Spirituality and Diversity Flashcards
Texas Administrative Code Title 22 Examing Board Chapter 217.11
Provide without discrimination, nursing services regardless of age, disability, economic status, gender, national origin, race, religion, health problems, or sexual orientation of the client served
ANA Code of Ethics for Nurses
The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
Professional Nursing Pledge
In the full knowledge of the responsibilities I am undertaking, I promise to care for my patients with all the knowledge, skills, and understanding I possess, without regard to race, color, creed, politics, social status…
I will respect, at all times, the dignity and religious beliefs of the patients under my care…
Spirituality
Complex concept that is unique to each individual and is dependent upon a person’s culture, development, life experiences, beliefs, and ideas about life
Spirituality surrounding a person
connectedness
transcendence and self-transcendence
faith and hope
inner strength and peace
meaning and purpose in life
Spiritual Wellness
Awareness of one’s inner self
Connection to a higher being, nature…
Values
Highly individualized
Spiritual Wellness Attributes
Harmony
Purpose
Self Acceptance
Clear values
Positive Outlook
Peace
Balance
Growth
Spiritual Wellness Maintenance
Do I make time for relaxation in my day?
Do I make time for quiet reflection?
Do my values guide my decisions and actions?
Am I accepting of the views of others?
Do I have a source of hope?
Can I offer forgiveness to others?
Spiritual Wellness Effects
Positive effect on health
Enhanced quality of life
Accept hardship and even mortality
Types of Spirituality
Religious and non-religious
Spirituality and Religion
Spirituality is found in all human cultures.
Expressed differently in religious faiths.
Spirituality does not have to include religion.
Being spiritual does not mean practicing religion.
CONGRUENCY
Spirituality and Health
Reduces Stress
Improved health outcomes with chronic conditions.
Helps with pain management
Comfort for the dying and bereaving.
Enhances recovery from illness and surgery
Spirituality and Health decreases
Decreases anxiety, depression, anger, discomfort, and feelings of isolation
Decreases alcohol and drug abuse
Decreases blood pressure and risk of heart disease
Spirituality and Health increases
Increases ability to cope
Increases feeling of hope, optimism, freedom from regret, inner peace and satisfaction with life
Spirituality in healing process
Enhances comfort
Provides inner peace
Helps patients come to terms with disability and death
Spirituality and Relationships
Relationships include - self, family, friends, and loved ones, Consider how you relate to the world around you.
Aspects of Relationships that effect spirituality
Love Hurt
Trust Mistrust
Communication
Reflect: your closest relationship(s)
Let us be grateful to the people who make us happy, they are the charming gardeners who make our souls blossom. ~Marcel ProustProust
You got this!!!!
Congruency
spiritual w/o actions in real time
Despite suffering…..
Feeling connected to others who are suffering
Feeling support love and room in my heart for others
Keep up the fight to endure, pushing beyond limitations
Transform this world into a place of wholeness and mutual support
Is an example of?
Spiritual Wellness
Spiritual Distress
“the state in which the individual experiences or is at risk for experiencing a disturbance in his belief system that is the source of his strength and hope.”
Spiritual Distress Characteristics
Concern with the meaning of life, suffering, and/or death
Concern about the belief system
Anger toward God/religious representatives
No longer participates in religious practices
Concern about his/her relationship with God
Questions meaning of own existence
Feels guilt, shame, remorse
Feels helpless and hopeless
Seeks spiritual assistance
Demonstrates gallows humor
Suffers from sleep disturbances
Alterations in mood or behavior
Spiritual Assessment
Faith/Belief
Life and Self-Responsibility
Connectedness to God or higher power and others
Life Satisfaction
Culture
Fellowship and Community
Ritual and Practice
Vocation
Nursing Care
Nurse-Patient Relationship
Compassionate Presence
Active listening to fears, hopes, dreams, and pain
Respect
Freedom of choice
No judgment
Use of support systems
Diet
Prayer/meditation
Nursing Actions
Offer to contact the pastoral care department
Plan activities to promote the healing of body, mind, and spirit
Offer to teach relaxation, guided imagery, and meditation technique
Religion
organized beliefs and worship “state of doing”
Agnostic
a person who believes that nothing is known or can be known of the existence or nature of God or of anything beyond material phenomena; a person who claims neither faith nor disbelief in God.
Atheist
a person who disbelieves or lacks belief in the existence of God or gods and an ultimate reality
Roman Catholicism
May desire Eucharist or mass daily
Sacrament of the Anointing of the Sick
Last Rites
Baptism of infants if prognosis is grave
Praying the Rosary
Meat-free diet on Fridays during lent
Birth Control may be prohibited
Confession
Mormonism/ Church of Latter Day Saints
Joseph Smith – prophet
Healthful living (no tea, alcohol, coffee or tobacco).
Believe in Jesus
Forgiveness of sins
Baptism for the newborn
Last rites
Communion
Jehovah’s Witness
Do not celebrate birthdays or holidays.
Refusal of blood products/no blood in food
Does not believe in an immediate afterlife
Jehovah is God – there is no trinity
Mennonites
Christian
Pacifism
Many speak low German and/or Spanish
Modest apparel for women
Caps indicate submission and headship order
God > man > woman
Islam (Muslim)
May engage in prayer three to five times a day facing Mecca.
Face, hands, and feet are washed before prayer
Right hand is used for everything but elimination
No pork or alcohol
Gender concordant care
Modesty
Judaism
Kosher certified foods
Sabbath is from sunset Friday to sunset Saturday
Sabbath may not want to use call light
Cremation is prohibited or highly discouraged
Daily prayers are valued
Circumcisions
Buddhism
No belief in a personal creator/God
Mindfulness and mental clarity
Quiet and peaceful environment.
May be vegetarian
Prefer family to bathe, toilet, feed…
Suffering is a part of life
Karma
Hinduism
Reincarnation
Personal hygiene is important and must be daily
Cremation common on day 2 after death
Right hand for eating, left hand for toileting.
Many are vegetarians
Accept death and illness as part of life
Elders have a strong influence on decision making
Diversity
The unique variations between individuals are informed by genetics and cultural background, refined by experience and personal choice.
Variations of Individuals
Race
Gender
Sexual orientation
Age
Education
Abilities/disabilities
Life Experiences
Geographic
Parental Status
Language
Profession/Occupation
Culture
Learned and shared beliefs involving: Knowledge, behaviors, ideas, attitudes, values, habits, work and lifestyle practices, traditions, languages, symbols, rituals, expression of thoughts and emotions, ceremonies, and practices that are unique to a particular group of people.
Transcultural Nursing
Leininger
comparative study of cultures to understand similarities and differences across human groups.
Cultural Sensitivity
being aware of cultural similarities and differences of others with out assigning them value based on similarities or differences.
Cultural competence
requires acquiring specific knowledge, skills, and attitudes to ensure delivery of culturally congruent care.
Cultural awareness
self-exam of one’s own bias
Cultural knowledge
sound education base about diversity
Cultural skills
gathering information through a cultural assessment and being aware of physical findings that are based on race/ethnicity
Cultural encounters
engage face to face
Cultural desire
want to engage with diverse populations
Cultural Congruent Care
-Demonstrates respect, equity and empathy
-Participates in lifelong learning to understand cultural preferences
-Creates an inventory of one’s own values, beliefs and cultural heritage
-Applies knowledge of variation in health beliefs, practices and communication patterns
-Respects decisions based on age, tradition, belief and family influence
-Promotes equal access to services, tests, interventions, health promotion
-Educates nurse colleagues and other professionals about cultural similarities and differences
-Considers the effects and impact of discrimination…
Bias (unconscious and implicit)
One sidedness, tendency to lean a certain way. Lack of impartiality.
Prejudices
Negative attitudes towards others based on race, gender, sexual orientation…
Ethnocentrism
Believing your way of living is superior to others. Cause of biases and prejudices
Cultural imposition
Use their own values and lifestyles and the absolute guide in dealing with patients.
Cultural Stereotype
All people of a certain racial or ethnic group are alike in certain aspects.
Discrimination
Behavior manifestations of prejudices
Culture and Life Transitions
Pregnancy
Childbirth
Newborn
Grief and Loss
Cultural and Healthcare
How different cultures view the following variables affects health care in significant ways:
What is the patient’s definition of health?
Health Promotion and Protection: how is health achieved and maintained?
Practitioners and Remedies: Who and what can heal a person?
Cultural Assessment
Family structure
Communication patterns
Foods with cultural significance
Time orientation
Space
Control
Cultural Assessment Questions
How do you prefer to be addressed?
Where were you born? Your parents? Your grandparents?
How long have you been in the US
Are you more comfortable reading materials in your native language if other than English?
How are important healthcare decisions made in your family?
Are there certain health care procedures and tests that your culture prohibits?
Ethnicity
A cultural group’s shared identity such as values, language, geographical space, racial characteristics
Race
The grouping of people based on biological similarities and attributes
Diversity Attitude Scale
Celebration = “We need each other.”
Affirmation = “I’ve got something to learn from you.”
Civility = “I respect your rights.”
Tolerance = “You have a right to be here.”
Intolerance = “I’ll work to keep you out”
Improving Your relationships with different kinds of people
Honestly assess your attitudes
Put yourself in perspective with others
Respect differences but don’t overlook similarities
Search for more knowledge
Treat people as individuals rather than stereotyping them
Worldview
Set of assumptions which guides how people perceive the world around them. Viewing the world through a lens which was created throughout our life
Etic
outsider perspective
Emic
insider perspective
Health disparities
A health difference because of a social, economic or environmental disadvantage or part of marginalized groups (people of color, gay, lesbian, bisexual, transgender, physically or mentally challenged and people not college educated)
What are these Examples of?
Black males have a higher incidence of colorectal cancer than white males
American Indian and Alaskan natives have a higher incidence of Diabetes Type 2 than whites.
Health disparities
Stressors and Stress
Physical, emotional or psychological perceived demands that may lead to growth, personal development or a crisis
Stress is the result of an
exposure to a stressor
Fight or Flight Response stimulates what part of CNS
SYMPATHETIC
Parasympathetic
feed, breed, and rest
Selye’s General Adaptation Syndrome
Any event (stressor) that threatens an individual leads to a 3 stage response
Alarm
Resistance
Exhaustion
Consequences of Stress
Highly variable
Type and number of stressors
Anticipated stressor
Perception of stressors
Length of time that stressor occurs
Type of coping mechanism implemented
Resilience of individual/feelings of competence
Previous experiences
State of health
Available resources
Medical History Assessment
General state of health
Illnesses
Surgeries
Medications
Treatments
Use of alcohol, tobacco and/or drugs
Changes in sleep, eating, sexual patterns
Social Assessment
Perception of Threat
Past Coping Patterns
Family dynamics/friends
Work/recreation
Living environment
Financial
General Assessment (observable)
General description and appearance
Behavior
Communication/Speech
Mood, affect and feelings
Judgment/Insight
Physical exam
S/S of Stress Cognitive
Decreased concentration, comprehension, & memory
S/S of Stress Behavioral
Irritability, withdrawal, violence
S/S of Stress Emotional
Fear, anxiety, depression, fatigue
S/S of Stress Physiological
Increased BP, HR, Respirations, etc
Somatic symptoms
Decreased immune response
Coping mechanisms
ways to which external or internal stress is managed, adapted to or acted upon. Susan Folkman and Richard Lazarus define coping as”constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing”
edTeach Coping Skills
Regular Exercise
Support systems
Time management
Guided imagery/visualization
Progressive muscle relaxation
Assertiveness training
Journal Writing
Positive affirmations
Massage
Pets
Prayer/meditation
Music
Singing
Laughter
Aromatherapy
Sleep
Healthy eating
Decrease the use of phones/internet
Organization
B vitamins
Sex
Hugging
