TRANSCULTURAL NURSING

Culturally Competent
Nursing Care
 Objectives
Understand Cultural Competence: Students will learn the importance of
cultural competence in providing respectful, patient-centered care.
Improve Patient Outcomes: Students will develop skills to enhance patient
outcomes by involving patients in their care through culturally sensitive
practices.
Develop Cross-Cultural Communication: Students will practice effective
communication techniques, including active listening and empathy, to engage
with patients from diverse cultures.
Conduct Cultural Assessments: Students will gain the ability to perform
thorough cultural assessments to better understand and address patients'
unique needs and values.
Apply Culturally Appropriate Care: Students will learn how to design and
implement care plans that respect and integrate patients' cultural preferences.
 Cultural
the use of language and other
communicative tools to carry out the

What is activities and commitments of

particular groups.

cultural and
intercultural
communication? Intercultural
the use of language and other
communicative tools to carry out the
activities and commitments of two
different groups.
 What is Culturally
Competent Nursing Care
What is Culturally Competent Nursing Care
Cultural competence in nursing refers to the ability to work
and care for a vast variety of people, regardless of their
cultural background. In an ever-diverse and complex word,
culturally competent nursing care has never been more
critical.
Cultural competence in nursing has grown increasingly
important in recent years, particularly as healthcare
professionals work to prioritize inclusion efforts.
Culturally competent nursing is considered one of the best
pathways toward truly patient-centered care.
Importance of Cultural
Competence in Nursing
Importance of Cultural Competence in Nursing
It helps improve overall patient outcomes, as nurses are able
to provide patients with the personalized care they both
need and deserve.
It allows patients to play a powerful role in their own
treatment plan. Patients who feel seen, heard and
represented within the healthcare system feel more
empowered to actively communicate with their care team
and advocate for themselves.
It improves overall health equity and access, as culturally
competent nursing care helps patients feel as if their needs
will be met within the healthcare system.
 Goal of Culturally
Competent and
Congruent Care
To provide respectful, meaningful, and competent care to people of
diverse cultures that leads to health and well-being or to face death
or disabilities of individuals or groups.
Categories of Cultural
Competence

1. Individual Cultural Competence

2. Organizational Cultural Competence
3. Cultural Baggage
 Categories of Cultural
Competence
1. Individual Cultural Competence - refers ro the care provided for
an individual client by one or more nurses, physicians, social
workers, and/or other health care, education, or social services.
2. Organizational Cultural Competence - focuses on the collective
competence of the members of an organization and their
effectiveness in meeting the diverse needs of their
effectiveness in meeting the diverse needs of their clients,
patients, staff and community.
3. Cultural Baggage - refers to the tendency for a person’s own
culture to be foremost in his/her assumptions, thought, words,
and behaviour.
4 Components for Culturally
Competent Care
Cultural Worldview
Cultural Differences
Cultural Practices and Worldviews
Cross-Cultural Skills
 4 Components for Culturally
Competent Care
Cultural Worldview

Defined as the general perception and beliefs about an individual

culture, cultural worldview plays a pivotal role in culturally competent
care. Nurses need to be aware of the cultural worldviews of various
cultures and actively work to dispel any stereotypes or myths that may
exist about those cultures.
 4 Components for Culturally
Competent Care
Cultural Differences

Cultural differences refer to the numerous traditions, beliefs and values that
are upheld within a particular culture and the differences that may exist
from one culture to another. Cultural differences between patients and care
providers can lead to unintended outcomes, which is why it’s essential that
nurses work to understand cultural differences and bridge the gap between
them.
 4 Components for Culturally
Competent Care
Cultural Practices and Worldviews

Cultural practices are the manifestation of a culture or subculture based on

shared beliefs and traditions. Again, awareness of various cultural practices
and worldviews can help nurses provide patients with personalized and
attentive care.
 4 Components for Culturally
Competent Care
Cross-Cultural Skills

A type of interpersonal skills that allow a professional to not only

understand the perspective of a person from a different culture but also
interact with them effectively and respectfully, cross-cultural skills are vital
among the nursing workforce. Nurses need cross-cultural skills in order to
provide their patients with compassionate care.
Guidelines for the Practice of
Culturally Competent Nursing
Care
Guidelines for the Practice of Culturally
Competent Nursing Care

1. Knowledge of Cultures
2. Education and Training in Culturally Competent Care
3. Critical reflection
4. Cross-Cultural Communication
5. Culturally Competent Practice
6. Cultural Competence in Health Care Systems and Organizations
7. Patient Advocacy and Empowerment
8. Multicultural Workforce
9. Cross-Cultural Leadership
10. Evidence-based Practice and Research
 Examples of
Culturally Competent
Nursing Care
Examples of Culturally Competent Nursing Care
The following are some of the ways nurses can become more
culturally competent while working with patients:

Avoiding assumptions
Active listening
Reflection on biases
Accommodation and education
Using common and understandable language
Recruiting diverse staff members
Working in diverse settings
Evaluating their own perspectives
 How Patients and
Hospitals Benefit from
Culturally Competent
Care
How Patients and Hospitals Benefit from
Culturally Competent Care

Enhanced Health Outcomes Across Diverse Communities

Reduced Health Disparities and Inequities
Increased Trust and Communication between patients and
Healthcare Providers
Strengthened Patient-Provider Relationships
Promotions of Inclusive Healthcare Practices
 5 STEP PROBLEM
SOLVING PROCESS
5 STEP PROBLEM SOLVING
PROCESS
1. Assessment:
This step involves gathering information about the client's cultural background,
including their beliefs, values, customs, and practices. It also involves conducting a
health history and physical examination.

2. Mutual Goal Setting:

In this step, the nurse and the client work together to establish mutually agreed-upon
goals for the client's care. These goals should be culturally appropriate and reflect
the client's values and preferences.

3. Care Planning:
Based on the information gathered in the first two steps, the nurse develops a care
plan that outlines the interventions that will be used to help the client achieve their
goals. The care plan should be culturally sensitive and tailored to the client's
individual needs.
5 STEP PROBLEM SOLVING
PROCESS
4. Implementation:
This step involves carrying out the interventions outlined in the care
plan. It is important to ensure that these interventions are culturally
appropriate and delivered in a way that is respectful of the client's beliefs
and values.

5. Evaluation of Care Plan and Objectives by Client and

Team:
This step involves evaluating the effectiveness of the care plan and the
extent to which the client's goals have been achieved. The evaluation
should be done in collaboration with the client and the healthcare team.
 Organizational Cultural
Competence
focuses on the collective competencies of the members of an
organization and their effectiveness in meeting the diverse needs of
their clients, patients, staff, and community.
The capacity to (1) value diversity, (2) conduct self-assessments, (3)
manage the dynamics of difference, (4) acquire and institutionalize
cultural knowledge, and (5) adapt to diversity and the cultural
contexts of the communities they serve
Incorporation of the previously mentioned items in all aspects of policy
making, administration, practice, and service delivery and systematic
involvement of consumers, key stakeholders, and communities.
 Culture Care Assessments
the systematic identification and documentation of
cultural care beliefs, meanings, values, symbols, and
practices of individuals or groups within a holistic
What is perspective, which includes the worldview, life
experiences, environmental context, ethnohistory,
Cultural Care language, and diverse social structure influence.

Assessments? focus on partial views as

psychomotor, physiological, or mental
conditions to that of holistic,
cultural, environmental,
ethnohistorical, and social structure
factors but still consider medical and
nursing phenomena.
 PURPOSES OF CULTURE CARE
ASSESSMENT
1. Understand client's cultural values, beliefs, and health patterns.
2. Provide a holistic basis for nursing decisions.
3. Tailor nursing care to fit the client's cultural needs.
4. Identify cultural conflicts between clients and healthcare providers.
5. Recognize dominant cultural themes for congruent care.
6. Compare cultural care practices for use in clinical and research
settings.
7. Identify similarities and differences in cultural care needs.
8. Use theoretical and research approaches for better care practices.
PRINCIPLES OF CULTURALOGICAL ASSESSMENTS
The first principle is to show a genuine and sincere interest in the client as one
listens to and learns from the client.

The second principle is to give attention to gender or class differences,

communication modes (with special language terms), and interpersonal space.

The third principle is to study the Sunrise Model dimensions and Culture Care
theory before assessing to draw on and use different components of the
Sunrise Model and their interrelationships.

A fourth principle for an effective culture care assessment is that the nurse
needs to remain fully aware of one’s own cultural biases and prejudices.
 PRINCIPLES OF CULTURALOGICAL ASSESSMENTS
The fifth principle to guide the nurse in doing a culturalogical assessment is to be aware
that clients may belong to subcultures or special groups such as the homeless, AIDS and
HIV infected, drug users, lesbians, gays, the deaf, and the mentally retarded, a knowledge
of which is required to assess accurately.

The sixth principle is that nurses need to know their own culture and areas of competencies
along with their deficits to become culturally competent practitioners.

The seventh principle to guide the nurse in doing a cultural care assessment is to clarify and
explain at the outset to the individual, family, or group the focus and purpose of the
assessment, including times to visit with them about their health care beliefs and practices.

The eighth principle is to seek a holistic view of the client’s world within his or her
environmental context by focusing on familiar and multiple factors depicted in the Sunrise
Model that influence care, illness, or well-being.
 PRINCIPLES OF CULTURALOGICAL ASSESSMENTS

The ninth principle is to remain an active listener and to discover the clients’ emic lifeways,
beliefs, and values as well as etic professional ways, to fit client expectations and create a
climate that is trusting so that the client feels it is safe and beneficial to share one’s
beliefs and lifeways.

The tenth principle is to reflect on learned “transcultural holding knowledge” about the
client’s culture and research-based care and health knowledge available today.
 CULTURAL
ASSESSMENT
TOOL
This is used to evaluate a patient's
cultural background and perspectives on
health and disease.
 SUNRISE
MODEL
BY MADELEINE LEININGER
In real-world nursing, the Sunrise Model helps to guide the delivery of holistic and
empathetic care. It emphasises that every patient encounter is unique and requires
a personalised approach to care. The Model highlights this uniqueness by
illustrating that care is dependent on a multitude of factors, most importantly
context and culture.

Similarly, the model helps to understand how the patient's social structure
affects their health behaviours and access to care, and offers insights into the
role of technology in healthcare delivery. It also assists in assessing the scope of
incorporating health practices from a patient's cultural background into their
current care plan.

Notably, the Sunrise Model doesn't offer a fixed care formula; instead, it serves
as a tool for nurses to tailor care on an individual level. This illustrates why
Leininger's work is integral to contemporary nursing, especially in an increasingly
multicultural world.
ALTERNATIVE SHORT
ASSESSMENT GUIDE
ADDITIONAL CULTURAL ASSESSMENT TOOLS

1. Giger and Davidhizar Transcultural Assessment Model

2. Purnell Model for Cultural Competence
3. Campinha-Bacote's Model of Cultural Competence
4. Heritage Assessment Tool
 CARING RITUALS
IMPORTANT TO ASSESS

Caring rituals play a crucial role in

promoting wellness, preventing illness, and
aiding recovery. These rituals are common
across different cultures and are used both
at home and in healthcare settings such as
hospitals.
 CARING RITUALS
1. Eating Rituals
2. Daily and Nightly Ritual Care Activities
3. Sleep and Rest Ritual Patterns
 SKILLS NEEDED FOR
CULTURAL
ASSESSMENT GUIDE
Skills Needed for Cultural Assessment
Active listening
Engaging with patients in a respectful way, understanding their beliefs
and values. This involves asking open-ended questions and showing
genuine interest in their cultural background. Additionally, cultural humility
and a willingness to learn from each patient's unique perspective are
essential for a successful assessment.
Empathy
Expressing genuine concern and respect for patients' cultural
viewpoints can help build trust and rapport, leading to more accurate
and comprehensive assessments. By acknowledging and validating the
diversity of cultural experiences, nurses can create a more inclusive
and patient-centered approach to care.

Cultural Knowledge
Being familiar with diverse cultural practices, religious concepts, health-
related customs, and family structures can help nurses provide more
effective and culturally sensitive care. This knowledge can also aid in
developing individualized care plans that respect and incorporate each
patient's cultural background. patient's cultural background.
 Skills Needed for Cultural Assessment
Critical Thinking
Investigating the impact of cultural influences on patient
care and health outcomes can help nurses critically
analyze and adapt their practices to better meet the
needs of diverse populations. By engaging in ongoing self-
reflection and education, nurses can continuously improve
their cultural competence and provide more equitable care
for all patients.

Adaptability
Modifying care plans to meet the cultural needs and
preferences of the patient requires nurses to be adaptable
and open-minded. This flexibility can lead to improved patient
outcomes and overall satisfaction with their care.

Cultural sensitivity
Refraining from language or actions that could be considered
insulting or disrespectful to patients from different cultural
backgrounds is essential for providing quality care. Nurses
must be aware of their own biases and actively work to
understand and respect the beliefs and practices of others
in order to promote positive patient experiences.
CROSS - CULTURAL
COMMUNICATION
 CROSS-CULTURAL
COMMUNICATION
Effective cross-cultural communication is essential for nurses to provide culturally competent care. It
involves understanding and respecting patients' diverse values, beliefs, practices, and unique healthcare
needs. By employing culturally appropriate verbal and nonverbal communication skills, nurses can
foster trust, build rapport, and deliver high-quality care that is tailored to the individual patient's cultural
background.

Madeleine Leininger’s Theory of Culture Care Diversity and Universality serves as a foundational
framework in transcultural nursing, emphasizing the need for nurses to understand and integrate
cultural factors into healthcare. Cross-cultural communication is essential in ensuring that nurses can
provide care that is respectful of and tailored to the cultural needs of diverse patient populations.
 Cross-Cultural Communication
in Transcultural Nursing
Cultural Awareness:
Cultural Sensitivity
Cultural Competence
Active Listening
Building trust
Accurately assessing patients’ health practices, beliefs, and symptoms
Providing patient-centered care
 Cross-Cultural Communication:
Comparing the Philippines to Global Settings
 Cross-Cultural Communication: Comparing the
Philippines to Global Settings

The Philippines, with its rich cultural heritage and history of foreign
influence, offers a unique perspective on cross-cultural communication. By
understanding the cultural nuances of the Philippines and comparing them
to other global settings, we can gain valuable insights into the challenges
and opportunities of cross-cultural interactions.
 Cross-Cultural Communication in the Philippines
In the Philippines, health practices are deeply influenced by the family unit, religious beliefs, and
traditional healing practices.

Philippines
Family Involvement:
Nurses should engage the family in care decisions,
recognizing their role in treatment discussions.
Traditional Medicine:
Acknowledge and integrate traditional practices
(e.g., herbal remedies, hilot) into care plans while
educating patients on modern interventions.
Religious Practices:
Respect and incorporate patients' religious beliefs
(e.g., Catholicism) into care plans, accommodating
rituals and spiritual needs.
Cross-Cultural Communication: A Global Perspective
Globally, nursing practices vary widely based on cultural contexts:

Western countries (e.g., U.S., Canada),

healthcare is highly technology-driven, with a strong emphasis on evidence-based
practice and patient autonomy. This dimension reflects a culture's focus on long-
term goals and traditions
(e.g., long-term orientation cultures like China vs. short-term orientation cultures like
the United States).

Individualism and Autonomy:

In Western countries, involves addressing the patient directly, ensuring that they understand
their medical choices and are empowered to make independent decisions. This contrasts with
the family-centered decision-making common in the Philippines.

Evidence-Based Practice:
Healthcare in Western countries is driven by technology and evidence-based medicine.
Communication is often clear, direct, and focused on delivering scientifically grounded care.
Nurses may have to navigate patient expectations for quick, efficient, and highly technical
care.
Cross-Cultural Communication: A Global Perspective
Globally, nursing practices vary widely based on cultural contexts:

Asian countries (e.g., Japan, China)

There is a balance between traditional practices (like acupuncture,
herbal medicine) and modern healthcare, with respect for Hierarchy and
Collectivism in decision-making.

Balance and Harmony:

Health in many Asian cultures is seen as a balance of forces (e.g., yin and
yang). Cross-cultural communication must involve discussing treatment
options in a way that acknowledges traditional views of health, such as
acupuncture, herbal remedies, and holistic practices.

Respect for Authority:

In Asian cultures, respect for authority figures, including healthcare
professionals, may lead patients to withhold their opinions or concerns.
Cross-Cultural Communication: A Global Perspective
Globally, nursing practices vary widely based on cultural contexts:

African cultures
often incorporate Community Health workers and place a high value on
Holistic care, considering the Physical, Emotional, and Spiritual well-being of
patients.

Respect for traditional beliefs and collaboration with community healers.

Language diversity is a significant factor, as nurses may need to
communicate in local languages or use interpreters to provide effective
care.

Respect for Authority: In Asian cultures, respect for authority figures,

including healthcare professionals, may lead patients to withhold their
opinions or concerns.
Cross-Cultural Communication: A Global Perspective
Globally, nursing practices vary widely based on cultural contexts:

Australia and Oceania

Health Practices: In Australia,

Health practices in Oceania vary greatly depending on the

region. In Pacific Island nations, traditional healing methods
are widely used, such as the application of herbs and the
performance of rituals. In Australia and New Zealand,
healthcare follows more Western principles but
acknowledges indigenous healing practices. Community
and family are central to health decisions, and there’s a
strong focus on maintaining balance with nature.
Cross-Cultural Communication: A Global Perspective
Globally, nursing practices vary widely based on cultural contexts:

Oceania
Health Practices: In Australia,

Health practices in Oceania vary greatly depending on the

region. In Pacific Island nations, traditional healing methods are
widely used, such as the application of herbs and the
performance of rituals.

In Australia and New Zealand, healthcare follows more Western

principles but acknowledges indigenous healing practices.
Community and family are central to health decisions, and
there’s a strong focus on maintaining balance with nature.
Cross-Cultural Communication: A Global
Perspective

Cross-cultural communication is essential in

today's interconnected world, particularly in
healthcare settings. Based on Madeleine
Leininger’s work in Transcultural Nursing,
effective communication across cultural
boundaries enhances patient outcomes and
fosters positive healthcare relationships.
Global Challenges and Strategies
1. Understanding Cultural Diversity
Leininger emphasized the importance of recognizing the unique
values and beliefs of diverse cultures to deliver respectful, tailored
care.

2. Communication Styles
Different cultures exhibit varying communication styles, requiring
healthcare providers to adapt and be sensitive to these differences to
facilitate understanding.

3. Building Trust and Rapport

Establishing trust is crucial. Leininger’s theory highlights the need for
healthcare providers to demonstrate cultural competence and
validate patients’ experiences to encourage open dialogue.
Global Challenges and Strategies
4. Cultural Safety and Competence
Cultural safety involves creating environments that respect patients'
cultural identities, while cultural competence entails continuous learning
about different cultures and recognizing personal biases.

5. Collaborative Care
Cross-cultural communication promotes collaborative care that includes
patients, families, and community resources, integrating modern medicine
with traditional practices.

6. Education and Training

Ongoing education in cultural awareness and sensitivity is vital for
healthcare providers to effectively engage in cross-cultural communication.
Conclusion
Global Challenges and Strategies
 Cross-cultural communication is a complex skill
that requires understanding cultural dimensions,
overcoming challenges, and adapting
communication styles. By embracing cultural
diversity and practicing effective communication
strategies, individuals and organizations can foster
stronger relationships and achieve global success
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

CULTURE AND PRACTICES

CONTINENTS COMMUNICATION HEALTHCARE

ASIAN SOUTHEAST ASIA:

Filipinos
- Communication is often - Healthcare decisions
indirect, with an often involve the
emphasis on non- family, with elders
confrontation and playing a significant
preserving harmony. role in decisions.
- Smiling and nodding are - Traditional healing
common even if there is practices such as
disagreement. hilot (massage
- Family and relationships therapy) and herbal
are central to remedies are still
communication. valued, alongside
modern medicine.

Thais
- Indirect communication - Herbal medicine and
is valued to avoid spiritual healing
conflict; direct (such as Buddhist
confrontation is rituals or offerings)
avoided. are common.
- The Wai gesture (hands - Thai massage and
in prayer position) is meditation are part of
common for greetings. holistic approaches
- Respect for hierarchy to health.
and elders is - Family often
emphasized in both supports decisions,
verbal and non-verbal but monks or spiritual
communication. leaders may also be
consulted.

Vietnamese
- Communication is often - Traditional
indirect, with an medicine, such as
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

emphasis on saving acupuncture, herbal

face and avoiding remedies, and
confrontation. cupping therapy, is
- Respect for elders is often integrated with
central, and titles are modern healthcare.
often used in - Family plays a major
conversation. role in decisions, and
- Silence may be used to ancestor worship
avoid disagreement. may be connected to
healthcare.

EAST ASIA:

Chinese - Traditional Chinese

- Communication is often Medicine (TCM)
indirect to avoid conflict practices like
and maintain harmony. acupuncture, herbal
- Respect for hierarchy is remedies, and
important, with the qigong are
elderly and those in commonly used
authority being treated alongside Western
with deference. medicine.
- Non-verbal cues like - Decisions are family-
tone and body language centered, with a
carry significant focus on maintaining
meaning. balance and
harmony.

Japanese - Healthcare is highly

- Communication is developed, but
highly formal and traditional methods
indirect, with politeness like acupuncture,
and humility being herbal medicine,
central values. and onsen (hot
- Silence is a common spring baths) are still
tool in conversation, and popular.
listening attentively is - Family plays a crucial
role in decision-
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

seen as a sign of making, particularly

respect. for elder care.
- Personal space is - End-of-life care is
respected, and bowing often influenced by
is the customary Buddhist practices.
greeting.

- Korean traditional
medicine, such as
Koreans herbal remedies
- Hierarchical and acupuncture,
communication based are commonly used
on age and social status alongside modern
is important. healthcare.
- Indirect communication - Elders are deeply
is often used to avoid respected and often
confrontation. make healthcare
- Respect is shown decisions.
through deferential - Family involvement
language and gestures is crucial in
like bowing. healthcare, and end-
of-life care follows
traditional rituals.

SOUTH ASIA: - Ayurveda, Yoga,

and Unani are
Indians traditional systems of
- Communication varies medicine practiced
by region and culture alongside modern
but is often indirect, with healthcare.
an emphasis on - Family plays a
politeness and central role in
maintaining social healthcare decisions,
harmony. especially regarding
- Respect for elders and the elderly.
social hierarchy is - Spirituality, prayer,
important. and religious rituals
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

-Personal space can are often integrated

vary, and physical touch into healthcare.
is common among close
friends and family. - Unani and
Pakistanis Ayurvedic medicine
- Communication is often are traditional
indirect, especially healthcare systems,
when discussing often practiced
sensitive topics. alongside modern
- Respect for elders and medicine.
authority is paramount, - Family and
and titles are used to community play a
show respect. crucial role in
- Personal space is decision-making.
respected, but close - Spiritual healing and
friends may engage in Islamic practices,
physical touch. such as reciting
Quranic verses, are
integral to
healthcare.

- Ayurvedic medicine
Sri Lankas is widely practiced,
- Communication is often alongside
generally polite and modern healthcare.
indirect, with a strong - Family and
emphasis on respect for community play key
authority and elders. roles in healthcare
- Non-verbal decisions, and elders
communication, such as are consulted.
body language and - Religious rituals and
facial expressions, are offerings, especially
important. Buddhist or Hindu
- Social hierarchy and traditions, may be
titles are respected in integrated into
conversation. healthcare.
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

MIDDLE EAST ARABS: Direct eye contact ARABS:

between men is a sign of Use of herbal remedies and
sincerity, but men often avoid cupping therapy (Hijama).
eye contact with women as a Decisions often made
sign of respect. Personal collectively with family input.
space is close among the same Prioritizing the needs of
gender. Greetings often elderly individuals in
involve a handshake or cheek healthcare.
kisses among men. Respect Increasing emphasis on
for elders is key, and gestures preventive health
are used to emphasize points. measures.
Discussing family issues
openly with strangers is often
avoided. Privacy and modesty
are crucial, especially in
interactions involving female
ARAB MUSLIMS: ARAB MUSLIMS:
Arabic is highly valued and Hygiene and Prayer:
considered the most perfect Ritual cleansing (washing
language due to its religious feet, arms, and face) is
significance in Islam. essential before prayer.
Understanding Arabic, even a Nurses should
few basic phrases, can foster accommodate or assist
positive communication. The patients with these
phrase "Inshallah" (if God wills) practices.
is commonly used to express Prayer is performed multiple
reliance on divine will. times a day, and providing a
Qur’anic verses are often clean and private space for
recited, and religious items like this is important.
prayer beads may be used for Family Involvement:
comfort and peace during care. Family is central in decision-
For non verbal communication, making, and elders hold
prayer and ritual practices are authority. Health-related
highly symbolic. For example, decisions often involve the
performing ritual cleansing extended family.
before prayer is essential. Caring for aging parents at
Modesty, particularly for home is a cultural norm, as
women, is important, and this nursing homes are rare.
extends to how nurses should Health Beliefs:
handle personal care tasks.
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

Health is seen as a holistic

concept that includes
physical and spiritual well-
being, guided by the unity
principle of "tawhid."
The concept of "evil eye"
and protective charms like
blue beads are used to
prevent harm.
Organ donation and
autopsies are generally not
accepted, as the body is
considered to belong to
God.
Modesty and Gender-
Specific Care:
Women may prefer female
healthcare providers,
especially during physical
exams, and may require
careful attention to modesty.
End-of-Life Practices:
Death is considered
predetermined by God, and
discussions about death
should be approached with
caution.
Religious rituals for washing
and shrouding the body are
important after death.

PERSIANS: Communication is PERSIANS:

indirect and nuanced, with an No specific practices
emphasis on politeness and mentioned but healthcare
hierarchy. Moderate eye likely aligns with respect for
contact and respect for hierarchy and family input.
personal space are common.
Gestures are used sparingly,
and physical touch in public
between genders is limited.
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

Politeness is often emphasized

in conversation, and criticism is
often delivered subtly.
KURDS: KURDS:
Generally direct Traditional medicine such
communication, especially as herbal remedies often
among men, but polite and used. Increasing integration
respectful in formal contexts. of modern healthcare
Personal space is close among practices.
the same gender, and gestures
are freely used.
TURKS: TURKS:
Eye contact is seen as a sign of Strong emphasis on
trust and interest, but overly modern healthcare but
intense eye contact can be also use of herbal remedies
uncomfortable. Physical touch and spiritual healing in some
is common between friends of cases. Family plays a role in
the same gender, such as healthcare decisions.
hand-holding or hugging.
Humor is often part of
communication, even in
serious conversations. Turkish
people may prefer direct
communication, but they
balance it with politeness and
warmth.
JEWISH ISRAELIS: JEWISH ISRAELIS:
More direct communication Modern healthcare
style, valuing system with advanced
straightforwardness. Moderate medical technologies.
personal space and eye Emphasis on family
contact are typical, with involvement in healthcare.
emphasis on sincerity and Kosher laws may influence
respect for elders. dietary needs in medical
care settings.

BEDOUINS: BEDOUINS:
Formal and respectful Use of traditional medicine
communication, particularly including herbal treatments.
with elders. Indirect styles are Nomadic lifestyle can
 Republic of the Philippines

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College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

common to avoid offense, and influence access to modern

personal space is close among healthcare. Family and tribal
the same gender. Eye contact leaders often involved in
may be limited between men healthcare decisions.
and women.

AFRICAN North Africa ( Egypt, North Africa (Egypt,

CONTINENT Morocco) Morocco)

Communication is typically Islamic traditions influence

formal and respectful, health practices, including
especially with elders and fasting for health (e.g.,
authority figures. Eye contact is Ramadan). Herbal
important but varies by social remedies like cumin and
status. mint are common. Modern
healthcare is accessible in
urban areas, but rural areas
may rely on traditional
healers.

West Africa (Nigeria, Ghana) West Africa (Nigeria,

Communication is often strong Ghana)
emphasis on respect for Traditional healers (e.g.,
elders. Family involvement in herbalists, diviners) play a
conversations is common, and major role alongside
gestures are important in modern medicine. Healing is
conveying meaning. often seen as a community
affair, with spiritual rituals
and herbal remedies
commonly used. Modern
medicine is increasingly
integrated with traditional
practices in urban settings.

East Africa (Kenya,

East Africa ( Kenya, Uganda) Uganda)
with a focus on hierarchy and Traditional healers and
respect for elders. Non- herbal medicine are widely
verbal cues, like body used, especially in rural
language, are significant in areas. Health is seen as
 Republic of the Philippines

University of Cabuyao
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College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

conversations. holistic, addressing

physical, emotional, and
spiritual aspects.
Community health
programs play a key role in
preventive care, especially
in maternal and child health.

Central Africa (Congo,

Cameroon)
Central Africa ( Congo,
Cameroon) Spiritual healers and
traditional medicine are
Communication often frequently used. Healthcare
emphasizes respect and often blends Western
collectivism, with a strong medicine with traditional
focus on community practices like herbal
participation. Elders have an treatments and rituals. In
influential role in health rural areas, modern
decisions. healthcare may be limited,
so reliance on community
healSouthern Africa (e.g.,

South Africa, Zimbabwe)

Southern Africa ( Zimbabwe) Traditional healers like

sangomas are commonly
Communication may be consulted for spiritual and
formal, with attention given to physical ailments. Health
deference and respect for practices often integrate
elders. Oral traditions and Western biomedical
personal greetings are treatments with
important. indigenous healing rituals.
There’s a strong focus on
community-based health
promotion and preventive
care.
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

AMERICAN UNITED STATES:

CONTINENT Direct and assertive, with a Family Involvement: In the
focus on clarity and efficiency. U.S., patient autonomy is
Open disagreements and prioritized, with individuals
opinions are common. encouraged to make their
own medical decisions,
CANADA: though family often offers
Verbal: Direct, assertive, and emotional support and may
focused on clarity. People assist if the patient agrees.
speak openly and may
Healthcare System: The
disagree without hesitation.
U.S. focuses on technology-
driven, evidence-based
Non-verbal: Eye contact is key
treatments, while alternative
for trust, but prolonged staring
practices like acupuncture
is avoided. Handshakes are
and chiropractic care are
common; personal space is
generally considered
respected.
complementary.

Religious Practices:
Religious beliefs, especially
NATIVE AMERICAN: in matters like end-of-life
care and treatment refusals,
Verbal: Indirect, respectful, can impact decisions. While
with silence valued for Christianity is predominant,
reflection. Conversations healthcare providers
unfold slowly, avoiding direct accommodate diverse
confrontation. religious practices when
requested.
Non-verbal: Limited eye
contact and gestures, as CANADA:
prolonged stares can be While patient autonomy is
intrusive. Personal space is respected, family members
respected, and handshakes often play a more active role
are softer or less frequent. in significant medical
decisions, especially in
LATIN AMERICAN: cases of serious illness or
Verbal: Communication is long-term care, with patient
generally indirect, with an consent. Canada’s
emphasis on politeness and universal healthcare system
maintaining social harmony. focuses on evidence-based
 Republic of the Philippines

University of Cabuyao
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College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

Building personal relationships care, using advanced

and small talk are key before medical technology.
discussing business. Alternative treatments like
Non-verbal: Gestures are acupuncture and
frequent, and physical touch chiropractic care are
(handshakes, hugs) is increasingly integrated
common. Eye contact is alongside conventional
important but can be softer medicine.Religious
when speaking to elders or in Practices: Canada is
formal settings. Personal religiously diverse, and
space tends to be closer than healthcare providers are
in Anglo-American cultures. committed to respecting
various religious beliefs,
SOUTH AMERICA: particularly in end-of-life
Verbal Communication: care and treatment
Highly expressive and decisions, ensuring patients'
sometimes indirect, especially cultural and spiritual needs
on sensitive topics, with a focus are met.
on small talk, humor, and
personal connections. NATIVE AMERICAN:
Family Involvement: Elders
Non-verbal Communication: and extended family are
Frequent physical contact like highly respected and often
hugs and cheek kisses, close consulted in collective
proximity during conversations, medical decisions. Native
prolonged eye contact to show American practices include
engagement, and large spiritual ceremonies, herbal
gestures for emotional remedies, and healing
expression. Personal space is rituals, with healers
more respected in professional sometimes preferred over
settings. modern medical
practitioners. Spirituality is
closely linked to health,
involving prayer, meditation,
and ceremonies like
smudging. Respect for
nature and ancestral spirits
influences decisions on end-
of-life care and medical
treatments.
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

LATIN AMERICAN:
Family is central to
healthcare decisions, with
patients often consulting
relatives before agreeing to
treatment. Extended family
members frequently attend
medical
appointments.Herbal
remedies and curanderos
(traditional healers) are
common, often used
alongside Western
medicine, with patients
seeking both types of
care.Religious Practices:
Catholicism significantly
influences health beliefs,
with many trusting in the
healing power of faith,
saints, and miracles. Rituals
like prayers and blessings,
including the anointing of
the sick, are commonly
integrated into care.

SOUTH AMERICA
Family plays a crucial role in
collective decision-making,
especially for older
members. Extended family
often visits hospitals and is
expected to be present
during significant medical
events. Afro-Brazilian
traditions like Candomblé
and herbal medicine are
common, often
 Republic of the Philippines

University of Cabuyao
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College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

complementing modern
treatments with a focus on
spiritual healing.

Religious Practices: While

Catholicism is dominant,
indigenous and African
religious influences are
significant in Brazil,
impacting health choices
and preferences for spiritual
healing and medical
interventions.

EUROPEAN Germans: Germans:

CONTINENT Emphasize direct Prioritize preventive care
communication; prioritize and emphasize order in
punctuality and cleanliness. medical decision-making.
May prefer organized and Prefer evidence-based
formal communication in methods. Germans value
healthcare settings. Privacy is punctuality in healthcare
highly regarded. and often adhere strictly to
prescribed regimens. Use of
herbal treatments such as
chamomile for the treatment
of colds.

French: French:
Prefer formal address, Strong dependence on
especially in professional public healthcare and
settings. Respect for hierarchy; medical practitioners.
body language and gestures Holistic care is respected.
are important, as French may Routine medical
use expressive appointments are common,
communication. and French pharmacies
provide consultations.
Homeopathy and herbal
remedies are widely
recognized.
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

Spanish: Spanish:
Friendly, intimate conversation Usage of curanderos
is common. Touch, such (traditional healers)
handshakes or back pats, is alongside with conventional
often used. Family participation medicine. Advice on health
in decision-making is from elderly people is
respected. valued, and garlic or
chamomile may be utilized
for general well-being.

Italians:
Prefer face-to-face Italians:
communication and emotional Olive oil is said to provide
expressiveness. Family is health advantages. Folk
central to health decisions; beliefs such as the
respect for traditions and social "malocchio" (evil eye)
hierarchy. persist, and some
individuals use protection
Poles: charms.
Exhibit formality in professional
settings; demonstrate respect Poles:
for authority figures. Family Usage of herbal treatments,
significantly influences such as mint, for digestive
healthcare decision-making. purposes. Religious rituals
Catholicism influences such as prayers or
caregiving through its pilgrimages are
principles of faith occasionally performed for
healing purposes.
Dutch:
Prefer open and honest
interaction. Prioritize efficiency
and personal autonomy in Dutch:
healthcare choices. An
Adopt cycling and outdoor
emphasis on direct
pursuits as preventive
communication. strategies. Euthanasia and
assisted dying are permitted
Greeks: under strict conditions.
Emotional expressiveness is Focus on individual
common. Family plays a accountability for health.
 Republic of the Philippines

University of Cabuyao
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College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

central role in health decisions. Limit medicine usage to

Respect for elders and essential situations only.
healthcare providers is
common Greeks:
Orthodox Christian
Russians: celebrations, including
Prefer formal and organised health blessings. Usage of
communication; healthcare olive oil, herbal treatments,
decisions frequently include and honey in medicinal
extended family members. uses.
Tradition and beliefs in religion
(Orthodox Christianity) may Russians:
influence the situation. Combination of standard
medical care and traditional
Finns: methods. Healthcare is
Value silence in frequently regarded as the
communication, reflecting responsibility of the state.
respect for others. Decision- Uses of saunas (banya) for
making is often individualistic. detoxification and sickness
Directness and honesty are prevention. Herbal
appreciated. medicines, such as
raspberry tea, are frequently
Portuguese: utilized for fever
Warm, personal management.
communication style; physical
touch is common. Family plays Finns:
a strong role in health Focus on public health and
decisions. Respect for sauna traditions. Mental
traditions and elders is central. health is prioritized as well.
The utilization of saunas has
Irish: become crucial for health
Politeness and indirect maintenance in Finland.
communication are valued; Forest walks, or forest
humour may be used to diffuse bathing, are regarded as
tension. Family involvement is good for mental health.
common in healthcare
decisions. Portuguese
Family-oriented healthcare
influenced by beliefs in
religion. Dependence on
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

family support during illness.

Some individuals utilize
religious symbols or prayers
for the purpose of healing.
Herbal treatments, such as
chamomile, are often
preferred.

Irish
Mental health and well-
being are receiving more
attention. Traditional
therapies, including the use
of St. John’s wort for mood
disorders. The belief in "fairy
doctors" traditionally
dominated but has faded
over time.

Oceana Continent Australia Australia

Verbal: Direct, straightforward Western medicine is
communication is preferred. predominant, with a focus
Patients often expect clear and on preventive care.
detailed explanations from Indigenous Australians may
healthcare providers. also rely on traditional
healing practices, with a
Non-verbal: Minimal use of holistic approach to health,
gestures; eye contact is incorporating spiritual well-
important but varies across being.
different cultural groups,
especially for Indigenous
Australians.

New Zealand (Māori) New Zealand (Māori)

Verbal: Respectful Māori health practices

communication is key, emphasize whānau (family)
especially when addressing involvement and a holistic
elders or those with authority. approach, focusing on
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025

Healthcare conversations are physical, mental, spiritual,

indirect to maintain harmony. and family well-being.
Western healthcare is used,
Non-verbal: Avoiding direct but there is respect for
eye contact with elders shows traditional healers
respect. Facial expressions
and gestures are important
when discussing health
concerns.

Papua New Guinea Papua New Guinea

Verbal: Health discussions are Traditional healers play a

often indirect and involve vital role, often using herbal
community leaders or elders. medicine and spiritual rituals
Storytelling and metaphors are to treat illnesses. Modern
used to discuss health issues. healthcare is accessible in
urban areas, but rural
Non-verbal: Respectful silence communities rely on
when elders speak, limited eye traditional practices for
contact. Gestures, like head healthcare.
nods, show agreement or
understanding.
 Republic of the Philippines

University of Cabuyao
(Pamantasan ng Cabuyao)
College of Health and Allied Sciences
Katapatan Mutual Homes, Brgy. Banay-banay, City of Cabuyao, Laguna, Philippines 4025
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