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Which of the following is NOT a characteristic of culturally competent nursing?
Cultural diversity refers to the presence of differences such as language, sexual orientation, and religion.
True
What is the definition of culture?
A shared system of beliefs, values, and behavioral expectations.
What is the main difference between culture and ethnicity?
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Which group is associated with an increased risk for hypertension, stroke, and sickle cell anemia?
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Which of the following terms describes the belief that one's own culture is superior to others?
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What does the term 'cultural imposition' mean?
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______ is whatever and whenever a patient says it is.
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The intimate zone of personal space is considered to be 1.5 to 4 feet.
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Which health belief system associates illness with supernatural forces and possibly punishment from God?
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Which group traditionally uses Curanderos as folk healers?
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What does 'cultural shock' refer to?
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Which health belief system is characterized by the understanding that illness can be a punishment from God?
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Hispanic folk health considers health and illness to be based on scientific principles.
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Name one common folk health practice among Native Americans.
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In Asian traditional health beliefs, well-being is often related to the balance of ____ and ____.
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What approach do Caucasian folk health beliefs emphasize?
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Match the group with their associated folk health practices:
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Assessing dietary habits is important for all cultural groups.
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Identify one nursing consideration for patients from a holistic health belief system.
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What term refers to the unfair treatment of individuals based on characteristics like race or gender?
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Cultural acculturation refers to a minority group adopting the characteristics of a dominant group.
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What is the definition of ethnicity?
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The state of being different, including aspects like language and religion, is known as __________.
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Match the following groups with their associated health concerns:
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Which concept involves recognizing and respecting cultural differences without imposing one’s own culture?
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Cultural blindness involves recognizing cultural differences and adapting behavior accordingly.
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What is a primary attribute of culturally competent nursing?
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The __________ zone of personal space typically extends from 1.5 to 4 feet.
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Which term describes a belief that one's own culture is superior to others?
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Study Notes
Cultural Nursing
- Nurses must be culturally sensitive, appropriate, and competent
- Cultural sensitivity involves being non-judgmental and aware of differences
- Cultural appropriateness is being non-judgmental
- Cultural competence involves attending to the patient's total situation
Culture
- Culture is unique to a specific group and evident in attitudes and institutions
- It includes non-physical traits and characteristics
- Learned and passed down through generations
- Learned by each new generation through both formal and informal life experiences
- Includes values, beliefs, attitudes, practices, habits, likes/dislikes, customs, and rituals
Cultural Concepts
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Culture: Shared system of beliefs, values, and behavioral expectations
- Defines roles and interactions with others, families, and communities
- Provides social structure for daily living
-
Ethnicity: Sense of identification with a collective cultural group
- Based on group's heritage
- Ethnic background is also ethnicity
- Examples include religion and language
- Religion: A system of beliefs, practices, and ethical values about divine or superhuman powers
-
Diversity: State of being different
- Examples include language, sexual orientation, and religion
- Stereotyping: Assuming everyone from the same culture, race, or ethnicity acts alike
- Cultural Imposition: Belief that everyone should conform to your own belief systems
- Cultural Blindness: Ignoring differences and proceeding as if they don't exist
- Culture Conflict: Becoming aware of cultural differences, feeling threatened, and responding by ridiculing the beliefs and traditions of others to feel more secure about one's own values
- Subculture: Large group of people who are members of a larger cultural group but have certain ethnic, occupational, or physical characteristics that are not common to the larger culture
- Cultural Acculturation or Assimilation: A minority group living with a dominant group and losing cultural characteristics that made them different, may take on the values of the dominant group
- Cultural Shock: Being placed in a different culture that is perceived as strange
- Race: Based on physical characteristics such as skin pigmentation, body stature, facial features, and hair texture
- Discrimination: Unfair or prejudicial treatment of people and groups based on characteristics such as race, gender, age, sexual orientation
- Ethnocentrism: Belief that one's ideas, beliefs, and practices of one's own culture are superior to those of another's culture
- Prejudice: An opinion formed without adequate knowledge, thought, or reason
- Bicultural: Combining cultural attitudes and customs between two nations
- Dominant Vs Minority Group: The dominant group is the one that holds the most power in society in comparison to minority groups
Nursing Assessment Parameters
- Include physiological variations, reactions to pain, language and communication, economic barriers, gender roles, and mental health
- Pain is whatever and whenever a patient says it is
Physiological Variations
-
Native Americans & Alaska Natives:
- Heart disease
- Cirrhosis of the liver
- Diabetes Mellitus
- Fetal Alcohol Syndrome
-
African Americans
- Hypertension
- Stroke
- Sickle Cell Anemia
- Lactose Intolerance
- Keloids
-
Asians
- Hypertension
- Cancer of the liver
- Lactose Intolerance
- Thalassemia
-
Hispanics
- Diabetes Mellitus
- Lactose Intolerance
-
Whites
- Breast Cancer
- Heart Disease
- Hypertension
- Diabetes Mellitus
- Obesity
-
Eastern European Jews
- Cystic Fibrosis
- Gaucher's Disease
- Spinal Muscular Atrophy
- Tay - Sachs's Disease
Communication
- Verbal Communication: Language usage, voice quality, use of silence, gender of speaker, use of interpreter
- Non Verbal Communication: Eye movement/eye contact, facial expression, use of touch, hand movement, body posture
Time Orientation
- Past: History and traditions guide the present and future (ex: East Asia)
- Present: "Eternal present," instant gratification and short-term benefits (ex: American, African, and Native Americans)
- Future: Planning for the future, long-term worldview (ex: Chinese and Japanese)
Personal Space
- Intimate Zone: 6 to 18 inches
- Personal Zone: 1.5 to 4 feet
- Social Zone: 4 to 12 feet
Health Belief Systems
-
Health Belief System: Framework influencing views on the cause of illness, prevention, treatment of illness, health promotion, and maintenance activities
-
Magico - Religious Health Belief System:
- Supernatural forces, evil spirits, God's will
- Illness = a punishment from God
- Hispanics, African, & Caribbean
-
Scientific Health Belief System (Bio Medical):
- Controlled physical and biochemical processes
- Analyzed and manipulated by humans
-
Holistic Health Belief System:
- Natural balance or harmony vs disequilibrium or disharmony
- Chinese Medicine and Native Americans
-
Magico - Religious Health Belief System:
Folk and Traditional Healthcare Practices
-
Asian: Well-being related to balance (yin & yang, energy, mind-body-spirit)
- Hot & Cold remedies
- Herbs
- May be upset with lab results and prefer death with an intact body, therefore may refuse surgery
-
Spanish: Curanderos (folk healers)
- Respect according to age or gender
- Roman Catholic Church influence
- May be difficult to convince of illness
- Health & Illness = God's will and for a reason, such as punishment
-
Caucasian
- Self-diagnosis of illness
- Use of OTC drugs
- Extensive use of exercise and exercise facilities
- Assess OTC medications, observe for signs and symptoms of toxic medication levels (especially fat soluble vitamins)
- Assess dietary habits
-
African Americans
- Varies, may include: Herb Doctors, Voodoo, and Faith Healing
- Assess folk healing
- Special care may be needed (hair, nails)
-
Native Americans
- Shaman = medicine man
- Herbs and psychological treatments
- Ceremonies, fasting, medications, heat, and massage
- Family is expected to participate in care
- Note-taking is taboo and insulting to the speaker
- Indirect eye contact is preferred
- Low tone of voice is respectful
Nursing Diagnoses Examples
- Impaired Verbal Communication related to inability to speak English and interpreter available
- Ineffective Management of Therapeutic Regimen related to mistrust of traditional healthcare personnel
Nursing Process
-
Assessment:
- Use of health belief system
- Language use
- Preference for family involvement
- Food preferences
- Space and time orientation
-
Diagnosis:
- Some NANDA diagnosis are included above
-
Planning:
- Become aware of the client's cultural heritage and health traditions
- Consider client's cultural influences
-
Implementation:
- Ensure to address the gap between the nurse's scientific world, and the client's cultural perspectives (views)
- Accommodate cultural practices
-
Evaluation:
- Compare client's expected outcomes with achieved outcomes
- Ensure client's health belief system has been taken into consideration
Cultural Nursing
- Nurses must be culturally sensitive, meaning they should be nonjudgemental, aware of cultural differences, and willing to work within the patient's cultural framework.
- Nurses should also be culturally appropriate - meaning they should behave and interact with patients in a way that is respectful of their cultural background.
- Culturally competent nurses are able to attend to all aspects of the patient's situation - including their social, emotional, and cultural needs, as well as their physical needs.
Culture
- Culture is a system of shared beliefs, values, and expectations that inform members' roles and interactions with each other, their families, and their communities.
- It also defines how people live their daily lives and provides social structure for living.
- Culture is learned through both formal and informal life experiences, and it is passed down through generations.
- The cultural system is reflected in a variety of ways, such as the attitudes, practices, customs, and beliefs of a group.
Ethnicity
- Ethnicity is a sense of identification with a cultural group that is based on its heritage.
- Ethnic background is synonymous with ethnicity.
- It often includes characteristics such as religion, language, and shared history.
Religion
- Religion is a system of beliefs and practices about divine or supernatural powers. It often guides the ethical values and behaviors of the group.
Diversity
- Diversity refers to the state of being different.
- It can involve aspects such as language, sexual orientation, religion, and more.
Stereotyping
- Stereotyping refers to making assumptions about all members of a group based solely on their culture, race, or ethnicity.
Cultural Imposition
- Cultural imposition occurs when individuals believe that everyone should conform to their belief system.
Cultural Blindness
- Cultural blindness is ignoring differences and pretending they do not exist.
Culture Conflict
- When individuals become aware of cultural differences, they may feel threatened and respond by ridiculing others' beliefs and traditions. Culture conflict can also be used to validate and reinforce one's own values.
Subculture
- A subculture is a large group of people who share the characteristics of a larger cultural group, but also have certain ethnic, occupational, or physical characteristics that are not shared by the larger cultural group.
Cultural Acculturation or Assimilation
- When a minority group lives with a dominant group, they often lose cultural characteristics that made them different, and take on the values of the dominant group through cultural acculturation or assimilation.
Cultural Shock
- When an individual is placed in a different culture that they perceive as strange, they might experience cultural shock.
Race
- Race is based on inherited physical characteristics such as skin pigmentation, body stature, facial features, and hair texture.
Discrimination
- Discrimination is prejudicial and unfair treatment of people and groups based on characteristics such as race, gender, age, or sexual orientation.
Ethnocentrism
- Ethnocentrism is the belief that one's own culture's ideas, practices, and beliefs are superior to other cultures.
Prejudice
- Prejudice is a preconceived opinion that is formed without adequate knowledge, thought, or reason.
Bicultural
- A bicultural individual combines the cultural attitudes and customs of two different nations.
Dominant vs Minority Group
- In any society, the dominant group holds the most power, while minority groups lack the same level of power.
Nursing Assessment Parameters
- Nursing assessment parameters that must be considered when working with patients of diverse backgrounds include:
- Physiological Variations
- Reactions to pain
- Language & Communication
- Economic Barriers
- Gender Roles
- Mental Health
- Gender Roles
Physiological Variations
- Native Americans & Alaska Natives have a higher prevalence of heart disease, cirrhosis of the liver, diabetes mellitus, and fetal alcohol syndrome.
- African Americans have a higher risk of hypertension, stroke, sickle cell anemia, lactose intolerance, and keloids.
- Asians are at increased risk for hypertension, cancer of the liver, lactose intolerance, and thalassemia.
- Hispanics have higher levels of diabetes mellitus and lactose intolerance.
- Whites are more likely to experience breast cancer, heart disease, hypertension, diabetes mellitus, and obesity.
- Eastern European Jews have a higher prevalence of cystic fibrosis, Gaucher’s Disease, spinal muscular atrophy, and Tay - Sachs’s Disease.
Pain
- Pain is subjective. It is whatever and whenever the patient says it is.
Verbal Communication
- When assessing verbal communication take into account factors such as:
- Language usage
- Voice quality
- Use of silence
- Gender of speaker
- Use of interpreters
Nonverbal Communication
- Assess nonverbal communication by looking for cues such as:
- Eye movement/eye contact
- Facial expression
- Use of touch
- Hand movement
- Body posture
Time Orientation
- Past Orientation: People with a past-oriented perspective use history and traditions to guide their present and future decisions. This is common in East Asia.
- Present Orientation: Those with a present orientation tend to live in the "eternal present," prioritizing instant gratification and short-term benefits. This is common in American, African, and Native American cultures.
- Future Orientation: People with a future orientation focus on long-term planning and have a view that emphasizes long-term goals. This is seen in Chinese and Japanese cultures.
Personal Space
- Intimate Zone: 6 to 18 inches - Typically reserved for intimate relationships.
- Personal Zone: 1.5 to 4 feet - Ideal for personal conversations and interactions.
- Social Zone: 4 to 12 feet - Suitable for public and formal interactions.
Health Belief Systems
-
Health Belief System: A framework that influences individuals' views on the causes of illness, prevention, treatment, health promotion, and maintenance activities.
- Magico-Religious Health Belief System: Explains illness based on supernatural forces, evil spirits, or God's will. Illness may be perceived as a punishment from God. Common among Hispanic, African, and Caribbean cultures.
- Scientific Health Belief System (Biomedical): Illness is explained by physical and biochemical processes that can be analyzed and manipulated by humans. This system is common in Western medicine.
- Holistic Health Belief System: Illness is attributed to an imbalance or disharmony in the natural world. Popular in Chinese Medicine, and among Native Americans.
Folk & Traditional Healthcare Practices
- Asian: Folk and traditional health care practices commonly emphasize the importance of balance (yin and yang, energy, mind-body-spirit connection). Hot and cold remedies, and herbs are popular.
- Spanish: Believe in Curanderos (folk healers). Respect is often given according to age or gender. The Roman Catholic Church is influential.
- Caucasian: Individuals in many Caucasian cultures make their own diagnoses, use over-the-counter drugs (vitamins and analgesics), and emphasize exercise as a health practice .
- African Americans: Folk and traditional health care practices are diverse, but may include practices from Herb Doctors, Voodoo, and faith healing.
- Native Americans: Shamans (medicine men) are traditionally used for healing. Herbs and psychological treatments are widely used. Fasting, ceremonies, medications, heat, and massage are also common practices.
Nursing Process
- Assessment: The nursing assessment should include questions about the patient’s health belief system, language use, family involvement preferences, dietary preferences, space and time orientation.
- Diagnosis: NANDA diagnoses, such as impaired verbal communication or ineffective management of therapeutic regimen may arise from cultural differences.
- Planning: The nurse should be aware of the patient’s cultural heritage and health traditions and consider their influence in the planning process.
- Implementation: The nurse should address the differences between their scientific worldview and the patient’s cultural perspectives. They should adapt their care to accommodate the patient’s cultural practices.
- Evaluation: The evaluation phase should compare the client’s expected outcomes with the achieved outcomes. The nurse should ensure that the patient’s health belief system has been taken into consideration.
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Description
Explore the importance of cultural sensitivity, appropriateness, and competence in nursing practices. This quiz covers key concepts of culture and ethnicity, emphasizing how they shape patient interactions and care. Understand the role of culture in healthcare to enhance your nursing effectiveness.
