Powerpoints and Notes Flashcards
What is culturally responsive care?
___________ ___________ ________ is care that is centered on the client’s cultural perspectives and integrates the client’s values and beliefs into the plan of care.
How do you deliver culturally responsive care?
Nurse must first develop self-awareness of his/her own cultures, attitudes, and beliefs
Examine the biases and assumptions nurse holds about different cultures.
Nurse needs to gain necessary knowledge and skills to create an environment of trust between nurse and client.
Knowledge needs to include understanding of health disparities, historical and current portrayals of racial and ethnic groups in society.
Cultural understanding, avoiding generalizations, and obtaining cultural assessment skills are essential in understanding client’s viewpoint, and learning what the client values as important.
Define culture.
_________ is the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups.
Described as the learned and shared patterns of information that a group used to generate meaning among its members.
Describe the difference between macro-cultures and micro-cultures.
Macro-cultures: national, ethnic, or racial groups
Micro-cultures: gender, age, or religious beliefs
Combine to shape the individual’s worldview and influence interaction with others.
Describe what a subculture is.
A __________ is composed of people who have a distinct identitiy and yet are related to a larger cultural group. Generally share ethnic origin or physical characteristics with the larger cultural group.
Examples: nurses,, feminists, etc.
Describe bicultural.
__________ is used to describe a person who has dual patterns of identification and crosses two cultures, lifestyles, and sets of values.
Example: child may be influenced by both mom and dad’s heritage
Define diversity.
_________ refers to the fact or state of being different.
Factors like sex, age, culture, ethnicity, socioeconomic status, educational attainment, religious affiliation, etc. are all influential.
Diversity occurs not only between cultural groups but within a cultural group as well.
Describe what race is.
________ has been used to refer to groupings of people according to common origin or background and associated with perceived biologic markers.
Ideas about race are culturally and socially transmitted and form the basis of racism, racial classification, and often complex racial identities.
*Hispanic is not classified by race, but rather by ethnicity.
Define ethnicity.
_________ is a term interchangeable with race. May be viewed as a relationship between individuals who believe that they have distinctive characteristics that make them a group.
May shift over time, people move into other ethnic groups, labeling can become problematic.
What is nationality?
____________ refers to the sovereign state or country where one has membership, which may be through birth, inheritance, or through naturalization.
People can be multinational
Define religion.
_______ is considered a system of beliefs, practices, and ethical values about divine or superhuman power worshipped as the creator(s) and ruler(s) of the universe
One’s religion is often determined by one’s ethnic group.
Illness is sometimes seen as punishment for the violation of religious codes and morals.
Define ethnocentrism.
___________ is the belief in the superiority of one’s own culture and lifestyle. Other viewpoints are often seen as different, wrong, and/or of lesser importance.
Xenophobia: the fear or dislike of people different from one’s self.
What is prejudice?
___________ is a preconceived notion or judgment that is based on sufficient knowledge.
May be favorable or unfavorable
Unfavorable can lead to stereotyping and discriminatory behavior toward groups of people.
Define racism.
_____ refers to assumptions held about racial groups. Assumptions include the belief that races are biologically discrete and exclusive groups that are inherently unequal and ranked hierarchically.
Institutional racism: system of advantage based on race where racial prejudice is combined with social power to implement racist policies and practices.
What is discrimination?
__________ refers to the differential and negative treatment of individuals on the basis of their race, ethnicity, gender, or other group membership.
Institutional discrimination: the uneven access by group membership to resources, status, and power resulting from policies and practices of organizations and institutions.
Define what generalizations are.
_____________ are statements about common cultural patterns.
May or may not be true at the individual.
Generalizations are often interpreted as statements describing every individual in a drop, which leads to stereotyping.
What is stereotyping?
_____________ refers to making the assumption that an individual reflects all characteristics associated with being a member of a group.
Stereotyping is a barrier to communication and understanding and propagates discriminatory behavior.
Describe cultural sensitivity.
_________ __________ implies that nurses possess some BASIC knowledge of and constructive attitudes toward the health traditions observed among the diverse cultural groups found in the setting in which they practice.
Describe what culturally appropriate means.
__________ ____________ implies that nurses must apply the underlying background knowledge that must be possessed to provide a given client with the best possible health care.
Define what it means to be culturally competent.
Culturally competent implies that, within the delivered care, nurses understand and attend to the total context of the client’s situation and use a COMPLEX combination of knowledge, attitudes, and skills.
Define health disparities.
________ __________ are the differences in care experienced by one population compared with another population.
Describe some examples of health disparities.
Blacks had rate of AIDS 10x higher than Whites.
Hispanics had rate 3x higher than non-hispanic whites.
Asian adults age 65 and over were 50% more likely than Whites to lack immunization against pneumonia
According to the USDHHS, what are the two major factors contributing to health disparities?
Inadequate access to care: From economic, geographic, linguistic, cultural, and healthcare financing.
Substandard quality of care: provider-client miscommunication, provider discrimination, stereotyping, or prejudice. Usually rated on four measures: effectiveness, client safety, timeliness, and client centeredness.
Define acculturation.
___________ is the involuntary process that occurs when people adapt to or borrow traits from another culture. The member of the non dominant cultural group is often forced to learn the new culture to survive.
Can also be defined as the changes of one’s cultural patterns to those of the host society.
What is assimilation?
___________ is the process by which an individual develops a new cultural identity.
Means becoming like the members of the dominant culture. More of a conscious decision that can cause stress and anxiety.
What is transcultural nursing?
__________ ___________ focuses on providing care within the differences and similarities of the beliefs, values, and patterns of cultures.
What five competencies relating to culture should be included within the nursing care?
- Apply knowledge of social and cultural factors that affect nursing and health care across multiple contexts.
- Use relevant data sources and best evidence in providing culturally competent care.
- Promote achievement of safe and quality outcomes of care for diverse populations.
- Advocate for social justice, including commitment to the health of vulnerable populations and the elimination of health disparities.
- Participate in continuous cultural competency development.
Describe magico-religious health belief.
_________-__________ states that health and illness are controlled by supernatural forces. The client may believe that the illness is the result of being “bad” or opposing Gods’ will.
Describe what scientific or biomedical health belief is.
This is based on the belief that life and life processes are controlled by physical and biochemical process that can be manipulated by humans.
The client with this view will believe that illness is caused by germs, viruses, bacteria, or breakdown of the human machine, the body.
What is the holistic health belief?
Holds that the forces of nature must be maintained in balance or harmony. Human life is one aspect of nature that must be in harmony with the rest of nature. When the natural balance or harmony is disturbed, illness results.
How can we convey cultural sensitivity?
Determine what language the client speaks
Learn about clients communication patterns
Be authentic with people and be honest about the knowledge you lack about their culture.
Show respect for the clients values, beliefs, and practices even if they differ from your own.
The heritage assessment takes time and may need to extend over several meetings.
What six factors are included in the Giger and Davidhizer Model for cultural assessment?
- Communication-language/dialect, willingness to share, gestures, eye contact, emotional expressiveness, respect, and deferences
- Space-comfort level and proximity to others, touch practices
- Social organization-family relations, role of elders, gender issues, religion
- Time- past versus present orientation, attention to schedules/timetable
- Environmental control-mastery of nature, health prevention values, health and illness beliefs
- Biological variations- appearances, genetic inheritance, disease susceptibility, nutrition.
Describe what socio-culture means.
Set of distinctive spiritual, material, intellectual and emotional features of society or a social group
-lifestyles, ways of living together, value systems, etc.
The way people live: affects how we treat each other.
Shapes health as much as genes do.
Describe the demographics for Hispanic, Latinos.
Statistics
Spanish or Latin American descent
Mexican Americans largest Hispanic American subgroup. Most Mexican Americans live in south-central and southwestern United States.
Describe the demographics of Mexican Americans.
Health issues:
-diabetes: 2x more commin compared to Anglo-Americans
- High rates of obesity and sedentary living among Mexican Americans
- Education and socioeconomic status
- Ancient folk practices, Curanderismo
Traditional folk healing
Religious beliefs and spirituality
Curanderos use herbs, aromas, and rituals (which can present some risks)
Cultural distrust of medicines that are not “natural”; may decline the treatment choosing traditional fold remedies instead. (may lead to self-treatment)
Describe the demographics of Islam.
There are 5 pillars
- Declaration of faith
- Prayer (if ill can set up; need to know direction of Mecca)
- Almsgiving
- Fasting (Ramadan) no sex, food, drink from dawn till dusk; ill excused
- Pilgrimage to Mecca
-ALSO, food, behavior, gender
What are Arab American Health Problems?
Higher rates of risk factors for heart disease, stroke, type 2 diabetes and irreversible kidney disease in Arab Americans than in the U.S. population as a whole.
-Federal health data is not collected for Arab Americans as a unique ethnic group
What are Arab/ Arab-American health beliefs?
Bad intentions toward a person can cause illness
Eveil Eye
Pendants, holy book verses, kohl may be worn
Will of God
Describe Arab Culture.
Halal meats, no pork for Islamic, Jewish
No alcohol for some
Shaking hands b/w male/female if not related
Eye contact frequently avoided
Education materials w/ little clothing not effective
Modestly important
Same sex examiner/interpreter important
Family structure of great importance
Chronic illness, mental illness, infertility a shame
Discipline for children, but not abuse
Birth
Death
Expressive about pain
Injections more effective than pills
Prefer Western medicine, but may also treat w/ home remedies
Describe African American demographics.
First immigrants to Jamestown, VA 1619
Slaves were not immigrants (8 million 18th, 19th Cent.)
Immigrants also from Caribbean Islands, Africa
Many different cultures
Describe some cultural preferences from African Americans.
Affectionate, touch important
Don’t use medical jargon
Modesty: respect
Some may not eat pork (religion)
Eat cooked greens, fresh fruits, red/yellow vegetables
Some may not want pain meds (addiction)
Usually seek prenatal care after 1st trimester
Active participant in birthing, breastfeeding
Elders=wisdom
Home/folk remedies
Illness God’s punishment, exposure to “wind”
Describe African American Health Beliefs.
The mind, body, and spirit are not separate and if you possess good health you are in harmony with nature.
Illness characterized as natural and unnatural, influenced by harmony or disharmony with God and nature
Illness is considered to be a state of disharmony. Natural illnesses are seen as occurring from natural causes whereas unnatural illnesses are attributed to demons and evil spirits.
Many believe in the abililty of others to heal. Use herbs and roots
The wearing of copper or silver bracelets from childhood is believed to protect female children
Geophagia common among pregnant African-American women. Controversial due to dangerous electrolyte deficiencies.
Describe the African American support system.
Kinship within villages of Africa is major support system.
High percentage of female headed households in community.
Usually rely on grandmothers, mothers, aunts, and godmothers to provide assistance.
Describe the African-American Religion/spirituality.
The reliance on healers reflects the deep religious faith.
Practices include attending church services, the wearing of veils by Muslim woman; and the distributing of religious literature by African American Jehovah Witnesses.
It has been noted that health screening programs may best be initiated through community and church activities where the entire family is usually present.
What are African-American medical problems?
Leading chronic illnesses that are causes of death are same as those for Caucasians
Infant mortality rates: more than double for Caucasians
Heart disease rates: 40% higher
Death rates for all cancers: 30% higher
33% more likely to develop diabetes
Death rate from HIV/AIDS: 7x higher
