Lesson 1, Topic 1
In Progress

The Nursing Process and Cultural Factors

May 3, 2021

When caring for patients, the nurse typically uses the nursing process to develop a plan of care. With use of the information gathered in an assessment, cultural behaviors can be determined and included in a plan of care accordingly.

Sometimes, North American Nursing Diagnosis Association–International (NANDA-I) nursing diagnoses are difficult to appropriately apply to culturally diverse patients. People from other cultures often do not share the biomedical health belief system on which these diagnoses are based. The exclusive use of our system to classify their problems and needs is unrealistic. Unfortunately, we sometimes end up labeling the patient’s behavior as abnormal when it is actually quite normal in the person’s own cultural context. The difficulties go even further, however. The goal of the nursing diagnosis system is to help change patient behavior, but doing so by imposing biomedically based health care beliefs and practices, without regard to cultural identity, violates the basic tenets of nursing’s patient-centered approach.

Certain nursing diagnoses are particularly problematic. The nurse should be cautious with use of nursing diagnoses such as deficient knowledge, impaired verbal communication, ineffective health maintenance, and noncompliance. Table 6-3 discusses limitations with use of these nursing diagnoses.

To provide care and lessen the limitations of the NANDA-I nursing diagnoses, the nurse should evaluate behavior from the perspective of the patient’s culture. The nurse, the health care system, or both may be required to change to accommodate, maintain, or reinforce patients’ health beliefs and practices. Perhaps the nurse will do this by reprioritizing nursing goals and changing procedures. A compromise is important between individual health beliefs and practices and those of the patient. The patient and family are unlikely to accept any of the health teaching or treatments the nurse attempts to provide if their own beliefs are not recognized. A mutually acceptable alliance with the patient is imperative. Remember that the ultimate goal is to assist the patient to achieve optimal health. One possible implication of this is that the nurse needs to adjust many of the accepted nursing interventions to accommodate patients and their cultures.

Because of a patient’s cultural background, the LPN/LVN sometimes must modify how an assessment is performed or care is provided or must adapt the usual routines of the institution to the patient’s needs. For instance, consideration should be given when accommodating cultural practices among Muslim patients. The nurse should allow Muslim women to keep the head, arms, and legs covered as much as possible. In addition, every attempt should be made to assign female staff members to care for Muslim women. Because Muslims pray several times each day, care should be scheduled around these times to allow the patient privacy and the necessary leisure to pray. The nurse should be ready to consider similar accommodations to meet the needs of patients in other culturally dependent, special circumstances.