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Community Exam 1 > Culture and Special Populations&Health Literacy > Flashcards

Culture and Special Populations&Health Literacy Flashcards

1
Q

levels of prevention

A

primary
secondary
tertiary

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2
Q

level of prevention that promotes health/intended to prevent disease/injury/disability

A

primary prevention

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3
Q

examples of primary prevention

A

Health education
providing vaccinations
needle exchange programs

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4
Q

level of prevention: Interventions designed to help diagnose conditions early

A

secondary prevention

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5
Q

examples of secondary prevention

A

Health screenings
testing for Covid/strep
self-breast exams/self-testicular exams
blood pressure screening

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6
Q

level of prevention: Interventions aimed at limiting disability of a condition

A

tertiary prevention

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7
Q

examples of tertiary prevention

A

Medications treating HTN
dialysis
physical or mental health rehabilitation/treatment

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8
Q

A combination of culturally congruent behaviors, practice attitudes, and polices that allow nurses to work effectively in cross-cultural situations

A

cultural competence

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9
Q

why should we strive for cultural competence

A

The nurse’s culture often differs from that of the client, leading to different understandings of communication, behaviors, and plans for care

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10
Q

Nonculturally competent/insensitive care can:

A

increase the cost of health care
and, most importantly, can negatively affect client health outcomes.

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11
Q

barriers to being culturally competent

A

Bias (prejudice/discrimination) and implicit bias
cultural conflict
cultural blindness

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12
Q

guidelines for providing culturally competent care

A
  1. Critical self-reflection …always… check your own inner responses/feelings. Assess yourself first
  2. Knowledge of cultures – talk to others – ask directly if there is anything related to their culture (even of the patient/client appears to be in the country’s mainstream culture)
  3. Education and training in culturally competent care
  4. Cross-cultural communication – adapting where you can
  5. Patient advocacy and empowerment -
  6. Evidence-based practice and research -
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13
Q

a set of beliefs, values, and assumptions about life that are widely held among a group of people and that are transmitted across generations

A

culture

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14
Q

a biological designation whereby group members share features (e.g., skin color, bone structure, genetic traits such as blood groupings)

A

race

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15
Q

shared feeling of peoplehood among a group of individuals

A

ethnicity

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16
Q

Refers to the degree of variation that is represented among populations based on lifestyle, ethnicity, race, interest, across place, and place of origin across time

Also includes the awareness of the presence of differences among the members of a social group or unit

A

cultural diversity

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17
Q

Although all cultures are not the same, all cultures have the same basic organizing factors:

A

Communication (verbal and nonverbal)
Space
Social organization
Time perception
Environmental control
Biological variations
Nutrition
***Also may have varying health practices

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18
Q

not a citizen but allowed to both live and work in the United States also known as lawful permanent residents

A

legal immigrant

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19
Q

admitted outside the usual quota restrictions based on fear of persecution due to their race, religion, nationality, social group, or political views

A

refugees

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20
Q

admitted to the United States for a limited duration and specific purpose (i.e., students, tourists), DACA

A

nonimmigrants

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21
Q

may have crossed the border illegally or legal permission expired; eligible only for emergency medical services

A

unauthorized immigrant

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22
Q

how many immigrants living in the US

A

44.7 million

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23
Q

appr how many immigrants are uninsured

A

1/3

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24
Q

poor health outcome factors for immigrants:

A

-Fear of immigration reinforcement often prevents seeking healthcare
-Live in low-income and segregated neighborhoods
-Work in low-wage occupations
-Unsafe working situations (i.e. exposure to toxic chemicals)

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25
factors to consider for providing health care for immigrants
Financial constraints (uninsured) Language barriers Differences in social, religious, and cultural backgrounds between the immigrant and the health care provider Providers’ lack of knowledge about high-risk diseases in the specific immigrant groups for whom they care Traditional healing or folk health care practices that may be unfamiliar to their US health care providers When working with immigrant populations, consider how your own background, beliefs, and knowledge may be significantly different from those of the people receiving care.
26
skills when working with immigrant populations
1. Self-awareness…assess yourself 2. Identify the client’s preferred or native language. 3. Learn the health-seeking behaviors for your immigrant client and their family members. 4. Get to know the community where the immigrant client lives. Read about the culture of your clients. 5. Get to know some of the traditional practices and remedies used by families and communities. 6. Learn how cultural subgroups explain common illnesses or events. 7. Try to see things from the viewpoint of the client, family, and community and accommodate rather than squash the client's view. 8. Conduct a cultural assessment focusing on what is working, what is not working, and changes that need to be made to accommodate cultural norms and promote positive health behaviors.
27
fewer years of formal education leads to:
lack of health literacy
28
rural health characteristics and health care for immigrants
Less likely to engage in preventive behavior More likely to smoke and report higher rates of alcohol use and obesity Tend to be working poor/not have insurance – delay care Difficulty accessing care due to transportation – no public transportation Cultural and social norms about health behaviors, lack of privacy (everybody knows everybody else’s business)
29
problems for health providers to give care
May live and practice in a particular community for decades May provide care to people who live in several counties Small staff to service large area Limited public health budgets and fewer staff
30
Rural Women’s Health Including Maternal and Infant/Child Health
Higher infant and maternal morbidity rates May have higher proportion of racial minorities near the town/city center and fewer specialists Extreme variations in pregnancy outcomes Children are more likely to work on farms (risk of injury)
31
particularly at risk are women who:
Live on or near Native Indian reservations Are migrant workers Are of African American descent
32
impacts of Covid in rural america
-Appears that rural Americans are more vulnerable to the pandemic than urban Americans due to the proportion of elderly persons, higher smoking rates, and prevalence of certain chronic diseases -Lack of healthcare professionals, nearly half of rural hospitals operate in a financial deficit and many had to close, lay-off or temporarily furlough staff. -Many farmworkers fear testing for COVID since a positive test might mean a permanent job loss.
33
occupational and environmental health problems in rural areas
lack of OSHA regulation for farming and ranching Common injuries/lack of training Common health issues for farmworkers Pesticide exposure Migrant farmworkers may not be informed of exposure risk, no workman’s compensation Symptoms of pesticide poisoning Heat stress/ heat exhaustion Lack of education related to the risks of the work
34
rural health care delivery issues and barriers to care
Lack of health care providers and services and great distances to obtain services Lack of personal transportation Unavailable public transportation or outreach services Unpredictable weather or travel conditions Inability to pay for care or lack of health care insurance Lack of know-how to procure publicly funded entitlements and services (health literacy issue) Inadequate provider attitudes and understanding about rural populations Language barriers (caregivers are not linguistically competent) Care and services not culturally and linguistically appropriate
35
Travels to do farm work; unable to return to permanent residence within the same day
migrant farmworker
36
Returns to permanent residence each day; works in farming at least 25 days or part-days per year; but does not work year-round in agriculture
seasonal farmworker
37
reasons why migrants may have lack of health care
Lack of knowledge about services Inability to afford care Affordable Care Act or health insurance subsidies Availability of services Transportation Hours of service Mobility and tracking Language barriers Discrimination Documentation Cultural aspects Children of migrant workers Dental disease Substance use Incidence of TB Incidence of HIV/AIDS Prevalence of diabetes Depression Anxiety-related disorders Domestic violence Children of migrant workers
38
high risk groups/ vulnerable populations
Poor, Homeless, Pregnant Teens, and Mentally Ill, LGBTQ+
39
what we need to consider with high at-risk groups/vulnerable populations
Identify health care needs, barriers to care, and essential health care services for each of these groups (all very similar issues related to access and ability to obtain proper care).
40
where to find federal income poverty guidelines
Temporary Assistance to Needy Families (TANF) Supplemental Nutrition Assistance Program (SNAP) Women, Infants, and Children (WIC) Head Start
41
effects of poverty across life span
Higher rates of chronic illness/more complex Higher infant morbidity and mortality Shorter life expectancy More significant complications and physical limitations resulting from chronic disease Hospitalization rates three times more than for persons with higher incomes
42
Lack of a fixed, regular, and adequate nighttime residence
homeless
43
types of homelessness
Chronic homelessness, transitional, and episodic, couch surfing (staying at someone’s house for short periods of time) Living in car Youth kicked out of their home (High population of LGBTQ+)
44
health risk for those experiencing homeslessness
Hypothermia and heat-related illnesses Communicable diseases Trauma Mental illness Use and abuse of tobacco, alcohol, and illicit drugs Barriers to getting adequate health care, including dental care Sexual trauma, prostitution or “survival sex” and unintended pregnancy
45
high risk populations dealing with homelessness
Pregnant women - Children Adolescents Older adults Veterans -women especially report military sexual trauma
46
Focus on moving people with mental health conditions out into the community, but resources were not in place => spike (that continues) in homeless population which includes people with mental health conditions or are cognitively limited
deinstitutionalization
47
at risk populations for mental health conditions
Children and adolescents (especially the LGBTQ+ population) Veterans Adults with serious mental illness Older adults People from other cultures/isolation
48
role of the nurse with homelessness
Create a trusting environment. Show respect, compassion, and concern. Avoid making assumptions. Advocate for accessible health care services/care coordination Focus on prevention/reduction of harm Develop a network of support for yourself.
49
Introduction to care of clients who abuse substances and experience Addiction*
Leading national health problem Causes more deaths, illnesses, and disabilities than any other health condition Substance abuse and addiction affect all ages, races, sexes, and segments of society. Affects the loved ones of the person
50
primary preventions of abuse of substances and addiction
Promotion of healthy lifestyles and resiliency factors -Assisting clients to achieve optimal health -Teaching assertiveness and decision-making skills -Teaching stress reduction and relaxation techniques Drug education -Teaching that no drug is completely safe and that any drug can be abused -Helping persons learn how to make informed decisions about their drug use to minimize potential harm
51
nurses role for drug addiction
Knowledge of community resources and how to mobilize them. Nurses are in ideal roles to assist with tertiary prevention for both the addicted person and the family.
52
community care of those experiencing violence
Violence is a pervasive public health, social, and developmental threat. It is leading cause of death and disability that disproportionally affects youth, low-income populations, and people of color. Significant mortality and morbidity result from violence
53
Step-by-step approach that is applicable to any community Public Health Approach to Violence Prevention
1. Identify the problem: Collect data to determine the “who”, “what”, where”, ‘when,’ and “how”. This is an epidemiological approach. 2. Identify the risk factors. Why do one person or one community experience violence, and another does not? 3. Develop and test prevention strategies and share this information with others. 4. Disseminate and implement the strategies in step 3.
54
types of fmaily violence
Intimate partner abuse Signs of abuse Abuse as a process Abuse of older Adults – by family or other carers, including extended care facilities
55
nursing interventions for family violence
Box 27.2: Assessing risk factors for violence in a community context Box 27.3: Prevention strategies for violence Box 27.4: Common Community Agencies/Services Human Trafficking Resources
56
“The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”
health literacy
57
Those most at risk of low health literacy:
Older adults (>65)/cognitive issues Minority populations, substantial part is r/t clinician (structural racism) issues/implicit bias English not the primary/first language Low socioeconomic status – why?
58
principles of health literacy
Use of plain language Focus on the most important concepts Reader friendly material Rate of concept presentation
59
Health Literacy – change in focus at CDC
Emphasize people’s ability to use health information rather than just understand it Focus on the ability to make “well-informed” decisions rather than “appropriate” ones Acknowledge that organizations have a responsibility to address health literacy Incorporate a public health perspective – recognizes that health literacy is connected to health equity
60
main components of teach back method
Caring tone of voice and attitude – non-shaming Comfortable body language/eye contact Plain language - Asking patient to explain back in own words Non-shaming, open-ended questions Avoiding yes or no questions Taking responsibility for explaining clearly Explaining again and re-checking for understanding Reader-friendly materials to support teaching Documenting use of teach-back
61
if the patient cannot teach back after several times:
Include a family member (on the phone/Face Time if not present) Record the information for the patient Ask another member of the healthcare team to explain the information

Community Exam 1 (4 decks)

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