Specific Core Nursing Content # 8: Cultural, Ethnic, and Spiritual Concepts

Clinical Learning Outcomes

  • Demonstrate competent generalist cultural and spiritual assessment
  • Expresses sensitivity and acceptance of others beliefs, attitudes and cultural needs
  • Demonstrate ability to create a culturally sensitive care plan.
  • Provide culturally and spiritually competent care within the scope of nursing that meets the needs of patients from diverse cultural, racial and ethnic backgrounds.

Teaching Strategies

Classroom Strategies
  • Lecture with focus on cultural issues and their effects on health and illness
  • Journal articles to supplement text:
    • Luhrmann, T.M., Padmavati, R., Tharoor, H., Osei, A. (2015). Differences in voice-hearing experiences of people with psychosis in the U.S.A., India and Ghana: interview based study. British Journal of Psychiatry 206(1), 41-44.
    • Adebimpe, V. (1981). Overview: White norms and psychiatric diagnosis of black patients. The American Journal of Psychiatry, 138(3), 279-285.
    • Cochran, et al. (2007). Mental health and substance use disorders among Latino and Asian American lesbian, gay and bisexual adults. Journal of Consulting and Clinical Psychology, 75(5), 785-794.
    • Elliott, R. (2011). Spirituality, mental health nursing and assessment. Journal of Community Nursing, 25(3), 4-10.
    • MacNeela, P., et al. (2012). A risk to himself: attitudes toward psychiatric patients and choice of psychosocial strategies among nurses in medical-surgical units. Research in Nursing and Health, 35, 200-213.
    • Neighbors, H., et al. (2008). Mental health service use among older African Americans: The national survey of American life. American Journal of Geriatric Psychiatry, 16(12), 948-956.
    • Rowland, M., et al. (2015). Cultural competency in the trenches. Journal of the Health Care for the Poor and Underserved, 24, 6-10.
    • Sethabouppha, H., Kane, C. (2005). Caring for the seriously mentally ill in Thailand: Buddhist family caregiving.Archives of Psychiatric Nursing, 1(2), 44-57.
Curricular Resources
Clinical Strategies
  • Have students complete a spiritual assessment.
  • Reflective journaling that addresses cultural differences [See appendix 2]
Case Studies
  • Focus on cultural influences on care and attitudes, i.e. stigma

Assessment Strategies

Spiritual Assessment – FICA, Retrieved from https://smhs.gwu.edu/gwish/clinical/fica/spiritual-history-tool

  • F- Faith and Belief
    “Do you consider yourself spiritual or religious?” or “Do you have spiritual beliefs that help you cope with stress?”  If the patient responds “NO” the healthcare provider might ask “What gives your life meaning?”
  • I – Importance
    “What importance does your faith or belief have in your life?” "Have your beliefs influenced how you take care of yourself in this illness?" "What role do your beliefs play regarding your health?”
  • C – Community
    “Are you part of a spiritual or religious community? Is this of support to you and how? Is there a group of people you really love or who are important to you?”
  • A – Address in Care
    “How would you like me, your healthcare provider, to address these issues in your healthcare?”  

HOPE Approach to Spiritual Assessment, Anadarajah, G., & Hight, E. (2000). Spirituality and medical practice: Using the HOPE questions as a practical tool for spiritual assessment. Retrieved from www.aafp.org/.

  • H - What are your sources of hope or Spiritual Resources comfort? What helps you during difficult times?
  • O - Are you a member of an Organized Religion? What religious practices are important to you?
  • P - Do you have personal spiritual beliefs that are separate from organized religion? What spiritual practices are most helpful to you?
  • E - Effects on Care:Is there any conflict between your beliefs and the care you will be receiving? Do you hold beliefs or follow practices that you believe may affect your care? Do you wish to consult with a religious or spiritual leader when you are ill or making decisions about your healthcare?

Case Assignment with Student Questions

View the case study.

  • How would the RN discuss the need for hospitalization with this client?
  • Are there alternatives to a hospitalization in this case?
  • How would the RN begin to forge an alliance with the family in order to help this client?
  • What are the most pressing clinical issues that the RN needs to address?
Clinical Skills Checklist
  • Student completes a spiritual assessment of their own belief system. (Standard 1. Assessment)
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