CMN 552
Module 5
Primary Study Guide
University of South Alabama
, CMN 552 – Module 5 Reading/Study Guide
Transcultural Nursing
DSM 5:
1. Define culture.
Culture refers to systems of knowledge, concepts, values, norms, and practices
that are learned and transmitted across generations. Culture includes language,
religion and spirituality, family structures, life-cycle stages, ceremonial rituals, customs,
and ways of understanding health and illness, as well as moral, political, economic,
and legal systems. Cultures are open, dynamic systems that undergo continuous
change over time; in the contemporary world, most individuals and groups are
exposed to multiple cultural contexts, which they use to fashion their own identities
and make sense of experience. This process of meaning-making derives from
developmental and everyday social experiences in specific contexts, including health
care, which may vary for each individual. Much of culture involves background
knowledge, values, and assumptions that remain implicit or presumed and so may be
difficult for individuals to describe. These features of culture make it crucial not to
overgeneralize cultural information or stereotype groups in terms of fixed cultural traits.
In relation to diagnosis, it is essential to recognize that all forms of illness and distress,
including the DSM disorders, are shaped by cultural contexts.
Culture influences how individuals fashion their identities, as well as how they interpret
and respond to symptoms and illness.
2. Define ethnicity.
Ethnicity is a culturally constructed group identity used to define peoples and communities. It may be
rooted in a common history, ancestry, geography, language, religion, or other shared characteristics
of a group, which distinguish that group from others. Ethnicity may be self- assigned or attributed by
outsiders. Increasing mobility, intermarriage, and intermixing of cultural groups have defined new
mixed, multiple, or hybrid ethnic identities. These processes may also lead to the dilution of ethnic
identification.
3. What does culture refer to in the Cultural Formation Interview (CFI)?
● The processes through which individuals assign meaning to experience, drawing from the
values, orientations, knowledge, and practices of the diverse social groups (e.g., ethnic
groups, faith groups, occupational groups, veterans’ groups) and communities in which
they participate.
● Aspects of individuals’ background, developmental experiences, and current social
contexts and position that affect their perspective, such as age, gender, social class,
geographic origin, migration, language, religion, sexual orientation, disability, or ethnic or
racialized background.
● The influence of family, friends, and other community members (particularly, the individual’s
social network) on the individual’s illness experience.
● The cultural background of the health care providers and the values and assumptions
embedded in the organization and practices of health care systems and institutions that
may affect the clinical interaction.
4. Identify the components of culture.
5. What are culture syndromes?
Cultural syndromes are clusters of symptoms and attributions that tend to co-occur among
individuals in specific cultural groups, communities, or contexts and that are recognized locally
as coherent patterns of experience.
Sadock:
6. What is altruism?
Altruism is a secular term referring to a selfless obligation of benevolence, respect, and caring for
humankind, all living creatures, and the environment. Philanthropists and those who selflessly feed
the hungry, clothe the naked, preserve and improve the environment, shelter the homeless, care for
the sick, protect the defenseless, assist the weak, and enlighten the uneducated rightfully feel that
they have accrued spiritual merits for their good deeds and attain a sense of meaningfulness in
their lives.
7. Define culture.
, Culture is defined as a set of meanings, norms, beliefs, values, and behavior patterns shared by a group of
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j people. These values include social relationships, language, nonverbal expression of thoughts and emo
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tions, moral and religious beliefs, rituals, technology, and economic beliefs and practices, among other i
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tems.
8. Discuss the relationship between race and physiognomy. jk jk jk jk jk jk
Race is a concept that entails people being grouped primarily by physiognomy.Although the scientific validi
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ty of the concept is now considered highly questionable, its impact on individuals and groups, however, i
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
s intense, due to its reference to physical, biological, and genetic underpinnings, and because of the inte
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
nsely emotional meanings and responses it generates. jk j k jk jk jk jk
9. What are models of mental illness? jk jk jk jk jk
10. What factors comprise cultural identity? jk jk jk jk
Cultural identity refers to the characteristics shared by a person’s cultural group. Identity allows for a se jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
lf-
j definition. Factors that comprise an individual’s cultural identity include race, ethnicity, country of origin,
k jk jk jk jk jk jk jk jk jk jk jk jk jk
j language use, religious and tradition-
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nourished beliefs, socioeconomic status, sexual orientation, migration history, experience of acculturat jk jk jk kj jk jk j k jk jk jk
ion, and the degree of affiliation with the individual’s group of origin. Cultural identity emerges throughou
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t the individual’s life and in social context. It is not a fixed trait of an individual or of the group of which the in
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dividual is part.An individual may have several cultural reference groups. jk jk kj jk jk jk jk jk jk jk
Evaluating the cultural identity of the patient allows identification of potential areas of strength and sup jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
port that may enhance treatment effectiveness, as well as vulnerabilities that may interfere with the prog
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
ress of treatment. Eliciting these data permits identification of unresolved cultural conflicts that may be ad
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk
dressed during treatment. These conflicts can be between the various aspects of the patient’s identity a j k jk kj jk jk jk jk jk jk jk jk jk jk jk jk
nd between traditional and mainstream cultural values, as well as behavioral expectations affecting the i
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ndividual.
Knowledge of the patient’s cultural identity allows the clinician to avoid misconceptions based on inadequ jk jk jk jk jk jk jk jk jk jk jk jk jk jk
ate background information or stereotypes related to race, ethnicity, and other aspects of cultural identit
j k jk jk jk jk jk jk jk jk jk jk jk jk jk
y. In addition, it assists in building rapport because the clinician is attempting to understand the individu
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
al as a person and not just as a representative of the cultural groups that have shaped the patient’s identi
jk jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
ty
11. What three concepts assist in a culturally competent evaluation? jk jk jk jk jk jk jk jk
Cultural Syndrome defined as a cluster or group of cooccurring symptoms found in a specific cultural group
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
, community, or context. The syndrome may or may not be recognized as an illness within the culture (e.g
j k jk jk kj jk jk jk jk jk jk jk jk jk jk jk jk jk jk
., it might be labeled differently) but may nevertheless occur and be recognized by an outside observer. D
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
SM-5 includes in itsAppendix, nine more or less well- j k jk jk kj jk jk jk jk jk
delineated cultural syndromes (Ataque de nervios, Dhat, syndrome, Khyâl cap, Kufungisisa, Maladi mo jk jk jk jk jk jk j k jk jk jk jk jk
un, Nervios, Shenjing shuairuo, Susto and Tajin kyofusho), that are connected to conditions in other cult
jk jk jk jk jk jk jk jk j k jk jk jk jk jk jk
ural contexts and specific diagnoses in DSM-5. jk jk jk jk jk jk
Cultural Idiom of Distress is a linguistic term, phrase or way of talking about suffering, shared with oth jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
er people from the same culture (i.e., ethnicity, religion, community) and used to express, communicate
j k jk jk jk jk jk jk jk jk jk jk jk jk jk
, or comment on distress in general.An idiom of distress need not be associated with specific symptoms
jk j k jk jk jk jk kj jk jk jk jk jk jk jk jk jk jk
, syndromes, or causal explanations. It may be used to convey a wide range of uncomfortable, emotiona
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
l pain or social shakiness including subclinical conditions or everyday experiences that do not necessari
jk jk j k jk jk jk jk kj jk jk jk jk jk jk
ly constitute mental disorders.
jk j k kj
Causal attribution is a label, an attempt at explaining or ascertaining the causes of the symptoms, illnes jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
s, or distress. Causal explanations may be part of folk classifications of disease used by laypeople or hea
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
lers, which, in a good number of cases, may provide temporary relief.
jk j k jk jk jk jk jk jk jk jk jk
12. Distinguish between the potential outcomes of acculturative stress: separation, integration, assi jk jk jk jk jk jk jk jk jk jk
milation, and marginalization. j k jk
Separation is characterized by individuals’wishes, both conscious and intuitive, to maintain their cultu jk jk jk jk kj jk jk jk jk jk jk jk jk
ral integrity, whether by actively resisting the incorporation of the values and social behavior patterns of
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
another cultural group or groups with whom they have regular contact, or by disengaging themselves fro
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
m contact with and the influence of those other cultural groups. Some religious cults are examples of sep
jk jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
aration.
Integration, as an outcome of acculturative stress, derives from the wish to both maintain a firm sense jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
of one’s cultural heritage and not abandon those values and behavioral characteristics that define the uni
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
queness of one’s culture of origin.At the same time, such individuals are able to incorporate enough of th jk j k jk jk jk kj jk jk jk jk jk jk jk jk jk jk jk jk
e value system and norms of behavior of the other cultural group with which they interact closely, to feel a
jk jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
nd behave like members of that cultural group, principally the majority host culture.Accordingly, the defin
jk jk j k jk jk jk jk jk jk jk jk jk kj jk jk
Module 5
Primary Study Guide
University of South Alabama
, CMN 552 – Module 5 Reading/Study Guide
Transcultural Nursing
DSM 5:
1. Define culture.
Culture refers to systems of knowledge, concepts, values, norms, and practices
that are learned and transmitted across generations. Culture includes language,
religion and spirituality, family structures, life-cycle stages, ceremonial rituals, customs,
and ways of understanding health and illness, as well as moral, political, economic,
and legal systems. Cultures are open, dynamic systems that undergo continuous
change over time; in the contemporary world, most individuals and groups are
exposed to multiple cultural contexts, which they use to fashion their own identities
and make sense of experience. This process of meaning-making derives from
developmental and everyday social experiences in specific contexts, including health
care, which may vary for each individual. Much of culture involves background
knowledge, values, and assumptions that remain implicit or presumed and so may be
difficult for individuals to describe. These features of culture make it crucial not to
overgeneralize cultural information or stereotype groups in terms of fixed cultural traits.
In relation to diagnosis, it is essential to recognize that all forms of illness and distress,
including the DSM disorders, are shaped by cultural contexts.
Culture influences how individuals fashion their identities, as well as how they interpret
and respond to symptoms and illness.
2. Define ethnicity.
Ethnicity is a culturally constructed group identity used to define peoples and communities. It may be
rooted in a common history, ancestry, geography, language, religion, or other shared characteristics
of a group, which distinguish that group from others. Ethnicity may be self- assigned or attributed by
outsiders. Increasing mobility, intermarriage, and intermixing of cultural groups have defined new
mixed, multiple, or hybrid ethnic identities. These processes may also lead to the dilution of ethnic
identification.
3. What does culture refer to in the Cultural Formation Interview (CFI)?
● The processes through which individuals assign meaning to experience, drawing from the
values, orientations, knowledge, and practices of the diverse social groups (e.g., ethnic
groups, faith groups, occupational groups, veterans’ groups) and communities in which
they participate.
● Aspects of individuals’ background, developmental experiences, and current social
contexts and position that affect their perspective, such as age, gender, social class,
geographic origin, migration, language, religion, sexual orientation, disability, or ethnic or
racialized background.
● The influence of family, friends, and other community members (particularly, the individual’s
social network) on the individual’s illness experience.
● The cultural background of the health care providers and the values and assumptions
embedded in the organization and practices of health care systems and institutions that
may affect the clinical interaction.
4. Identify the components of culture.
5. What are culture syndromes?
Cultural syndromes are clusters of symptoms and attributions that tend to co-occur among
individuals in specific cultural groups, communities, or contexts and that are recognized locally
as coherent patterns of experience.
Sadock:
6. What is altruism?
Altruism is a secular term referring to a selfless obligation of benevolence, respect, and caring for
humankind, all living creatures, and the environment. Philanthropists and those who selflessly feed
the hungry, clothe the naked, preserve and improve the environment, shelter the homeless, care for
the sick, protect the defenseless, assist the weak, and enlighten the uneducated rightfully feel that
they have accrued spiritual merits for their good deeds and attain a sense of meaningfulness in
their lives.
7. Define culture.
, Culture is defined as a set of meanings, norms, beliefs, values, and behavior patterns shared by a group of
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
j people. These values include social relationships, language, nonverbal expression of thoughts and emo
k jk jk jk jk jk kj jk jk jk jk kj jk
tions, moral and religious beliefs, rituals, technology, and economic beliefs and practices, among other i
j k jk jk jk jk jk jk jk jk jk jk jk jk jk
tems.
8. Discuss the relationship between race and physiognomy. jk jk jk jk jk jk
Race is a concept that entails people being grouped primarily by physiognomy.Although the scientific validi
jk jk jk jk jk jk jk jk jk jk jk kj jk jk jk
ty of the concept is now considered highly questionable, its impact on individuals and groups, however, i
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
s intense, due to its reference to physical, biological, and genetic underpinnings, and because of the inte
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
nsely emotional meanings and responses it generates. jk j k jk jk jk jk
9. What are models of mental illness? jk jk jk jk jk
10. What factors comprise cultural identity? jk jk jk jk
Cultural identity refers to the characteristics shared by a person’s cultural group. Identity allows for a se jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
lf-
j definition. Factors that comprise an individual’s cultural identity include race, ethnicity, country of origin,
k jk jk jk jk jk jk jk jk jk jk jk jk jk
j language use, religious and tradition-
k jk jk kj jk
nourished beliefs, socioeconomic status, sexual orientation, migration history, experience of acculturat jk jk jk kj jk jk j k jk jk jk
ion, and the degree of affiliation with the individual’s group of origin. Cultural identity emerges throughou
jk jk jk jk jk jk jk jk jk jk jk jk j k jk jk
t the individual’s life and in social context. It is not a fixed trait of an individual or of the group of which the in
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk j k jk jk jk jk jk
dividual is part.An individual may have several cultural reference groups. jk jk kj jk jk jk jk jk jk jk
Evaluating the cultural identity of the patient allows identification of potential areas of strength and sup jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
port that may enhance treatment effectiveness, as well as vulnerabilities that may interfere with the prog
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
ress of treatment. Eliciting these data permits identification of unresolved cultural conflicts that may be ad
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk
dressed during treatment. These conflicts can be between the various aspects of the patient’s identity a j k jk kj jk jk jk jk jk jk jk jk jk jk jk jk
nd between traditional and mainstream cultural values, as well as behavioral expectations affecting the i
jk j k jk jk jk jk jk kj jk jk jk kj jk jk
ndividual.
Knowledge of the patient’s cultural identity allows the clinician to avoid misconceptions based on inadequ jk jk jk jk jk jk jk jk jk jk jk jk jk jk
ate background information or stereotypes related to race, ethnicity, and other aspects of cultural identit
j k jk jk jk jk jk jk jk jk jk jk jk jk jk
y. In addition, it assists in building rapport because the clinician is attempting to understand the individu
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
al as a person and not just as a representative of the cultural groups that have shaped the patient’s identi
jk jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
ty
11. What three concepts assist in a culturally competent evaluation? jk jk jk jk jk jk jk jk
Cultural Syndrome defined as a cluster or group of cooccurring symptoms found in a specific cultural group
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
, community, or context. The syndrome may or may not be recognized as an illness within the culture (e.g
j k jk jk kj jk jk jk jk jk jk jk jk jk jk jk jk jk jk
., it might be labeled differently) but may nevertheless occur and be recognized by an outside observer. D
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
SM-5 includes in itsAppendix, nine more or less well- j k jk jk kj jk jk jk jk jk
delineated cultural syndromes (Ataque de nervios, Dhat, syndrome, Khyâl cap, Kufungisisa, Maladi mo jk jk jk jk jk jk j k jk jk jk jk jk
un, Nervios, Shenjing shuairuo, Susto and Tajin kyofusho), that are connected to conditions in other cult
jk jk jk jk jk jk jk jk j k jk jk jk jk jk jk
ural contexts and specific diagnoses in DSM-5. jk jk jk jk jk jk
Cultural Idiom of Distress is a linguistic term, phrase or way of talking about suffering, shared with oth jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
er people from the same culture (i.e., ethnicity, religion, community) and used to express, communicate
j k jk jk jk jk jk jk jk jk jk jk jk jk jk
, or comment on distress in general.An idiom of distress need not be associated with specific symptoms
jk j k jk jk jk jk kj jk jk jk jk jk jk jk jk jk jk
, syndromes, or causal explanations. It may be used to convey a wide range of uncomfortable, emotiona
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
l pain or social shakiness including subclinical conditions or everyday experiences that do not necessari
jk jk j k jk jk jk jk kj jk jk jk jk jk jk
ly constitute mental disorders.
jk j k kj
Causal attribution is a label, an attempt at explaining or ascertaining the causes of the symptoms, illnes jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
s, or distress. Causal explanations may be part of folk classifications of disease used by laypeople or hea
jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
lers, which, in a good number of cases, may provide temporary relief.
jk j k jk jk jk jk jk jk jk jk jk
12. Distinguish between the potential outcomes of acculturative stress: separation, integration, assi jk jk jk jk jk jk jk jk jk jk
milation, and marginalization. j k jk
Separation is characterized by individuals’wishes, both conscious and intuitive, to maintain their cultu jk jk jk jk kj jk jk jk jk jk jk jk jk
ral integrity, whether by actively resisting the incorporation of the values and social behavior patterns of
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
another cultural group or groups with whom they have regular contact, or by disengaging themselves fro
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
m contact with and the influence of those other cultural groups. Some religious cults are examples of sep
jk jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
aration.
Integration, as an outcome of acculturative stress, derives from the wish to both maintain a firm sense jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
of one’s cultural heritage and not abandon those values and behavioral characteristics that define the uni
j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk
queness of one’s culture of origin.At the same time, such individuals are able to incorporate enough of th jk j k jk jk jk kj jk jk jk jk jk jk jk jk jk jk jk jk
e value system and norms of behavior of the other cultural group with which they interact closely, to feel a
jk jk j k jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
nd behave like members of that cultural group, principally the majority host culture.Accordingly, the defin
jk jk j k jk jk jk jk jk jk jk jk jk kj jk jk
