Culture & Clinical Care, edited by Juliene G. Lipson and Suzanne L. Dibble. San Francisco, Calif: UCSF Nursing Press; 2005. 487 pages, $33.95 (paperback).
This book is based on the premise that healthcare providers who are culturally aware, sensitive to others' needs, and knowledgeable in appropriate cross-cultural healthcare are likely to have successful outcomes when they care for culturally diverse clients. The book is written for healthcare providers to identify cultural issues that may affect healthcare. With chapters on European American groups, this book is a newer edition to Culture Care & Nursing Care: A Pocket Guide by the same editors.
The introduction lays the foundation for further discussion among clinicians in respect to the importance of culture and its relationship to delivering appropriate cross-cultural healthcare. Sources of diversity, such as immigrant status, race or ethnicity, socioeconomic class, sexual orientation, disability, and communication patterns, are described. Examples that demonstrate how these sources apply to specific cultural groups are provided. The editors make it clear that clients who are the experts of their own "lives, culture, and experiences" are the most important sources of cultural assessment data.
Each of the 35 chapters focuses on a specific cultural or ethnic group. The groups are (1) Afghans, (2) African Americans, (3) American Indians/Alaskan Natives, (4) Arabs, (5) Brazilians, (6) Cambodians (Khmer), (7) Central Americans (Guatemalans, Nicaraguans, and Salvadorans), (8) Chinese, (9) Colombians, (10) Cubans, (11) Dominicans, (12) East Indians, (13) Ethiopians and Eritreans, (14) Filipinos, (15) Germans, (16) Greeks, (17) Haitians, (18) Hawaiians, (19) Hmong, (20) Iranians, (21) Irish, (22) Italians, (23) Japanese, (24) Koreans, (25) Mexicans, (26) Nigerians, (27) Pakistanis, (28) Polish, (29) Puerto Ricans, (30) Roma (Gypsies), (31) Russians and others from the former Soviet Union, (32) Samoans, (33) Vietnamese, (34) West Indians (Caribbeans), and (35) (former) Yugoslavians. These groups were selected because of their respective size in the US census or the lack of readily available information elsewhere.
In each of the chapters, readers will find information for the specific culture/ethnic group organized under subheadings relating to identity, spiritual and religious orientation, communication, activities of daily living, food practices, symptom management, birth rituals of new mothers and infant, developmental and sexual issues, family relationships, illness beliefs, health issues, and death rituals. There are further subheadings under each of these categories to allow for quick access of information and to identify similarities and differences between groups.
The following are examples extracted from 7 of the subheadings to demonstrate similarities and differences between 2 cultural groups: Dominicans prefer direct eye contact, are not concerned about sharing personal space with others, seldom admit to pain, and do not seek care until the symptom is disabling, and the women tend to seek prenatal care as soon as they are aware of pregnancy; health is perceived as God's will and illness is perceived as punishment. Haitians tend to avoid eye contact, are not concerned about sharing personal space with others, and exhibit low threshold of pain, and the women often opt not to seek prenatal care, and believe that maintaining equilibrium and praying is the prescription for health and illness is caused by God.
The book Culture & Clinical Care has relevant, timely, and useful information to guide clinicians in developing knowledge salient to eliminating racial and health disparities in communities. Chapters are presented in alphabetical order. The content is clearly presented by authors who seem to have lived the experience of the particular culture that they describe. It is gratifying to observe that diversity among Blacks is recognized and cultural patterns of groups, such as Haitians, Nigerians, and West Indians, are addressed. Consistency in the chapter information enables clinicians to make cross-cultural comparisons among groups. However, clinicians should be mindful that the information in this book should be used only as a guide to interpreting behavior since personal experiences bring a larger perspective that might dominate the perspectives of people in these cultures. The authors draw from the literature, but mainly the content presented is from personal experiences. Thus, the information should never replace the cultural assessment of an individual.
With 487 pages of text and references, I highly recommend Culture & Clinical Care to those who work with culturally diverse clients. The book can be perused from beginning to end to assess available content, but may be best used when there is a need to learn more about a culture or ethnic group. I strongly recommend this book to everyone who cares for or work with clients different from themselves
Cynthia E. Degazon, PhD, RN
Associate Professor, Hunter-Bellevue School of Nursing at, the City University of New York