Ch04.pptx

Book cover for Understanding MedicalSurgical Nursing, Seventh Edition. Chapter 4 Cultural Influences on Nursing Care Copyright ©2023 F.A. Davis Company Learning Outcomes  Define common concepts related to culture and spirituality.  Describe attributes of culturally diverse patients and their f...

Book cover for Understanding MedicalSurgical Nursing, Seventh Edition. Chapter 4 Cultural Influences on Nursing Care Copyright ©2023 F.A. Davis Company Learning Outcomes  Define common concepts related to culture and spirituality.  Describe attributes of culturally diverse patients and their families and how they affect nursing care.  Identify data you should collect from culturally diverse patients and their families.  Apply a holistic approach to patient care that respects cultural and spiritual characteristics and Copyright ©2023 F.A. Davis Company Culture  The socially transmitted behavior patterns, beliefs, values, customs, arts, and all other characteristics of people that guide their view of the world Copyright ©2023 F.A. Davis Company Cultural Terms to Know  Cultural sensitivity • Using culturally appropriate language and not offending another person’s cultural beliefs  Cultural awareness • An appreciation for and attention to a culture’s celebrations, foods, and traditional arts and clothing  Cultural competence • The skills and knowledge required to provide effective nursing care Copyright ©2023 F.A. Davis Company Cultural Terms to Know (continued)  Cultural humility • A lifelong process of thinking about one’s own cultural beliefs and identities while learning about others  Ethnocentrism • Thinking that one culture’s ways of thinking, acting, and believing are the only right and natural ways  Stereotype • An opinion or belief about a group of people that is ascribed to an individual Copyright ©2023 F.A. Davis Company Spirituality  Simply defined, it is the essential connections that provide meaning and purpose in life.  These essential connections may include a belief in God or a higher power.  Addressing spirituality • Improves patients’ comfort levels emotionally and physically • Has a positive effect on patients’ Copyright ©2023 F.A. Davis Company Nurse’s Role  Pay attention to and document patient or family spiritual practices.  Verify that the practices assist in managing stress of their illness.  Encourage the spiritual practices in the future. Copyright ©2023 F.A. Davis Company Cultural Self-Assessment  What is your cultural background?  How do you define spirituality for yourself?  What language do you speak at home?  Who is the head of your family?  What foods do you eat that are unique to your family or community?  What kinds of health-care providers (HCPs) do you see?  Copyright ©2023 F.A. Davis Company Characteristics of Cultural Diversity  Primary characteristics • • • • • • • Nationality Race Ethnicity Skin color Gender Age Spirituality and religious affiliation Copyright ©2023 F.A. Davis Company Characteristics of Cultural Diversity (continued)  Secondary characteristics • • • • • Marital status Parental status Physical characteristics Sexual orientation Gender roles Copyright ©2023 F.A. Davis Company • Socioeconomic status • Education • Occupation • Military experience • Political beliefs Cultural Phenomena Across All Cultural Groups  Communication styles  Space  Time orientation  Social organization  Environmental control/health beliefs  Choice of HCP  Biological variations  Death and dying issues Copyright ©2023 F.A. Davis Company Communication Styles Verbal Nonverbal  Spoken language  Dialects  Voice volume  Eye contact  Perception of time  Physical closeness Copyright ©2023 F.A. Davis Company Nursing Communication Assessment and Strategies  Speak slowly and clearly.  Provide written instructions in patient’s preferred language.  Use professional interpreters.  Avoid appearing rushed.  Ask patient to restate what they heard.  Explain why specific questions are asked. Copyright ©2023 F.A. Davis Company Space  Space refers to one’s “personal space.”  Personal space tends to be different when speaking with close friends versus strangers.  It differs across cultures.  The need for space is important for the patient’s privacy, autonomy, security, and self-identity. Copyright ©2023 F.A. Davis Company Space (continued)  Nursing assessment and strategies • Make sure your patient is comfortable before interviewing them. • Make sure patient’s physical environment is arranged to ensure safety, security, and familiarity. • Maintain appropriate physical distance (observe for cues). Copyright ©2023 F.A. Davis Company Time Orientation  Clock time versus social time  Orientation • Past • Present • Future Copyright ©2023 F.A. Davis Company Time Orientation (continued)  Nursing assessment and strategies • Have a clock in patient’s room. • Assess for orientation; reorient to time as needed. • Give time options as appropriate. • Ask about usual routines. • Ask about routine around meals and personal care. Copyright ©2023 F.A. Davis Company Social Organization  Patriarchal, matriarchal, or egalitarian  Gender roles and elder roles vary across families and cultures.  Extended family may be important. Copyright ©2023 F.A. Davis Company Social Organization (continued)  Nursing assessment and strategies • Ask who lives in the patient’s household and how they are related. • Ask who they discuss decisions with. • Ask what their responsibilities are at home. • Observe family interactions. • Let family members decide where they want to stand or sit for comfort. Copyright ©2023 F.A. Davis Company Environmental Control  Three concepts • Perception of ability to control what happens to one’s health • Beliefs about health and illness • Beliefs in alternative health-care therapies  The nurse should consider the patient’s cultural values and beliefs. Copyright ©2023 F.A. Davis Company Environmental Control (continued)  Nursing assessment and strategies • Never stereotype. • Perform a cultural assessment of all patients. • Ask about religious beliefs and practices. • Ask how patient has managed illness to date, including home remedies. Copyright ©2023 F.A. Davis Company Choice of Health-Care Providers  HCP choices are made based on the patient’s perceived health status and previous experiences. • Physicians versus traditional healers • Religious influences • Respect modesty and assign samegender providers when requested. Copyright ©2023 F.A. Davis Company Choice of Health-Care Providers (continued)  Nursing assessment and strategies • Ask what HCP patient sees when ill. • Ask if patients object to male or female HCP. • Observe for alternative care providers who may visit the patient. Copyright ©2023 F.A. Davis Company Biological Variations  Biological variations refer to ways in which people are different from one another physiologically and genetically. • • • • Body structure Skin color Susceptibility to certain diseases Intolerances to particular foods or substances Copyright ©2023 F.A. Davis Company Biological Variations (continued)  Nursing assessment and strategies • Teach about biological variations that may pertain to patient. • Determine and respect the patient’s eating pattern. • Support the patient’s choice to avoid foods. • Teach good nutritional habits, paying attention to preferences. Copyright ©2023 F.A. Davis Company Death and Dying Issues and End-of-Life Issues  Death rituals of cultural groups are the least likely to change over time.  Become knowledgeable about rituals surrounding death and bereavement. • • • • Burial practices Autopsy beliefs Expression of grief Provide a private space for families to grieve. Copyright ©2023 F.A. Davis Company Death and Dying and End-of-Life Issues (continued)  Nursing assessment and strategies • Support family in their expression of grief. • Observe for differences in the expression of grief among family members. • Offer to obtain a religious counselor/spiritual leader if the family wishes. Copyright ©2023 F.A. Davis Company Racial and Ethnic Groups  White  Hispanic/Latinx  Black  American Indian/Alaskan Native  Arab American  Asian Native Hawaiian or other Pacific Islander Copyright ©2023 F.A. Davis Company Culturally Responsive Care  Recognize value that patients and families bring to the care team.  Acknowledge the diverse beliefs and values of patients and families.  Integrate cultural practices into care.  Learn about cultural groups.  Acknowledge your own beliefs and biases. Copyright ©2023 F.A. Davis Company Health Disparities  Health disparities are preventable differences in disease burden, injury, or opportunities to achieve optimal health.  This occurs when culturally responsive care is not in place. Copyright ©2023 F.A. Davis Company Nurse’s Role  Nurses are best positioned to help ensure that patients receive optimal care. • They can integrate the patients’ beliefs, values and traditions as much as possible. • They play a critical role as front-line care providers. • They are often the first person and last person that patients and families interact with on the health-care team. • They can make a big difference in the Copyright ©2023 F.A. Davis Company Review Question #1 Which of the following means “to have an appreciation for and attention to a culture’s celebrations, foods, and traditional arts and clothing”? 1. Cultural sensitivity 2. Cultural competence 3. Cultural awareness 4. Cultural diversity Copyright ©2023 F.A. Davis Company Review Question #1 Answer Correct Answer: 3 Copyright ©2023 F.A. Davis Company Review #2 Question Which is the most prominent value in Western 1. Spiritualmedicine? focus 2. Tradition 3. Balance with nature 4. Research base Copyright ©2023 F.A. Davis Company Review Question #2 Answer Correct Answer: 4 Copyright ©2023 F.A. Davis Company Review Question #3 Which interpreter is best to use with an ill patient who has limited English proficiency? 1. Patient’s child 2. Patient’s parent 3. Patient’s friend 4. Hospital employee Copyright ©2023 F.A. Davis Company Review Question #3 Answer Correct Answer: 4 Copyright ©2023 F.A. Davis Company Review Question #4 What are actions the nurse can take to provide spiritual care for patients? Select all that apply. 1. Provide religious counseling. 2. Follow patients’ cues. 3. Be aware of one’s own spirituality. 4. Ask how the patient is coping. 5. Turn on religious programming. Copyright ©2023 F.A. Davis Company Review Question #4 Answer Correct Answer: 2, 3, 4 Copyright ©2023 F.A. Davis Company