Cultural Competency




Culturalcompetence, cultural tolerance and respect for divergent culturalperspectives and attitudes are critical in nursing practice. Cultureplays a significant role in human interaction by promoting a harmonyand social identity. It has direct impacts on attitudes andperceptions towards health care. Therefore, culture influence howindividuals are likely to perceive and respond to nursinginterventions aimed at promoting health. Identifying cultural valuesand beliefs that have direct and indirect impacts on health care areessential in embracing cultural diversity. Cultural competenceenables nursing professionals to avoid practices that conflict withcultural beliefs and values in the community (Adel, 2015). This paperfocuses on the significance of cultural competencies among nursingprofessionals working in the Chinese and Saudi Arabian cultures. InSaudi Arabia, the cultural setting is greatly influenced by theMuslim culture as well as traditional Arab culture. Although thesociety in Saudi Arabia is not hostile to modern medicalinterventions, it is a profoundly religious and conservative society.Islamic observance dominates all aspects of life in Saudi Arabia,including their perceptions and attitudes towards health care (Mufti,2012). The Chinese culture is one of the oldest cultures in theworld. Although there are some aspects of cultural beliefs and valuesthat are uniform, Chinese culture is very diverse. Culture in theChinese society has an influence on how the population perceivesmedical care and nursing interventions (Tseng, 2012).

Comparisonof Chinese and Saudi Arabian cultures

Genderroles have a tremendous impact on both Chinese and Saudi Arabiancultures. These roles have direct effects on nursing practice. In theChinese culture, men have a higher value compared to women. Accordingto the Confucian and Taoism philosophies and traditions, the roles ofwomen in the society are restricted to the home. The culture dictatesthat women should obey their fathers and husbands. In thispatriarchal society, women are the primary caregivers and have theresponsibility of taking care of children, the sick and elderly(Carreiro, 2012). Consequently, the Chinese society is more likely toview the nursing roles as women duties due to the culturalresponsibilities of mothers, daughters, and wives. The gender rolesin Saudi Arabia are relatively similar to Chinese culture. Islamicteachings in Saudi Arabia culture dictates gender roles. The cultureallows discrimination and segregation of women and emphasizes thelack of capacity among women. For example, women in the Saudi Arabiansociety require a male guardian to make medical decisions (Sidumo,2010). While Confucianism or Taoism forms the basis of beliefs andvalues in the Chinese culture, Islamic teachings dictate the SaudiArabian beliefs and values. Due to the geographical size of China,the cultural beliefs, and values in the Chinese culture are diverse,while in Saudi Arabia, they are relatively uniform. Some of thesebeliefs and values have implications on health care (WHO, 2005).

Inboth the Chinese and Saudi Arabian cultures, the adults have aresponsibility of taking care of children and the elderly. Childrendo not have the ability to make decisions of their own while theelderly may not be able to take care of themselves. Traditionalreligious practices such as worshiping Shang Di play a huge role inthe traditional Chinese culture. The influence of these religions hasdeclined of these traditions. Buddhism is the largest religion in theChinese culture that has an impact health care. Although Buddhism isnot opposed to modern medicine, meditation plays a significant rolein the healing process (WHO, 2005). In the Saudi Arabian culture,religion has an influence on all aspects of life. Islamic traditionsdetermine the essential dimensions of the culture (WHO, 2005).Education has a huge impact on attitudes of society towards modernmedicine. In the China, primary education is compulsory.Consequently, about 94 percent of the Chinese adult population isliterate. In Saudi Arabia, all levels of education are provided bythe government for free. As a result, there is a relatively highlevel of literacy, especially among males. However, being an Islamicstate, religious education dominates the Saudi Arabian system. Forexample, Islamic education is compulsory at all stages, includinguniversity level. The official language in China is Chinese whileArabic is the official language in Saudi Arabia (CIA, 2016).

Theantecedents in the two cultures have several consequences that havean impact on nursing interventions. Some of the adverse effects mayinclude negative attitudes towards male caregivers or male nurses andethical issues associated with the autonomy of an adult woman in theabsence of a male guardian in the Saudi Arabian society. Thesecultural impacts can have adverse effects on the attitudes of themembers of the community towards nursing intervention. The divergentcultural traditions in the Chinese culture may result in undesirableimpacts. The higher literacy levels and general acceptance of modernmedicine in both societies have positive consequences. Education hasa proportionate impact on the perceptions and attitudes towardsnursing interventions and health promotion.


Boththe Chinese and Saudi Arabia cultures have an aspect of alternativemedicine. The most important traditional medicine and treatmentmeasures in Saudi Arabia are spiritual healing and herbal medicine.Arabic medicine is an important part of traditional medicine in SaudiArabia. It includes the knowledge and practices of the indigenouspeople of the Arab region which aimed at promoting health throughprevention and treatment of diseases. Modern medicine has dominatedthe health care system in Saudi Arabia, but a significant proportionof the society practices traditional medicine such as spiritualhealing, bone setting, herbal medicine and capping among others(Long, 2012). Additionally, despite the role of traditionalmedicine, only qualified medical workers are legally allowed toprescribe drugs. The government funded health care system in SaudiArabia is well developed and regulated. Traditional medicalpractitioners exist mainly in the rural areas (WHO, 2005). Thetraditional medicine in China has evolved over thousands of years andwidely practiced in the modern Chinese society. Some of the mostcommon Chinese traditional medicine and practices includesacupuncture, herbal medicine, diet therapy, massage (tui na) and taichi which involves manipulation of the body and the mind of thepatient. There are a large number of Chinese traditional medicinepractitioners in China and other parts of the world. Chinesetraditional medicine, mainly acupuncture is very popular in diversesocieties and can be used concurrently with modern medicine (Chan,2011 Yoo, 2013).

However,it is important to note that although these cultures have welldeveloped traditional medicine, there are no specializedpractitioners with defined roles such as nurses, physicians orcertified midwives. Modern medicine has introduced these specializedfunctions. Additionally, there are no advanced medical proceduressuch as surgeries, blood transfusion, organ transplant, and therapies(WHO, 2005).

Thereare several traditional and religious beliefs in these cultures thatrelate to pregnancy and childbirth, childbearing, aging, death andafterlife that have an influence on attitudes towards health.Generally, in the Chinese society, a pregnant woman should be takencare of by the community. Chinese beliefs and traditions argue thatthe state of mind of the mother, her relationships and what she eatshas a direct impact on the baby. There are also taboos which definedwhat a pregnant woman should do or not do. During childbirth, thename of the child is used to scare away bad spirits. Additionally,the mother is freed from other duties to take care of the infant. Insome Chinese societies, colostrum is considered to be dirty andtherefore not given to the child. Aging is a natural process in theChinese culture. Death is viewed negatively and marks the end oflife. Religion, mainly Buddhism influences the understanding of deathand afterlife in the modern culture (Kuiper, 2011). There aresimilar traditions related to pregnancy and childbirth in the SaudiArabian culture. These traditions range from taboos to lifestyleguidelines. For example, pregnant women are not expected to eatspecific foods and are obligated to particular prayers every day fordivine intervention. Islamic traditions, as well as traditions in theArab culture, form the basis of these traditions. Prenatal care andchildbirth in the Saudi Arabian culture is a women affair. Althoughthere are changes in society that have resulted in changes inattitudes, traditionally, male medical workers were not allowed totake care of pregnant mothers. Islamic traditions also determineconcepts related to marriage, aging, death and afterlife (Rassool,2014).

Culturalcompetence about these aspects and their implication towards nursingintervention is critical for nurses working in these cultures. Forexample, in the Chinese culture, pregnant women are relieved otherresponsibility after giving birth. They are therefore likely todepend heavily on other people, including nurses. Despite theinfluence of the modern medicine on some cultural beliefs, many womenin the contemporary society are likely to be influenced bytraditional dogmas. Pregnant mothers are liable to make food choicesand lifestyle decisions based on traditions and taboos. Understandingthese cultural aspects of the society prevents the likelihood ofconflicts and enhances the effectiveness of the nursing interventions(Yoo, 2013). In the Saudi Arabian culture, it is important fornurses to understand the specific guidelines that relate tochildbirth practices. For example, men are not allowed in labor wardsdue to cultural traditions (Rassool, 2014).


TheChinese and Saudi Arabian cultures have both positive and adversecultural effects on nursing interventions. The cultural beliefs andperception about health and diseases can have different impacts onhow individuals from these societies will perceive health care. Someof these cultural beliefs are likely to be congruent with modernapproaches to medicine while others conflict with nursinginterventions. The majority of cultural beliefs and values in theChinese culture are congruent with contemporary nursinginterventions. Although identification of the essential culturalroles of medical practitioners and their boundaries during practiceis necessary, the Chinese culture has positive attitudes towardshealth care (Meng, 2011). The Saudi Arabian culture also supportsmodern approaches to illnesses and medical treatments. Although thecommunity practices traditional Arab medicine, there are nosignificant hindrances to nursing interventions. Reproductive healthis an important determinant of cultural consequences on health insociety. Both the Chinese culture and the Saudi Arabian culturepromote healthy childbearing practices. Although there are specificcultural restrictions such as the role of men in the childbirth, theyare not interference with accessibility to nursing care (WHO, 2005).

However,some of the cultural beliefs and attitudes can have negativeconsequences on health. The most significant adverse effect ofculture on nursing intervention is culture-specific illnesses. Theseinvolve an explicit understanding of a particular disease which canlimit medical interventions. For example, in the Chinese culture,mental health problems are associated with lack of self-control whichrestricts the willingness of a patient to discuss mental healthissues (Tseng, 2012). Communication breakdown or inappropriatecommunication can have a negative consequence on medical outcomes.For example, in the Saudi Arabian culture, women are not allowed tomake decisions without a male guardian. Therefore, failure to involvemale guardians in medical decisions may result in negativeconsequences (Rassool, 2014). Fear, mainly the fear of punishmentfrom God, can have adverse effects on nursing, in the Saudi Arabianculture. The dependence on God and fear of punishment has a directimpact on all aspects of life in the Arabic culture. This results inthe overindulgence on the role of divine power in the emergence ofdiseases as well as the role of modern medicine and interventions onhealing (Mufti, 2012).


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