Culturally Responsive Nursing Care : Chapter 18 Flashcards
Culturally Responsive Care
Care that is centered on the clients cultural perspective and integrates the clients values and beliefs into the plan of care.
Develop self-awareness
Gain knowledge and skills to create an environment where trust can be developed with the client
Responds to the clients needs
Cultural Concepts
Culture - “thoughts”, communications, actions, beliefs of institutions (religious, racial). Learned or shared patterns of info that generates a message. Within Macro- culture (national, ethnic, racial groups) are micro-cultures (gender, age, or religious beliefs).
Subculture - people who have a distinct identity yet are related to a larger cultural group. ex…occupational groups (nurses), societal (feminists)
Bicultural - person who dual patterns of identification and crosses 2 cultures, lifestyles, and values. ex…biracial child White and African American
Diversity - fact or state of being different. Occurs between and within cultural groups. ex…sex, age, culture, socioeconomic status, educational status
Race -
Ethnicity - interchangeably used w/ race. Self defined. Excludes the term Hispanic from racial categories. Relationship between individuals who believe that they have distinctive characteristics that make them a group.
Cultural Concepts (2)
Nationality - the sovereign state or country where one has membership, which may be through birth, inheritance, or naturalization.
Religion - system of beliefs about divine or superhuman power worshiped as the creator and ruler of the universe.
Ethnocentrism - belief in the superiority of one own culture and lifestyle. ex… “xenophobia”- the fear or dislike of people different from ones self.
Racism - assumptions held about racial groups. Belief that races are biologically discrete and exclusive groups that are inherently unequal and ranked hierarchically.
Discrimination - differential and neg treatment of individuals on the basis of their race, ethnicity, gender.
Generalizations - common cultural patterns. Doesn’t hold true at individual levels and should only serve as an opening for individuals to better understand each other. Interpreted as statements that can be misled for stereotyping.
Stereotyping - assumption that individual reflects all characteristics associated with being a member of a group.
Health Disparities
differences in care experienced by one population compared to another.
2 major factors contributing to health disparities :
- inadequate access to care
- substained quality of care
Immigration
Acculturation - involuntary process that occurs when people incorporate traits from another culture. Changes of ones cultural patterns to those of the host society
Assimilation - process by which individuals develop a new cultural identity. Becoming like members if the dominant culture.
Cultural Models of Nursing Care
Culturally responsive care - context in which the client lives, situations in which the client’s health problems arise
Transcultural nursing - formed by Maeliene Leininger, provides care within the differences and similarities of the beliefs, values, and patterns of cultures.
Cultural Competence
lifelong process in which the nurse continuously strives to achieve the ability and availability to work effectively within the cultural context of a client
1) cultural desire - motivation to want to engage in the process of becoming culturally aware
2) cultural awareness - self exam of one’s own prejudices and biases towards other cultures and exploration of ones own ethnic background
3) cultural knowledge - a sound educational foundation concerning various worldviews of different cultures
4) cultural skills - the ability to collect culturally relevant info regarding the clients health in a culturally sensitive manner
5) cultural encounters - engaging in face-to-face cultural interactions w/ people from diverse backgrounds ad learning to modify one’s existing beliefs and prevent possible stereotyping
HEALTH Traditions Model
Maintain Health
Physical
- proper clothing , proper diet, exercise/rest
Mental
- concentration,social and family support systems, hobbies
Spiritual
- religious worship, prayer, meditation
HEALTH Traditions Model
Protect Health
Physical
- special foods and food combination, symbolic clothing
Mental
- avoid certain people who can cause illness, family activities
Spiritual
- religious customs, superstitions, wearing amulets and other symbolic objects to prevent, the “evil eye” or defray other sources of harm
HEALTH Traditions Model
Restore Health
Physical
- homeopathic remedies, liniments, herbal teas, special foods, massage, acupuncture/moxibustion
Mental
- relaxation, exorcism, curanderos and other traditional healers. nerve teas
Spiritual
- religious rituals, special prayers, meditation, traditional healings, exorcism
Health Practices and Beliefs
Magico-religious health belief
- health and illness are controlled by supernatural forces
- illness is the result of being “bad”,
- getting well is also dependent on God’s will
- some cultures believe magic can cause illness
Scientific or biomedical health belief
- life is controlled by physical and biochemical processes that can be manipulated by humans
- illness is caused by germs, viruses, bacteria, or breakdown of the body
- expects pills as a treatment or sx to cure health problems
Holistic health belief
- forces of nature must be maintained or balance or harmony
- human life is one aspect of nature that must be in harmony w/ the rest of nature
- Natural balance is disturbed then illness arouses
- Yin Yang- Chinese culture Yin (cold) such as cancer, Yang (hot food ex…tea) treatment,
Folk Medicine
beliefs and practices relating to illness prevention and healing that derive from cultural traditions rather than from modern medicine’s scientific base
- thought to be more humanistic than biomedical health care
- less expensive
- consultation takes place in the community of the recipient
- ritual practice on the part of the healer or the client
- less frightening
Culture Variation : Verbal Communication
- Difference is vocabulary, grammatical structure, voice qualities, intonation, rhythm, speed, pronunciation, and silence
- ex….The word boot in America refers to a shoe in England the word boot refers to the trunk of a car
- Initiating verbal communication may be influenced by cultural values.
- ex…Nurse wants to do assessment quickly, but client may feel as if the nurse doesn’t have time for them and feel offended w/ the nurse asking so many questions right away
- Interaction between people who speak different languages become difficult
- Translator - converts written material (pt. edu pamphlets) from one language to another
- Interpreter - transforms the message expressed in a source language into its equivalent in a target language, so that the interpreted message has the potential of eliciting the same response in the listener as the original message.
- Cultural broker - interpreter engages both the nurse and client effectively and efficiently in accessing the nuances and hidden sociocultural assumptions embedded in eachother’s language.
Cultural Variations : Nonverbal Communication Behaviors
- 2 Aspects nurses should be aware of when w/ nonverbal communication
1) what does it means to the client
2) what specific nonverbal behaviors mean int he clients culture
Includes use of:
-silence
- touch - American use firm handshake as a greeting and stength, European’s kiss to greet, Asian’s only older people are allowed to touch the head of others (children are never patted on the head)
- eye movement - Western culture views eye contact important to express you are listening and attentive. Others view it as impolite or an invasion of privacy. Hmong’s consider continuous eye contact rude, and intermittent as acceptable.
- facial expressions -
- body posture - V sign mean victory in some cultures, but offensive in others. Giving a thumbs up means great job in U.S.A., but is not acceptable in the Middle East it is equivalent to the middle finger in the U.S.A. Tapping the index finger on one’s temple may mean someone is smart in the U.S.A. but crazy in the Netherlands.
Developing Self- Awareness
Identify his or own cultural, beliefs, and assumption
1) Awareness - “Am I aware of my biases and prejudices and racism”?
2) Skills - “Do I have the skill to conduct a cultural assessment in a sensitive manner”?
3) Knowledge - “Am I knowledgeable about the worldviews of a diverse cultural and ethnic groups”?
4) Encounter - “Do I seek face-to-face and other type of interactions with people who are different from me”?
5) Desire - “Do I really “want” to become culturally competent”?
