Med-Surg · chapter 2 · Culturally Competent Care
Cultural Assessment
The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 3 practice questions with the reasoning.
Key points
Purpose of cultural assessment
A cultural assessment enables nurses to deliver care that respects individual cultural values, beliefs, and practices. By incorporating cultural consideration into nursing assessments, interventions, and care planning, nurses can improve health outcomes, enhance patient satisfaction, and contribute to the elimination of health-care disparities.
Patient-centered care assumption
Assuming that all people are the same and view the world through the same lens is not a way to provide patient-centered care.
Transcultural model purpose
The purpose of the model is to guide nurses in conducting a comprehensive and culturally sensitive assessment of patients by collecting data on the impact of cultural factors on health beliefs, health care–seeking behaviors, and treatment preferences (Giger Davidhizar, 2002).
Model assessment components
The Transcultural Assessment Model includes considering language barriers, nonverbal cues, and culturally appropriate communication styles, and understanding cultural perspectives on time, attitudes toward punctuality, scheduling, and the perception of illness (Giger Davidhizar, 2002).
Certified medical interpreters
Health-care professionals should be aware of language differences even within the same culture and utilize certified medical interpreters or translation services when necessary to ensure clear and accurate communication with patients.
Nonverbal communication differences
Communication includes both verbal and nonverbal elements, with 90 percent of messaging coming mainly from nonverbal communication, which includes body language, facial expressions, gestures, and eye contact (Park Park, 2018).
Open-ended patient understanding
Because communication is so complex, even when we speak the same language, remember that asking a patient an open-ended question to explain what they understand is better than asking the closed-ended question of if they understand.
Cultural views of time
In health-care settings, understanding these cultural variations in the interpretation of time can help health-care providers communicate effectively, manage appointment scheduling, and address patient expectations.
Respecting personal space
Respect for personal boundaries is important as different cultures have varying norms and expectations regarding personal space. Some cultures, such as the Latinx culture, may value closer physical proximity during interactions, while others may prefer more personal space, such as the Asian culture.
Patient privacy practices
Honoring privacy respects patient’s privacy and confidentiality. It involves providing adequate physical space for confidential discussions, ensuring appropriate privacy measures of closing doors or dividing curtains, and considering cultural norms when determining the level of privacy required for different individuals.
Social determinants impact
Factors such as socioeconomic status, access to health care, discrimination, and power differentials within societies can greatly impact health outcomes. These are known as social determinants of health.
Environmental control in care
By understanding these cultural perspectives, nurses can provide culturally appropriate care that respects and integrates patients’ beliefs and practices related to environmental control.
Biological variations and screening
Genetic differences, metabolic variations, and susceptibility to certain diseases can vary across populations. Nurses can advocate for targeted screenings, genetic counseling, and interventions that address the specific needs of diverse populations.
Culturally congruent care outcomes
Providing culturally congruent care may improve patient satisfaction, and adherence to treatment can assist the nurse in recognizing unique needs, collaborating with the patient to find ways to accommodate their needs, and explaining the rationale for medical treatment in ways the patient can understand.
Terms to know
- cultural assessment
- A cultural assessment is a method for systematically gathering information about a patient’s cultural beliefs, values, practices, and perceptions as they relate to health care.
- space
- In the context of health care, space refers to the physical, psychological, and social dimensions that affect human relationships and communication.
- Social organization
- Social organization refers to the way societies structure themselves, including their social hierarchies, roles, norms, values, and relationships.
- social determinants of health
- These are known as social determinants of health.
- Biological variations
- Biological variations refer to the diversity and differences in human biology, genetics, and physiological processes that exist among individuals and populations.
- competemility
- Josepha Campinha-Bacote created a new word, “competemility,” which is a combination of the words “competence” and “humility” intended to guide health-care service providers through care that transcends cultural competence and addresses personal biases.
Practice questions
Stuck on select-all-that-apply? How to take them one option at a time.
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Every question here, with the answer
At the end of an admission interview, a medical interpreter confirms that Ms. Gonzalez wants her husband present for all care conversations. She had been quiet before he arrived but now appears more relaxed. Which communication plan should you document?
- Use a medical interpreter and include the husband as the primary decision-maker.
- Have a medical interpreter and the patient's husband available for care conversations and education.
- Have the husband answer questions and interpret during future care conversations.
- Use a medical interpreter for education, with the husband waiting outside to preserve privacy.
Answer: Have a medical interpreter and the patient's husband available for care conversations and education.
The interpreter confirmed the patient's preference, so the plan should preserve both interpreter support and her husband's presence. Having the husband interpret replaces the medical interpreter, while excluding him contradicts her stated preference. Wanting him present does not establish that he is the primary decision-maker.
At 1400, you are updating a patient's care plan before a discussion of confidential health information. Which entries appropriately address physical privacy during the discussion? Select all that apply.
- Speak quietly at the bedside instead of adjusting the physical privacy setup.
- Close the door or use dividing curtains as appropriate.
- Reserve door or curtain closure for personal care rather than conversations.
- Use the same privacy arrangement for every patient to maintain consistency.
- Arrange adequate physical space for the confidential discussion.
Answer: Close the door or use dividing curtains as appropriate., Arrange adequate physical space for the confidential discussion.
The section calls for adequate physical space and privacy measures such as closing doors or using dividing curtains during confidential discussions. Speaking quietly alone, applying a uniform setup without considering individual needs, or reserving privacy measures for personal care does not meet the guidance described.
During a 0900 cultural assessment, a woman from South Asia reports not taking her medications because her husband does not believe in Western medicine and expects her to follow his wishes. Which entry best captures the social factor identified in this assessment?
- Patient personally rejects Western medicine and therefore does not take prescribed medications.
- Patient reports not taking medications because her husband opposes Western medicine and expects her to comply with his wishes.
- Patient prefers traditional remedies instead of prescribed medications.
- Patient is not taking medications because she needs additional education about their benefits.
Answer: Patient reports not taking medications because her husband opposes Western medicine and expects her to comply with his wishes.
The patient's report identifies family authority as a factor in medication-taking, which the section describes as part of social organization. The other entries assume a preference for traditional remedies, her own rejection of Western medicine, or an education deficit that the interview did not establish.
Where every quote comes from
Section 2.2 Cultural Assessment of Medical-Surgical Nursing by Christy Bowen, Bridget Carey, Jessica Palozie, Maren Reinholdt, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.