Culture is learned through both formal and informal experiences and influences how people view themselves and behave. It also guides what is seen as acceptable within a group. While cultural practices are generally affected by the environment, there are also differences within cultures due to individual influences. When people move to an unfamiliar culture, they may experience psychological discomfort known as cultural shock. Nurses should consider how a patient's culture could impact their health beliefs, practices and expectations during care. Developing cultural self-awareness involves objectively examining one's own values and practices.