Dimensions of Culture

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Culturally-based health beliefs can have a profound impact on clinical care, affecting the accuracy of health histories as well as compliance with treatment recommendations. These questions serve as a guide for accessing important information from patients about their backgrounds and culturally-based health beliefs. You may not ask all of these questions in every interview, however it is important to cover most of them. The English proficiency of a specific patient will help you decide how to put each questions in your own words. Relying on a professional interpreter whenever possible is crucial.

Cultural Affiliations

• Where were you born?
• What cultural groups do you feel connected with?
• Where have you lived, and when?

Health Related Beliefs and Practices

• If you were sick at home, who would care for you?
• Who are the healers or health care providers in your culture?
• Are there any practices in your religion that help you stay healthy (such as prayer, wearing of talismans or charms, massage, medicines)?
• What medicines, remedies, or treatments have your tried? Have your family or friends recommended any treatments or medicines? Have you gotten any medicines while traveling back home that you might use for this (illness/condition?)
• Do you have preferences about your health care providers: Do you prefer them to be male or female, younger or older than you?
• What parts of your body do you feel modest about, and how would you like your privacy respected?

Nutrition

• Do you eat certain foods to stay healthy?
• Who usually eats with you? What types of food does your family eat?
• What do you believe is the right size and shape for your body? Do you feel that you are at your ideal weight?
• Are you a vegetarian? Do you abstain from certain foods or from drinking alcohol?
• Do you change your diet during certain times of the year or for religious ceremonies?
• Do you smoke? Do you live with someone who smokes?

Educational Background

• How many years of schooling have you completed?
• Can you read or write English or do you prefer to read and write in another language?
• How do you like to learn about new things: by talking to someone, by reading something, or by demonstration?

Socioeconomic Considerations

• Who do you consider to be the most important members of your family?
• Who makes most of the health care decisions for your family?
• Who is the principal wage earner in your family? Are there other sources of support for your family?

Some questions to ask yourself or to look into:

Cultural Aspects of Disease Incidence

• Are there specific genetic or acquired conditions that are more prevalent for this patient’s cultural group (e.g., hypertension, Tay Sachs, lactose intolerance)?
• Are there socio-environmental conditions that are more prevalent for this patient’s cultural group (e.g., lead poisoning, automobile accidents)
• Are there diseases against which this patient has an increased resistance (e.g. malaria for people with sickle cell anemia)?
  How recently has the patient immigrated

(Adapted from Andrews and Boyle 1997)