Understanding and Navigating Cultural Perspectives in Healthcare

In providing care, it is vital that nurses know and understand the culture of those they are taking care of. If they do, they can offer care that is uniquely tailored to the patient so that the patient can feel comfortable and understood. To be able to do this, nurses must study the different cultures of the world and be willing to ask questions when patients come in that are from a cultural background with which the nurse is unfamiliar. So, to come to an understanding of some different cultures and their approach to medicine, the Asian, Native American, and African cultures will be examined.

Asian Culture

In contrast to Western culture, the Asian culture is very focused on maintaining balance within the body. One of the concepts from Asian culture that is more or less common knowledge in the West is the idea of Yin and Yang. Within the idea of Yin and Yang, it is vital that a person maintain balance in their life, meaning emotions, thoughts, hot, cold, and so on. Similar to this concept is the idea of qi and blood. Within the understanding of the culture, qi and blood interact together to cause blood to move throughout the body and move energy throughout the body (Chung, Ma, Lau, Wong, Yeoh, & Griffiths, 2012). Treatment such as acupuncture can be used to open up qi paths and treat ailments. People from Asian cultures are reluctant to share health information or voice pain or discomfort. When people from Asian cultures receive treatment from Western healthcare, they often blend in traditional methods from their own culture together with the treatments they are receiving (Yeung, 2006). So, the best things a nurse can do to care for their Asian patient is to ask the patient what they think is the cause of their ailment. The nurse may learn that the patient believes that something is out of balance in their life. At this point, the nurse needs to be an advocate for the patient and see how the nurse and the patient can work together to blend the best of both treatments so that the patient believes that the balance in their body is being restored. This may mean combining the use of herbs with the prescribed drugs they receive from a doctor. As the nurse converses with the patient, they should inquire what treatments the patient has already attempted or if they have seen anyone before coming to the hospital for treatment. This can provide information to nurse to understand how the patient sees their condition and is trying to treat it as well as provide insight into who the patient relies on for medical information. Most importantly, the nurse should no signs of disbelief in the patient’s practices as this can quickly shut down communication and trust between the nurse and the patient. If the patient feels that they are understood and that the nurse respects the traditional medical practices of the patient, such as acupuncture, then the patient will trust the nurse. Then, the nurse can advocate for the patient to the doctor so the patient can receive treatments such as acupuncture or foods that are hot or cold so that the patient feels like they are healing too. Asian medical practices have been found to be effective treatments and should be considered especially when treating an Asian patient (Yeung, 2006).

Native American Culture

The peoples of the Native American tribes have various approaches to treat ailments affecting their health. Common beliefs amongst these people are heavily connected to spirituality. The health and wellbeing of a person in this culture relies on a harmonic relationship between self and the environment around them (Koithan & Farrell, 2010). Practices may vary among tribes, however, almost all tribes use some combination of herbs, ceremonies, prayer, and therapies to treat or even prevent ailments. Some practices may come across as particularly strange to practitioners of Western medicine. These could include using song and dance to treat conditions. Also, it is common for Native American people to consult a shaman or medicine man who can provide herbs, dances, or other forms of treatment for disease. Interestingly enough, it has been found that the younger generations in Native American culture that have abandoned traditional practices are experiencing a greater incidence of disease and worse health states (Koithan & Farrell, 2010). In providing treatment for people from these cultures, the nurse needs to learn what tribe the patient is a part of and what practices he uses to treat and prevent diseases. The nurse would also do well to inquire about whether or not the patient has gone to a medicine man or shaman, what the medicine man or shaman prescribed, and if the patient would like to also include the medicine man or shaman in their health care (Bassett, Tsosie, & Nannauck, 2012). Similar to the approach with Asian cultures, if the nurse can be an advocate for the patient and help to blend the practices of the Western doctor with the traditional practices of the medicine man or shaman, then they can provide optimal care for their patient. On top of this, including the family into the treatment and care of the patient can help with any feelings of isolation that a Native American patient may feel in a hospital setting. (Bassett, Tsosie, & Nannauck, 2012. In keeping with the idea of how important the connection between person and earth is in Native American culture, it may be important for the nurse to provide ways for the patient to feel connection to the earth. One example may be simply opening a window to allow fresh air to enter the room and provide a view of the sky (Koithan & Farrell, 2010). Effective care will require open communication between the patient and the nurse that allows for understanding, trust, and respect.

African Culture

Perhaps one of the most varied cultures when it comes to approaches to medicine is the African culture. Like the Native American peoples, the African people can belong to different tribes that have different beliefs and ideas regarding medicine. However, an overarching idea in their culture is the reliance upon ancestors to communicate with God. Similar to how Catholics may use prayers to the saints to communicate with God, people from African cultures go through their deceased ancestors to communicate with God (Mokgobi, 2016). They often refer to tradition healers to learn how to properly communicate with their ancestors and God. Within this culture, people could believe that their ailment is a result of witchcraft or a punishment by ancestors. There are also various types of healers, birth attendants, diviners, and yet other roles that are commonly used in medicine within this culture (Mokgobi, 2016). If a nurse is in charge of the care of a patient from an African culture, the nurse needs to first identify the beliefs of the patient and their understanding of the cause of their disease. A patient that believes their disease is a punishment by their ancestors or an act of witchcraft may not feel very well taken care of by being prescribed some medications. The nurse should do their best to try to include a traditional healer when possible to provide spiritual treatment to aid in the physical treatment that the doctor provides. If the patient is giving birth, she may appreciate the presence of a traditional birth attendant in keeping with their beliefs. As the nurse talks with the patient, he or she needs to learn about the patient’s beliefs and ideas regarding medicine, even if the nurse is familiar with African culture. This is because there are many tribes and places where traditional medicine may be practiced more than in other places. The more the nurse understands about the patient’s culture, the greater care the nurse can potentially provide for the patient. Doctors and others from the very science-based practice of medicine in Western culture may be reluctant to include alternative medicine from the culture of an African patient. However, the nurse must act as the advocate in helping the patient obtain the specific treatment that they feel they need not just for their physical wellbeing, but also for their spiritual and mental wellbeing (James, Wardle, Steel, & Adams, 2018)

Conclusion

Healthcare is a mixing pot of various cultures. A nurse can never know what culture they may come across on any given day. Consequentially, nurses must do all they can to familiarize themselves with the culture of the patient they are caring for. Upon reaching an understanding of a patient’s culture, the nurse must be a fearless advocate for the needs of the patient. This could be daunting for the nurse to stand for practices that they do not fully understand or believe and ask the doctor to respect them. As the nurse is the middle person between the care provider and the patient this is vital. Truly effective healthcare that meets all needs, physical, mental, spiritual, and psychological, can only be met by blending the beliefs and practices of the patient with the practices of the hospital, nurse, and doctor.

References

1. Bassett, D., Tsosie, U., & Nannauck, S. (2012). “Our Culture Is Medicine”: Perspectives of Native Healers on Posttrauma Recovery Among American Indian and Alaska Native Patients. The Permanente Journal, 16(1). doi: 10.7812/tpp/11-123
2. Chung, V. C. H., Ma, P. H. X., Lau, C. H., Wong, S. Y. S., Yeoh, E. K., & Griffiths, S. M. (2012). Views on traditional Chinese medicine amongst Chinese population: a systematic review of qualitative and quantitative studies. Health Expectations, 17(5), 622–636. doi: 10.1111/j.1369-7625.2012.00794.x
3. James, P., Wardle, J., Steel, A., & Adams, J. (2018). Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. Advances in Integrative Medicine, 6. doi: 10.1016/j.aimed.2019.03.214
4. Koithan, M., & Farrell, C. (2010). Indigenous Native American Healing Traditions. The Journal for Nurse Practitioners, 6(6), 477–478. doi: 10.1016/j.nurpra.2010.03.016
5. Mokgobi, M. (2016). Health Care Practitioners’ Attitudes towards Traditional African Healing. Alternative, Complementary & Integrative Medicine, 3(2), 1–5. doi: 10.24966/acim-7562/100025
6. Yeung, H. W. (2006, November 23). Chinese Medicine: a peer-reviewed open access journal for evidence-led Chinese medicine. Retrieved October 5, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761144/.