Thisis an example of an assessment guide that is intended to help the learner as he or
she strives toward cultural competency.
Cultural Affiliations
With what cultural group(s) does the client report affiliations (e.g., American, Hispanic,
Navajo, or combination)?
To what degree does the client identify with the cultural group
(e.g., ?we? concept of solidarity or as a fringe member)?
Where was the client born?
Where has the client lived (country, city) and when (during what years)? Note: If a
recent relocation to the United States, knowledge of prevalent diseases in country of
origin may be helpful. Current residence? Occupation?
Values Orientation
What are the client?s attitudes, values, and beliefs about developmental life events such
as birth and death, health, illness, and healthcare providers?
Does culture affect the manner in which the client relates to body image change resulting
from illness or surgery (e.g., importance of appearance, beauty, strength, and roles in
cultural group)? Is there a cultural stigma associated with the client?s illness (i.e., how is
the illness or client condition viewed by the larger culture)?
How does the client view work, leisure, education?
How does the client perceive change?
How does the client perceive changes in lifestyle relating to current illness or surgery?
How does the client value privacy, courtesy, touch and relationships with individuals of
different ages, social class (or caste), and gender?
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How does the client view biomedical/scientific health care (e.g., suspiciously, fearfully,
acceptingly)? How does the client relate to persons outside of his or her cultural group
(e.g., withdrawal, verbally or nonverbally expressive, negatively or positively)?
Cultural Sanctions and Restrictions
How does the client?s cultural group regard expression of emotion and feelings,
spirituality, and religious beliefs? How are dying, death, and grieving expressed in a
culturally appropriate manner?
How is modesty expressed by men and women? Are there culturally defined expectations
about male-female relationships, including the nurse-client relationship?
Does the client have any restrictions related to sexuality, exposure of body parts, certain
types of surgery (e.g., amputation, vasectomy, hysterectomy)?
Are there any restrictions against discussion of dead relatives or fears related to the
unknown?
Communication
What language does the client speak at home? What other languages does the client speak
or read? In what language would the client prefer to communicate with you?
What is the fluency level of the client in English?both written and spoken use of the
language? Remember that the stress of illness may cause clients to use a more familiar
language and to temporarily forget some English.
Does the client need an interpreter? If so, is there a relative or friend whom the client
would like to interpret? Is there anyone whom the client would prefer did not serve as an
interpreter (e.g., member of the opposite sex, a person younger/older than the client,
member of a rival tribe or nation)?
What are the rules (linguistics) and modes (style) of communication? How does the client
prefer to be addressed?
Is it necessary to vary the technique of communication during the interview and
examination to accommodate the client?s cultural background (e.g., tempo of conversation,
eye contact, sensitivity to topical taboos, norms of confidentiality, and style of
explanation)?
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