Ethnicity Lecture Notes PDF

LECTURE OF CULTURE/ETHNICITY Concept of Cultural Nursing Nurses have to be: - Culturally Sensitive: non judgemental attitude, aware of differences - Culturally Appropriate: non judgemental attitude - Culturally Competent: attends to pt TOTAL situation Charact...

LECTURE OF CULTURE/ETHNICITY Concept of Cultural Nursing Nurses have to be: - Culturally Sensitive: non judgemental attitude, aware of differences - Culturally Appropriate: non judgemental attitude - Culturally Competent: attends to pt TOTAL situation Characteristics & Universal Attributes Culture: is apparent in the attitudes & institutions unique to the culture - Includes non - physical traits or characteristics - It is learned & passed through generations - It is learned by each new generation through both formal & informal life experiences Includes: - Values, Beliefs, Attitudes - Practice, Habits - Likes & Dislikes - Customs & Rituals Differentiate & Terms - Culture: is defined as a shared system of beliefs, values, & behavioral expectations (defines roles & interactions with others & in families & communities, provides social structure for daily living) - Ethnicity: sense of identification with a collective cultural group (based on group’s heritage, Ethnic Background = Ethnicity, ex: religion & language) - Religion: a system of beliefs, practices & ethical values about devine or superhuman powers - Diversity: state of being different (language, sexual orientation, religion, etc) - Stereotyping: assuming everyone from the same culture, race, ethnicity act alike - Cultural Imposition: belief that everyone should conform to your own belief systems - Cultural Blindness: when one ignores differences & proceeds as they don't exist - Culture Conflict: becoming aware of cultural differences, feel threatened & respond by ridiculing the beliefs & traditions of others to make themselves feel more secure about their own values - Subculture: large group of people who are members of the larger cultural group but who have certain ethnic, occupational, or physical characteristics that are not common to larger culture  - Cultural Acculturation or Assimilation: a minority group living with dominant group, and losing cultural characteristics that made them different, may take on the values of the dominant group - Cultural Shock: placed in a different culture they perceive as strange - Race: based on physical characteristics such as skin pigmentation, body stature, facial features, and hair texture - Discrimination: the 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 own’s one culture are superior to those of another’s culture - Prejudice: an opinion formed without adequate knowledge, thought, or a reason - Bicultural: combining cultural attitudes & customs between two nations - Dominant Vs Minority Group: the dominant group is that which holds the most power in society compared to minority groups Nursing Assessment Parameters Include Physiological Variations, Reactions to Pain, Language & Communication, Economic Barriers, Gender Roles, Mental Health, Gender Roles 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 PAIN IS WHATEVER & WHENEVER A PATIENT SAYS IT IS 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 of Orientation Past- history & traditions guide present & future (ex: East Asia) Present- “eternal present”, instant gratification & short term benefits (ex: American, African & Native Americans) Future- Planning for future, long-term worldview (ex: Chinese & 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 - Is a framework influencing views on cause of illness, prevention, treatments of illness, health promotion & maintenance activities 1. Magico - Religious Health Belief System (Supernatural Forces, Evil Spirits, God’s Will) - Illness = a punishment from god  HISPANICS, AFRICAN, & CARIBBEAN 2. Scientific Health Belief System (Bio Medical): - controlled physical & biochemical processes - analyzed & manipulated by humans 3. Holistic Health Belief System - Natural balance or Harmony - VS disequilibrium or disharmony CHINESE MEDICINE & NATIVE AMERICANS Asian Folk & Traditional HC: well being-related to balance (such as yin & yan, energy, mind-body-spirit) - Hot & Cold remedies, and Herbs Nsg Considerations: may be upset w/lab results, may prefer death w intact body -> may refuse surgery Spanish Folk & Traditional HC: Curanderos (folk healers) - Respect according to age or gender - Roman Catholic Church Influential Nsg Considerations: may be difficult to convince of illness, Health & Illness = God’s will & for a reason-such as punishment Caucasian Folk & Traditional HC: self diagnosis of illness,/ Use of OTC drugs (vitamins & analgesics),/ Extensive use of exercise & exercise facilities Nsg Considerations: assess OTC medications (observe for S&S toxic medication levels, especially fat soluble vitamins),/ assess dietary habits African Americans Folk & Traditional HC: varies-may include: Herb Doctors,/ Voodoo & Faith Healing Nsg Considerations: assess folk healing,/ special care may be needed ( hair, nails) Native Americans Folk & Traditional HC: Shaman = medicine man,/ Herbs & psychological treatments,/ Ceremonies, Fasting, Medications, Heat & Massage Nsg Considerations: family = expected to participate in care,/ note-taking = taboo & insult to speaker,/ indirect eye contact preferred,/ low tone of voice = respectful Nursing Diagnosis 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 & time orientation Diagnosis: have some NANDA diagnosis (above) Planning: become aware of client’s cultural heritage, & health traditions,/ consider client’s cultural influences Implementation: ensure to address the gap between the nurse’s scientific world, & the client’s cultural perspectives (views),/ accommodate cultural practice Evaluation: compare client’s expected outcomes with achieved outcomes, ensure client’s health belief system has been taken into consideration