The Five Basic Interactional Phenomena

Nurses working in transcultural contexts need to be clear on five basic concepts, namely, culture encounter,
enculturation, acculturation, socialization, and assimilation. These concepts come largely from anthropology
and are essential in transcultural nursing.

1. Culture encounter or contact refers to a situation in which a person from one culture meets or briefly interacts
with a person from another culture. With brief, casual encounters and exchange of ideas, one rarely adopts the
values, beliefs, and lifeways of a cultural stranger. A nurse having brief encounters with people from another culture
or a client seldom grasps and understands strangers and their cultural lifeways. Nor does one then become an
“expert” or an authority about a culture. For example, nurses giving tours, making brief visits, or having encounters
with people of different cultures seldom become “transcultural experts” of the cultures. The lack of in-depth
knowledge or preparation prior to the encounter is usually evident. There are, however, nurses in the past and today
who have had such brief encounters such as giving tours or traveling abroad without cultural background
knowledge. Some publish, give lectures, and declare themselves as “cultural experts” of designated cultures. This
often leads to “cultural backlash” and ethical problems when local cultures discover their culture was not presented
accurately or understood following such brief encounters. This remains a serious problem today in nursing.

2. Enculturation is a very important phenomenon to understand in transcultural nursing. It refers to the process by
which one learns to take on or live by a particular culture with its specific values, beliefs, and practices. One can
speak of a child becoming “enculturated” in learning how to become an Italian, Anglo-American, Amish, or
whatever the parents or individual lives by or chooses. The child becomes enculturated when he or she shows
acceptable behavior of the cultural values, beliefs, and actions. Nurses are also enculturated within the nursing
profession by learning the norms (rules of behavior), values, and other expectations of the nursing culture. It is
important that nursing students become enculturated into nursing values, norms, and lifeways to survive, function,
and become professional nurses. Nurses become enculturated into local hospitals, community agencies, and other
health services to accept and maintain practice expectations. Some clients may become enculturated to a hospital,
especially if they stay in the institution over a long period of time such as with chronic illnesses or disabilities.
However, not all children, clients, students, and nurses become enculturated into fully accepting the values, norms,
and practices desired. One has to assess if one is enculturated to another lifeway.

3. Acculturation is closely related to enculturation but has some differences. Acculturation refers to the process by
which an individual or group from Culture A learns how to take on many (but not all) values, behaviors, norms, and
lifeways of Culture B. Acculturated individuals generally reflect that they have taken on or adopted the lifeways and
values of another culture by their actions and other expressions. It is, however, interesting that an individual from
Culture A may still retain and use some traditional values and practices from the old culture, but this does not
interfere with taking on new culture norms. With acculturation, one generally becomes attracted to another culture
for various reasons and almost unintentionally learns to take on the lifeways of the new culture in dress, talk, and
daily living. This person or family becomes acculturated to the new culture. For example, a Vietnamese family came
as refugees to the United States and initially retained their own traditional values, but after 10 years had become
acculturated and took on Anglo-American lifeways. It is interesting that many acculturated Vietnamese families tend
to retain their traditional religious beliefs and kinship values and seldom relinquish them for Anglo-American
lifeways. Economics, education, and technologies are more readily accepted and taken on or adopted. Actually, few
cultures become fully or 100% acculturated to another lifeway. Instead, cultures are selective in what they choose to
change and retain. When many values and lifeways of a different culture are evident, they are usually acculturated.
It is important that transcultural nurses assess individuals or families to determine if they are living by traditional or
new cultural values for quality care outcomes.

4. Socialization differs slightly from the above concepts. It refers to the social process whereby an individual or
group from a particular culture learns how to function within the larger society (or country), that is to know how to
interact appropriately with others and how to survive, work, and live in relative harmony within a ociety. For
example, when the Chinese and Japanese people first came to the United States, they were eager to learn how to
become a citizen of the United States. They learned about becoming a United States citizen and how to buy goods,
interact, and communicate with Americans and others in the American society. Other immigrants in many countries
who want to remain in the society realize they need to be socialized into it. They often refer to this as “taking on the
new ways” or “living in x society.” Socialization is different from acculturation because the goal of socialization is
to learn how to adapt to and function in a large society with its dominant values, ethos, or national lifeways. It is not
necessarily becoming acculturated to a particular local culture or another culture. It requires becoming an acceptable
member of the dominant and larger society.

5. Assimilation refers to the way an individual or group from one culture very selectively and usually intentionally
selects certain features of another culture without necessarily taking on many or all attributes of lifeways that would
declare one to be acculturated. It is fascinating to see how individuals and families select or choose what they want
or will accept of another culture. Assimilation is different from becoming fully acculturated or enculturated to
another culture. With assimilation, the individual generally may be attracted to certain features, values, material
goods or lifeways of a culture, but does not adopt the total lifeways of another culture. For example, a Navaho nurse
liked the specific way that Anglo-American nurses fed newborn infants so she adopted these particular attributes to
feed Navaho children. The Navaho nurse did not like the way Anglo-American nurses handled the Navaho mother’s
placenta and the umbilical cord after delivery, and she did not assimilate the total Anglo-American infant-care
practices. The Navaho nurse knew what was acceptable and not acceptable to her people. This Navaho nurse
encouraged American nurses to use the traditional Navaho infant cradleboard in maternal care while caring for
Navaho women for several cultural reasons such as the infant feeling more secure in the cradle and the use of the
cradle naturally fits in the mother’s hogan (home). The Anglo-American nurse assimilated this practice into her
nursing and found it helpful, but she did not adopt all the Navaho maternal-child traditional care practices. The five
above concepts are important to understand to assess, interpret, and bwork effectively with different cultures.