Some of the factors are:

• Cultural background of the nurse; differences and similarities between the patient and the nurse.
• Definition of health and illness accepted by a specific culture; concepts relating to the causes of illness and injury.
• Folk medicine practices.
• Attitudes toward health care, relationships, and interactions (e.g., personal space, eye contact).
• Economic level of the patient and family (socioeconomic status).
• Environmental factors and related disorders (e.g., ghetto living, lead poisoning).
• Specific names and terms related to the illness or disorder (e.g.,”bad blood,” “mal ojo”); use of slang.
• Language differences between the health care staff and the patient and family.
• Modesty and concept of the human body.
• Reactions to pain, aging, and death.
• Attitudes about childbirth, abortion, sexual expression, children born to unmarried parents, and homosexuality.
• Attitudes about mental illness and retardation.
• Diets in relation to religious and cultural practices; dietary taboos.
• Attitudes about physical appearance and obesity; adaptation to special therapeutic diets.
• Importance of religion and religious practices.
• Religious practices in illness and death; specific prohibitions.
• Group identity; importance and type of family structure; cohesiveness within the group; traditional roles of men and women.
• Blacks and Raza/Latino cultures have long used roots, potions, and herbs for treating illnesses.
• “Visibility” of ethnic background (that is, Black, Oriental).
• Disorders specific to a cultural group (that is, Tay-Sachs, sickle cell anemia).
• Attitudes about school; educational level and aspirations of most members of the group.
• Predominant occupations within the group; role models.
• “Americanization” of younger members.
• Numbers of people belonging to that group in the same geographic area as the health care facility.
• Prejudices within a cultural group relating to other members of the same group.
• Stereotypes about other cultural/ethnic groups.
• Mixed families (mixed races, religions, or cultural backgrounds).