Lecture 2

Question 1

Caring

Answer 1

universal phenomenon influencing the ways in which people think, feel, and behave in relation to one another

Question 2

Caring has been studied from a variety of perspectives, both ethical and philosophical.

Answer 2

Leininger’s Transcultural Caring
Watson’s Transpersonal Caring
Swanson’s Theory of Caring (5 caring processes)

Question 3

Madeleine Leininger

Answer 3

Stresses the importance of understanding cultural caring behaviors

The essence and central, unifying, and dominant domain that distinguishes nursing from other health disciplines
An essential human need, necessary for the health and survival of all individuals
Assists an individual or group in improving a human condition
Helps protect, develop, nurture, and sustain people

Question 4

Jean Watson

Answer 4

**10 Carative Factors
Care promotes healing and wholeness
Rejects the disease orientation to health care
Places care before cure
Emphasizes the nurse-client relationship

Question 5

Swanson’s Theory of Caring

Answer 5

five categories or processes **Table 7-2

Question 6

Patient perceptions

Answer 6

important because healthcare is placing a greater emphasis of patient satisfaction.

Question 7

Patients value the affective dimension of nursing car

Answer 7

Connecting w/ patients and their families

Being present

Respecting values, beliefs, and choices

Question 8

Patients’ become active partners in plan of care when nurses are

Answer 8

Sensitive
Sympathetic
Compassionate
Interested

Question 9

Ethic of Care

Answer 9

professional, ethical covenant that nursing has with the public.

In any patient encounter a nurse needs to know what behavior is ethically appropriate.

Places the nurse as the patient’s advocate who solves ethical dilemmas by creating a relationship and giving priority to each patient’s unique personhood

Question 10

Caring

Answer 10

is a product of culture, values, experiences, and relationships with others.

Question 11

Caring behaviors include

Answer 11

Providing presence
Touch
Listening

Question 12

Providing Presence

Answer 12

“Being there”
“Being with”
Established presence includes:
Eye contact
Body language
Voice tone
Listening
Positive/Encouraging attitude

Question 13

Touch

Answer 13

comforting approach that reaches out to patients to communicate concern and support.

Contact – skin to skin
Non-contact – eye contact

Creates a connection:
Task-oriented touch - performing task or procedure

Caring touch – nonverbal communication; holding hand, back massage, position patient

Protective touch – protects a nurse and/or patient. Most obvious form of protective touch, preventing an accident. Can protect a nurse emotionally as they distance themselves from a patient when they are unable to tolerate suffering or needs to escape from a situation that is causing tension (negative feelings in a patient?)

Question 14

Listening

Answer 14

critical component of nursing care and is necessary for meaningful interactions with patients.

To listen effectively means to silence yourself and listen with openness.

Opens lines of communication

Creates a mutual relationship

By actively listening you begin to truly know your patients and what is important to them.

Question 15

Knowing the Patient

Answer 15

Develops over time

The core process of clinical decision making

Aspects of knowing include:
Responses to therapy, routines, and habits
Coping resources
Physical capacities and endurance

Question 16

Spiritual Care

Answer 16

health is achieved when a person can find a balance between their life values, goals and belief systems and those of others.

Research show a link between spirit, mind, and body.

Question 17

Intrapersonally

Answer 17

connected to oneself

Question 18

Interpersonally

Answer 18

connected to others and the environment

Question 19

Transpersonally

Answer 19

connected with the unseen, God, or higher power

Question 20

Relieving Pain and Suffering

Answer 20

Caring nursing actions that give a patient comfort, dignity, respect, and peace.

Suffering and pain are multifaceted:
Physically
Emotionally
Socially
Spiritually

Question 21

Family Care

Answer 21

People experience life through relationships with others.

Caring does not occur in isolation from a patient’s family.

Family is an integral resource and should be active participants in plan of care.

Nurse should learn about patients’ families and what their roles are in the patients’ life.

Understand the patients illness may impose stress on family members as well.

Question 22

Challenge of Caring

Answer 22

Challenges
Task-oriented biomedical model
Institutional demands
Time constraints
Reliance on technology, cost-effective strategies, and standardized work processes
If health care is to make a positive difference in patients’ lives, health care must become more holistic and humanistic.

Question 23

Health disparity

Answer 23

A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

An inequality or difference between the health status of a disadvantaged group , such as people with low incomes and wealth ,and an advantaged group such as people with high income and wealth

Difference/inequality between disadvantaged and advantaged groups related to incidence, prevalence, and outcomes health conditions, diseases, and complications

Question 24

Members of the disadvantaged group/marginalized group experience:

Answer 24

Increased incidence of disease
Poor health outcomes
Die at an earlier age

Question 25

Health Care Disparities

Answer 25

Differences among populations in the: Availability, Accessibility, Quality of health care services (e.g., screening, diagnostic, treatment, management, and rehabilitation) aimed at prevention, treatment, and management of diseases and their complications.

Question 26

Social Determinants of Health

Answer 26

access to social and economic opportunities; the resources and supports available in our homes, neighborhoods, and communities; the quality of our schooling; t he safety of our workplaces; the cleanliness of our water, food, and air; the nature of our social interactions and relationships. The conditions in which we live explain in part why some Americans are healthier than others

Question 27

Which “disparity” deals with incidence, prevalence, and outcomes of health conditions, diseases, and related complications

Answer 27

Health Disparity

Question 28

Addressing HC Disparities

Answer 28

Focus on cultural competency, health literacy, and patient- and family-centered care Recognize that valuing each patient’s unique needs improves the overall safety and quality of care and helps to eliminate health disparities.

Question 29

Culture

Answer 29

Norms, values, and traditions Ethnicity, race (physical characteristics ; color of skin), nationality, and language Gender, sexual orientation, location, class, and immigration status

Question 30

Intersectionality

Answer 30

Belonging simultaneously to multiple social groups

Question 31

Oppression

Answer 31

A system of advantages and disadvantages tied to our membership in social groups

Question 32

Transcultural Nursing

Answer 32

Leininger (2002a) A comparative study of cultures to understand similarities (culture universal) and differences (culture-specific) across human groups.

Question 33

Goal of Transcultural Nursing is to Provide

Answer 33

Culturally congruent care Care that fits a person’s life patterns, values, and system of meaning Requires specific knowledge, skills, and attitudes in the delivery of culturally congruent care

Question 34

Disease

Answer 34

Malfunctioning biological or psychological processes

Question 35

Illness

Answer 35

The way that individuals and families react to disease

Question 36

Cultural Competency

Answer 36

Defined as the enabling of health care providers to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients.

Question 37

How do organizations do this, by integrating the following

Answer 37

* value diversity * cultural self assessment * manage the dynamics of difference * institutionalize cultural knowledge * adapt to diversity

Question 38

Cultural Awareness

Answer 38

Becoming more self-aware of your biases and attitudes about human behavior is the first step in providing patient-centered care Bias: a predisposition to see people or things in a certain light, either positive or negative.

Question 39

Selected Components of Cultural Assessment

Answer 39

``` Ethnic heritage and ethnohistory Bicultural history Social organization Religious and spiritual beliefs Communication patterns sexual orientation/gender identity Caring beliefs and practices Socioeconomic status ```

Question 40

Linguistic Competence

Answer 40

Communicate effectively and convey information in a manner that is easily understood by diverse audiences * Limited English proficiency * Low literacy skills/not literate * Disabilities * Hard of hearing/deaf Interpretive services Do not use patient’s family members

Question 41

Health Literacy

Answer 41

The ability to obtain, process, and understand health information needed to make informed health decisions

Question 42

Teach-Back Method

Answer 42

The teach-back method is an intervention that helps you to confirm that you have explained what a patient needs to know in a manner that the patient understands.  When using this technique, do not ask a patient, "Do you understand?" or "Do you have any questions?"  Instead ask open-ended questions to verify his/her understanding

Question 43

Cultural Encounters

Answer 43

Are interventions that involve a nurse directly interacting with patients from culturally diverse backgrounds Provide opportunities to learn about other cultures and develop effective intercultural communication Facilitates the development of refining, or modifying existing values, beliefs, and practices to develop cultural desire , awareness, skill, and knowledge

Question 44

Cultural Desire

Answer 44

The motivation of a health care professional to “want to”—not “have to”—engage in the process of becoming culturally competent Natural desire to engage in the cultural competence process motivated by passion, commitment, and caring

Question 45

Core Measures

Answer 45

Joint Commission and Centers for Medicare and Medicaid services developed standards, which include considering patient’s unique cultural perspectives Core measures are key quality indicators that help health care institutions improve performance, increase accountability, and reduce costs Intended to reduce health disparities