Chapter 5:

Cultural
Diversity
By: Nicholas Antonucci, Jessica
Hudock, Vanessa Kline,
Emilie Moore and Megan Nestor
 Objective 1
Explain concepts of cultural
diversity and respect
What is Culture?
● Culture is a shared system of values, beliefs and behaviors that are apart of your daily
life.
● Culture works to provide a social structure
● Components of Culture
○ Language
○ Personal identification
○ Communication
○ Customs
○ Institutions specific to ethnic or religious groups
Cultural Diversity
● The coexistance of different ethinic, biological sex, racial and socioeconomic groups
within one unit
● Cultural Diversity includes
○ People of varying religion, language, physical size and sexual orientation
● Healthcare providers must understand cultural diversity to be able to fully
understand characteristics common to different populations
Cultural Respect
● Requires nurses to be sensitive to cultural factors
○ This provides culturally respectful care to everyone
● Allows nurses to provide services that are both respectful and beneficial to the
patient
● Cultural Respect is crucial to being able to improve health care and decrease
health disparities
● Culture affects how health, healing, illness, disease and healthcare delivery are
perceived
 Objective 2
Describe influences that affect
culturally respectful health care
Culturally Respectful Nursing
➔ Understand the effects of certain illnesses on specific
populations
➔ Certain communities reactions to pain may differ
➔ Mental health considerations
➔ Biological Sex Roles
➔ Language and Communication barriers
➔ Family and Community support of health care
➔ Common Health Disparities
 Cultural Assessment- Interviewing
Beliefs, Traditions, Cultural belief of
and Cultural the etiology of
Practices illness, related to
healing
Culturally Attitudes towards
defined, health seeking help from
related needs health care
providers
Incorporating Aspects Passing
Seek Cultural Information
Assistance Further
As the healthcare Ensure that when doing
professional, ask family shift changes or
members or colleagues interprofessional work

Use Professional
Accommodation Respect
Models Ensure that there Above all respect
Using things like needs and practices their views as your
the ESFT Model or are considered in patient
Purnell Model treatment
 Objective 3
Discuss examples of how diversity
affects health and illness care,
including culturally based
traditional care
How Diversity Affects Health and Illness Care
● Diversity groups include people of varying religion, language, physical size,
sexual orientation, age, disability, occupational status and geographic
location
● Culture is an integral component of both health and illness because of the
cultural values and beliefs that we learn in our families and communities
● Nurses and other health care providers must be familiar with the concepts
of cultural diversity in order to understand characteristics common to
certain populations
● Nurses must also be sensitive to cultural factors in order to provide
culturally respectful care to people of diverse backgrounds
Clinical Examples
● Cultural and language differences are believed to be the major barriers to
ethnic and racial groups receiving health care services
● Minorities have been shown to have decreased access to preventive care
and treatment
● The better a patient is represented and understand the better they can be
treated
● Cultural competency can be obtained when the healthcare providers offer
services to meet the social, cultural and linguistic needs of their patients
 Objective 4
Identify factors commonly
included in a transcultural
assessment of health-related
beliefs and practices
Transcultural Nursing
● Providing nursing care that is planned and implemented in a way that is
sensitive to the needs of individuals, families, and groups representing the
diverse cultural populations within our society.
● A nurse who is culturally respectful has the knowledge and skills to adapt
nursing care to cultural similarities and differences
● This involves developing awareness, acquiring knowledge and practicing
skills.
● Each patient is considered a unique person
● In providing care to a person from a culture that is different from your
own, or the dominant culture, you may use past experiences with
members of that culture as a guide but never to answer all of the issues.
● Learn from the mistakes, do not repeat them.
● Repeated mistakes are careless and disrespectful; will adversely affect
your interactions with patients and coworkers.
Health Related Beliefs and Practices
● how does the patient attribute illness and disease
● What are the patients cultural beliefs related to body size and shape
ideally? Is their self- image comparable to their ideal?
● How does the patient identify their health related condition?
● How do the patients beliefs promote health?
● What is their religious affiliation? How actively involved are they?
● Does the patient rely on cultural healers? Who determines when they are
sick or healthy? Who influences choices of treatment?
● What types of cultural healings does the patient engage in?
● How are healthcare providers perceived? What are the expectations of the
nurses and nursing care?
● How does the patient’s cultural group view mental disorders? Are the
differences acceptable behaviors to physical versus psychological
illnesses?
 Objective 5
Practice cultural respect when
assessing and providing nursing
care for patients from diverse
cultural groups
Nursing Care for Patients from Diverse Cultural Groups
● It is important to treat every patient with the same respect that you would
anyone
● The nurse should learn more about the specific cultural group to make
sure that they don’t offend them and that they are comfortable
● The nurse should avoid making assumptions and not just about diverse
cultural groups, about any patient that they have
● You would want to make sure that if there is a language barrier that you
overcome that by either finding a translator, you should not use a family
member as a translator because they could be biased
● The nurse should be patient with cultural diverse people as they might
have some trust issue with how they have been treated in the past
● In the long run you need to be aware of what someone from a Diverse
Cultural Groups needs or wants
 Objective 6
Discuss factors in the health care
system and in nursing that
facilitate or impede culturally
competent nursing care
Factors that Facilitate or Impede Culturally Competent Nursing Care

Facilitate Impede
● When performing an ● The nurse should not use any jargon to
assessment on a patient it is get in the way of teaching or caring for a
important that you are aware of patient with a different cultural
the beliefs that the patient background.
might have ● The nurse should not make assumptions
● Improve communication or judgements on the patient on things
barriers that might get in the that they might know
way of providing adequate care ● The patient may have a thick accent so its
● You should build trust with import to listen to them closely and to be
your patient to make sure you patient with the clients
don't scare them when taking
care of them
Case Study
A Muslim woman and her husband are on a
rehabilitation unit at the hospital you are working
at. The husband explains to the staff that she must
be in the care of female staff only. It is considered
immodist of a Muslim woman’s body to be seen by
males that are not her husband. As her nurse, how
would you following QSEN competencies to
provide proper care this patient?
Patient-Centered Care
● Providing care that is both respectful and most efficient for this patient
● Respecting the patients values and preferences
● Communicate and Educate as needed
● Include family and friends in care
Teamwork and Collaboration
➔ In the healthcare industry teamwork can be defined as the ability to “function
effectively with nursing and interprofessional teams, fostering open
communication, mutual respect, and shared decision-making to achieve quality
patient care” (QSEN, 2019, par. 6).

In regards to this competency through the case study

➔ Through the QSEN competency it is encouraged that the nursing staff work
together with other hospital staff to ensure this patients utmost safety
➔ For the patient who is a muslim woman, by the request of the husband and their
cultural background/beliefs, its important to keep the staff all female out of
respect
◆ This can be important depending on her needs, but also the chain of family command
for any needed procedures
◆ The staff of both shifts needs to be aware when handing off, and any interdisciplinary
communication to work with the patient will need to be made aware and ensure a
female is available for accurate and respectful care
◆ It can be very important to accommodate to ensure a good patient staff relationship
is created and that she is compliant with her care to ensure healing
Safety
● As always it is important to recognize the importance of what you say to
the patient when taking care of them, so that you do not insult them
● It would also be best that you make the female comfortable and make
sure that there are no men in the room when providing care to her.
○ In doing that you want to make sure that you provide her with
adequate privacy
● The nurse should work together with other staff with providing her with
only female caregivers
● A lot of people today see the Muslim community as an enemy so it is best
that you make sure that you are theuraputically communicating with her
and her husband to make sure that they know they are safe
● Finally, you should learn more about there religion and their practices so
that you don’t become offended if you offer them a care route and they
decide against it
Quality Improvement
● Quality Improvement is defined as using data to monitor the outcomes of
care processes and using improvement methods to design and test
changes to continuously improve the quality and safety of health care
systems.
● An example that could be used in this scenario is using signs on the door
or top of chart to indicate the preference for no male health care providers
● Another example would be asking patients of different cultural,
socioeconomic, religious and sexual orientation to complete a
questionnaire at the end of their hospital stay to evaluate the care they
were given
○ The questionnaire could include suggestions that could have
increased their satisfaction when it came to their care
Evidence-Based Practice
● Evidence- Based Practice is defined as the integration of best current
evidence with clinical experience and patient/family preference and values
for delivery of optimal health care.
● In this scenario, per the families request, it is important to participate
effectively in appropriate data collection. The nurses that treat this patient
should be females to ensure that their religious practices are maintained.
● Valuing the need for continuous improvement in clinical practice based on
new knowledge is necessary, by respecting the patient and family wishes,
we ensure that the practices are continuously used through every muslim
patient as requested.
● Improvements can be made by using nursing research to gain more
knowledge regarding the care of muslim women. The information learned
in nursing research can be used to integrate practices into other patient
care as well.
Informatics
● Informatics is the use of information and technology to communicate,
manage knowledge, mitigate error and support decision making.
● In the patient's chart, it should be identified that the patient requests
female nurses only due to religious beliefs. In the event that the patient
returns, by keeping this information on file, it ensures that the patient
wishes will always be granted.
● It is important for nurses to improve their knowledge of different practices,
and by using technology and straying away from error, we make sure that
every preference is known and kept into consideration.
Case Study Question
Which is the correct plan of action by the nurse?
A. Explain to the patient’s husband that the unit
consists of 4 male nurses and the hospital is short
staffed
B. Explain to the patient’s husband that his wife is in a
U.S hospital and they should observe U.S customs
C. Find a female nurse to swap patients with
D. Discharge the patient
Resources
Bartlett, C.T.P.L.J. L. Lippincott CoursePoint Enhanced for Taylor's Fundamentals of Nursing.

[CoursePoint]. Retrieved from

https://coursepoint.vitalsource.com/#/books/9781975123116/

QSEN Competencies. (n.d.-b). QSEN Institute. Retrieved March 20, 2021, from

https://qsen.org/competencies/pre-licensure-ksas/