Cultural Awareness, Transcultural Nursing, and Health Practices Explained | Chapter 5 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

Welcome to Chapter 5 of the Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri. In this essential chapter, nursing students develop the skills needed to deliver culturally competent, patient-centered care by understanding how culture, religion, and health beliefs impact nursing practices. Whether you’re preparing for the NCLEX-PN or seeking to expand your knowledge as a future nurse, this guide provides a comprehensive foundation in transcultural nursing.

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The Importance of Cultural Competence in Nursing

Cultural competence is more than a buzzword; it’s a professional responsibility for nurses. This chapter explores the necessity of individualized care planning that respects diverse cultural backgrounds, religious beliefs, family structures, and health traditions. Culturally competent care not only improves health outcomes but also fosters trust and safety between nurses and clients.

Transcultural Assessment: Giger and Davidhizar’s Model

A key highlight is the Giger and Davidhizar Transcultural Assessment Model, a framework that evaluates clients across six domains:

• Communication
• Space
• Social Organization
• Time
• Environmental Control
• Biological Variations

This model helps nurses deliver individualized, holistic care that meets each client’s unique needs.

Cultural Groups: Health Beliefs, Practices, and Family Structures

Chapter 5 examines major cultural groups and highlights important distinctions in health beliefs, family roles, and risk factors:

• African Americans: Strong family networks, variable dietary practices, increased hypertension and diabetes risk.
• Amish: Community-oriented, limited technology use, unique approaches to health care and childbirth.
• Asian Americans: Emphasis on respect for elders, traditional medicine, and modest communication styles.
• Hispanic and Latino Americans: Close family bonds, strong spiritual beliefs, and use of traditional healing.
• Native Americans: Holistic health beliefs, importance of harmony, increased risk for substance abuse and diabetes.
• White Americans: Diverse backgrounds with varied health beliefs and dietary customs.

Religion and Health Practices: Diet, Healing, and End-of-Life Care

Understanding religious customs is vital to safe and respectful nursing care. Key considerations include:

• Islam: Halal dietary laws, prayer rituals, fasting during Ramadan, specific end-of-life beliefs.
• Judaism: Kosher dietary restrictions, Sabbath observance, cultural mourning practices.
• Hinduism: Vegetarianism, beliefs about life, death, and spiritual purity.
• Christianity: Prayer, sacraments, and variations in dietary restrictions by denomination.
• Buddhism: Meditation, vegetarianism, views on suffering and reincarnation.

Complementary, Alternative, and Traditional Healing Practices

Culturally competent nurses recognize and respect the use of complementary and alternative medicine (CAM):

• Energy medicine (e.g., Reiki, acupuncture)
• Mind-body interventions (e.g., meditation, yoga)
• Biologically based therapies (e.g., herbal supplements)
• Manipulative practices (e.g., massage)

Nurses must be aware of potential interactions between herbal supplements and prescribed medications, as well as possible contraindications.

Communication, Health Literacy, and Family Dynamics

• Use language-appropriate resources and professional interpreters to overcome language barriers.
• Assess and address health literacy to ensure understanding of treatment plans and medication instructions.
• Respect family roles, decision-making processes, and preferences for care participation.

Legal, Ethical, and Spiritual Considerations in Cross-Cultural Care

Delivering culturally appropriate care means respecting legal and ethical boundaries, maintaining patient autonomy, and honoring spiritual and emotional needs throughout the care process, including at the end of life.

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Conclusion: Delivering Culturally Sensitive Nursing Care

Chapter 5 of Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) provides nursing students with essential tools for delivering safe, culturally competent, and holistic care. By understanding health beliefs, communication styles, and religious practices—and integrating complementary therapies when appropriate—future nurses are empowered to promote health and respect every client’s unique identity.

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