· Culture is characterized by universality, uniqueness, stability, changeability, subliminality, and variability.

· Potential negative responses to people of another culture include ethnocentrism, cultural blindness, cultural shock, cultural conflict, cultural imposition, stereotyping racism, prejudice, and discrimination.

· Ethnocentrism is grounded in the belief that one's own cultural beliefs and practices are superior to those of other cultural groups.

· Cultural blindness is a failure to acknowledge the existence of cultural differences.

· Cultural shock results in immobilization due to perceptions of overwhelming cultural differences. 

· Cultural conflict occurs when one ridicules the beliefs and practice of another culture because of perceived threats to one's own beliefs and values.

· In cultural imposition, one believes that everyone should conform to the tenets of one's own cultural group.

· Stereotyping occurs when one refuses to acknowledge differences among members of a cultural group.

· Racism is the belief that people can be grouped by biophysical traits that indicate superiority or inferiority.

· Prejudice is unfavorable attitudes toward a group based on preconception not facts.

· Discrimination is differential treatment of an individual or group based on unfavorable attitudes toward the group.

· Positive responses by nurses to another cultural group include cultural sensitivity, cultural relativism, cultural accommodation, and culture brokering.

· Cultural sensitivity is characterized by an awareness of and respect for cultural differences and their influence on health.

· Cultural relativism is the ability to view beliefs and behaviors within their cultural context.

· Cultural accommodation is modification of health care in light of cultural factors.

· Culture brokering involves mediation between individuals or groups from different cultures.

· In assessing another culture, community health nurses should view the culture in the context in which it developed, examine the underlying premises of cultural behavior, inquire into the meaning of behavior in the cultural context, and recognize the existence of intra-cultural variation. These are the basic principles of cultural assessment.

· Considerations in cultural assessment related to the biophysical dimension include age composition and attitudes to age, genetic inheritance, and factors related to physiologic function such as attitudes to body parts and functions, folk illnesses recognized by the cultural group, and common medical diagnoses experienced by the group.

· Aspects of the psychological dimension to be considered in cultural assessment include cultural attitudes toward mental illness, preeminence of individual or group goals, modes of authority and decision making, attitudes toward change, quality of relationships with the larger society, and the prevalence of significant mental illness.

· Social dimension factors addressed in cultural assessment include interpersonal relationships, acceptable demeanor, communication, beliefs and values, religion and magic, and the economic status of members of the cultural group.

· Behavioral dimension factors related to culture include dietary practices, beliefs and practices related to life events, sexual practices, and other health-related behaviors.

· Aspects of cultural assessment related to the health system dimension include cultural definitions of health and illness and perceptions of disease causation, folk health practitioners and practices, and the relationship of the folk health care system to the professional health care system.

· Similarities between folk and scientific health care system include similar diagnostic techniques; use of verbal and nonverbal communication; naming of illnesses, use of suggestion, interpretation, emotional support, and manipulation as therapeutic modalities; use of medicinal substances and some form of laying on of hands; expert-lay relationships; explanations of disease and treatment rationales. Differences include more attention to religious and social implications of disease, lack of distinction between mental and physical illness, community-orientation, familiar surroundings, humanism, practicality, holism, greater emphasis on prevention, cultural support, and moderate cost in the folk system as compared to the scientific system.

· Plans for the care of clients from another culture should be based on the clients' culturally derived beliefs and values. As far as possible, interventions should incorporate aspects of the client's culture and minimize disruption of the client's usual lifestyle.