CULTURE AND HEALTH 1rename
amprevel's version from 2016-04-09 06:46
Culturally Responsive Care 1
|Culturally responsive care||focused on ct cultural point of view. Integrate ct values, beliefs into POC.|
|To develop culturally responsive care, nurses must||- dev. self awareness of his or her own culture, attitudes and beliefs |
-examine the biases and assumptions he or she holds.
-Gain necessary knowledge and skills to create env where trust and can be developed
-Understanding of health disparities
-Historical and current portrayals of racial and ethnic groups in society
-Cultural knowledge can help nurse to better understand different perspectives
-But, generalizations may not hold true for individuals
|Culture||-learned and shared patterns of information that a group uses to generate meaning among its members. |
-dynamic pattern of learned behavior, values, expectations, beliefs, and artifacts, which are held by a group of people and guide their thinking, decisions, and actions.
|Patterns of culture include|
-nonverbal language – invisible aspects: values, norms, expectations, beliefs, customs, thoughts, institutions, actions
-material goods – visible aspects: artifacts
|macro-cultures||national, ethnic, or racial groups|
|micro cultures||gender, age, or religious beliefs|
|subculture||people who have a distinct identity and yet are related to a larger cultural group. generally shares ethnic origin or physical characteristics with the larger cultural group. Includes: |
-occupational groups (e.g., nurses),
-societal groups (e.g., feminists), and
-ethnic groups (e.g., Cajuns)
Culturally Responsive Care 2
|Multicultural||a person who has multiple patterns of identification or crosses several cultures, lifestyles, and sets of values. often used interchangeably with bicultural, biracial, multiracial, and multiethnic.|
|Diversity||being different. Many factors account for diversity: |
-sex, age, culture, ethnicity, SES, education, religious affiliation, etc
-occurs not only between cultural groups but also within a cultural group.
|Race||-often used interchangeably with the terms ethnicity and culture. |
-Human Genome Project – no genetically distinct races, 99.9% genetically alike
|Ethnicity||-often interchangeably used with race. |
-May be viewed as a relationship among individuals who believe that they have distinctive characteristics that make them a group.
|Nationality||-used interchangeably with ethnicity or citizenship. |
-sovereign state or country where an individual has membership, which may be through birth, through inheritance (parents), or through naturalization.
-Possible to be a member of a nation where no such country is officially recognized, ex: Kurds, Basques, and Native Americans.
-Persons may be multinational.
|Religion and culture||system of beliefs, practices, and ethical values about divine or superhuman power worshipped as the creator(s) and ruler(s) of the universe. |
-Ethnicity and religion are related: one’s religion is often determined by one’s ethnic group.
-Illness sometimes seen as punishment for the violation of religious codes and morals.
Culturally Responsive Care 3
|Ethnocentrism||belief in the superiority of one’s own culture and lifestyle. Other viewpoints are not only considered different, but also wrong or of lesser importance.|
|xenophobia||the fear or dislike of people different from one’s self.|
|Prejudice||preconceived notion or judgment that is not based on sufficient knowledge; may be favorable or unfavorable. Unfavorable prejudice may lead to stereotyping and discriminatory behavior toward groups of people. Many types, including racial prejudice.|
|Racism||assumptions held about racial groups. Assumptions include the belief that races are biologically discrete and exclusive groups that are inherently unequal and ranked hierarchically. Cultural behaviors are viewed as inherited and exclusive to each group and form the basis of judging persons based on their racial classification.|
|Institutional racism or institutional discrimination||denial of opportunities and equal rights based on race.|
|White privilege||System that advantages whites over other races|
|Discrimination||negative treatment of individuals or groups on the basis of their race, ethnicity, gender, or other group membership. |
-occurs when rights and opportunities are denied for arbitrary or prejudicial reasons.
|Generalizations||statements about common cultural patterns. |
-May not hold true at the individual level, should serve only as openings for individuals to better understand each other. Often interpreted as statements describing every individual in a group, which leads to stereotyping.
-People may live within their traditional heritage or they may embrace both their original ethnocultural traditional heritage(s) and the modern culture of the United States.
|Stereotyping||making the assumption that an individual reflects all characteristics associated with being a member of a group.|
Health Disparities 1
|Health disparities||differences in care experienced by one population compared with another population. Contributing factors:|
-Health system level factors: System complexity
-Care process factors: Provider stereotyping, minimal skill in caring for patients from diverse socio –cultural background
-Patient factors: Difficulty navigating health system, mistrust and discomfort
|2012 National Healthcare Disparities Report||health care quality and access are substandard for some groups. quality improving over time while access and disparities are not. |
-Quality – seniors, blacks, Asians, American Indians and AKNs (AI/AN’s), poor received worse care than whites or high income
-Access – black, Asians, AI/ANs, Hispanics, poor had worse access to care than white, non-Hispanic or high income
|Causes of health disparities||determinants of health: |
-Social determinants of health—examples include gender, socioeconomic status, employment status, educational attainment, food security status, availability of housing and transportation, racism, and health system access and quality
-Behavioral determinants of health—examples include patterns of overweight and obesity; exercise norms; and use of illicit drugs, tobacco, or alcohol
-Environmental determinants of health—examples include lead exposure, asthma triggers, workplace safety factors, unsafe or polluted living conditions
-Biological and genetic determinants of health—examples include family history of heart disease and inherited conditions such as hemophilia and cystic fibrosis
|Healthy People 2020||calls for nursing to contribute to eliminating health disparities by gender, race or ethnicity, education, income, disability, geographic location, and sexual orientation. Goals: |
-High quality, longer lives free of preventable disease, disability, injury, and premature death
-Health equity, eliminate disparities , and improve health of all groups
-Create social and physical environments that promote good health for all
-Promote quality of life, health development, and healthy behaviors across al life stages
Health Disparities 2
|Civil Rights Act in 1964||has not eliminated health disparities.|
|health equity||the highest possible standard of health for all people, especially those at greatest risk for poor health. Efforts to address disparities are aimed at achieving this. Several nationwide efforts to increase emphasis on culturally appropriate beginning with The National Partnership for Action to End Health Disparities (NPA).|
|Racial and Ethnic Approaches to Community Health Across the United States (REACH U.S.)||initiative that strives to eliminate racial and ethnic disparities in infant mortality, deficits in breast and cervical cancer screening/management, cardiovascular diseases, diabetes, HIV infections/AIDS, and child and adult immunizations.|
|Are demographics of nurses roughly equal to demographics of US?||No. nurse workforce demographics do not reflect national demographics, essential that nurses be committed to reducing health care disparities by providing culturally responsive care.|
|Acculturation||Involuntary process that occurs when people incorporate traits from another culture. Members of the nondominant cultural group are often forced to adopt the new culture to survive. The changes of one’s cultural patterns to those of the host society. Most groups in the United States modify some of their traditional cultural characteristics.|
|Assimilation||conscious process by which an individual develops a new cultural identity. Becoming like the members of the dominant culture. Not always possible and may be a source of stress and anxiety.|
Cultural Models of Nursing Care: AACN Competencies, Cultural competence model, HEALTH Traditions Model
|Transcultural nursing||focuses on providing care within the differences and similarities of the beliefs, values, and patterns of cultures (Leininger & McFarland, 2010).|
|Madeline Leininger||(1950s) created the theory of culture care diversity and universality. founder of transcultural nursing.|
|Josepha Camphina-Bacote||(2002) Process of Cultural Competence in the Delivery of Healthcare Services Model. Does consulting work.|
|American Association of Colleges of Nursing Competencies||End-of-program cultural competencies for BSN prorgams. Competencies used to guide nursing practice: |
1. Apply knowledge of social and cultural factors that affect nursing and health care across multiple contexts.
2. Use relevant data sources and best evidence in providing culturally competent care.
3. Promote achievement of safe and quality outcomes of care for diverse populations.
4. Advocate for social justice, including commitment to the health of vulnerable populations and the elimination of health disparities.
5. Participate in continuous cultural competence development
|Cultural Competence model||(Bacote, 2011) |
• ability of health organizations and practitioners to recognize the cultural beliefs, attitudes and health practices of diverse populations, and to apply that knowledge in every intervention; at the systems level or at the individual level.
• “the ongoing process in which the health care professional continuously strives to achieve the ability and availability to work effectively within the cultural context of the patient (individual, family, community).”
|HEALTH Traditions Model||Concept of holistic health and describes what people do from a traditional perspective to maintain, protect, and restore health. |
• traditional refers to those customs, beliefs, or practices that have existed for many generations without changing
• consists of Nine Interrelated Facets of Health (Physical, Mental, and Spiritual) and Personal Methods of Maintaining Health, Protecting Health, and Restoring Health
• many of symbols are used across many cultures. A major aspect of conducting the heritage assessment of a client is to determine what items are used by a specific person and its meaning to the person.
|Heritage Consistency||The degree to which one’s lifestyle reflects the traditional cultural attitudes, values, and behaviors of the group. |
• Exists on a continuum.
• Interaction of one’s: Ethnicity, Religion, Socialization
|heritage consistent||clients are identifying with their traditional cultural heritage|
|heritage inconsistent||cts have acculturated into the dominant culture of the modern society|