Dr. TIsh Smyer Introduces Compelling Reasons for Care You have one of the most personally challenging jobs within the nursing profession.

• You are working with a different culture.
• This can be rewarding but difficult and frustrating at times. 
• What we know about our world, our world view, guides our nursing practice.
• This may not always be the world view of those we are caring for.
• These modules are preparing you to see and appreciate the world from a different perspective.

Module 1 presents a theory of culture care which is based on Madeleine Leininger's theory of "Culture Care Diversity and Universality".  Certain concepts from this theory will allow us to explore specific aspects of nursing care that occur outside our "world view".  These concepts become tools we use to better understand a specific culture.

It also allows us to develop specific nursing interventions which are more effective given a specific culture.  We are going to be reviewing several key concepts in this section.

• World View
• Cultural Care
• Influencing factors on cultural and social structure

Madonna Blue Horse Beard, a Native American and a Registered Nurse, explains the concept of world view, both past and present, in the next video segment.  As you listen, identify how your culture may differ from the Native American culture.  Keep in mind that the definition of World View is:

"The way people tend to look out on the world or their universe to form a picture or a value stance about their life or world around them" (Leininger, 1991).

Thank you Madonna.  As you can see, the underlying assumptions about our world is very different in the Native American culture as compared to the traditional dominant western culture.  We are now going to explore Cultural Care concepts in the next PowerPoint presentation.  Try to identify your values, meanings and action modes as they compare to the Native American culture.  Keep in mind that the definition of Cultural Care is:

"the subjectively and objectively learned and transmitted values, beliefs, and patterned lifeways that assist, support facilitate, or enable another individual or group to maintain their well being, health, to improve their human condition and lifeways, or to deal with illness, handicaps, or death" (Leininger, 1991).

In the next video segment, Madonna Blue Horse Beard elaborates on values within the culture of Native Americans.  Keep in mind Cultural Care concepts as you listen.

Madonna eloquently explained the values related to Native American culture.  Another concept related to understanding culture are the cultural and social structure dimensions within a society.  This includes the religious, kinship (social), political, economic, educational, technologic, cultural values, and ethnohistorical factors. 

As an example:  the economic repercussion of poverty and its impact on reservation and urban Native Americans.  What impact has the introduction of gambling had on Native American culture and way of life? 

Viewing a culture through this theory demonstrates how these factors may be interrelated and function to influence human behavior in different environmental contexts.

Leininger defines cultural and social structure dimensions as

"the dynamic patterns and features of interrelated structural and organizational factors of a particular culture".

Understanding the three concepts explored, World View, Cultural Care, and identifying the influencing factors related to cultural and social structures helps us to understand the Native American Culture.

There is another important aspect to culture to visit before we end the module.  That relates to interpersonal relationships and values.  There are several prominent concepts related by Huff and Kline (1999) which give us some understanding of this important feature of health care and communication and relationships when dealing with the Native American Elder.

• In the Native American Culture the fundamental element is RESPECT.
• "Respect is how one presents himself or herself to the world and how one acts.  Respect is tied to being Indian and Native (p. 286)
• Native American Elders describe respect as:

Kline and Huff also relate that cultural sensitivity does not only relate to knowledge of traditional medicine or that care only be provided by within culture carers.  They state that care this is open and accepting of other world views and types of interactions are the most important features.

Madonna Blue Horse Beard elaborates on behavior and interactions between cultures in the next video segment.

This ends Section 1 of Module 1.  To review, we have defined and elaborated on the following concepts.
 

Thank you for your time and attention. 
Please be sure to take the Post-Test for Section 1. 

Proceed to Section 2