessment tools.
7. For additional information on transcultural assessment, cultural and linguistic standards (CLAS), and diverse cultures please access:
   • Charles Kemp's Beliefs Assesment at Baylor University
   • Full text of CLAS recommendations
   • CLAS recommendations and diverse cultures (pay particular attention to OCR Guideline Memorandum)

References

Seidel, H. M., Ball, J. W., Dains, J. E., & Benedict, G. W. (1995). Mosby's guide to physical examination (3rd ed.). St. Louis, MO: Mosby.

Bibliography

• American Nurses Association. (1997). Improving minority health outcomes through culturally-specific care. Nursing Trends & Issues 2 (3), 1-8.
  
  This article addresses the mental health status of African, Hispanic, Native American/Alaskan, and Asian/Pacific Islanders. Issues related to over diagnosis and culturally inappropriate treatment are addressed. For instance, Hispanics may be more frequently diagnosed with schizophrenia and available mental health care is limited for elderly minority populations.
  
  
• Andrews, M. M., & Boyle, J. S. (1995). Transcultural concepts in nursing care (2nd ed.). Philadelphia, PA: J. B. Lippincott.
  
  This is a comprehensive book which includes discussion on the theoretical aspects of transcultural nursing and care. Using a developmental approach information about various cultures is provided. The authors also include issues related to alterations in life style, perspectives in mental health, concepts in critical care, aspects of pain, community issues, and religion. International nursing and health completes this text.
  
  
• Clark, A. L. (1981). Culture & child-rearing. Philadelphia, PA: F. A. Davis.
  
  While the text would appear to be dated this book provides a fine overview of child rearing practices in various cultures. The cultures included are: American Indian, Black American, Japanese American, Chinese American, Filipino American, Mexican American, Puerto Rican American, and Vietnamese American.
  
  
• Davidhizar, R., & Giger, J. N. (1997). When touch is not the best approach. Journal of Clinical Nursing, 6, 203-206.
  
  Touch has many meanings to different individuals. The use of touch varies by culture as well as other factors such as socioeconomic level. Those individuals from a lower socioeconomic status are more responsive to touch than those at middle or upper levels. In some cultures provision of care is appropriate within but not between genders. No particulars are provided on the Asian, Hispanic, or Native American cultures.
  
  
• Giger, J. N., & Davidhizar, R. E. (1991). Transcultural nursing. St. Louis, MO: Mosby Year Book.
  
  This text provides extensive information about cultural assessments and interventions. Cultural groups include Black Americans, Mexican Americans, Navajo Indians, Appalachians, American Eskimos, Italian Americans, Irish Americans, Soviet Americans, Chinese Americans, Filipino Americans, Vietnamese Americans, East Indian Hindu Americans, Haitian Americans, and Jewish Americans.
  
  
• Giger, J. N., Davidhizar, R., Johnson, J. Y., & Poole, V. L. (1997). Health promotion among ethnic minorities: The importance of cultural phenomena. Rehabilitation Nursing, 22, 303-310.
  
  In order to promote and maintain health nurses must use strategies that are culturally appropriate. Communication and touch may be practiced more openly in certain cultures than others. Personal space must also be protected and varies by cultures. Social organizations also vary by ethnicity and may provide nurses with cues about client behaviors. Temporal orientation becomes important in promoting health maintenance since, for instance, some cultures are not future oriented (e.g., Navajo). An individual's perceived control of the environment may also play a role in health promotion and maintenance. For instance, a Hispanic woman may not seek prenatal care because they rely on their own belief system and find language a barrier to care. Biological variations also play a role in health promotion and maintenance.
  
  
• Leininger, M. (1997). Understanding cultural pain for improved health care. Journal of Transcultural Nursing, 9 (1), 32-35.
  
  Cultural pain may be experienced when nurses fail to understand cultural practices. Leininger provides examples. A nurse makes a statement about the beauty of a Mexican infant; this is interpreted as "envy" The mother then practices certain rituals to undo harm done to her infant. A Vietnamese child's head was to be covered to protect his head and sacred spirits before and during surgery. This was not carried through and caused pain to his family.
  
  
• Mahon, P. Y. (1997). Transcultural nursing a source guide. Journal of Nursing Staff Development, 13, 218-222.
  
  Mahon provides an annotated bibliography for resources pertinent to transcultural nursing. The synopsis includes both books and journals.
  
  
• Narayan, M. C. (1997). Cultural assessment in home healthcare. Home Healthcare Nurse, 15, 663-672.
  
  This article provides a cultural assessment checklist and form for gathering data. It briefly reviews social etiquette, the importance of the client's understanding of the problem, as well as nutritional, pain, psychosocial, and role behavior assessments.

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