Exam 4 (Ch 13- Factors Affecting Health) Flashcards Preview

Nursing Lecture > Exam 4 (Ch 13- Factors Affecting Health) > Flashcards

Flashcards in Exam 4 (Ch 13- Factors Affecting Health) Deck (99):
1

Culture

What people in a group have in common, but it changes over time.

2

Purnell and Paulanka define culture as

"the totality of socially transmitted behavior patterns, arts, beliefs, values, customs, lifeways, and all other products of human work and thought characteristics of population of people that guides their worldview and decision making."

3

Characteristics of culture:

Culture is learned
It is taught
It is shared by its members
It is Dynamic and Adaptive
It is complex
It is diverse
It exists at many levels
It has common beliefs and practices
It is all-encompassing
It provides identity

4

Bicultural

Describes a person who identifies with two cultures and integrates some of the values and lifestyles of each into his life.

5

Multicultural

Refers to many cultures. Describes groups rather than individuals.

6

Socialization

The process of learning to become a member of a society or a group. A person becomes socialized by learning social rules and roles, by learning the behaviors, norms, values, and perceptions of others in the same group or role.

7

Immigrants

New members of a group or country

8

Acculturation

Assuming the characteristics of another culture\

9

Cultural assimilation

When the new members of a group or country gradually learn and take on the essential values, beliefs, and behaviors of the dominant culture.

10

A person becomes assimilated when they:

-Learn to speak the dominant language,
-Marry a member from the new culture,
-and make close, personal relationships with members of the new group.

11

Ethnocentrism

The tendency to think that your own group (cultural, professional, ethnic, or social) is superior to others and to view behaviors and beliefs that differ greatly from your own as somehow wrong, strange, or unenlightened.

12

Dominant culture

The group that has the most authority or power to control values and reward or punish behaviors. It is usually, but not always, the largest group.

13

Subcultures

groups within a larger culture or social system that have some characteristics (e.g. values, behaviors, ancestry, ways of living) that are different from those of the dominant culture.

14

Minority groups

Made up of individuals who share race, religion, or ethnic heritage; however, a minority group has fewer members than the majority group.
Sometimes used to refer to a group of people who receive different and unequal treatment from others in society. Some consider it an offensive term b/c it suggests inferiority and marginalization

15

Vulnerable Populations

Groups who are more likely to develop health problems and experience poorer outcomes because of limited access to care, high-risk behaviors, and/or multiple and cumulative stressors.

e.g. people who are homeless, poor, or mentally ill; people with physical disabilities; the very young; and older adults.

16

Healthy People 2020

Public health initiative. Addresses the care of vulnerable populations and includes as one of 4 broad goals, the elimination of health inequalities.

17

Ethnicity

Similar to culture in that it refers to groups whose members share a common social and cultural heritage that is passed down from generation to generation. Similar to subculture and race.

18

Ethnic group

Group that has some characteristics in common (e.g., race, ancestry, physical characteristics, geographic region, lifestyle, religion) that are no shared or understood by outsiders.

e.g. French Canadians, Roman Catholics, Hmongs,and Latinos

19

U.S. Census Bureau identifies two categories for ethnicity:

1) Hispanic, Latino, or Spanish and
2) Not Hispanic, Latino or Spanish.

Subcategories of 1: Mexican, Mexican American, Chicano, Puerto Rican, Cuban, and other Hispanic, Latino, or Spanish origin.

20

Latino

Refers only to people from Latin America (Central or South America)

21

Spanish origin:

Implies origin in Spain

22

Race

Strictly related to biology. It refers to the grouping of people based on biological similarities, such as skin color, blood type, or bone structure.

23

Religion

Refers to an ordered system of beliefs regarding the cause, nature, and purpose of the universe, especially the beliefs related to the worship of a God or gods.

May be confused with ethnicity (e.g., the Jewish culture overlaps with Jewish faith community).

24

Values

Help shape health related beliefs and practices.

25

Personal value

A principle or standard that has meaning or worth to an individual
e.g. cleanliness

26

Belief

Something that one accepts as true
e.g. "I believe that germs cause disease"

27

A practice

A set of behaviors that one follows

e.g. I always wash my hands before preparing food

28

Dominant U.S culture values

youth, beauty, success, independence, and material belongings

29

Culture universals (culture commonalities)

the values, beliefs, and practices that people from all cultures share

e.g. all cultures celebrate the birth of a new baby in some way

30

Culture Specifics (Culture diversities)

Those values, beliefs, and practices that are special or unique to a culture.

e.g. cultures celebrate "birth rites" in different ways

31

Cultural stereotype

A widely held but oversimplified and unsubstantiated belief that all people of a certain racial or ethnic group are alike in certain respects.

Stereotypes are not always negative

32

Cultural archetype

An example of a person or thing--something that is recurrent--and it has its basis in facts; a symbol for remembering that is usually not negative

e.g. Mexican Americans having brown eyes or European Americans having light-colored skin.

33

6 culture specifics that influence health:

1. Communication
2. Space
3. Time orientation
4. Social organization
5. Environmental Control
6. Biological Variations

34

Communication

Verbal and nonverbal language
i.e spoken language, gestures, eye contact, and even silences

35

Space

Refers to a person's personal space, or how the person relates toward the space around him.

36

Territoriality

The behavior and attitude that people exhibit about the area around them they have claimed.

37

Examples of attitudes towards personal space:

-Americans, Canadians of Northern European ancestry, and the British keep at least 18 in. of space b/t them and the person that they're talking to
-Arabs and others from the Middle East typically stand quite close when talking
-Germans usually require a great deal of space, and consider looking into a room an invasion of privacy

38

Time orientation

Some persons tend to be present- or future-oriented, whereas others are more rooted in the past

e.g. clients who are present-oriented tend to show up late (or not at all) for appointments; written or telephone reminders should be provided

39

Social Organization

Includes the family unit (e.g., nuclear, single-parent, or extended family) and the wider organizations (e.g., community, religious, ethnic) with which the individual or family identifies.

e.g. in Middle Eastern and Latino cultures, the man is likely to be the dominant family member and the woman the homemaker.

40

Environmental Control

Refers to a person's perception of his ability to plan activities that control nature or direct environmental factors.

e.g. Asian Americans tend to accept pain stoically, and not demand relief

41

Biological Variations

Ways in which people are different genetically and physiologically; they create susceptibility to certain diseases and injuries
*Body build and structure, skin color, vital signs, enzymatic and genetic variations, and drug metabolism

42

Other cultural specifics

-Religion and Philosophy
-Education
-Technology
-Politics and the Law
-Economy

43

Religion and Philosophy

A person's religion may determine what healthcare is acceptable to him.
e.g. Jehovah's Witnesses do not accept blood transfusions, and many religions forbid abortion

44

Education

Education influences the perception of wellness and illness and the knowledge of options that are available for healthcare.

45

Technology

Availability of supplies and equipment determines what is used in the healthcare setting and what comes to be culturally expected.

46

Politics and the Law

Governmental policies affect healthcare. They determine what practitioners will be available and what programs will be funded.

47

Economy

The condition of the economy directly affects the availability of funds for publicly funded services. It also affects the individual's ability to pay for healthcare.

48

Indigenous Healthcare System

Consists of folk medicine and tradition healing methods, which may also include over the counter and self-treatment remedies.

49

Professional Healthcare System

Run by a set of professional healthcare providers who have been formally educated and trained for their appropriate roles and responsibilities.

50

Biomedical Healthcare System

Also known as Western medicine and allopathic medicine, combines Western biomedical beliefs with traditional North American values of self-reliance, individualism, and aggressive action.

51

Generally speaking, people follow one of 3 major health belief systems:

1. Scientific,
2. Magico-religious, or
3. Holistic

52

Magico-Religious System

Belief in supernatural (mystical) forces.

e.g., voodoo which is practiced in some developing nation in Africa, Latin America, and the Caribbean and which considers the lion a spiritual symbol

53

Holistic Belief System

Can be similar to magico-religious, but it focuses more on the need for harmony and balance of the body with nature

54

Culture of the North American Healthcare System:

-Belief in and reliance on the biomedical system
-Valuing of technology
-Desire to conquer disease
-Definition of health as the absence or mineralization of disease
-Adherence to a set of ethical standards and codes of conduct

55

Largest subculture within the healthcare culture:

Nursing

56

Culture of nursing

The learned and transmitted lifeways, values, symbols, patterns, and normative practices of members of the nursing profession that are not the same as those of the mainstream culture.

57

Nursing values include:

-Silent suffering as a response to pain
-Objective reporting and description of pain, but not an emotional response
-Use of the nursing process
-Nursing autonomy
-Caring
-Knowledge
-Critical thinking

58

Traditional healing

refers to alternative beliefs, those that are not of the Western, North American, biomedical, or professional healthcare systems

59

Folk medicine

Defined as the beliefs and practices that the members of a cultural group follow when they are ill, as opposed to more conventional standards

60

Complementary medicine

The use of rigorously tested therapies to complement those of conventional medicine

e.g. chiropractic care, biofeedback, and the use of certain supplements

61

Alternative medicine

Defined as therapies used instead of conventional (i.e., biomedical) medicine, and whose reliability ahs not been validated through clinical testing in the United States

e.g., iridology, aromatherapy, and magnet therapy

62

TCM

Traditional Chinese Medicine

63

Ayurveda

the traditional healthcare system of India

64

Cultural awareness

Refers to an appreciation of the external signs of diversity

65

Cultural sensitivity

Refers to the personal attitudes and being careful not to say or do something that might be offensive to someone from a different culture

66

Cultural competence

Is attained on a continuum ranging from cultural destructiveness (most negative) to cultural proficiency (most positive). You become more aware of and sensitive to the needs of individuals from various ethnocultural groups over time.

67

QSEN

Quality and Safety Education for Nurses

68

Purnell model for cultural competence stresses:

Teamwork in providing culturally sensitive and competent care to improve outcomes for individuals, families, and communities

69

Cultural competence

Defined as "having the knowledge, abilities, and skills to deliver care congruent with the client's cultural beliefs and practices."

70

Leininger's theory

Goal is to guide research that will assist nurses to provide culturally congruent care that would contribute to the health or well-being of people using her three modes of nursing care actions and decisions.

71

ASKED

-Awareness: similar to cultural sensitivity in other models
-Skills: refers to your ability to conduct with sensitivity a cultural assessment and a culturally based physical assessment.
-Knowledge: the information you have about cultural worldviews and theories.
-Encounters: It takes practice to become culturally competent
-Desire: Suggests that you must want to be culturally competent

72

Bias

one-sidedness: a tendency to "lean" a certain way, a lack of impartiality

73

Cultural stereotype

The unsubstantiated belief that all people of a certain racial or ethnic group are alike in certain respects. May be positive or negative

74

Prejudice

Refers to negative attitudes toward other people based on faulty and rigid stereotypes about race, gender, sexual orientation, etc.

75

Discrimination

Refers to the behavioral manifestations of prejudice.
e.g., before the 1960s many US hospitals refused treatment to African Americans

76

Racism

A form of prejudice and discrimination based on the belief that race is the principal determining factor of human traits and capabilities and that racial differences produce an inherent superiority (or inferiority).

77

Sexism

The assumption that members of one sex are superior to those of the other sex.

78

Male chauvinism

assumption of male superiority

79

Language barrier

affect your ability to communicate with clients. Involves foreign languages, dialects, regionalisms (word or pronunciation particular to a specific region), street talk, and jargon

80

Ebonics

Also called black Vernacular English or AAVE, is a type of English that has, in the past, been spoken primarily by blacks, but many white youth enamored with hip-hop culture now embrace Ebonics as a way to connect with the street culture.

81

Lipson and Meleis suggest that the following minimum information is important when taking a cultural assessment:

-Language(s) spoken; proficiency in language of the host
-Length of time client has been in the host country
-Where client was raised
-Ethnic affiliation and identity
-Usual religious practices
-Nonverbal communication style
-Family roles and primary decision-maker about the client's healthcare
-Social support in the host country

82

Risk for imbalanced nutrition: Less than body requirements

might apply to a patient who is hospitalized and cannot obtain foods prepared in the traditional way of his ethnic group

83

Impaired Parenting

could occur if the patient's traditional methods of discipline are not acceptable or appropriate in the dominant culture

84

Spiritual Distress

might occur because a necessary treatment is not congruent with a client's religious beliefs

85

Powerlessness

might occur when the patient is unable to make healthcare personnel understand the importance of his religious and dietary beliefs

86

Impaired verbal communication

is sometimes used for patients who do not speak or understand the nurse's language. Better use as the etiology of the diagnoses, such as Ineffective Therapeutic Regimen Management

87

Risk for Noncompliance

can be used for clients and/or caregivers who do not follow a health-promoting or therapeutic plan the healthcare provider believes they agreed to. (Nonadherence vs. noncompliance)

88

Leininger's Modes:

1. Cultural care preservation/maintenance: sustains clients' cultural lifestyles in meaningful ways.
e.g. encouraging the family to bring ethnic foods that are appropriate for client's prescribed diet
2. Cultural care accommodation/negotiation: adapts clients' lifestyles or nurses' actions.
e.g. negotiating with the client to continue seeing the curandero, but to come to the clinic every 6 wks to have his BP checked.
3. Cultural care repatterning/reconstructuring changes nurses' action or clients' lifestyles into different patters.
e.g. When p/t absolutely refuses to medication, the nurse uses massage, distraction, and other nonpharmacological techniques to help relieve his pain

89

CLAS

National Standards for Culturally and Linguistically Appropriate Services

90

CLAS Guidelines

require healthcare organizations receiving federal funding to provide language assistance services, including bilingual staff and interpreter services, at no cost to the patient.

91

Interpreter

Specially trained to provide the meaning behind the words

92

Translator

Restates the words from one language to another

93

"take a trip to BALI"

BE aware of your own cultural heritage
APPRECIATE that the client is unique: influenced, but not defined by his culture
LEARN about the client's cultural group
INCORPORATE the client's cultural values/Behaviors into the care plan

94

Unconscious Incompetence

Not being aware that you lack knowledge about another culture

95

Conscious Incompetence

Being aware that you lack knowledge about another culture

96

Conscious competence

learning about the client's culture, verifying generalizations about the culture and providing culture specific interventions.

97

Unconscious competence

automatically providing culturally congruent care to clients of diverse cultures

98

LIVE

Like
Inquire
Visit
Experience

99

LEARN

Listen
Evaluate
Acknowledge
Recommend
Negotiate