Chapter 5: Cultural Influences In Nursing In Community Health Flashcards
Legal immigrant
Not a citizen but allowed to both live and work in the U.S. Aka lawful permanent residents
Refugees
Admitted outside the usual quota restrictions based on fear of persecution d/t to their race, religion, nationality, social group or political views
Nonimmigrants
Admitted to the U.S. for a limited duration and specific purpose (i.e students, tourists)
Unauthorized immigrant
May have cross the border illegally or legal permission expired.
Eligible only for emergency medical services.
Immigrant Health Issues
Immigrants in the US add about $10 billion to the economy annually and that an immigrant family will pay $80,000 more in taxes than they consume services.
Factors to Consider for Providing Care for Immigrants
- Financial constraints (uninsured)
- Language barriers
- Differences in social, religious, and cultural backgrounds between the immigrant and the health care provider
- Providers’ lack of knowledge about high-risk diseases in the specific immigrant groups for whom they care
- Traditional healing or folk health care practices that may be unfamiliar to their U.S. health care providers
- When working with immigrant populations, consider how your own background, beliefs, and knowledge may be significantly different from those of the people receiving care.
Non-citizens are three times more likely to be
Uninsured than are citizens d/t lower rates of both public and private coverage.
Similarly, non-citizen children and citizen children in mixed citizenship status families are more likely to be uninsured than are children of citizens.
Culture
a set of beliefs, values, and assumptions about life that are widely held among a group of people and that are transmitted across generations
Race
a biological designation whereby group members share features (e.g., skin color, bone structure, genetic traits such as blood groupings)
Ethnicity
shared feeling of peoplehood among a group of individuals
Cultural Competence
A combination of culturally congruent behaviors, practice attitudes, and polices that allow nurses to work effectively in cross-cultural situations
Four Principles of Cultural Competence
- Care is designed for the specific client
- Care is based on the uniqueness of the person’s culture and includes cultural norms and values
- Care includes self-employment strategies to facilitate client decision making in regard to health behavior
- Care is provided with sensitivity and is based on the cultural uniqueness of clients
The nurse’s culture often differs from that of the client, leading to
different understandings of communication, behaviors, and plans for care.
Non-culturally competent care may lead to
An increase in the cost of health care and decrease the opportunity for positive client outcomes.
To meet some of the objectives for persons of different cultures as outlined in Healthy People 2020,
lifestyle and personal choices must be considered.
What are two principles for developing cultural competence?
- Maintain a broad, objective, and open attitude toward individuals and their cultures.
- Avoid seeing all individuals as alike.
What are the three stages of developing cultural competence?
- Culturally incompetent
- Culturally sensitive
- Culturally competent
What are the three dimensions of each stage in developing cultural competence?
- Cognitive (thinking)
- Affective (feeling)
- Psychomotor (doing)
What are the 5 concepts of cultural competence?
- Cultural awareness
- Cultural knowledge
- Cultural skill
- Cultural encounter
- Cultural desire
What are the dimensions of cultural competence?
Cultural preservation
Cultural accommodation
Cultural repatterning
Cultural brokering
What factors inhibit development of cultural competence?
Stereotyping Prejudice Racism Ethnocentrism Cultural blindness Cultural imposition Cultural conflict Cultural shock
During a cultural nursing assessment, the nurse asks about the following issues
Ethnic background Religious preference Family patterns Cultural values Language Education Politics Health practices
Two Phases of an In-Depth Cultural Assessment
Data-collecting phase
Organizing phase
In-Depth Cultural Assessment: Data-collecting Phase
- The nurse collects self-identifying data similar to that collected in the brief assessment.
- The nurse raises a variety of questions that seek information on clients’ perception of what brings them to the health care system, the illness, and previous and anticipated treatments.
- After the nursing diagnosis is made, the nurse identifies cultural factors that may influence the effectiveness of nursing care actions.
In-Depth Cultural Assessment: Organizing Phase
Data related to the client’s and family’s views on optimal treatment choices are routinely examined and areas of difference between the client’s cultural needs and the goals of Western medicine are identified.
Things to consider when conducting a cultural assessment
- Be aware of the environment.
- Know about community social organizations.
- Know the specific areas that the nurse wants to focus on.
- Select a strategy to help gather cultural data.
- Identify a confidante.
- Know the appropriate questions to ask.
- Interview other nurses or health care professionals.
- Talk with formal and informal cultural leaders.
- Be aware that all information has both subjective and objective data.
- Avoid pitfalls.
- Be sincere, open, and honest.
Although all cultures are not the same, all cultural have the same basic organizing factors:
- Communication (verbal and nonverbal)
- Space
- Social organization
- Time perception
- Environmental control
- Biological variations
- Culture and nutrition
Members of minority groups are over represented on the
lower tiers of the socioeconomic ladder
Poor economic achievement is also a common characteristic among
populations at risk, such as those in poverty, the homeless, migrant workers, and refugees.
Nursing Judgement
Nurses should be able to distinguish between cultural and socioeconomic class issues and not interpret behavior as having a cultural origin when in fact it is based on socioeconomic class
