Chapter 7 Client's Response to Illness

Question 1

Culture

Answer 1

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

Question 2

Factors in a Cultural Assessment

Answer 2

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

Question 3

Diversity

Answer 3

Refers to the vast array of differences that exist among populations

Question 4

Individual Factors: Age, Growth, & Development

Answer 4

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

Question 5

Trust vs. Mistrust

Answer 5

Age: Infant

Tasks: Viewing the world as safe & reliable
- Viewing relationships as nurturing, stable, & dependable

Question 6

Autonomy vs. Shame & Doubt

Answer 6

Age: Toddler

Task: Achieving a sense of control & free will

Question 7

Initiative vs Guilt

Answer 7

Age: Preschool

Task: Beginning to develop a conscience & learning to manage conflict & anxiety

Question 8

Industry vs. Inferiority

Answer 8

Age: School age

Tasks: Building confidence in own abilities & taking pleasure in accomplishment

Question 9

Identity vs. Role Diffusion

Answer 9

Age: Adolescent

Task: Formulating a sense of belief & belonging

Question 10

Intimacy vs. Isolation

Answer 10

Age: YA

Tasks: Forming adult, loving relationships & meaningful attachment to others

Question 11

Generativity vs. Stagnation

Answer 11

Age: Middle Adult

Task: Establishing the following generation

Question 12

Ego Integrity vs. Despair

Answer 12

Age: Older Adult

Task: Accepting responsibility for oneself & life

Question 13

Individual Factors: Genetics & Biologic Factors

Answer 13

Heredity & genetics are NOT under voluntary control
- We CANNOT change these factors

Predispose us to many illnesses

Question 14

Individual Factors: Physical Health & Health Factors

Answer 14

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

Question 15

Individual Factors: Response to Drugs

Answer 15

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

Question 16

Individual Factors: Self-Efficacy

Answer 16

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

Question 17

4 Ways to Empower an Individual

Answer 17

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)

Question 18

Social Modeling

Answer 18

Observing successful people instills the idea that one can also succeed

Question 19

Social Persuasion

Answer 19

Persuading people to believe in themselves

Question 20

Individual Factors: Hardiness

Answer 20

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

Question 21

The 3 Components of Hardiness

Answer 21

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

Question 22

Individual Factors: Resilience & Resourcefulness

Answer 22

Resilience: having healthy responses to stressful
circumstances or risky situations

Resourcefulness: using problem-solving abilities and
believing that one can cope with adverse situations

Question 23

Individual Factors: Spirituality

Answer 23

Beliefs about the meaning and purpose of life

Question 24

Interpersonal Factors

Answer 24

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

Question 25

Sense of Belonging

Answer 25

The feeling of connectedness with or involving in
a social system/environment of which a person
feels an integral part

Question 26

Social Networks

Answer 26

Groups of people one knows & w/ whom one feels connected to

Question 27

Social Support

Answer 27

Comes from friends, family, & healthcare providers who help a person when a problem arises

Question 28

Social Determinants of Health (SDOH)

Answer 28

Conditions where people live, learn, work, & play that affect a wide range of health risks and outcomes

Strongly influences a person’s health

Question 29

Socioeconomic Status

Answer 29

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

Question 30

Health Literacy

Answer 30

The person’s ability to find, understand, and use info & services to make informed health-related decisions

Question 31

Nurse’s Role in Working with Clients of Various
Cultures

Answer 31

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?”