Acculturation, or is it more a cultural shock?

Contributor: Kunta Gautam, MSN, MPH, CPNP

In a brief nutshell, I would like to share my experiences in Western culture versus Southeast Asian culture. I learned many different things with acculturation in western culture regarding self-care. The cultural practices in western culture emphasize self-care as an essential part of daily lives. Rituals involving self-care like oral care, skincare, beautifying yourself, regular spa, and massage are perceived as needed for one’s well-being. Each household has two or more washrooms and vanity areas. People have a list of daytime products, nighttime products, dietary supplements for skin, hair, nail, and bones. There are age-specific vitamins and different natural or organic oils for skin enrichment. People dress up for success, beautify themselves and give importance to their general appearance. Breasts in women are a symbol of beauty. An annual physical checkup is a routine, more mandatory thing for everybody. It is not only the physical exam but also dental, eye, and other screening diagnostic tests according to the age seem to be a part of everybody’s lives.

My discussion is based upon the theoretical underpinnings provided by the Roper-Logan-Tierney model (2000) of nursing based on activities of daily living (ALs). The differences in cultural practice can be reflected in some of the living activities mentioned in this theory, such as personal cleansing and dressing, eliminating body wastes, maintaining a safe environment, expressing sexuality and communication. Sociocultural and environmental factors greatly influence these activities. Contact and gestures used in human interaction are noticeably different between Western and Southeast Asian cultures.  

Coming from a Southeast Asian culture, my initial impression was that Western cultural practice was very different from what I was used to and what I was brought up in. This cultural practice was performed in my eastern culture, but it was minimal and fundamental. When I say minimal, I mean to say that the self-care routine primarily consisted of bathing and oral care. This was performed inside the home environment or in the backyard in a separate area from home. These bodily rituals were done early in the morning, and people had other priorities to move on with the day. People did not care much about other areas of self-care. They did not have different skin products, organic oils, or vitamins for skin, hair, nails, and bones. Self-care rituals, including skincare products, were considered a luxury and a sign of richness and wealth. Breasts were viewed more as a part of the human body, less a symbol of beauty in the eastern culture where I grew up. People seem to be more focused on their daily responsibilities and did not practice giving importance to self-care, beautifying themselves, and knowing their self-worth. They did not consider annual routine physical checkups as a part of their life. People did not consider visiting dentists or eye doctors regularly. A dentist appointment was required only when we had a dental problem, such as teeth injury, bleeding gums, or tooth infection. There was no concept of seeing a dental hygienist using dental floss or mouth rinse. I had a health-related environment at my home as my father owned a pharmacy store. Honestly, I don’t recall having any dental checkups besides tooth removal.

In western culture, I initially thought, “why are people spending so much time, effort, and money on these unnecessary acts?”. I would then call these acts secondary life needs, considering food, money, and shelter as primary needs.

My home had two washrooms (which was a good number). Vanity was a collective effort in a small area inside the bedroom and not in the washroom. I remember my little vanity with very minimum things. Beautifying yourself was going to the salon for a haircut. Skincare products were very minimum, this may sound funny, but I remember using free samples of moisturizing skin ointment from my father’s pharmacy store.

I migrated to Houston, Texas, in 2002. Initially, coming from the eastern culture of Nepal, I experienced cultural shock. Many different practices that I encountered did not seem essential or appropriate. Few things I perceived as wrong acts, for example, expressing affection in public, using words like ‘honey,’ ‘sweetie,’ ‘sweetheart’ to strangers, smiling at strangers passing by, hugging as a method of greeting, all these were wrong to me.

Along the acculturation process to western culture and understanding the differences in cultural practices, I can now collaborate the best of both cultures. It took me a long time to understand the importance of self-care and prioritizing myself and my needs while attending to other responsibilities in my life. I have realized how equally important it is to set a time apart just for yourself for your mental and physical wellbeing.

Nonetheless, with my lived experiences in two different worlds, although I have now lived longer in Texas than my entire years in southeast Asia, I will conclude that there are no right or wrong cultural practices. We all belong to different cultural variations, and our environment and lived experiences shape our culture.


Roper, N., Logan, W., & Tierney, A. J. (2000). The Roper-Logan-Tierney model of nursing: Based on activities of living. Churchill Livingstone.

About Kunta Gautam, MSN, MPH, CPNP

Kunta Gautam

I am Kunta Gautam. I completed the MSN/MPH dual degree program from The University of Texas Health Science Center at Houston in a pediatric nurse practitioner track and community health practice module. I currently work as an urgent care nurse practitioner at Texas Children’s Hospital. I blend my clinical practice and public health knowledge among the pediatric population in my practice. Besides my role as a clinician, I am also an adjunct faculty at Texas Woman’s University, Houston and an NP preceptor at my workplace. My background in nursing includes clinical nursing in the Neurosurgery area. My experience in the nurse practitioner role lies in Physical Medicine and Rehabilitation, Cardiology, and General Pediatrics. With my experience working closely with children with special needs, I have a greater interest towards this population. My research interests lie in children under autism spectrum disorder and their parents. I emphasize mothers of these children regarding their self-care and prioritizing their general health and wellbeing. I am currently pursuing a Doctorate of Philosophy in Nursing Science at the Nelda Stark School of Nursing, at Texas Woman’s University, Houston, and plan to serve families with an autism spectrum disorder.


Thank you to Wyona M. Freysteinson, PhD, MN, RN, FAAN for her valuable guidance and providing me with the motivation to write this blog.

6 thoughts on “Acculturation, or is it more a cultural shock?

  1. Congratulations Kunta, for a very nicely explained blog comparing Activities of living routine between South East Asian and American cultures. This is a good way to introduce different cultures so people don’t have to go to India to learn about the lifestyle of India.

    • Thank you for your comment, Shahnaz. This was solely my experience associated with my childhood almost two decades ago. I have noticed changes in the activities of daily living among people over time. In recent years, the increase in international travel has brought some changes in cultural practices to the areas where resources are available.

  2. Thank you for this post about your heartfelt observations of differences between daily Southeast Asian and American practices. As a child of Irish immigrants, growing up I was acutely aware of how different my parents were from American neighbors. My NYC surroundings were chock full of immigrants trying to navigate their adopted home; little did I know I was not alone in my thoughts! Over the years, I have studies cultural dynamics and travelled extensively. I’ve seen first-hand the seemingly endless influences of cultural practices: environment, education, religion, politics, and economics. American individualism contrasts the collective nature of many eastern countries; however these phenomena are indeed on a continuum. In addition, consumerism is increasing globally. Reflection of personal experience lends credibility to knowledge about culture concepts and richly enhances empathy and understanding, particularly of immigrant patients. Thank you Kunta!

    • Greetings, Dr. Martin,
      Thank you for sharing your personal experience and providing great insight into cultural variations in this post. Interestingly, NYC and Houston are highly culturally diverse cities. I always encounter a diverse group of people professionally and personally. I have not experienced any difficulty expressing my thoughts and concerns, or my point of view, no matter how different it may sound from the others. Hospitals I have worked at are recognized for being culturally sensitive to the patients. Designated language interpreters and patient liaisons are crucial workforces in most healthcare settings. I think cultural practice can be considered a perception of causality as to how to perform our daily activities and self-care. I am always inspired to learn how different practices we have on an individual level and yet how similar we are collective. I enjoyed learning your thoughts on this. Thank you, Dr. Martin!

  3. Kunta, this was an enlightening and enjoyable post that reminded me of how self-care practices are certainly conceived differently across populations. The nursing model of ADL that you applied is a nice fit. As I was reading, I smiled thinking of how I’ll save money to schedule a special facial, massage, or haircut, all in the name of self care! Also, your post triggered me to reflect on good wishes from friends who counseled, “be sure to take care of you” at a time my husband underwent medical care. American individualism can be both a blessing and a deterrent to well-being; we can learn much from your balance between the two. Good luck in your PhD program and I look forward to future publications from you!

    • Hello Dr. Simpson, thank you for your kind words and your feedback on applying the nursing model. I agree with you. American individualism can genuinely be a blessing if we know our necessities first, what makes us happy, prioritize our needs, and utilize the resources reasonably. Minimizing unrealistic expectations and avoiding societal pressure would help optimize our well-being. Thank you!

Leave a Reply