Fundamentals of Nursing.docx

Jeurden Salaam 8/19/2024 Fundamentals of Nursing **Chapter Five: Culturally Respectful Care** **Learning Objectives:** 1. Explain concepts of cultural diversity and respect. 2. Describe influences that affect culturally respectful health care. 3. Discuss examples of how diversity affects h...

Jeurden Salaam 8/19/2024 Fundamentals of Nursing **Chapter Five: Culturally Respectful Care** **Learning Objectives:** 1. Explain concepts of cultural diversity and respect. 2. Describe influences that affect culturally respectful health care. 3. Discuss examples of how diversity affects health and illness care, including culturally based traditional care. 4. Practice cultural respect when assessing and providing nursing care for patients from diverse cultural groups. 5. Discuss factors in the health care system and in nursing that facilitate or impede culturally competent nursing care. - **Coexistence** of different [ethnic, racial and socioeconomic groups] within one social unit is **Cultural Diversity.** - Religion - Language - Physical Size - Sexual orientation - Disability - Occupational status - Geographical location - Nurses that [deliver services that are respectful of and responsive] to the health beliefs, practices, and cultural and linguistic needs of diverse pts' are practicing **Cultural Respect.** - A [shared system of beliefs, values, and behavioral expectations] are **Culture.** - [Large groups of people who are members of a larger cultural group] are a part of a **Subculture.** Ex: Nursing is a subculture of the larger health care system - Two groups in society, A larger group with the [most authority to control values and sanctions of society] which is the **Dominant group** and the usually [smaller group physically or culturally different] from the dominant called the **Minority group**. - [Taking on the values] of the dominant group and [losing different cultural characteristics] is called **Cultural Assimilation**. Ex: Immigrants encountering a new dominant culture at work. - When placed in a [different culture perceived as strange] a person may have **Culture. Shock**-which causes psychological discomfort or distress. - The sense of [identification with a collective cultural group] is **Ethnicity**. - [Specific physical characteristic]s are **Race.** - The five major Categories are: - American or Alaska Native - Asian - Black or African American - Native Hawaiian or other Pacific Islander - White - [Assuming] **all** [members of a culture, ethnic, group or race act alike] is **Stereotyping.** - **[Holding]** **attitudes** towards people or associate stereotypes with them [w/h or w/o conscious knowledge] is **Implicit bias.** - **Belief** that everyone should [conform to own belief] is **Cultural Imposition**. - [**Ignoring** differences and proceeds as though nonexistence] is **Cultural Blindness.** - **[Feeling threatened]** by [cultural differences and responding w/h ridicule] is **Cultural Conflict.** - Some groups are **predisposed** to [certain diseases/conditions] which is called **Physiologic Variations.** **Population** **Common Health Problems** ----------------------------------- ------------------------------------------------------------------------------ Native American and Alaska Native Heart disease, Cirrhosis of liver, Diabetes mellitus, Fetal alcohol syndrome African American Hypertension, Stroke, Sickle cell anemia, Lactose intolerance, Keloids Asian Cancer of liver, Lactose intolerance Thalassemia Hispanic Diabetes mellitus, Lactose intolerance White Breast cancer, Heart disease, Hypertension, Diabetes mellitus, Obesity Eastern European Jewish Cystic fibrosis, Gaucher disease, Spinal muscular atrophy, Tay-Sachs disease - Most expressions and behaviors towards pain are culturally prescribed. Some allow or even encourage while others suppress or encourage suppression of emotions. - Take into consideration: **(1)** Culture is an important to individuality and each person has right to express beliefs about pain, **(2)** Respect patient's right to respond to pain in own manner, **(3)** Never stereotype perceptions of or responses to pain based on culture - Behavioral patterns for **mental wellness and reactions** are [specific to groups.] - Dominant figure varies from the male/female per cultural group- which is called **Assigned Sex Roles.** - The ability of caregivers and organizations to understand and effectively respond to the linguistic needs of patients and their families in an HC encounter is called **Linguistic Competence.** - Area around a person regarded as part of the person is their **Personal Space.** - If personal space isn't respected or considered person may become angry or uncomfortable. - Providing physical understand cultural personal space preferences. **Culturally Sensitive Medical Interviewing Tools** E. Explanation (How do you explain your illness) T. Treatment (What treatment have you tried?) H. Healers (Have you sought any advice from folk healers?) N. Negotiate (Mutually acceptable options) I. Intervention ( I agree on Intervention) C. Collaboration ( With patient, family, and healers) Learn Model L. Listen to the patient's perspective E. Explain and share your own perspective. A. Acknowledge differences and similarities btw these 2 perspectives R. Recommend a treatment plan N. Negotiate a mutually agreed- on-treatment plan - Food preferences and preparation methods often are culturally influenced. - Patient's culturally influenced preferences may be at risk for inadequate nutrition. - May be possible for family/friends to bring foods that satisfy patient's nutritional needs - Many cultural and ethnic groups consider the needs of any family member to be = or \< than their own. - May be unwilling to share private information about family w/h outside people. - Poverty leads to unmet health needs and is a factor in the development of illness, part of Socioeconomic Factors. - Values and beliefs about health, illness and health care can be influenced by cultural, ethnic or religious groups. - Illnesses are classified as either natural or unnatural- Natural are caused by dangerous agents (cold air or impurities) Unnatural are punishment from God resulting in evil forces or witchcraft causing mental or physical problems. - Some cultures believe the power to heal is a gift from God bestowed to certain people. Folk/traditional healers know what is wrong w/h them through divine intervention and experience. - To have cultural competence you must use or learn these: - Developing self-awareness. - Demonstrating knowledge and understanding of patient's culture. - Accepting and respecting cultural differences. - Not assuming that health care provider's beliefs and values are same as client. - Resisting judgmental attitudes. - Being open to and comfortable w/h cultural encounters. - **ESFT Model:** A cross-cultural communication tool that helps health care providers strengthen communication and identify potential threats to treatment adherence. - **E. Explanatory model of health and illness.** - What do you think caused your problem? - Why do you think it started when it did? - How does it affect you? - What worries you most? - What kind of treatment do you think you should receive? - **S. Social and environmental factors** - How do you get your medications? - Are they difficult to afford - Do you have time to pick them up? - Do you have help getting them if you need it? - **F. Fears** - Does the medication sound okay to you? - Have you heard anything about this medication? - Are you concerned about the dosage? - Are you worried about the adverse effects? - **T. Therapeutic contracting** - Do you understand how to take the medication? - Can you tell me how you will take it? - Belief that one's ideas, beliefs and practice are the best/superior or most preferred to those of others is called **Ethnocentrism.** - Recognition of diversity and power imbalances among individuals or communities, w/h the action of being open, self-aware, egoless, flexible, exuding respect and supportive interactions, focusing on both self and other to formulate a tailored response is **Cultural Humility.** - The study of how different cultures affect health, illness, and health practices is **Transcultural Nursing.**