Cultural Diversity: Factors Influencing Growth and Development PDF

- C U LT U R A L D I V E R S I T Y - FACTORS INFLUENCING GROWTH AND DEVELOPMENT D R. S E R P İ L TO P Ç U 1  CULTURAL DIVERSITY Cultural diversity is culture, ethnicity and race Culture Culture defined as a shared system of b...

- C U LT U R A L D I V E R S I T Y - FACTORS INFLUENCING GROWTH AND DEVELOPMENT D R. S E R P İ L TO P Ç U 1  CULTURAL DIVERSITY Cultural diversity is culture, ethnicity and race Culture Culture defined as a shared system of beliefs, values, and behavioral expectations that provides social structure for daily living. Culture defines roles and interactions with others as well as within families and communities 2  CULTURAL DIVERSITY- CULTURE It is shared by and provides an identity for, all members of the same cultural group Culture is learned by each new generation through both formal and informal life experiences. Language is the primary means of transmitting culture Cultural practices and beliefs may evolve over time Culture are differences both within cultures and among cultures 3  CULTURAL DIVERSITY- CULTURE A dominant group is the group that has the most ability to control the values of the society. It usually is (but does not have to be) the largest group in a society Minority groups usually have some physical or cultural characteristic (such as race, religious beliefs, or occupation) that identifies the people within it as different from the dominant group. 4  CULTURAL DIVERSITY- CULTURE When a minority group lives within a dominant group, many of their members may lose the cultural characteristics This process is called cultural assimilation or acculturation For example, when people immigrate and encounter a new dominant culture, as they go to work, go to school, and learn the dominant language, they often move closer to the dominant culture. 5  CULTURAL DIVERSITY- CULTURE Mutual cultural assimilation also does occur, with some characteristics of both groups being traded For example, many Hispanic immigrants to the United States learn to speak English, and many Americans learn to cook and enjoy traditional Hispanic foods. 6  CULTURAL DIVERSITY- CULTURE Another possibility is culture shock, or the feelings a person experiences when placed in a different culture perceived as strange The person may then feel foolish, fearful, incompetent, inadequate, or humiliated These feelings eventually can lead to frustration, anxiety, and loss of self-esteem 7  CULTURAL DIVERSITY- ETHNICITY People within an ethnic group generally share unique cultural and social beliefs and behavior patterns, including language and dialect, religious practices, literature, folklore, music, political interests, food preferences, and employment patterns 8 9 CULTURAL DIVERSITY-RACE Although the term ethnicity often is used interchangeably with race, these terms are not the same Racial categories are typically based on specific physical characteristics such as skin pigmentation, body stature, facial features, and hair texture Ethnicity: It is based on cultural and social identity. It refers to elements such as the culture, language, religion, traditions and customs to which a person belongs. 10  CULTURAL DIVERSITY-RACE Etnisity in Turkey; Türk, boşnak, arnavut, kürt, zaza, gürcü,çerkez, çingene, ermeni, süryani, rum, yahudi Race; Kafkas, moğol, avustralya, kongo, capoid 11 CULTURAL INFLUENCES ON HEALTHCARE Turkey is multicultural, multiethnic, and multiracial Therefore, nurses must be aware of, and sensitive to, the needs of a culturally diverse patient population Remember that what may seem reasonable and important to a patient may seem ridiculous and irrelevant to a nurse 12  CULTURAL INFLUENCES ON HEALTHCARE- Physiologic Variations Various studies have shown that certain racial and ethnic groups are more prone to developing specific diseases and conditions Use knowledge of these individualized risk factors when interviewing a patient to complete a health history 13 CULTURAL INFLUENCES ON HEALTHCARE- Physiologic Variations 14  CULTURAL INFLUENCES ON HEALTHCARE- Reactions To Pain Some cultures allow the open expression of emotions experienced by a person in pain, whereas other cultures don’t Nurses often assume that a patient who does not complain of pain is not having pain Therefore, a patient who deals with pain quietly may have their pain-reduction needs ignored. Nonverbal signals; 15  CULTURAL INFLUENCES ON HEALTHCARE- Mental Health Many ethnic groups have their own norms or acceptable patterns of behavior for psychological well-being and normal psychological reactions to certain situations. For example; - Turkish people deal with problems within the family and would view it as inappropriate to tell problems to a stranger. - Traditional Chinese people often consider mental illness a stigma; therefore, seeking psychiatric help would be a disgrace to the family. 16  CULTURAL INFLUENCES ON HEALTHCARE- Gender Roles In many cultures, the man is the dominant figure and generally makes decisions for all family members In male-dominant cultures, women are usually passive In many African American and Caucasian families, the woman is often dominant Knowing who is the dominant member of the family is important when planning nursing care For example, if the dominant member is ill and can no longer make decisions, the whole family may be anxious and confused 17 CULTURAL INFLUENCES ON HEALTHCARE- Language (Linguistics) And Communication When people from another part of the world move to the Turkey, they may speak their own language fluently but have difficulty speaking Turkish. This is especially true for the women or older adults in the family if they do not work outside the home, or for people who live in proximity to others who speak their primary language Children usually assimilate more rapidly and learn the language of the dominant culture quickly because??? 18  CULTURAL INFLUENCES ON HEALTHCARE- Language (Linguistics) And Communication It can be difficult to describe symptoms or give a personal health history when patient doesn’t understand the questions being asked Many agencies also have a qualified interpreter, or one can be found in the community To avoid misinterpretation of questions and answers, it is important to use an interpreter who understands the healthcare system 19  CULTURAL INFLUENCES ON HEALTHCARE-Personal Space Personal space is the area around a person regarded as part of the person This area individualize to each person and to different cultures and ethnic groups When providing nursing care that involves physical contact, you should know the patient’s cultural personal space preferences., 20  CULTURAL INFLUENCES ON HEALTHCARE-Personal Space For example; North America & Northern Europe: Prefer more personal space; physical distance is important, especially with strangers. Latin America & Mediterranean: Stand closer; touching (like a light pat) is common and friendly. Middle East: Close space, especially among same-gender; greater distance between men and women who aren't family. East Asia: Prefer more space, less touch, but are accustomed to closeness in crowded places (like public transport). 21  CULTURAL INFLUENCES ON HEALTHCARE- Food And Nutrition Food preferences and how foods are prepared often are related culturally Patients in a hospital or long-term care setting often do not have much choice of foods. This may be at risk for inadequate nutrition. 22 CULTURAL INFLUENCES ON HEALTHCARE- Family Support In many cultural and ethnic groups, people have large, extended families They may be unwilling to share private information about family members with those outside the family (including healthcare providers) Including the family in planning care for any patient is a major component in nursing care to meet individualized needs 23 CULTURAL INFLUENCES ON HEALTHCARE- Socioeconomic Factors Poverty has long been a barrier to adequate healthcare. It prevents many people from consistently meeting their basic human needs To stretch their available money and to pool resources, many poor people live in crowded conditions, with several families living together in one household This conditions contribute to an increased incidence of disease and illness because of poor sanitation, and poor health habits. 24  Bir hastanın dini inançları nedeniyle belirli bir tedaviyi reddetmesi durumunda hemşirenin en uygun tepkisi ne olmalıdır? A) Hastayı tedaviye ikna etmeye çalışır. B) Hastaya inançlarına saygı göstererek alternatif çözümler sunar. C) Hastanın kararını görmezden gelir ve tedaviyi sürdürür. D) Hastanın tedaviyi tamamen reddetmesini sağlar. 25 FACTORS INFLUENCING GROWTH AND DEVELOPMENT 26  FACTORS INFLUENCING GROWTH AND DEVELOPMENT Humans grow and develop throughout life Growth is an increase in body size or changes in body cell structure, function, and complexity. Development is an orderly pattern of changes in structure, thoughts, feelings, or behaviors resulting from maturation, experiences, and learning. 27 WHT IMPORTANT GROWTH AND DEVELOPMENT FOR NURSES? Nurses promote health in people from birth to death All people, regardless of age, have unique healthcare needs that result from their; physical, intellectual, emotional, sociocultural, spiritual, and environmental dimensions at their developmental level To plan and give holistic and individualized care, the nurse must understand typical growth and development; characteristics, tasks, and needs of patients of all ages 28  FACTORS INFLUENCING GROWTH AND DEVELOPMENT Heredity A complex series of processes transmits genetic information from parents to children. The genetic composition of an individual determines physical characteristics such as skin color, hair texture, facial features, body structure, as well as a predisposition to certain diseases Heredity determines to a great extent the rate of physical and mental development 29  FACTORS INFLUENCING GROWTH AND DEVELOPMENT Life Experiences A person’s experiences can also influence the rate of growth and development Differences in physical growth rates between a child whose family can afford food, shelter, and health care and a child whose family has little, if any, resources. Elderly person who is enjoying retirement, has an adequate income, and an active support system. 30  FACTORS INFLUENCING GROWTH AND DEVELOPMENT Health Status Individuals experiencing wellness are progressing normally along the life cycle However, illness or disability can interfere with the achievement of developmental milestones 31  FACTORS INFLUENCING GROWTH AND DEVELOPMENT Prenatal, Individual, and Caregiver Factors Fetal development can be altered by maternal age Individual factors that might result in altered development from birth through adolescence include congenital or genetic disorders, brain damage from accidents or abuse, vision and hearing impairments, chronic illness, inadequate nutrition, chemotherapy or radiation therapy, lead poisoning, poverty, and substance abuse. Caregiver factors that negatively affect development are neglect and abuse, mental illness, mental retardation, or a severe learning disability. 32  FACTORS INFLUENCING GROWTH AND DEVELOPMENT Environment and Nutrition The effect of each can occur independently, but they are more likely to be interrelated - Infants who are malnourished in utero develop fewer brain cells - Substance abuse by a pregnant woman increases the risk for congenital anomalies, low birthweight, and prematurity in her developing fetus - Substance abuse by adolescents and young adults is associated with an increased incidence of teenage pregnancy, violence, accidents and suicide. 33 HOLISTIC FRAMEWORK FOR NURSING 34  HOLISTIC FRAMEWORK FOR NURSING Providing care to the whole person is a basic concept of professional nurses Knowledge of growth and development concepts are essential for nurses Developmental progress, or lack of progress, in one aspect affects all other dimensions of life 35  HOLISTIC FRAMEWORK FOR NURSING Alterations in expected patterns are indicators for early intervention. The infant who does not sit, crawl, or walk at expected times The adolescent girl who has not experienced menarche at the expected time The adult who has failed to develop adequate problem-solving skills 36  STAGES OF THE LIFE CYCLE 1- Prenatal Period The prenatal period consists of three developmental phases: the germinal, embryonic, and fetal stages. The germinal stage begins with conception and lasts approximately 10 to 14 days The embryonic stage begins the first 2 to 8 weeks after fertilization of an egg by a sperm The fetal stage begins the intrauterine developmental period from 8 weeks to birth 37  STAGES OF THE LIFE CYCLE Nursing Implications- Prenatal Period The pregnant woman needs to have physical examinations and screenings during the entire pregnancy. The mother’s emotional state can bring about biochemical changes in the fetus. Women who consume insufficient amounts of protein during pregnancy have a high rate of giving birth to premature and low birth weight infants By teaching pregnant women how to relax, the nurse can promote a supportive environment for the developing embryo and fetus. 38  STAGES OF THE LIFE CYCLE Nursing Implications- Prenatal Period Wellness Promotion Other nursing interventions that promote prenatal health include: Screening (blood pressure measurement, urine sugar analysis) Teaching (nutritional guidelines) Counseling (e.g., guidance about bonding with the child and incorporating a child into a family unit) Promoting the use of complementary/alternative modalities to reduce stress 39 STAGES OF THE LIFE CYCLE Nursing Implications- Prenatal Period Safety Considerations Maternal blood can addition to providing the fetus with wholesome nutrients, also transport toxins Toxins in the cigarette often result in increased risk of premature birth, retarded growth, learning difficulties, and fetal death Use of alcohol during pregnancy can result in fetal alcohol syndrome (FAS) Typically, FAS infants are small, have facial abnormalities (such as thin upper lips and short, upturned noses), may have some degree of brain damage and intellectual problems 40  STAGES OF THE LIFE CYCLE 2- Neonatal Period The neonatal period (the first 28 days of life following birth) is a time of major adjustment to extrauterine life The neonate’s activities, which are reflexive in nature, consist primarily of sucking, crying, eliminating, and sleeping 41  STAGES OF THE LIFE CYCLE 2- Neonatal Period The neonate undergoes psychological adaptation. Bonding, the formation of attachment between parent and child, begins at birth when the neonate and parent make initial eye contact. The quality of parent-neonate bonding lays the foundation for trust that is necessary for the development of future interpersonal relationships. 42  STAGES OF THE LIFE CYCLE Nursing Implications- Neonatal Period Wellness Promotion Teaching is one of the most important nursing activities that promote neonatal wellness. Parents need information about basic newborn needs nutrition, infection control (especially handwashing and hygienic diaper changing practices), care of the umbilicus, and incorporating the newborn into the family unit 43  STAGES OF THE LIFE CYCLE Nursing Implications- Neonatal Period Wellness Promotion Other nursing interventions that promote neonatal wellness; Continually assessing the neonate’s physiological status Monitoring nutritional status. Providing a clean environment to protect neonates from infection Conducting screening tests; for example, the blood test for phenylketonuria (PKU), Promoting early parent-neonate interaction 44  STAGES OF THE LIFE CYCLE Nursing Implications- Neonatal Period Safety Considerations Safety is of primary concern when caring for neonates because neonates are totally dependent on others to meet their needs. Accidents are the primary cause of neonatal mortality One of the most important neonatal accident prevention methods is to teach parents about the use of infant car seats. Newborns should not be in contact with anyone experiencing an infectious disease. 45  STAGES OF THE LIFE CYCLE 3- Infant Period Infancy (the developmental stage from the first month to the first year of life) is a time of continued adaptation. During this stage, the infant experiences rapid physiologic growth 46  STAGES OF THE LIFE CYCLE Infant Period- Nursing Implications Wellness Promotion Parents need guidance from the nurse in caring for their infants are; Nutrition (It is recommended that infants be breastfed for the first 6 to 24 months) Protection from infection (Nurses should confirm that infants receive all necessary immunizations) Promotion of sleep 47  STAGES OF THE LIFE CYCLE 4- Toddler The toddler period begins at 12 to 24 months of age, The family is very important to the toddler in that the family promotes language development and teaches toileting skills Nurses can greatly influence the quality of parent child interaction by teaching parents about developmental concepts When toddlers are hospitalized (for an extended time or only a day), fear and anxiety can make the experience a negative one. Toddlers need to have regular health examinations, and immunizations remain an essential part of health care 48 STAGES OF THE LIFE CYCLE Nursing Implication- Toddler Nurses can play a key role in the toddler’s nutritional counseling Respiratory infections are common health threats to the toddler Common type of accident occurring with toddlers involves car accident and toys Toddlers, with their increased mobility and curiosity, are especially prone to accidental poisonings 49  STAGES OF THE LIFE CYCLE 5- School-Age Child During the school-age period, physical changes occur in a slow, even, continuous pace. Participation in school activities, team sports, and play contributes to an enlarging social network As the school-age child’s cognitive abilities expand, creativity is expressed in a variety of unique ways. 50  STAGES OF THE LIFE CYCLE Nursing Implication- School-Age Child Nurses can promote wellness in the school-age child by teaching parents to: Encourage healthy lifestyles Have children immunized Provide nutritious meals Teach children appropriate hygienic measures Schedule regular checkups with the primary health care provider Establish sleep patterns alternating with periods of activity 51  STAGES OF THE LIFE CYCLE 6- Preadolescent Preadolescence (developmental stage from the ages of 10 to 12 years) is marked by rapid physiological changes Girls generally experience preadolescence at a younger age than boys Approximately 2 years after the appearance of breast buds, menarche (onset of the first menstrual period) occurs 52  STAGES OF THE LIFE CYCLE Nursing Implications- Preadolescent The preadolescent needs information about nutrition, rest and activity, and the physiological changes that are occurring The child must learn about the growth, sexual changes, and psychosocial changes The preadolescent is at risk for injury from sports and play activities Another major health risk posed to many preadolescents is violence both in and away from the home. Other topics for promoting preadolescent safety are: substance abuse prevention, sex education and development of healthy lifestyles. 53  STAGES OF THE LIFE CYCLE 6- Adolescent Adolescence (the developmental stage from the ages of 13 to 20 years) begins with the onset of puberty Numerous physiological changes and rapid physical growth occur during this stage Questions such as “Who am I?” and “What is really important?” are common for adolescents to consider Most adolescents are greatly concerned about their appearance and this emphasis on physical attractiveness sometimes results in eating disorders, such as anorexia nervosa, bulimia and obesity 54  STAGES OF THE LIFE CYCLE Nursing Implications- Adolescent The nurse promotes the adolescent’s wellness primarily through teaching Areas to be emphasized in health education of adolescents include hygiene, nutrition, sex education, developmental changes, and substance abuse prevention Unhealthy behaviors contribute to the three major causes of adolescent death: accidents, homicide and suicide Many health problems in adolescents are related to sexual behaviors including acquired immunodeficiency syndrome (AIDS), sexually transmitted diseases (STDs) and unplanned pregnancy 55  STAGES OF THE LIFE CYCLE 7- Young Adult Physical growth stabilizes during young adulthood (the developmental stage from the ages of 21 to approximately 40 years). Nursing Implications Usually, young adulthood is the healthiest time in a person’s life Preventive measures for young adults focus on two primary areas: 1. Avoidance of accident, injury, and violence 2. Development of health-promoting behaviors 56  STAGES OF THE LIFE CYCLE 8- Middle Adult Middle adulthood (the developmental stage from the ages of 40 to 65 years) is characterized by productivity and responsibility Physiological changes that affect many of the body systems occur during this term The evaluation of goals often leads to a midlife crisis, especially if individuals feel they have accomplished little or not lived up to earlier self-expectations 57  STAGES OF THE LIFE CYCLE Nursing Implications- Middle Adult As health educators, nurses can encourage middle-aged adults to assume more responsibility for their own health Self-care education topics appropriate for the middle-aged adult include: Acceptance of aging Nutrition Exercise and weight control Substance abuse prevention Stress management Recommendations for health screening (cholesterol screening, prostate examination, mammogram etc). 58  STAGES OF THE LIFE CYCLE Nursing Implications- Middle Adult Safety Considerations Automobile accidents, especially those involving the use of alcohol Occupational health hazards such as exposure to environmental toxins Middle adulthood is also unhealthy lifestyle practices, such as smoking, sedentary habits, inadequate nutrition, and overuse of alcohol, begins to exert adverse effects 59 STAGES OF THE LIFE CYCLE 9- Older Adult Older adulthood is the developmental stage occurring from age 65 and beyond Older adults have several psychosocial tasks to accomplish, such as: - To find meaning in one’s life - Establishing meaningful roles - Adjusting to infirmities - Coping with losses and changes - Preparing for death 60  STAGES OF THE LIFE CYCLE Nursing Implications- Older Adult Wellness Promotion Health promotion activities should be implemented with the elderly to maintain functional independence Specific topics that are developmentally appropriate for older clients are: use of leisure time, increased socialization, engaging in regular physical activity, maintaining a positive mental attitude, and developing and maintaining healthy lifestyles Falls pose a major health threat to the elderly 61