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NURSING AND CULTURE: STRIKING A BALANACE 

OLOYEDE OREOLUWA RUTH MATRICULATION NUMBER: NSC/2015/837 

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What is culture? Types of culture Elements of Culture Characteristics of Culture Impact of culture on health care and  health seeking behaviour Nursing and culture: Striking a balance Conclusion  

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Photo by RhondaK Native Florida Folk Artist on Unsplash

Humans are a cultural species,  constantly navigating a complex web of culturally bound  practices, norms, and views. Cultural practices reflect values and beliefs held  by members of a community for periods often spanning  generations. Every social group in the world has  specific cultural practices and  beliefs, some of which are beneficial to all members,  while others are harmful to a specific group or  even to all groups, while its practitioners are  seemingly unaware. Nowadays, healthcare professionals worldwide,  including nurses, deliver  care for increasing numbers of culturally diverse patients.  Our society is based on evolution of various cultural practices that has influenced  the way we eat, dress, think, solve problems and  even maintain, improve and maintain our health status. It is imperative for nurses,  who are also members of the same society to strive  to carry out their responsibilities and  duties, while striking a balance: doing what is  right, without undermining  the culture and tradition of the society.  

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Culture is an umbrella term which encompasses  the social behavior and  norms found in human societies,  as well as the knowledge, beliefs, arts, laws, customs,  capabilities, and habits of the individuals in these groups (Hart, 2019). Culture can also be defined  as the feature and knowledge of a particular group of people,  bounding language, religion, cuisine, social habits,  music and arts. It is an integrated set of pattern of human activities,  knowledge and belief within a community or  social group and the symbolic structures  (Heine & Ruby, 2017).  Humans acquire culture through the learning processes of enculturation and  socialization, which is  shown by the diversity of cultures across societies. Culture is also constantly evolving , according to times and civilization. 

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Social scientists have developed  two basic categories to define  things produced by a society. First is Material Culture and  second is Nonmaterial Culture (Willis & Elmer, 2016). Material or Tangible Culture: Material culture refers  to the physical objects,  resources, and spaces that people use  to define their culture. These include houses, schools,  churches, mosques, offices, temples, factories and  plants, clothes, food, utensils, roads, ornaments,  tools, goods and products, stores and many more. All of these man-made objects and  things that have been evolved  over ages for man's well-being and  comfort are material culture (Hart, 2019). Material culture does not mean  that it is an object that is  bought and sold; it can also be something we all make. For example, cooking is a common thing we all do  in different societies and  there are different types of food in each society,  and therefore is a part of our material culture. 

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Non material or Intangible Culture:  The other type of culture is  non material culture which cannot be  touch, feel, taste or hold. Non material culture belongs  to the nonphysical ideas that people have  about their culture, including beliefs, values, rules,  norms, morals, languages, social roles, ethics, music,  literature, customs, traditions,  organizations and institutions. Non material culture is  just as big of impact on our lives as material culture. 

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Culture has its own characteristics. They are discussed below (UNESCO,  2020; Willis & Elmer, 2016): Learnt: Culture is learnt from their elders because it is  not biological. Culture is not the thing you study  or inherit but it is just the process you pass from it.  Instead, you learn culture subconsciously without paying  any attention. Children copy behaviours and adopt different roles and  values. We learn our culture not only from our parents but  also from families, institutions, media and other people. Shared: Culture is something that is  shared because we share our culture with other members of our group. Culture is always transferred by sharing. Culture is shared in many ways like social communication, group discussions, public speaking, TV, internet. Social: Culture is not a one person phenomena. It is a product of society and  it grows through social interaction.  Culture can also be a result of thoughts of social influence. 

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Continuous: Culture is a continuous process and  adapts changes in the environment.  Culture is growing whole with the achievements of the past and  present and provide the future achievements of mankind. Culture is the result of past and present experiences. Integrated: Culture is also integrated  because its various parts are interconnected. All components of culture are  connected to one another and  to gain an extensive understanding of culture,  we must learn about all these different components. 

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IMPACT OF HEALTH ON HEALTH-SEEKING BEHAVIOUR 

Health practices of individuals are  shaped and modified by the cultural beliefs,  traditions and norms of the society. In traditional cultures,  beliefs about disease causation result in customs and  practices that have serious impact on the acceptance of certain orthodox health care norms or  practices.  Health itself is a cultural concept because culture frames and  shapes how we perceive the world and our experiences. Along with other determinants of health and  disease, culture helps to define: How patients and health care providers view  health and illness. What patients and health care providers believe  about the causes of disease. For example, some patients are  unaware of germ theory and  may instead believe in fatalism,  a djinn (in rural Afghanistan, an evil spirit that seizes  infants and is responsible for tetanus-like illness),  the 'evil eye', or a demon. They may not accept a diagnosis and  may even believe they cannot change  the course of events. Instead, they can only accept  circumstances as they unfold (Willis & Elmer, 2016).  

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Photo by Devi Puspita Amartha Yahya on Unsplash

Which diseases or conditions are stigmatized and why. In many cultures, depression is  a common stigma and seeing  a psychiatrist means a person is "crazy". What types of health promotion activities are  practiced, recommended or insured. In some cultures, in Africa, being "strong" means being  big and having a store of energy against famine,  and "strong" women are chubby, desirable and are  seen as healthy, and these might just mean  a person is overweight or  even obese and unhealthy (Ugwueje, 2011) How illness and pain are experienced and expressed. In some cultures, stoicism is  the norm, even in the face of severe pain. In other cultures, people openly express  moderately painful feelings. The degree to which pain should be  investigated or treated may differ.  

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Culture also affects: Acceptance of a diagnosis, including who should be  told, when and how. Perception of the amount of control individuals have  in preventing and controlling disease. Acceptance of preventive or  health promotion measures (e.g.,  vaccines, prenatal care,  birth control, screening tests, etc.). Use of direct versus indirect communication. Making or avoiding eye contact can be  viewed as rude or polite, depending on culture.  Willingness to discuss symptoms with a health care provider,  or with an interpreter being present. Influence of family dynamics,  including traditional gender roles,  filial responsibilities,  and patterns of support among family members. How accessible the health system is , as well as how well it functions.  

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NURSING AND CULTURE: STRIKING A BALANCE  

Nurses are required to care  for all categories of patients from different cultural backgrounds and  all walks of life. While some aspects of cultures are  considered harmless and sometimes even advantageous,  some aspects may be harmful. The nurse in this instance is expected to understand , communicate with, and  interact with people effectively and  encourage aspects of culture that fosters  good health and gently educate  people to shun practices and traditions that do not. Striking a balance in this case centers around: Acquiring knowledge of various cultural practices and  views of the world Understanding the relationship between patients and  their understanding of disease and  health care, in relation to their culture Developing communication skills to promote  and achieve interaction among cultures Ensuring a positive attitude is  displayed toward differences and various cultures  

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NURSING AND CULTURE: STRIKING  A BALANCE CONT'D  

Striking a balance in this case involves  more than tolerating another's cultures and practices. Instead, it aims to help  the nurse them through bridging  gaps and personalizing care. There are many traits an actions that will aid  the nurse in ensuring that a balance is  maintained at all times. They include but are not limited to the following: Speaking in terms that are  easy for the patient to follow and understand. Not judging or disregarding a patient's belief and  religious background, but encouraging them to do  what works best for them. Empathizing with the patient at all times. Valuing the individual and applauding strengths and  individuality. Respecting, understanding and working with differing  cultural perceptions of effective or  appropriate treatment. Ask about and record how your patients like  to be addressed, receive  health care and treatment information. Ascertaining the patient's understanding of his or  her own health or illness. 

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Identifying alternative therapies that may interfere  with treatments and explain  why patients should shun them Ignoring alternative therapies that are  harmless, so as to strengthen  the patients resolve on prognosis of illness Assessing situations carefully at all times. The nurse is required to also look  out for practices that may have injured  the patient, such as feet burning  and giving cow urine for convulsions,  female genital mutilation and so on. Explaining the rationale behind orthodox health care therapies at every point in time. This aids acceptance of positively impactful therapies. 

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Cultural influences are  an integral aspects of health care that is  often ignored or handled with levity. Unfortunately, culture influences  a lot more that food, dressing or religion. Culture plays an important role in determining  practices that members of the society undertake  to seek better health and maintain their health. Not all aspects of cultures are  to be encouraged or discouraged. Some have good basis in health care while some others,  over the years have been found to be derogatory. However good or bad these practices are , it is important to note  that many of these practices have been  in use before mainstream health care therapies became  generally accepted. Therefore, it is up to the health care worker,  especially the nurse, to be  knowledgeable enough to discern  the position of cultural practices that interfere  with health care and handle them appropriately.  

NURSING AND CULTURE: STRIKING A BALANACE

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