Cultural Diversity and Nursing

Question 1

Why do you think it is important to examine our own culture in relation to health & illness?

Answer 1

to beware of culture imposition (imposing your culture on someone else)

Question 2

Why do you think it would be important to examine our patients’ own cultural beliefs?

Answer 2

moral imagination; imagine what its like to be in another person’s situation

Question 3

What is culture?

Answer 3

The learned, shared, & transmitted values, beliefs, norms, & life way practices of a particular group that guide thinking, decisions, & actions in patterned ways.

Question 4

What is cultural diversity based on?

Answer 4

ethnicity, religion, language, education, skills

Question 5

What does culture affect?

Answer 5

ways of perceiving, behaving, & evaluating the world, & serves as a guide for people’s values, beliefs, & practices, including those related to health & illness

Question 6

What does stereotyping mean?

Answer 6

making an assumption of a culture. racial profiling

Question 7

What is ethnicity?

Answer 7

Refers to groups whose members feel a sense of common identity.

Share a common social and cultural heritage
Common language, history, physical characteristics and geographical space.
Beware of ethnocentrism !

Question 8

What is ethnocentrism?

Answer 8

Is a tendency of individuals to believe that their way of viewing and responding to the world is the most correct, natural, and superior

Question 9

What is the Transcultural Assessment Model?

Answer 9

Underlying premise : each person is culturally unique and should be assessed according to 6 cultural phenomena: communication, space, social organization, time, environmental control, and biological variations.

Question 10

what is the goal of transcultural assessment model?

Answer 10

Aims to provide care appropriate to those cultures (culturally ‘congruent’/ ‘competent’ care)* must take into account the person’s culture so as to improve nursing care & patient well-being

Question 11

what are the 6 cultural phenomena?

Answer 11

communication
 space
social organization
 time
 environmental control
 biological variations.

Question 12

What is cultural competent care?

Answer 12

offers a means to assess patient’s unique health care needs including their specific cultural health practices.

It is the provision of health care across cultural boundaries & takes into account the context in which the patient lives, as well as the situations in which the patient’s health problems arise.

Question 13

Cultural competence is the application of?

Answer 13

knowledge
skill
attitude
personal attribute

provide appropriate care & services in relation to cultural characteristics of their patients …includes valuing diversity, knowing about cultural mores & traditions of the populations being served & being sensitive to these while caring for the individual

Question 14

competent?

Answer 14

Understands & attends to patient’s

situation & recognizes that this is a complex combination of knowledge, attitudes, & skill

Question 15

appropriate?

Answer 15

Nurse applies the underlying background knowledge that must be possessed to provide patients with holistic cultural care

Question 16

sensitive?

Answer 16

Nurse possess constructive & open attitude toward health traditions observed among diverse cultural groups.

Question 17

What is the goal of cultural assessment?

Answer 17

generate from patients themselves significant information that will enable culturally congruent care

Question 18

How did Leininger define transcultural nursing?

Answer 18

to provide meaningful & effective nursing care to patients according to their culture, values, & health & illness contexts

Question 19

What was the goal of Leininger’s sunrise model?

Answer 19

Create a nurse-patient partnership that ensures accurate assessment, needs & goals of the patient based on their culture

Question 20

Leininger’s goal can only be achieves by a nurse who is what?

Answer 20

has an open attitude, knowledge & skill to implement culturally competent care

Question 21

What is important when providing culturally competent care?

Answer 21

Learn all significant rituals, customs & health practices of the major cultural groups you deal with

Include cultural assessment of patient & family in all nursing assessments

Recognize patient/families’ right to choose

Convey respect for traditional practices

Question 22

What is the explanatory model?

Answer 22

culturally significant issues for caregivers

asking patients about themselves

Question 23

Explanatory model according to the patient?

Answer 23

patient’s “set of beliefs regarding what causes his/her disease & the methods that would potentially treat his/her condition best.”

It is important to determine how the patient’s different experiences & beliefs might affect their health & health care.

Question 24

Questions you can ask pt about based on explanatory model about their illness/care?

Answer 24

• What do you call the problem?
• What do you think has caused the problem?
• What do you think the sickness does to you?
• How severe is the sickness?

What are the major problems or difficulties this sickness has caused in your life?

• What have you done for this problem up to now?
• What type of treatment do you think you should receive?

Question 25

List of questions used to learn about patient’s explanatory model of illness are?

Answer 25

What are the most important results you hope to achieve from the treatment?

• What do you fear most about the sickness? treatment?
• Who else should be consulted or involved in your care?

Question 26

What is Giger and Davidhizar’s assessment model?

Answer 26

guide nurses in their assessment of how culture has influenced their patient’s health beliefs & behaviors

Question 27

6 factors affecting health according to giger/davidhizar’s assessment model?

Answer 27

• communication
  
  • space
  • time orientation
  • social organization
  • environmental control
  • biological variations

Question 28

Communication barrier

Indicators that patients do not understand what is being spoken include?

Answer 28

• Efforts to change subject
• Absence of questions
• Inappropriate laughter
• Non-verbal cues (Nodding head to everything even if they do not understand)
• Reply “yes” to everything
• Remaining Silent

Always Ask! Necessary to 1st determine level of fluency in English (may need interpreter)

Question 29

Communicating with pt’s who are limited in french/english strategies?

Answer 29

WORKING WITH INTERPETERS
USE GESTURES, PANTOMIMES, POINT TO SELF
 DO NOT ASK QUESTIONS THAT CAN BE ANSWERED WITH “YES” OR “NO”
SPEAK IN LOW MODERATE TONE
AVOID MEDICAL JARGON, USE SIMPLE WORDS
USE WORDS IN PATIENTS’ LANGUAGE
VALIDATE UNDERSTANDING, SUMMARIZE OFTEN
BE ORGANIZED, SLOW DOWN, USE PICTURES
USE TRANSLATION MATERIALS
ASSESS CLIENT’S ABILITY TO READ IN OWN LANGUAGE BEFORE GIVING ENGLISH/FRENCH MATERIALS

Question 30

To remember when working with an interpreter?

Answer 30

Try for best choice of interpreter re: barriers of gender, class, region, or tribe
■ Realize interpreter may ‘modify’ what you’ve said to correspond to cultural norms or taboos.
■ Talk directly to individual (not interpreter)
■ Check 1st with interpreter on delicate subjects
■ Check back with interpreter about how much was really understood
■ Even a telephone call to a friend or family member can be useful when trying to ensure that basic information is clearly passed on

Question 31

What doe social organization refer to?

Answer 31

Refers to the family unit (nuclear, single-parent, extended.

And the social group organizations (religious or ethnic) with which patients & their families may identify with.

Countless barriers-unemployment, homelessness, poverty can prevent people from entering the health care system.

Question 32

What is important to know in regards to social organization?

Answer 32

understand individual’s family or community context (who’s involved in health care matters, importance of individual vs. collective)

How are decisions made? Who needs to be involved in specific discussions (i.e. around diet or treatment plan)?

How family as whole affected by person’s illness (i.e. in some cultures can be normal for family to take all responsibility off shoulders of ill person)

What broader community structures play part in individual’s daily life? (church, neighborhood organization, club)

Question 33

What is environmental control?

Answer 33

patient’s traditional health & illness belief, the practice of folk medicine, & the use of traditional healers

Question 34

Why do biological variations matter?

Answer 34

Differences in metabolisms can lead to different therapeutic levels of medication, dietary requirements (lactose intolerance)

■ Differential susceptibility to disease (or morbidity rates) within certain groups - i.e. Sickle cell anemia, PKU, Tay-Sachs, CF, Hypertension, Diabetes

Question 35

What to remember when interviewing patients?

Answer 35

■ Develop awareness of one’s own cultural heritage

■ Become aware of patient’s culture as described by the patient (be genuine & honest about knowledge you lack here)

■ Plan care with patient in way that incorporates patient’s cultural values

Question 36

What to ask to patients of different culture when you are caring for them?

Answer 36

“Do you have any cultural practices that may be affected by this hospitalization?”

■“Are there any religious beliefs or customs that we can help you with while you’re in the hospital?”

Question 37

different views on health & illness?

Answer 37

cultures have different ways of defining pain

cultures use home remedies for treatment. always assess patients cultural therapies

Question 38

Religious views on different procedures?

Answer 38

■ BLOOD TRANSFUSIONS- Forbidden in Jehovah’s Witness. Ordinarily not used by members of Christian Science
■ ORGAN DONATIONS- Must be discussed with family first in Islam. Forbidden in Jehovah’s Witness. Seek Rabbi consultation in some Judaism sectors.
■ ABORTION- Forbidden in Baha’i, Roman Catholic, Christian Science, Church of Jesus Christ of Latter-day Saints, Islam, Jehovah’s Witness. Therapeutic might be permitted with Rabbinical consultation in Judaism