After reviewing this module’s assigned readings, you will create a mind map identifying the six cultural phenomena that should be considered when providing culturally appropriate care to patients, according to Giger and Davidhizar. For each phenomenon, provide a brief description and example.
This mind map will be useful as you learn about the various cultural groups week to week and begin to prepare for your module seven assignment. For further project details and the final submission grading rubric, refer to Module five Assignment.
Mind Map: Giger and Davidhizar’s Six Cultural Phenomena
Central Idea: Culturally Appropriate Care (Giger & Davidhizar Model)
1. Communication
- Description: The entire process of human interaction, including verbal and non-verbal styles, language, tone, volume, and silence. It is the primary means of establishing a helping relationship.
- Example: A patient from a culture that values quiet respect (e.g., some Native American or Asian cultures) may avoid direct eye contact with the nurse. The nurse should recognize this as a sign of respect, not disinterest or dishonesty, and avoid forcing eye contact.
2. Space
- Description: The degree of comfort or discomfort people feel regarding the distance between themselves and others during interaction. This includes personal, territorial, and ambient space.
- Example: A patient from a Latin American or Middle Eastern culture may be accustomed to standing very close (intimate zone) during a conversation. An Anglo-American nurse who prefers a larger personal space (personal zone) might feel uncomfortable and step back. The nurse must understand this is culturally normal for the patient and adjust their own reaction accordingly.
3. Social Organization
- Description: How a cultural group structures itself around family (nuclear vs. extended), religion, ethnicity, interest groups, and roles (e.g., gender roles, decision-makers).
- Example: In many Asian and Hispanic cultures, healthcare decisions are often made collectively by the family, not just the individual patient. A nurse proposing a treatment plan should ensure the entire family (or the identified family leader) is present for discussions to facilitate agreement and adherence.
4. Time
- Description: How a culture perceives and measures time. This can be divided into:
- Clock/Linear Time: Time is viewed as a commodity to be spent, saved, or wasted (future-oriented).
- Social/Circular Time: Time is viewed as flexible and centered around the event and social interaction (present-oriented).
- Example: A patient from a culture with a social-time orientation (e.g., some African or Latin American cultures) may arrive late for an appointment because they stopped to help a neighbor. The healthcare provider, operating on clock-time, might view this as non-compliance. Understanding this difference helps the provider avoid a judgmental attitude and work with the patient to find practical solutions.
5. Environmental Control
- Description: The ability of individuals within a culture to plan activities that control nature or direct environmental factors. It also relates to an individual’s perception of their ability to control the outcomes of their health (internal vs. external locus of control).
- Example: A patient with a strong belief in an external locus of control (e.g., “God’s will” or fate) may appear passive about their illness, believing recovery is out of their hands. A nurse working with a patient from a culture with strong roots in fatalism (belief in destiny) should integrate the patient’s beliefs (e.g., praying, consulting a spiritual healer) into the care plan alongside medical treatment, rather than dismissing them.
6. Biological Variations
- Description: The inherent genetic, biological, and physiological differences between individuals from different racial and ethnic groups. This includes body structure, skin color, enzymatic differences, susceptibility to disease, and nutritional preferences/metabolism.
- Example:****Genetic: A nurse should be aware that people of African descent are at higher risk for sickle cell disease, while people of Northern European descent are at higher risk for cystic fibrosis.
- Physiological: A patient of Asian descent may experience the “alcohol flush reaction” due to a genetic enzyme deficiency, which can also affect the metabolism of certain medications. The nurse must monitor for adverse drug reactions specific to the patient’s ancestry.
