Flashcards in Cultural Diversity and Nursing Deck (38):
Why do you think it is important to examine our own culture in relation to health & illness?
to beware of culture imposition (imposing your culture on someone else)
Why do you think it would be important to examine our patients’ own cultural beliefs?
moral imagination; imagine what its like to be in another person's situation
What is culture?
The learned, shared, & transmitted values, beliefs, norms, & life way practices of a particular group that guide thinking, decisions, & actions in patterned ways.
What is cultural diversity based on?
ethnicity, religion, language, education, skills
What does culture affect?
ways of perceiving, behaving, & evaluating the world, & serves as a guide for people’s values, beliefs, & practices, including those related to health & illness
What does stereotyping mean?
making an assumption of a culture. racial profiling
What is ethnicity?
Refers to groups whose members feel a sense of common identity.
Share a common social and cultural heritage
Common language, history, physical characteristics and geographical space.
Beware of ethnocentrism !
What is ethnocentrism?
Is a tendency of individuals to believe that their way of viewing and responding to the world is the most correct, natural, and superior
What is the Transcultural Assessment Model?
Underlying premise : each person is culturally unique and should be assessed according to 6 cultural phenomena: communication, space, social organization, time, environmental control, and biological variations.
what is the goal of transcultural assessment model?
Aims to provide care appropriate to those cultures (culturally ‘congruent’/ ‘competent’ care)* must take into account the person’s culture so as to improve nursing care & patient well-being
what are the 6 cultural phenomena?
What is cultural competent care?
offers a means to assess patient’s unique health care needs including their specific cultural health practices.
It is the provision of health care across cultural boundaries & takes into account the context in which the patient lives, as well as the situations in which the patient’s health problems arise.
Cultural competence is the application of?
provide appropriate care & services in relation to cultural characteristics of their patients …includes valuing diversity, knowing about cultural mores & traditions of the populations being served & being sensitive to these while caring for the individual
Understands & attends to patient’s
situation & recognizes that this is a complex combination of knowledge, attitudes, & skill
Nurse applies the underlying background knowledge that must be possessed to provide patients with holistic cultural care
Nurse possess constructive & open attitude toward health traditions observed among diverse cultural groups.
What is the goal of cultural assessment?
generate from patients themselves significant information that will enable culturally congruent care
How did Leininger define transcultural nursing?
to provide meaningful & effective nursing care to patients according to their culture, values, & health & illness contexts
What was the goal of Leininger's sunrise model?
Create a nurse-patient partnership that ensures accurate assessment, needs & goals of the patient based on their culture
Leininger's goal can only be achieves by a nurse who is what?
has an open attitude, knowledge & skill to implement culturally competent care
What is important when providing culturally competent care?
Learn all significant rituals, customs & health practices of the major cultural groups you deal with
Include cultural assessment of patient & family in all nursing assessments
Recognize patient/families’ right to choose
Convey respect for traditional practices
What is the explanatory model?
culturally significant issues for caregivers
(asking patients about themselves)
Explanatory model according to the patient?
patient’s “set of beliefs regarding what causes his/her disease & the methods that would potentially treat his/her condition best.”
It is important to determine how the patient’s different experiences & beliefs might affect their health & health care.
Questions you can ask pt about based on explanatory model about their illness/care?
-What do you call the problem?
-What do you think has caused the problem?
-What do you think the sickness does to you?
-How severe is the sickness?
What are the major problems or difficulties this sickness has caused in your life?
-What have you done for this problem up to now?
-What type of treatment do you think you should receive?
List of questions used to learn about patient’s explanatory model of illness are?
What are the most important results you hope to achieve from the treatment?
-What do you fear most about the sickness? treatment?
-Who else should be consulted or involved in your care?
What is Giger and Davidhizar's assessment model?
guide nurses in their assessment of how culture has influenced their patient’s health beliefs & behaviors
6 factors affecting health according to giger/davidhizar's assessment model?
Indicators that patients do not understand what is being spoken include?
-Efforts to change subject
-Absence of questions
-Non-verbal cues (Nodding head to everything even if they do not understand)
-Reply “yes” to everything
Always Ask! Necessary to 1st determine level of fluency in English (may need interpreter)
Communicating with pt's who are limited in french/english strategies?
WORKING WITH INTERPETERS
USE GESTURES, PANTOMIMES, POINT TO SELF
DO NOT ASK QUESTIONS THAT CAN BE ANSWERED WITH “YES” OR “NO”
SPEAK IN LOW MODERATE TONE
AVOID MEDICAL JARGON, USE SIMPLE WORDS
USE WORDS IN PATIENTS’ LANGUAGE
VALIDATE UNDERSTANDING, SUMMARIZE OFTEN
BE ORGANIZED, SLOW DOWN, USE PICTURES
USE TRANSLATION MATERIALS
ASSESS CLIENT’S ABILITY TO READ IN OWN LANGUAGE BEFORE GIVING ENGLISH/FRENCH MATERIALS
To remember when working with an interpreter?
Try for best choice of interpreter re: barriers of gender, class, region, or tribe
■ Realize interpreter may ‘modify’ what you’ve said to correspond to cultural norms or taboos.
■ Talk directly to individual (not interpreter)
■ Check 1st with interpreter on delicate subjects
■ Check back with interpreter about how much was really understood
■ Even a telephone call to a friend or family member can be useful when trying to ensure that basic information is clearly passed on
What doe social organization refer to?
Refers to the family unit (nuclear, single-parent, extended.
And the social group organizations (religious or ethnic) with which patients & their families may identify with.
Countless barriers-unemployment, homelessness, poverty can prevent people from entering the health care system.
What is important to know in regards to social organization?
understand individual’s family or community context (who’s involved in health care matters, importance of individual vs. collective)
How are decisions made? Who needs to be involved in specific discussions (i.e. around diet or treatment plan)?
How family as whole affected by person’s illness (i.e. in some cultures can be normal for family to take all responsibility off shoulders of ill person)
What broader community structures play part in individual’s daily life? (church, neighborhood organization, club)
What is environmental control?
patient’s traditional health & illness belief, the practice of folk medicine, & the use of traditional healers
Why do biological variations matter?
Differences in metabolisms can lead to different therapeutic levels of medication, dietary requirements (lactose intolerance)
■ Differential susceptibility to disease (or morbidity rates) within certain groups - i.e. Sickle cell anemia, PKU, Tay-Sachs, CF, Hypertension, Diabetes
What to remember when interviewing patients?
■ Develop awareness of one’s own cultural heritage
■ Become aware of patient’s culture as described by the patient (be genuine & honest about knowledge you lack here)
■ Plan care with patient in way that incorporates patient’s cultural values
What to ask to patients of different culture when you are caring for them?
“Do you have any cultural practices that may be affected by this hospitalization?”
■“Are there any religious beliefs or customs that we can help you with while you’re in the hospital?”
different views on health & illness?
cultures have different ways of defining pain
cultures use home remedies for treatment. always assess patients cultural therapies