3.8: Cultural Assessment
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- Ernstmeyer & Christman (Eds.)
- Chippewa Valley Technical College via OpenRN
After establishing a culturally sensitive environment, nurses should incorporate a cultural assessment when caring for all patients. There are many assessment guides used for patient interviews that are adaptable to a variety of health care settings and are designed to facilitate understanding and communication. The Four Cs of Culture model [1] is an example of a quick cultural assessment tool that asks questions about what the patient C onsiders to be a problem, the C ause of the problem, how they are C oping with the problem, and how C oncerned they are about the problem. See the following box for examples of sample answers to the four Cs assessment.
Four Cs of Culture [2]
1. What do you think is wrong? What is worrying you? (In other words, discover what the patient C onsiders to be the problem and what they C all it.)
- A patient with a diagnosis of pneumonia believes his body is “unbalanced.”
2. What do you think C aused this problem? How did this happen?
- The patient believes this illness is a punishment for a misdeed.
- The patient avoids eating certain foods to treat the illness while also using home remedies such as herbal tea.
3. How serious is this problem for you? How C oncerned are you?
- A patient views the illness as being “God’s will” and states, “It’s in God’s hands.”
A more comprehensive cultural assessment tool, inspired by R. E. Spector’s Heritage Assessment interview, [3] is described in the following box.
Sample Cultural Assessment Interview (Adapted from Spector’s Heritage Assessment Tool) [4]
- Where were you born? Where were your parents born?
- What pronoun do you use (he, she, they)?
- In what language are you most comfortable speaking and reading?
- Did you grow up in a city or a town or a rural setting?
- When you were growing up, who lived with you and your family?
- Are your friends from the same cultural background as you?
- What is your religious preference?
- Do you have any dietary preferences related to your religious or cultural beliefs?
- In your culture, how do you celebrate the birth of a baby? A wedding?
- When a woman is pregnant, are there any special customs she needs to follow? Any special foods?
- When someone in your family is ill, who cares for them? What foods are prepared? Is there anything the ill person should avoid or refrain from doing?
- What home remedies might be used if someone is ill?
- As a family member is approaching death, what actions do you find comforting?
- After a loved one dies, what rituals are performed?
- What do you think a nurse should know about your culture if a family member is hospitalized?
- Who makes the decisions in your family?
- How are elders viewed in your culture?
- Are there any special beliefs regarding organ donation or blood transfusions that are held in your culture?
- Is your culture known for any special customs (e.g., rites of passage, foods, holidays, etc.)?
- Galanti, G. A. (2014). Caring for patients from different cultures (5th ed.). University of Pennsylvania Press. ↵
- Galanti, G. A. (2014). Caring for patients from different cultures (5th ed.). University of Pennsylvania Press. ↵
- Spector, R. E. (2017). Cultural diversity in health and illness (9th ed.). Pearson Education. ↵
- Spector, R. E. (2017). Cultural diversity in health and illness (9th ed.). Pearson Education. ↵