Cultural Competence Flashcards
Total US population passed ____ million in the autumn of 2006
300
1 out of __ US residents was in a group other than single race non-hispanic white.
3
Minority or “emerging minority” population totaled __ million people. ______ are the largest and fastest growing group. Followed by Asians, american indians & alaska natives, native hawaiians and other pacific islanders.
98, hispanics
In comparison to the population as a whole:
- emerging majority groups tend to be ______, with lower median ages and high proportions of the population under the age of 18.
- The non-hispanic, single-race, white population has an ____ median age and a smaller proportion of the pop under the age of 18 years.
younger, older
There is one birth every __ seconds. one death every __ seconds, and one international migrant every __ seconds. Therefore, our country gains one person every 11 seconds.
8, 13, 30
An act that says services cannot be denied to people of limited english proficiency.
Title VI of the Civil rights act of 1964
According to the 2000 census, ___ million americans over 5 years of age speak a language other than English in their homes.
*this represented an increase of 15 million people over the numbers documented by the 1990 census
47
What states require that providers offer language assistance in heath care settings?
California, massachusetts, and new york
Possessing basic knowledge of and constructive attitudes toward diverse cultural populations
culturally sensitive
Applying underlying background knowledge necessary to provide the best possible health care.
Culturally appropriate
Understanding and attending to total context of patient’s situation including immigration status, stress factors, social factors, and cultural similarities/differences
Culturally competent
The thoughts, communications, actions, beliefs, values, and institutions of racial, ethnic, religious or social groups
Culture
What are the characteristics of culture?
Learned, shared, adapted, dynamic
______ describes a group united by:
- common geographic origin
- migratory status
- religion
- race
- language
- shared values, traditions, or symbols
- food preferences
Ethnicity
______ is a system of beliefs, practices and ethical values, belief in a divine or superhuman power
Religion
What are some health related behaviors affected by religion?
Meditating, exercising/physical fitness, sleep habits, vaccinations, willingness to undergo physical exam, pilgrimage, truthfulness about how you feel, hoping for a recovery, coping with stress, genetic screening and counseling, living with a disability, caring for children
The process of being raised within a culture and acquiring the characteristics of that group
socialization
The process of adapting to acquiring another culture
acculturation
The process by which a person develops a new cultural identity and becomes like the members of the dominant culture
Assimilation
Differing views of the same disease: Epilepsy
- Uganda: ______, untreatable
- Greece: source of family shame
- Mexican-american: evidence of physical ________
- Hutterites: having endured a trial by god.
Contagious, imbalance
For older patients, culture is likely to define their family ________ and affect their knowledge of the systems used by the dominant culture.
responsibilities
Theories of causation biomedical:
- Assumes cause and _____
- Views the body as a machine
- Life can be divided into parts
- Endorses ____ theory
effect, germ
Forces of nature must be kept in balance, embraces the idea of opposing categories or forces (yin/yang, hot/cold)
Naturalistic
Supernatural powers predominate in the area of health and illness, examples include voodoo, witchcraft, and faith healing
magicoreligious
Folk healers for the hispanic culture include _______, espiritualista, yerbo, or sabedor
curandero
Folk healers for the black culture include a hougan, ________, and old lady
spirtualist
Folk healers for the american indian culture is a _____ and medicine woman/man
shaman
Folk healers for the Asian culture include ______, acupuncturists, bone setters (joint manipulation)
herbalists
Folk healers for Amish peeps include a ______.
Braucher (gift of healing)
Steps of cultural competence:
- Understanding one’s own heritage-based cultural ______, beliefs, attitudes and practices
- Identifying meaning of “health” to patient
- Understanding how the health care system works
- Acquiring ______ about the social backgrounds of one’s patients
- Becoming familiar with ______, interpretive services and community resources used by (and available to) your patients and yourself.
values, knowledge, language
R.E.S.P.E.C.T:
- ______ that you must know the heritage of yourself and your patient
- ______ the patient within cultural context
- ______ questions that are simple and speak them slowly.
- ______questions throughout the exam
- _______patient to discuss meaning of health and illness with you
- ______patient’s understanding and acceptance of recommendations
- ______the patient within the boundaries of his or her heritage.
realize, examine, select, pace, encourage, check, touch
During an assessment, the nurse notices that a patient is handling a small charm that is tied to a leather strip around his neck. Which action by the nurse is appropriate?
A) Ask the patient about the item and its significance.
B) Ask the patient to lock the item with other valuables in the hospital’s safe.
C) Tell the patient that a family member should take valuables home.
D) No action is necessary
Ask the patient about the item and its significance.
Page: 21 The nurse should inquire about the amulet’s meaning. Amulets, such as charms, are often seen as an important means of protection from “evil spirits” by some cultures.
In the majority culture of America, coughing, sweating, and diarrhea are symptoms of an illness. For some individuals of Mexican-American origin, however, these symptoms are a normal part of living. The nurse recognizes that this is true, probably because Mexican-Americans:
A) have less efficient immune systems and are often ill.
B) consider these symptoms a part of normal living, not symptoms of ill health.
C) come from Mexico and coughing is normal and healthy there.
D) are usually in a lower socioeconomic group and are more likely to be sick.
consider these symptoms a part of normal living, not symptoms of ill health.
Page: 27 The nurse needs to identify the meaning of health to the patient, remembering that concepts are derived, in part, from the way in which members of the cultural group define health.
Among many Asians there is a belief in the yin/yang theory, rooted in the ancient Chinese philosophy of Tao. The nurse recognizes which statement that most accurately reflects “health” in an Asian with this belief?
A) A person is able to work and produce.
B) A person is happy, stable, and feels good.
C) All aspects of the person are in perfect balance.
D) A person is able to care for others and function socially.
All aspects of the person are in perfect balance.
Page: 21 Many Asians believe in the yin/yang theory, in which health is believed to exist when all aspects of the person are in perfect balance. The other statements do not describe this theory.
An individual who takes the magicoreligious perspective of illness and disease is likely to believe that his or her illness was caused by:
A) germs and viruses.
B) supernatural forces.
C) eating imbalanced foods.
D) an imbalance within his or her spiritual nature.
supernatural forces.
Page: 21 The basic premise of the magicoreligious perspective is that the world is seen as an arena in which supernatural forces dominate. The fate of the world and those in it depends on the actions of supernatural forces for good or evil. The other answers do not reflect the magicoreligious perspective.
If an American Indian has come to the clinic to seek help with regulating her diabetes, the nurse can expect that she:
A) will comply with the treatment prescribed.
B) has obviously given up her beliefs in naturalistic causes of disease.
C) may also be seeking the assistance of a shaman or medicine man.
D) will need extra help in dealing with her illness and may be experiencing a crisis of faith.
may also be seeking the assistance of a shaman or medicine man.
Page: 23 When self-treatment is unsuccessful, the individual may turn to the lay or folk healing systems, to spiritual or religious healing, or to scientific biomedicine. In addition to seeking help from a biomedical or scientific health care provider, patients may also seek help from folk or religious healers.
An elderly Mexican-American woman with traditional beliefs has been admitted to an inpatient care unit. A culturally-sensitive nurse would:
A) contact the hospital administrator about the best course of action.
B) automatically get a curandero for her because it is not culturally appropriate for her to request one.
C) further assess the patient’s cultural beliefs and offer the patient assistance in contacting a curandero or priest if she desires.
D) ask the family what they would like to do because Mexican-Americans traditionally give control of decisions to their families.
further assess the patient’s cultural beliefs and offer the patient assistance in contacting a curandero or priest if she desires.
Pages: 22-23 In addition to seeking help from the biomedical/scientific health care provider, patients may also seek help from folk or religious healers. Some people, such as those of Mexican-American or American Indian origins, may believe that the cure is incomplete unless the body, mind, and spirit are also healed (although the division of the person into parts is a Western concept).
The nurse is reviewing concepts of cultural aspects of pain. Which statement is true regarding pain?
A) All patients will behave the same way when in pain.
B) Just as patients vary in their perceptions of pain, so will they vary in their expressions of pain.
C) Cultural norms have very little to do with pain tolerance, because pain tolerance is always biologically determined.
D) A patient’s expression of pain is largely dependent on the amount of tissue injury associated with the pain.
Just as patients vary in their perceptions of pain, so will they vary in their expressions of pain.
Page: 25 In addition to expecting variations in pain perception and tolerance, the nurse should expect variations in the expression of pain. It is well known that individuals turn to their social environment for validation and comparison. The other statements are incorrect.
The nurse recognizes that working with children with a different cultural perspective may be especially difficult because:
A) children have spiritual needs that are influenced by their stages of development.
B) children have spiritual needs that are direct reflections of what is occurring in their homes.
C) religious beliefs rarely affect the parents’ perceptions of the illness.
D) parents are often the decision makers, and they have no knowledge of their children’s spiritual needs.
children have spiritual needs that are influenced by their stages of development.
Page: 20. Illness during childhood may be an especially difficult clinical situation. Children, as well as adults, have spiritual needs that vary according to the child’s developmental level and the religious climate that exists in the family. The other statements are not correct.
When providing culturally competent care, nurses must incorporate cultural assessments into their health assessments. Which statement is most appropriate to use when initiating an assessment of cultural beliefs with an elderly American Indian patient?
A) “Are you of the Christian faith?”
B) “Do you want to see a medicine man?”
C) “How often do you seek help from medical providers?”
D) “What cultural or spiritual beliefs are important to you?”
“What cultural or spiritual beliefs are important to you?”
Page: 17. The nurse needs to assess the cultural beliefs and practices of the patient. American Indians may seek assistance from a medicine man or shaman, but the nurse should not assume this. An open-ended question regarding cultural and spiritual beliefs is best used initially when performing a cultural assessment
When planning a cultural assessment, the nurse should include which component?
A) Family history
B) Chief complaint
C) Medical history
D) Health-related beliefs
Health-related beliefs
Pages: 19-20. Health-related beliefs and practices are one component of a cultural assessment. The other items reflect other aspects of the patient’s history.
