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87❂ ACTIVITIES TO PROMOTE
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UNIT 1 Foundations of Community Health Nursing Examine your ordering of these options. Whatvalues can be identified based on your responses in this exercise? How do these values emerge in your behavior?
9. Request to attend two or three sessions of an ethics committee meeting of a community health agency.
Observe and make notes on (a) what values are evident in the discussion, (b) what ethical principles are used, (c) what decision-making framework is used, and (d) what you would have liked to contribute if you had been a member of the committee.
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Western Institute of Nursing: http://www.winuring.org 90
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People everywhere share common biological and psychological needs, and the function of all cultures is to fulfill such needs; the nature of the culture is determined by its function .”
—Bronislaw Malinowski (1884–1942), Cultural AnthropologistLEARNING OBJECTIVES
Upon mastery of this chapter, you should be able to:
◆ Define and explain the concept of culture.
◆ Discuss the meaning of cultural diversity and its significance for community health nursing.
◆ Describe the meaning and effects of ethnocentrism on community health nursing practice.
◆ Identify five characteristics shared by all cultures.
◆ Contrast the health-related values, beliefs, and practices of selected culturally diverse populations with those of the dominant U.S. culture.
◆ Conduct a cultural assessment.
◆ Apply transcultural nursing principles in community health nursing practice.
KEY TERMS
Complementary therapies Cultural assessment Cultural diversity Cultural relativism Cultural self-awareness Cultural sensitivity Culture
Culture shock Dominant values Enculturation Ethnic group Ethnicity Ethnocentrism Ethnorelativism Folk medicine Home remedies Integrated health care Microculture
Minority group Norms
Race Subcultures Tacit
Transcultural nursing Value
5
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Americansociety values individuality, and we are a coun- try of immigrants. Many different cultural groups and races built this nation. For example, pilgrims came here hundreds of years ago, to seek freedom to practice their religious beliefs. It took powerful independence to pioneer the West in the 1800s. Partly because of this pioneer spirit, people from all nations have sought to live in America. Some came of their own free will for adventure and opportunity. Others saw this land as a refuge from political, religious, or eco- nomic strife. Still others were brought here against their will. Consequently, we have not become the ideal melting pot once described, but rather, an amalgamation of people who have different values, ideals, and behaviors.Americans have many differences, but we also have much in common. In the Western culture, there is joy in see- ing children grow and develop in unique ways. An individ- ual’s creative achievements are applauded. There is also respect for one another’s personal preferences about food, dress, or personal beliefs. The right to be oneself—and thereby to be different from others—is even protected by state and federal laws.
Although individuality is a cherished American value, there are limits to the range of differences most Americans find acceptable. People whose behavior falls outside the acceptable range may be labeled as misfits. For example, the U.S. culture approves moderate social drinking, but not alcoholism. The beliefs and sanctions of the dominant or majority culture are called dominant values. In the United States, the majority culture is made up largely of European Americans whose dominant values include the work ethic, thrift, success, independence, initiative, privacy, cleanli- ness, youthfulness, attractive appearance, and a focus on the future. However, in some regions and states, European Americans are not the majority. For example, in California, 53% of the population are “people of color,” and the domi- nant culture is no longer European American (California Pan-Ethnic Health Network, 2007, ¶ 3); the proportion of the population identified as White is projected to continue to fall below other ethnicities (Legislative Analyst’s Office, 2000).
Dominant values are important to consider in the prac- tice of community health nursing because they can shape people’s thoughts and behaviors. Why are some client behaviors acceptable to health professionals and others not?
Why do nurses have such difficulty persuading certain clients to accept new ways of thinking and acting? Explana- tions can be found by examining the concept of culture, especially its influence on health and on community health nursing practice. For example, an emphasis on the need for milk in the diet may reflect cultural blindness, considering the number of people in diverse ethnic groups who are lac- tose intolerant (Swagerty, Walling, & Klein, 2002). Regard- less of their own cultural backgrounds, nurses are socialized throughout the educational process; the biomedical model is frequently the framework, and dominant social values are often involuntarily reinforced.