Sociocultural influences on family health promotion and health protection by Bomar &
Nearly all aspect of family life and health promotion are influenced by culture.
Rapid Population Changes Fuel Cultural Diversity
More than 33 million people migrated to the United-States between 1990 and 2000, the largest
census-to-census growth ever. The contention that diversity is found only in large and coastal
cities is no longer a reality.
Health promotion is experienced, transformed, and maintained within the family system. To be
effective in encouraging families to engage in health-promotion behaviors, the clinician needs to
be cognizant of the roles of different family member in health promoting activities. A key to
achieving health promotion goals with families from a culture different that of the health care
professional is the health care professional’s knowledge of the client’s culture. The challenge of
the 21st century is for health care professionals, especially registered nurses, to become skilled,
adept, and expert in providing care that is culturally competent, if not culturally proficient.
Sociocultural Theories and Conceptual Models
Leininger’s Sunrise model is one of the earliest and the most commonly used for understanding
and providing culturally competent nursing care. The central concept is human care and caring.
The model shows that culturally congruent care includes cultural care patterning, cultural care
accommodation, and cultural care preservation.
Element essential to becoming a culturally competent institution or agency are the following:
1) Valuing cultural diversity
2)Having the capacity for cultural self-assessment
3) Being conscious of the dynamics inherent when cultures interact
4) Having institutionalized cultural knowledge
5) Having developed adaptations of service delivery and policies reflecting an understanding of
Leminger (2002) suggest that nurses working within transcultural setting need an understanding
of the following anthropological concepts:
1)Culture encounter refers to a situation in which a person from another culture meets or briefly
meets with another person from another culture.
2) Enculturation refers to the process by which one learns to take on or live by a particular
culture with its specific values, beliefs, and practices.
3)Acculturation refers to the process by which an individual from group Culture A learn how to
take on many values, behaviors, norms, and lifestyles of culture B.
4) Socialization is the process whereby an individual or group from a particular culture learns
how to function in the larger society, that is to know how to interact appropriately with others
and how to survive, work, and live in harmony with in a society.
5) Assimilation refers to the way an individual or group from one culture or group from one
culture very selectively and usually intentionally selects certain features of another culture
without necessarily taking on many or all attributes of lifeways that would declare on to be
Little recognition is given to the fact that acculturation occurs to varying degrees. In addition, the
processes of acculturation are stressful for families as they learn, make mistakes, reflect and
make modifications to live, work, and play within the prominent culture.
The nurse is concerned by the human kind and also considers the individuality of the client.