Chapter 7 Client's Response to Illness Flashcards
Culture
All the socially learned behaviors, values, beliefs, customs & ways of thinking of a population that guides its members’ views of themselves & the world
Affects all aspects of a person’s being, including health, illness, & treatment
Factors in a Cultural Assessment
Communication
Physical Distance or Space: 3-6 feet
Social Organization
Time Orientation: Precise or Approximate
- In U.S. time is precise
Environmental Control
Biologic Variation
Diversity
Refers to the vast array of differences that exist among populations
Individual Factors: Age, Growth, & Development
Strongly impacts how a person deals w/illness
Can also influence how they express illness
- Nurses must be aware of a child’s level of language & work to understand the experience as the child describes it
Erick Erickson described psychosocial development across the life span in terms of developmental tasks to accomplish at each stage
Trust vs. Mistrust
Age: Infant
Tasks: Viewing the world as safe & reliable
- Viewing relationships as nurturing, stable, & dependable
Autonomy vs. Shame & Doubt
Age: Toddler
Task: Achieving a sense of control & free will
Initiative vs Guilt
Age: Preschool
Task: Beginning to develop a conscience & learning to manage conflict & anxiety
Industry vs. Inferiority
Age: School age
Tasks: Building confidence in own abilities & taking pleasure in accomplishment
Identity vs. Role Diffusion
Age: Adolescent
Task: Formulating a sense of belief & belonging
Intimacy vs. Isolation
Age: YA
Tasks: Forming adult, loving relationships & meaningful attachment to others
Generativity vs. Stagnation
Age: Middle Adult
Task: Establishing the following generation
Ego Integrity vs. Despair
Age: Older Adult
Task: Accepting responsibility for oneself & life
Individual Factors: Genetics & Biologic Factors
Heredity & genetics are NOT under voluntary control
- We CANNOT change these factors
Predispose us to many illnesses
Individual Factors: Physical Health & Health Factors
The healthier the person, the better he or she can cope w/ stress or illness
Poor nutritional status, lack of sleep, or a chronic physical illness may impair a person’s way to cope
Health practices, such as exercising, can greatly improve health & diminish the negative effects of some illnesses
Individual Factors: Response to Drugs
Biologic difference among ethnic groups greatly affect
client’s responses to treatment, particularly with
psychotropics
- Ethnic groups vary in the metabolism & efficacy of
drugs
Poor metabolizers metabolize drugs more slowly
- Serum level of the drug remains higher-> increases frequency & severity of side effects
- Clients w/ poor metabolism may need lower doses to achieve the desired effect
Individual Factors: Self-Efficacy
The belief that personal abilities and efforts affect
the events in one’s life
A person that believes their behavior can make a difference is more likely to take action
- People w/ HIGH self-efficacy: Self-motivated, cope effectively w/stress, & request support from others when needed
- People w/ LOW self-efficacy: Low aspirations, experience much self-doubt, & may be plagued w/ depression & anxiety
4 Ways to Empower an Individual
1) Experience of success or mastery in overcoming obstacles
2) Social Modeling
3) Social Persuasion
4) Reducing stress, building physical strength, & learning how to interpret physical sensations positively
- Viewing fatigue as accomplishing something vs lack of stamina)
Social Modeling
Observing successful people instills the idea that one can also succeed
Social Persuasion
Persuading people to believe in themselves
Individual Factors: Hardiness
The ability to resist illness when under stress
Found to have a moderating/buffering effect on people experiencing stress
Stressful events cause more harm to people w/ low hardiness than those w/higher hardiness
- Those w/ high hardiness perceive stressors more accurately & are able to problem-solve more effectively
The 3 Components of Hardiness
1) Commitment: Active involvement in life activities
2) Control: Ability to make appropriate decisions in life
3) Challenge: Ability to perceive change as beneficial rather than stressful
Individual Factors: Resilience & Resourcefulness
Resilience: having healthy responses to stressful
circumstances or risky situations
Resourcefulness: using problem-solving abilities and
believing that one can cope with adverse situations
Individual Factors: Spirituality
Beliefs about the meaning and purpose of life
Interpersonal Factors
1) Sense of Belonging
2) Social Networks & Social Support
3) Family Support: Family can be a key factor in the recovery of clients w/ psychiatric illnesses
Sense of Belonging
The feeling of connectedness with or involving in
a social system/environment of which a person
feels an integral part
Social Networks
Groups of people one knows & w/ whom one feels connected to
Social Support
Comes from friends, family, & healthcare providers who help a person when a problem arises
Social Determinants of Health (SDOH)
Conditions where people live, learn, work, & play that affect a wide range of health risks and outcomes
Strongly influences a person’s health
Socioeconomic Status
Refers to one’s income, education, and occupation
Poverty places clients at risk for threats to health
such as:
- Inadequate housing
- Lead paint
- Gang-related violence
- Drug trafficking
- Substandard schools
These all go along w/those of lower economic status
Health Literacy
The person’s ability to find, understand, and use info & services to make informed health-related decisions
Nurse’s Role in Working with Clients of Various
Cultures
It is the nurse’s responsibility to find out as much as possible about a client’s cultural values, beliefs, and health practices
Important to assess for client preferences
Be open and objective
Never make assumptions about what is “usual” in a culture, even if the client is from the same cultural group as you
Always ask!
Sample questions to elicit more information:
“Do you follow any dietary preferences or restrictions?”
“How can I assist you in practicing your religious or spiritual beliefs?”
“How do you think this health problem came about?”
