Nursing Foundations - Unit 4 (Culture)

olanjones's version from 2016-04-12 04:16

Concepts of Culture

Question Answer
Culturally responsive carefocused on client cultural point of view. Integrate client values, beliefs into POC.
To develop culturally responsive care, nurses must
-be self-aware of his/her own culture, attitudes, beliefs, and possible biases and assumptions held.
-Gain understanding of health disparities, different perspectives
-Avoid generalizations
Culturedynamic 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-culturesnational, ethnic, or racial groups
Micro culturesgender, age, or religious beliefs
Subculturepeople 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)
Multiculturala 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.
Diversitybeing different, occurs not only between cultural groups but also within a cultural group. Many factors account for diversity (sex, ethnicity, SES, etc)
Raceoften used interchangeably with the terms ethnicity and culture. *Human Genome Project – no genetically distinct races, 99.9% genetically alike*
Ethnicityoften interchangeably used with race. May be viewed as a relationship among individuals who believe that they have distinctive characteristics that make them a group.
Nationalityused interchangeably with ethnicity or citizenship. Place where an individual has membership (may be multinational). It is possible to be a member of a nation where no such country is officially recognized, ex: Kurds, Basques, and Native Americans.
Religion and culturesystem of beliefs, practices, and ethical values about divine or superhuman power worshiped as the creator of the universe. (Illness sometimes seen as punishment for the violation of religious codes and morals.)

CLAS Standards

Question Answer
CLAS stands forCulturally and Linguistically Appropriate Services in Health Care (CLAS)
What are CLAS Standards?To provide competent language assistance and easy-to-understand multimedia to individuals who have limited English proficiency and to make sure they are informed of the availability of these services
Three themes of within CLASCulturally Competent Care (1-3); Language Access Services(4-7); Organizational Supports for Cultural Competence (8-14).
Ways CLAS can Improve healthImproved access, Reduced medical errors, Improved adherence, satisfaction, and effectiveness of services, Reduced financial costs and risks
Purpose of CLASServe as guiding principles for the delivery of quality health care to diverse populations.

Commonly Held Health Belief Views

Question Answer
Magico-Religious Health BeliefsHealth & illness controlled by supernatural forces, result of “being bad” or opposing God’s will
Biomedical Health BeliefsIllness caused by germs, bacteria, or a breakdown of the ‘human machine,’ belief that pills, treatments, or surgery will cure
Holistic Health Beliefshuman life is an aspect of nature, balance with nature. Symbols = medicine wheel, yin and yang
Nurses must keep in mind/considertreatment strategy consistent with the client’s beliefs may have a better chance of being successful. What folk or family healing practices that may have been used/be in use. Whether any harm is resulting from this practice.
Folk medicinebeliefs and practices relating to illness prevention and healing that derive from cultural traditions rather than from modern medicine’s scientific base. Often more comfortable and less frightening for the client.
Components of Biomedical Health beliefs• Meliorism (make it better by human effort)
• Dominance over nature
• Activism
• Timeliness
• Therapeutic aggressiveness (stronger=better)
• Future orientation (plan, newer=better)
• Standardization (treat similar the same)

Interpreter Use Guidelines

Question Answer
Avoid using a family memberto help maintain clients privacy
Be aware of gender/age differencesusing same gender interpreter may avoid embarrassment
Choose an interpreter who is politically or socially compatible with clientto help client focus on the health situation
Address questions to the clientthis is the person to whom the information is relevant
Ask interpreter to interpret as closely as possible to the words used by the nurseto ensure proper message is relayed
Speak slowly and distinctly (no metaphors)to avoid confusion
Observe facial expressions/body language that client assumes when interacting with interpreterto help gauge clients understanding and perception of the information
Become aware of individual expressions used in specific regions and acknowledge them when using interpreting servicesto help client feel connected and important

Impacts of Culture

Question Answer
Health beliefstreatment strategies that are consistent with client’s beliefs have a better chance of being successful
Self-care practicesviews on menstrual blood flow may affect thoughts on birth control, hot/cold balance, herbal remedies
Family patternsconcept of family is complex and influenced by personal and social values (machismo, matriarchal, extended families)
Communicationcultural variations in both verbal/nonverbal communication
Biological risk factorshealth risks may be more prevalent in certain groups
When assessing a client, the nurse considersthe client’s cultural values, beliefs, and practices related to health and health care

Culturally Competent Care Delivery

Question Answer
5 constructs of culturally competent care deliverydesire, awareness, knowledge, skills, encounters
Desirethe motivation to “want to” engage in the process of becoming culturally aware, culturally knowledgeable, culturally skillful, and seeking cultural encounters
Awarenessof one’s own cultural attributes & bias
Knowledgeunderstanding of client’s heritage and health traditions in terms of how the client maintains, protects, and restores health
Skills (communication)collect culturally relevant data regarding the client’s health in a culturally sensitive manner (respect personal space, cultural rules on touch, eye contact, use of silence)
Barriers to culturally competent care deliverylack of info on particulars of a groups behaviors, inability to understand social and cultural customs of a group, a lack of awareness of your feelings about the cultures of people from an identified group

Nursing Management

Question Answer
ASKED modelhelps nurses to develop cultural consciousness: Awareness, Skill, Knowledge, Encounters, Desire. Campinha-Bacote (2007); nurses reflect on questions which focus on how well prepared they are to acknowledge their own biases, their openness to embracing differences in people, and their willingness to learn appropriate means of communicating and caring for diverse populations.
LEARNcommonly used cultural assessment tool (Berlin & Fowkes, 1983): -Listen actively with empathy to the client’s perception of the problem.
-Explain what you think you heard/ask for clarification.
-Acknowledge the importance of what is said and what it means.
-Recommend inclusive strategies.
-Negotiate the plan of care by collaborating with the client and others.
The 4 C’s of Culturewere a cultural assessment tool developed by Slavin, Galanti, and Kuo:
-What do you call your problem?
-What do you think caused your problem?
-How do you cope with your condition
-What are your concerns regarding the condition and/or recommended treatment



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