Multiculturalism

Question 1

Goal of Transcultural Nursing

Answer 1

Congruent, sensitive, and competent nursing care

Question 2

Cultural Effectiveness

Answer 2

• Involves a partnership between the healthcare provider and the client
• Essential to the accurate assessment of client health status, needs and goals
• Linked to good health outcomes
• Cultural sensitivity and cultural competence

Question 3

Cultural Sensitvity

Answer 3

• Tool for increasing nursing efficiency to provide care in spite of cultural barriers
• Control orientation
• Emphasizes understanding, respect, personal growth and communication
• Knowing the total patient, through cultural assessment & communication & the delivery of care respectfully and accepting

17

Question 4

Cultural Competence

Answer 4

• The ability to apply knowledge, attitudes, and skills that enhance cross-cultural communication and foster meaningful, respectful interactions with others
• A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency or those professionals to work effectively in cross-cultural situations.
• The ability to effectively serve culturally diverse population.
• Cultural competence VERSUS cultural awareness and cultural sensitivity

Question 5

Nursing Responsibilities

Answer 5

Cultural assessment: understanding personal beliefs and values of nurse and client

Cultural knowledge: learning about health beliefs and values of the client

Verbal/non-verbal communication: between nurse and client

Partnership: among client, healthcare providers, and funding agencies (the

Question 6

Assessment: Communication

Answer 6

Questions:

• What languages do you speak at home?
• What languages are you most comfortable speaking?
• In what language can you read and write?
• How do you want us to talk to you?
• How do we address you? What should we call you?
• What kinds of communication offend or upset you?
• What words would you use to describe how you feel?
• Do you need an interpreter?

Question 7

Assessment Space

Answer 7

Personal Space

• Varies across cultures
• Physical assessment and personal care
• Ask permission before touching, observing, or responding to client’s level of comfort.
• Ask for preferred alternative
• Look at body movements
• Perception of space (e.g. staying very close to their ill loved ones)
• ​Intimate zone
• Personal distance
• Social distance
• Public distance

Physical or Environmental Space

• Proximity to others (where do other members of family live?)
• Living space (e.g. 3rdfloor 2-bedroom apartment)
• Look at home arrangements (e.g. pictures, religious artifacts, etc.)

Question 8

Social Organization

Answer 8

Family Unit

• Nuclear families versus extended families
• Social hierarchy linked to age, gender, level of education and position.
• Role expectations (family roles, relationships, and function)

Social Group Organization

• May also include: work, leisure, religion (worship), friends.

Questions

• Who lives with you?
• Whom do you consider members of your family?
• Where do you live?
• Who makes the decision for you or your family?
• Whom do you go to outside of your family for support?

Question 9

TIme

Answer 9

• For some cultures, it is more important to attend to a social role than to arrive on time for an appointment with a healthcare professional.
• Time orientation: Some cultures are future oriented; others are past or present oriented
• Difference in time orientation may become important in healthcare measures such as long-term planning/explanations of medication schedules.

Question 10

Biological Variation

Answer 10

• Medications
• Dermatological variations
• Disease occurrence and susceptibility
• Pain
• Diet

Question 11

Factors in assessing

Answer 11

• Perception of health and illness
• Use of traditional remedies & practitioners
• Perception of nurses and hospitals: Since you came to this country, have you had contact with doctors or hospitals?
• Perception of care in hospitals
• Role of the family:

1. Determine who should be involved in communication and decision-making
2. Individualistic versus collectivist
3. Who provides care when patient is in hospital?
   * Emotional support: Need to assess the emotional climate of the family and look at how best to give emotional support to the individual and the members of the family.

Question 12

Working in diverse teams positive and negative

Answer 12

Positive

• Creates opportunities for cultural encounters and interactions
• Can generate a greater variety of ideas

_Negative _

• Work force diversity does not necessarily result in cultural competence
• Racially and ethnically mixed groups experience more conflict and miscommunication
• Cultural misunderstandings can lead to tension within the work team, miscommunication, and wrongful assumptions
• Ethics
• Trust

Minimized through

• Respect
• Empathy
• Learning from difference

Question 13

Nursing Diagnosis

Answer 13

• Impaired verbal communication r/t foreign language barrier.
• Social isolation r/t recent move away from neighborhood and friends of same ethnic group.
• Spiritual distress r/t inability to take part in significant culturally based rituals regularly.
• Powerlessness r/t inability to make HC providers understand importance of dietary and social values and beliefs.