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.Akey to
achieving health promotion goals with families from a culture different that of the health care
professtonal is the health care professional’s knowledge of the client’s culture. The challenge of
the 21 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 CultureAlearn 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. These two foundations of nursing practice reflect a transcultural approachto health care, in which
the nurse attempts to recognize and transcend barriers and obstacles established by cultural
Key Concept and Terms Related to Culture
Specific set of social, shared, educational, religious, and professional behaviors, practices, and
values that individual learn and ascribe to while participating in or outside of groups with whom
they typically interact.
Culture is based on symbols
Culture is shared
Culture is learned
Culture is adaptive
Culture has explicit and implicit rules of behavior.
Human cultures have special items, artifacts, objects, dress, and actions that have a
Food, ceremonies, rituals, food feast, and religious rituals that are passed from one
generation to another
There variation within and between cultures.
Ancient , nonscientific, political classification of human beings and is based on physiological
characteristics such as skin color, eye shape, and texture of hair. Race is narrower term than
ethnicity and social construct that denotes a human biological definition. Therefore it should be
discarded because of the negative connotation of the words racism and racist. However, race is
used for national statistical analysis.
Racism: Social construct that includes beliefs that assert racial differences in character and in
intelligence and suggest superiority of one race or ethnic group over another.Acommon
outcome of racism, discrimination, cultural insults, and cultural backlash is cultural pain. It refers
to suffering, discomfort, or being greatly offended by an individual or group who shows a great
lack of sensitivity toward another’s cultural experience.
¨The broader social and culturally preferred term that describes a sense of community
transmitted over generations by families. It provides an individual the basis by which the self can
Used to denote a person or family from a group other than a white ethnic group such as
Australian, German, Swedish, or Irish. This term conjures up a feeling of “less than” and is not
preferred by members of ethnic groups.
Implies mental acceptance of truths learn through family and community.
Values Persistent, powerful and directive standards that people use to make sense of and to direct their
lives and interactions. Common are of difference in values among groups include human nature,
privacy, time orientation, family roles and responsibility, and work ethic.
Usual practices or habits carried out by a defined population. They are orderly, comprehensive,
and standardized expectations, specifying ways in which things are and should be done and the
rights and obligations of individuals.
The lens through which the individuals, families, or groups view the universe. Generalization
about groups are frequently over simplifications. The probability that everybody within a specific
ethnic group will behave the same is highly unlikely. However, family values reflect both the
society and the subculture with which the individual or family identifies. Identification with a
specific value system is generally based on ethnic background, SES, peer group, religious
preference, and gender.
Set of behaviors that promote awareness, respect, and responsiveness toward individuals,
families, and groups.
Qualities of a culturally competent person:
Demonstrating awareness of one’s own existence, sensations, thoughts, beliefs, values,
and environment without an undue influence on those from another backg