Culturally Competent Care Quiz
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What is the nurse's role in addressing spiritual care needs in palliative and end-of-life care?

  • Assessing and addressing the patient's social needs only
  • Assessing and addressing the patient's financial needs only
  • Assessing and addressing the patient's spiritual and emotional needs (correct)
  • Assessing and addressing the patient's physical needs only

    • According to the Clinical Practice Guidelines for Quality Palliative Care, what is recommended in relation to cultural considerations for patients and families facing end of life?

  • Advising patients and families to abandon their cultural practices
  • Excluding cultural practices from the care plan
  • Ignoring cultural considerations to focus solely on medical care
  • Paying attention to cultural considerations for patients and families (correct)

    • In end-of-life care, according to the World Health Organization (WHO), what is considered paramount?

  • Control of pain, other symptoms, and psychological, social, and spiritual problems (correct)
  • Control of pain only
  • Control of social problems only
  • Control of psychological problems only

    • Which domain is included in holistic care?

    <p>Physical</p> Signup and view all the answers

    What does spirituality involve?

    <p>Relationship with oneself, others, and the transcendent</p> Signup and view all the answers

    What is a means of expressing spirituality?

    <p>Religion</p> Signup and view all the answers

    What does spiritual care involve?

    <p>Compassionate presence and deep listening</p> Signup and view all the answers

    Which tool can be used for spiritual assessment?

    <p>FICA spiritual assessment</p> Signup and view all the answers

    What is culture?

    <p>Patterns of learned behaviors and values shared among groups</p> Signup and view all the answers

    How does culture shape individuals' understanding of illness and death?

    <p>It impacts choices related to caregivers, access to services, and symptom management</p> Signup and view all the answers

    What does culture influence in palliative care?

    <p>Beliefs and practices of patients, family caregivers, and healthcare professionals</p> Signup and view all the answers

    What is an example of cultural competency in palliative care?

    <p>WRHA Indigenous Health-Patient services team providing elder care, language services, traditional medicines, and ceremonies</p> Signup and view all the answers

    What is included in a spiritual assessment using the FICA spiritual assessment tool?

    <p>Questions about faith, importance of beliefs, community, and address in care</p> Signup and view all the answers

    What aspects does culture influence in palliative care?

    <p>Beliefs and practices of patients, family caregivers, healthcare professionals.</p> Signup and view all the answers

    What does a spiritual assessment involve?

    <p>Compassionate presence and deep listening.</p> Signup and view all the answers

    What is the main goal of providing culturally competent care?

    <p>To honor diverse cultural beliefs</p> Signup and view all the answers

    Which model of care has evolved to include cultural awareness and sensitivity?

    <p>Client-centered model</p> Signup and view all the answers

    What is cultural safety based on?

    <p>Respectful engagement and non-discriminatory environments</p> Signup and view all the answers

    What is cultural humility a process of?

    <p>Self-reflection for health professionals</p> Signup and view all the answers

    How may lack of cultural safety affect patients?

    <p>Make them feel afraid to seek healthcare</p> Signup and view all the answers

    What aspects of healthcare may be influenced by culture?

    <p>Pain expression and choice of treatment</p> Signup and view all the answers

    Why can providing palliative care to newcomers in Manitoba be complex?

    <p>Due to cultural differences and increasing visible minorities</p> Signup and view all the answers

    What fundamental value is recognized in Canada's constitution?

    <p>Multiculturalism</p> Signup and view all the answers

    What principle recognizes a person's right to decide their healthcare based on their beliefs, values, and life plan?

    <p>Autonomy</p> Signup and view all the answers

    In non-western cultures, who may be involved in healthcare decisions?

    <p>Family or community members as well as Western healthcare team</p> Signup and view all the answers

    What kind of needs and values do recent immigrants have primarily due to cultural and religious differences?

    <p>Diverse needs and values influenced by cultural and religious differences</p> Signup and view all the answers

    What does multiculturalism allow individuals to practice?

    <p>Their religion, belief, and customs</p> Signup and view all the answers

    In Filipino hospitals, which system allows family members, especially mothers, to stay with the dying person?

    <p>The bantay (watcher) system</p> Signup and view all the answers

    Why is organ donation generally not accepted in Filipino spiritual beliefs?

    <p>To keep the body intact for burial</p> Signup and view all the answers

    What is the Chinese cultural view on revealing a prognosis to dying patients?

    <p>They prefer not to reveal a prognosis</p> Signup and view all the answers

    In Canadian hospitals, what do Hindu families prefer to do before the deceased loved ones are removed from the hospital?

    <p>Wash and dress the deceased loved ones</p> Signup and view all the answers

    How soon must the body be cremated after death according to Hindu traditions?

    <p>Within 24 hours of death</p> Signup and view all the answers

    Why do Muslim families prefer not to disclose a prognosis to dying relatives?

    <p>To view death as an act of God</p> Signup and view all the answers

    What is the primary focus of Buddhist perspectives of end-of-life care?

    <p>Personal spiritual development</p> Signup and view all the answers

    What is the focus of WRHA Indigenous Health?

    <p>Identifying and implementing culturally safe environments, practices, and services</p> Signup and view all the answers

    What was the significance of the case of Brian Sinclair?

    <p>Spurred discussion on cultural safety</p> Signup and view all the answers

    Which culture emphasizes the importance of family in end-of-life care interactions?

    <p>Filipino culture</p> Signup and view all the answers

    What does the term 'cultural safety' primarily entail?

    <p>Actions leading to safe and inclusive environments</p> Signup and view all the answers

    Which country's population increase is mentioned in the text?

    <p>Canada</p> Signup and view all the answers

    What is the primary concern raised in Ontario related to health care bias?

    <p>Cultural safety for indigenous patients</p> Signup and view all the answers

    Which culture's values include finding meaning in existence and death?

    <p>Filipino culture</p> Signup and view all the answers

    What is the main focus of the required readings that were removed?

    <p>'End-of-life care among Indigenous Canadians'</p> Signup and view all the answers

    What is a top intervention for Filipino patients at end of life according to the text?

    <p>'Spiritual comfort'</p> Signup and view all the answers

    Which symptom do many people fear most after a diagnosis of advanced cancer?

    <p>Pain</p> Signup and view all the answers

    According to M. McCaffery in 1968, how has pain been defined?

    <p>As whatever the experiencing person says it is, existing whenever the experiencing person says it does</p> Signup and view all the answers

    What is one of the most frequent reasons for palliative consultations?

    <p>Unrelieved pain</p> Signup and view all the answers

    What is predictive for the last 6 months for advanced cancer patients?

    <p>Advanced cancer</p> Signup and view all the answers

    What percentage of cancer pain is caused by the cancer itself?

    <p>75%</p> Signup and view all the answers

    According to the Winnipeg Regional Health Authority (WRHA), what do the clinical practice guidelines recommend for pain assessment and management?

    <p>Non-opioids, weak opioids, strong opioids, and interventional pain therapy</p> Signup and view all the answers

    What does the Canadian Virtual Hospice identify as the fifth vital sign?

    <p>VHS pain (visceral, head, and somatic pain)</p> Signup and view all the answers

    How much more potent is fentanyl compared to common opioids?

    <p>100 times</p> Signup and view all the answers

    What percentage of patients can achieve adequate pain control with proper assessment and management?

    <p>Up to 90%</p> Signup and view all the answers

    What is a common misconception about morphine mentioned in the text?

    <p>All of the above</p> Signup and view all the answers

    What does the World Health Organization (WHO) pain ladder recommend for pain management?

    <p>Non-opioids, weak opioids, strong opioids, and interventional pain therapy</p> Signup and view all the answers

    What is a common barrier to optimal pain assessment mentioned in the text?

    <p>All of the above</p> Signup and view all the answers

    What is a potential outcome of opioidphobia mentioned in the text?

    <p>Addiction to opioids</p> Signup and view all the answers

    What percentage of patients reported being asked about their pain during clinical visits?

    <p>58%</p> Signup and view all the answers

    According to the Winnipeg Regional Health Authority (WRHA), what is crucial before treatment to determine the cause, type, severity, and impact of pain on the patient?

    <p>Pain assessment</p> Signup and view all the answers

    What aspect of pain is not only physical but also includes emotional, social, financial, spiritual, and bureaucratic aspects?

    <p>Pain experience</p> Signup and view all the answers

    What is the primary focus of managing breakthrough pain in cancer patients?

    <p>Effectively treating and addressing the impact on quality of life</p> Signup and view all the answers

    What is the maximum recommended dose of fentanyl for treating breakthrough pain, given every 15 minutes up to 3 times per hour?

    <p>20 micrograms per application</p> Signup and view all the answers

    What is the common side effect of opioids that can limit their use in some patients?

    <p>Nausea</p> Signup and view all the answers

    According to Pal (2010), when should healthcare professionals give incident pain medications to cover peak pain?

    <p>5-10 minutes before activities</p> Signup and view all the answers

    What did Ferrell & Coyle (2019) note about the knowledge and confidence of oncology professionals in managing breakthrough pain?

    <p>They lack knowledge and confidence</p> Signup and view all the answers

    What is the impact of end-of-dose failure of background analgesic on breakthrough pain?

    <p>It exacerbates breakthrough pain</p> Signup and view all the answers

    What is the primary challenge in using opioids to manage peak pain and maintain a steady level between painful episodes?

    <p>Desire for more potent analgesics with rapid onset</p> Signup and view all the answers

    Which short-acting analgesic is often given approximately 10 minutes prior to activity for treating breakthrough pain?

    <p>Intranasal fentanyl</p> Signup and view all the answers

    What is the defining characteristic of nociceptive pain?

    <p>It is often worse with movement</p> Signup and view all the answers

    Which type of pain originates from mesodermal tissues like bone, muscle, ligaments, and fascia?

    <p>Deep somatic pain</p> Signup and view all the answers

    What term describes experiencing pain from a non-painful stimulus, which is a possible element of neuropathic pain?

    <p>Allodynia</p> Signup and view all the answers

    What is the primary cause of bone pain for cancer patients?

    <p>Metastasis</p> Signup and view all the answers

    What type of pain arises from the endoderm layer and is often felt on the body surface with referred pain?

    <p>Visceral pain</p> Signup and view all the answers

    Which type of pain can be easily mapped out with dermatome charts and is described as sharp, burning, or tingling?

    <p>Cutaneous pain</p> Signup and view all the answers

    What type of pain arises from nerve damage and is often described as burning, numb, tingling, or crawling sensations?

    <p>Neuropathic pain</p> Signup and view all the answers

    What term describes an unpleasant sensory and emotional experience associated with tissue damage?

    <p>'Pain' itself</p> Signup and view all the answers

    What term describes the experience of having various pains with different causes?

    <p>'Multifocal' pains</p> Signup and view all the answers

    What approach involves thorough assessment of pain, discussions about goals of care, investigations, treatments, and ongoing reassessment?

    <p>Palliative care approach</p> Signup and view all the answers

    What is a common assessment tool used for patients with palliative care, especially those with cancer, to assess chronic pain?

    <p>Edmonton Symptom Assessment System Revised (ESAS-R)</p> Signup and view all the answers

    What type of pain often goes down to a specific dermatome and can change its location according to the Neuropathic Pain Assessment Guideline?

    <p>Neuropathic Pain</p> Signup and view all the answers

    In pain assessment, which tool uses a scale of 0 (no symptom) to 10 (worst possible symptom) to assess pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, anxiety, depression, and wellbeing?

    <p>Edmonton Symptom Assessment System Revised (ESAS-R)</p> Signup and view all the answers

    What is a key aspect of pain assessment questions?

    <p>Asking about the location, description, duration, and severity of pain</p> Signup and view all the answers

    Which assessment tool is commonly used for patients with palliative care, especially those with cancer, to assess chronic pain?

    <p>Edmonton Symptom Assessment System Revised (ESAS-R)</p> Signup and view all the answers

    Which aspect of pain assessment considers the patient's experience and is included in assessment tools like the NRS and Wong-Baker FACES pain rating scale?

    <p>Description of Pain</p> Signup and view all the answers

    What does the ESAS-R assess besides pain for patients with palliative care?

    <p>Anxiety and Depression</p> Signup and view all the answers

    Which assessment tool uses facial expressions to rate pain for patients?

    <p>Wong-Baker FACES pain rating scale</p> Signup and view all the answers

    What is a common tool used for assessing pain that includes verbal descriptors such as 'mild,' 'moderate,' or 'severe'?

    <p>Verbal Descriptors</p> Signup and view all the answers

    Which assessment tool includes assessing symptoms on a scale from 0 (no symptom) to 10 (worst possible symptom) for patients receiving palliative care?

    <p>Edmonton Symptom Assessment System Revised (ESAS-R)</p> Signup and view all the answers

    Study Notes

    • Manitoban population increased due to immigrant influx (Census2011, Winnipeg Free Press 08/8/12)

    • Importance of cultural awareness and knowledge for palliative care health professionals (Feser, 2003)

    • Discussion on cultural safety spurred by the case of Brian Sinclair, an Aboriginal man who died in a Winnipeg hospital after waiting 34 hours in a wheelchair (CMAJ, November 27, 2014)

    • Health care bias concerns in Ontario raised by the death of an Indigenous mother (Global News Winnipeg, Dec. 18, 2023)

    • Cultural safety is not just about awareness, but actions that lead to safe and inclusive environments (CMAJ, Nov. 27, 2014)

    • WRHA Indigenous Health focuses on communication, identifying and implementing culturally safe environments, practices, and services (WRHA Indigenous Health)

    • Contact information for Indigenous patient services

    • Required readings on end-of-life care among Indigenous Canadians removed

    • Importance of family in Filipino culture and its impact on end-of-life care interactions (Virola, 2010, Wright et al, 2008)

    • Top interventions for Filipino patients at end of life include spiritual comfort (Journal of Palliative Care, 15(1), 31-38)

    • Filipino values of finding meaning in existence and death preserve dignity at the end of life (Religious Understanding of a Good Death in Hospice Palliative Care)

    • Disregard for dignity shown to a woman who died curled up in pain on the floor of Seven Oaks General Hospital (no specific source)

    • Patients with chronic illnesses like arthritis may experience new pain as a sign of disease recurrence or new areas of disease.

    • Indigenous health services may incorporate traditional herbs and consult with spiritual teams in pain assessment and management.

    • The Neuropathic Pain Assessment Guideline mentions that neuropathic pain often goes down to a specific dermatome, and its location can change.

    • Pain can have cultural and spiritual influences on its expression, meaning, and treatment.

    • Pain assessment questions include asking about the location, description, duration, and severity of pain. Some assessment tools include the Numeric Rating Scale (NRS), Verbal Descriptors, Victoria Symptom Assessment Scale, and Wong-Baker FACES pain rating scale.

    • Patients with palliative care, especially those with cancer, commonly experience chronic pain and should have it assessed regularly using tools like the Edmonton Symptom Assessment System Revised (ESAS-R).

    • The ESAS-R assesses pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, anxiety, depression, and wellbeing on a scale of 0 (no symptom) to 10 (worst possible symptom).

    • The Canadian Problem Checklist includes a variety of concerns in physical, spiritual, practical, and emotional categories, such as concentration/memory, sleep, weight, constipation, and fears/worries.

    • The assessment tools aim to provide healthcare professionals with accurate and comprehensive information about the patient's pain experience to develop effective treatment plans.

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    Test your knowledge on providing culturally competent care to diverse cultural groups at end of life. Explore the application of knowledge, skills, and attitudes required by nurses to maximize respectful relationships with diverse populations of clients and coworkers.

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