Cultural and Spiritual Assessment in Nursing

Cultural and Spiritual Assessment

• Cultural assessment is crucial for providing patient-centered care
• To care for someone, one must understand who they are, who the other person is, and bridge the gap between the two (Jean Watson).
• Understanding cultural influences is vital for nurses to provide effective and appropriate care.

Defining Culture

• Culture encompasses learned values, beliefs, norms, and lifestyles that shape individual thinking and actions. (College of Nurses)
• It includes the totality of socially transmitted knowledge, values, beliefs, and lifeways of a particular group, guiding their behaviours. (Potter & Perry)
• Culture is a dynamic and ever-changing process.
• It has both visible and invisible components.
• Cultures can be further divided into subcultures.

Why Study Cultural Considerations in Nursing?

• Understanding the impact of culture on families from diverse backgrounds.
• Learning about different health practices across cultures.
• Recognizing personal biases, values, and beliefs and their effect on delivering care.
• Gaining the ability to provide better support.

Multiculturalism in Canada

• "Visible minority" populations in Canada are growing, and immigration rates have outpaced the natural birth rate.
• Recent immigrants are more often from Asia than Europe.
• Canada's approach to multiculturalism is debated, with some advocating a "cultural mosaic" and others a "cultural melting pot."

Ethnicity

• Ethnicity refers to shared social and cultural heritage among groups.
• Members of ethnic groups often share a sense of common identity.
• Ethnicity is distinct from race, which is primarily based on biological attributes.

Culture and Socialization

• Enculturation is the process of socialization into one's primary culture during childhood.
• Acculturation involves adapting to and adopting characteristics of a new culture.
• Assimilation happens when an individual abandons their ethnic identity to adopt the dominant culture.

Cultural Conflicts

• Ethnocentrism is the tendency to view one's own culture as superior to others.
• Cultural imposition occurs when one's values and beliefs are imposed on clients, impacting care delivery.
• Stereotyping involves making generalizations about specific cultural groups.
• Discrimination is treating individuals unfairly due to their group membership.

Cultural Awareness

• Nurses should view clients' beliefs and practices with tolerance and avoid judgment.
• Nurses need to understand how their own culture might influence their care practices.
• Cultural sensitivity is an integral part of the therapeutic nurse-client relationship

Three Types of Nursing Interventions Pertaining to Culturally Sensitive Care

• Preserve existing cultural practices when appropriate and beneficial
• Accommodate the patient's cultural practices as needed
• Repattern care practices for more culturally congruent outcomes

Culturally Congruent Care

• Care practices should be tailored for the specific needs, beliefs, and values of clients.
• Culturally congruent care can differ from mainstream healthcare practices.
• Nurses must be culturally competent and adaptive in their care delivery.

Culturally Competent Care

• Utilizing culturally based knowledge to provide creative and meaningful care that aligns with clients' lifeways and needs.

Culturally Sensitive Care by the College of Nurses

• Critically evaluate personal biases.
• Learn about cultural backgrounds.
• Communicate effectively with clients and their families.

Cultural Assessment

• Communication: Understanding how feelings are expressed, the use of verbal/nonverbal communication varies according to culture.
• Space: Recognizing diverse spatial requirements.
• Social Organization: Different cultural and familial structures influence behaviour and healthcare decisions.
  • Understand social roles in families and cultural groups
• Time: How different cultures view time and schedule can affect care delivery.

Spirituality

• Spirituality is the centre of a person's life, connecting people through concepts like God, nature, or relationships to find meaning in life.
• Spirituality is a personal matter.
• The patient's interconnected mind, body, and spirit should be considered in their care

Spiritual Distress

• Spiritual distress is a disruption in the integrating principle that pervades a person's entire being.
• It involves the person's interactions with their wider community and their belief system.

Ineffective Spiritual Behaviours

• Expressing doubts or concerns regarding the meaning of life.
• Expressing anger towards a higher power, such as God.
• Verbalizing inner conflicts about faith.
• Discontinuing religious rituals.
• Blaming oneself for illness or distress.
• Viewing illness as a punishment.
• Requests for spiritual assistance

Adaptive Spiritual Behaviors

• Demonstrates confidence in faith.
• Acts in accordance to their values and beliefs.
• Takes personal responsibility for their wellbeing.
• Exhibit feelings of self-worth.
• Experiences moral comfort.

Nursing Interventions Specific to Spiritual Distress

• Recognizing spiritual distress and its impact on the patient.
• Showing respect and valuing the patient.
• Creating a private and personal environment for the patient.
• Respecting the patient’s privacy when communicating
• Offering spiritual support, counselling or referral to an advisor.
• Encouraging family or friends to visit
• Providing access to religious services whenever it is possible.