Chapter 5: Cultural Influences In Nursing In Community Health

Question 1

Legal immigrant

Answer 1

Not a citizen but allowed to both live and work in the U.S. Aka lawful permanent residents

Question 2

Refugees

Answer 2

Admitted outside the usual quota restrictions based on fear of persecution d/t to their race, religion, nationality, social group or political views

Question 3

Nonimmigrants

Answer 3

Admitted to the U.S. for a limited duration and specific purpose (i.e students, tourists)

Question 4

Unauthorized immigrant

Answer 4

May have cross the border illegally or legal permission expired.
Eligible only for emergency medical services.

Question 5

Immigrant Health Issues

Answer 5

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.

Question 6

Factors to Consider for Providing Care for Immigrants

Answer 6

• 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.

Question 7

Non-citizens are three times more likely to be

Answer 7

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.

Question 8

Culture

Answer 8

a set of beliefs, values, and assumptions about life that are widely held among a group of people and that are transmitted across generations

Question 9

Race

Answer 9

a biological designation whereby group members share features (e.g., skin color, bone structure, genetic traits such as blood groupings)

Question 10

Ethnicity

Answer 10

shared feeling of peoplehood among a group of individuals

Question 11

Cultural Competence

Answer 11

A combination of culturally congruent behaviors, practice attitudes, and polices that allow nurses to work effectively in cross-cultural situations

Question 12

Four Principles of Cultural Competence

Answer 12

1. Care is designed for the specific client
2. Care is based on the uniqueness of the person’s culture and includes cultural norms and values
3. Care includes self-employment strategies to facilitate client decision making in regard to health behavior
4. Care is provided with sensitivity and is based on the cultural uniqueness of clients

Question 13

The nurse’s culture often differs from that of the client, leading to

Answer 13

different understandings of communication, behaviors, and plans for care.

Question 14

Non-culturally competent care may lead to

Answer 14

An increase in the cost of health care and decrease the opportunity for positive client outcomes.

Question 15

To meet some of the objectives for persons of different cultures as outlined in Healthy People 2020,

Answer 15

lifestyle and personal choices must be considered.

Question 16

What are two principles for developing cultural competence?

Answer 16

1. Maintain a broad, objective, and open attitude toward individuals and their cultures.
2. Avoid seeing all individuals as alike.

Question 17

What are the three stages of developing cultural competence?

Answer 17

1. Culturally incompetent
2. Culturally sensitive
3. Culturally competent

Question 18

What are the three dimensions of each stage in developing cultural competence?

Answer 18

1. Cognitive (thinking)
2. Affective (feeling)
3. Psychomotor (doing)

Question 19

What are the 5 concepts of cultural competence?

Answer 19

1. Cultural awareness
2. Cultural knowledge
3. Cultural skill
4. Cultural encounter
5. Cultural desire

Question 20

What are the dimensions of cultural competence?

Answer 20

Cultural preservation
Cultural accommodation
Cultural repatterning
Cultural brokering

Question 21

What factors inhibit development of cultural competence?

Answer 21

Stereotyping
Prejudice
Racism
Ethnocentrism
Cultural blindness
Cultural imposition
Cultural conflict
Cultural shock

Question 22

During a cultural nursing assessment, the nurse asks about the following issues

Answer 22

Ethnic background
Religious preference
Family patterns
Cultural values
Language
Education
Politics
Health practices

Question 23

Two Phases of an In-Depth Cultural Assessment

Answer 23

Data-collecting phase

Organizing phase

Question 24

In-Depth Cultural Assessment: Data-collecting Phase

Answer 24

1. The nurse collects self-identifying data similar to that collected in the brief assessment.
2. 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.
3. After the nursing diagnosis is made, the nurse identifies cultural factors that may influence the effectiveness of nursing care actions.

Question 25

In-Depth Cultural Assessment: Organizing Phase

Answer 25

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.

Question 26

Things to consider when conducting a cultural assessment

Answer 26

• 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.

Question 27

Although all cultures are not the same, all cultural have the same basic organizing factors:

Answer 27

• Communication (verbal and nonverbal)
• Space
• Social organization
• Time perception
• Environmental control
• Biological variations
• Culture and nutrition

Question 28

Members of minority groups are over represented on the

Answer 28

lower tiers of the socioeconomic ladder

Question 29

Poor economic achievement is also a common characteristic among

Answer 29

populations at risk, such as those in poverty, the homeless, migrant workers, and refugees.

Question 30

Nursing Judgement

Answer 30

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