Test 3 - Culture Flashcards
2 emerging majority groups…
younger with lower median wages
higher proportions under 18 years old
new immigrants have minimal understanding of…
modern health care delivery system
modern medical practices and interventions
English language
unfair or avoidable health differences affect people who experience…
social, economic disadvantage
National Standards for Culturally and Linguistically Appropriate Services in Healthcare (CLAS)…
15 standards designed to improve the quality of care and eliminate health disparities
first standard of CLAS…
health care organizations should ensure patients receive effective, understandable, and effective care that is provided in manner compatible with their cultural health beliefs and practices and preferred language
Effective Care defined…
positive outcomes and satisfaction for patients
Respectful Care defined…
considers values, preferences, and expressed needs of patient
Cultural and Linguistic Competence defined…
congruent behaviors, attitudes, and policies that come together in a system among professionals that enables work in cross-cultural situations
Culturally Sensitive defined…
Possessing basic knowledge of and constructive attitudes toward diverse cultural populations
Culturally Appropriate defined…
Applying underlying background knowledge necessary to provide the best possible health care
Culturally Competent defined…
Understanding and attending to total context of patient’s situation including the following:
- immigration status
- stress and social factors
- cultural similarities and differences
Culture defined…
thoughts, communications, actions, beliefs, values, and institutions of racial, ethnic, religious, or social groups
4 Characteristics of Culture (LSAD)…
- Learned from birth
- Shared by members of the same cultural group
- Adapted to specific conditions
- Dynamic and ever changing
7 Cultural Competency Questions…
- who are you meeting for the first time?
- where does the patient come from?
- what is their heritage?
- what is their cultural background: ethnicity and religion?
- Does the patient understand, speak, and read English?
- What language do they speak?
- what are their health and illness beliefs and practices?
Race defined…
self ID, a social construct referring to a group with similar physical traits
Ethnicity defined…
self ID, a social group with shared traits…may have common geographic origin, language, and traditions
Acculturation defined…
process of adopting the culture and behavior of the majority culture
Acculturative Stress defined…
losses and changes associated with integration of new beliefs
Religion and Spirituality defined…
organized system of beliefs versus individual’s unique experience
Ethnicity descriptions…
- common geographic origin
- migratory status
- religion
- race
- language
- shared values, traditions, or symbols
- food preferences
Socialization defined…
process of being raised within a culture and acquiring characteristics of that group
Assimilation defined…
process of developing a new cultural identity and becoming like members of dominant culture
Biculturalism defined…
dual pattern of identification and often of divided loyalty
how does culture affect choices of parents regarding medical decisions for their children…
- presumed cause of illness
- first treatment tried
- acceptability of treatments offered by clinicians
for older patients, culture is likely to do the following…
- define family responsibilities
- affect their view and knowledge of health care systems used by dominant culture
Religion defined…
- belief in divine or superhuman power or powers to be obeyed and worshiped as creator/ruler of the universe
- system of beliefs, practices, and ethical values
- shared experience of spirituality
spiritual well-being correlates with:
- less loneliness
- hardiness and hope
- less symptom distress
- enhanced coping and improved quality of life
5 steps to Cultural Competence…
- understand one’s own heritage-based beliefs, values, attitudes, and practices
- identify meaning of “health” to patient
- understand how health care system works
- acquire knowledge about social backgrounds of patients
- become familiar with languages, interpretive services, and community resources available to nurses and patients
Title VI Civil Rights Act of 1964…
requires compliance of all agencies receiving federal assistance such as Medicare/Medicaid funds
risks of patients with Limited English Proficiency (LEP)…
at risk for poorer health outcomes due to barrier of language present during health care delivery interactions
5 Social Determinants of Health (SDOH)…
- Social and community contect
- Education
- Economic stability
- Neighborhood and built environment
- Health and healthcare
4 Components of Spiritual Assessment…
- faith of beliefs: “what is your faith or belief?”
- importance and influence: “is it important in your life?”
- community: “are you part of a religious community?”
- address: “how would you like me to address this in your care?”
Spirituality Assessment: RCOPE…
- guides practitioners to understand the patient’s religious coping mechanisms
- examines if the patient uses positive or negative religious coping
- 4 (or more) questions, patient rates how often this is applied to them on a scale of 1 to 4
RCOPE assessing positive religious coping…
- looked for a stronger connection with God
- sought God’s love and care
- sought help from God in letting go of anger
- tried to coordinate my plans with God
- tried to see how God might be trying to strengthen me in this situation
- asked forgiveness for sins
- focused on religion to stop worrying about problems
RCOPE assessing negative religious coping…
- wondered if God has abandoned me
- felt punished by God for my lack of devotion
- wondered what I did for God to punish me
- questioned God’s love for me
- wondered whether my church had abandoned me
- decided the devil made this happen
- questioned the power of God
health-related behaviors affected by religion…
- meditating, exercise and physical fitness, sleep habits
- truthfulness about how patient feels
- hoping for recovery, and coping with stress
- caring for children and living with a disbaility
Health defined…
balance of a person is a complex, interrelated phenomenon
- within one’s being: physical, mental, spiritual
- in outside world: natural, communal, metaphysical
Illness defined…
loss of a person’s balance, either within one’s being or in outside world
Biomedical health-related belief and practice…
scientific theory of microorganisms such as bacteria and viruses as the source of illness and disease
Naturalistic health-related belief and practice…
human life is just one aspect of nature…forces of nature must be kept in a natural balance or harmony
Magicoreligious health-related belief and practice…
fate depends on supernatural forces for good and evil
Differing views of Epilepsy…
- Uganda: contagious, untreatable
- Greece: source of family shame
- Mexican-American community: evidence of physical imbalance
- Hutterites: evidence of having endured trial by God
Traditional Folk Healers and Treatments…
- Hispanic: curandero, espritualista, yerbo, sabedor
- Black: hougan, spiritualist, old lady
- American Indian: shaman, medicine woman/man
- Asian: herbalist, acupuncturist, bone setters
- Amish: braucher
Transcultural Expression of Pain…
- expectations, manifestations, and management of pain are all embedded in a cultural context
- pain has been found to be a highly personal experience depending on cultural learning, the meaning of the situation, and other factors unique to the person
- silent suffering has been identified as one of the most valued responses to pain by health care professionals
first effort at treatment…
often self-care
home treatment is attractive for…
accessibility, especially people from rural or sparsely populated areas
home treatment may do what…
mobilize person’s social support network and provide a caring environment in which to convalesce
Culture and Respect…
- must know heritage of yourself and patient
- examine patient within cultural context
- use simple questions and speak slowly
- pace the questioning throughout the exam
- encourage patient to discuss meaning of health and illness with you
- check patient’s understanding and acceptance of recommendations
- touch patient within boundaries of their heritage
Ethnocentrism defined…
the tendency to view your own way of life as the most desirable, acceptable, or best
3 reasons why all this matters…
- nursing requires interpersonal skills
- many assessment findings vary depending on a person’s cultural or racial background
- it is how we would want to be treated
5 non-verbal behaviors…
- eye contact
- facial expression
- gestures
- touch
- personal space
remember, we always start with understanding of…
our own beliefs, values, heritage
