Theoretical Foundations of Community Health Nursing

Question 1

Theory for Community Health Nursing (For CHNs)

Answer 1

1. guides practice in situations where rigorous research-based evidence is not available
2. theories can support understanding of why things are the way they are
3. integrated with theories developed in public health and the social sciences to guide the practice, research, and education of CHNs
4. Core concepts, patterns of knowing, and different levels of theoretical knowledge in nursing are important foundations for understanding theory and how it can be used.

Question 2

The problem is Narrow Understanding of Culture

Answer 2

A narrow view of culture means that the snapshot excludes a huge backdrop of context
“values, beliefs, knowledge and customs that exist outside of patriarchy, racism, and colonialism” are excluded from the snapshot, which leads to “an understanding that reduces all facets of social life to issues of culture”
Its like missing the fact that the family in the snapshot is standing on the edge of a volcano, and then attributing their drive to run away to ‘culture’

Question 3

the snapshot problem

Answer 3

assumptions about so-called cultural characteristics feed into stereotypes about a groups’ values, beliefs, and lifestyles
- it draws our attention away from the wider social, historical and economical contexts that shape peoples’ lives
- It enables us to overlook the “burden of history”
- Defining attributes of Social Justice

Question 4

Visible minority

Answer 4

People of colour; people who are neither Indigenous nor Caucasian

Question 5

Racially visible

Answer 5

Terminology more commonly used to indicate “visible minority” status. Includes Indigenous people

Question 6

Diversity

Answer 6

Refers to the uniqueness of the client within the cultural context
Focuses on client assets that build capacity
Two types
- Visible diversity
- Invisible diversity

Question 7

Types of Diversity

Answer 7

• Ethnic diversity
• Linguistic diversity
• Religious diversity
• Sexuality and gender diversity
• Disability/diverse abilities

Question 8

Assumptions & Characteristics of Culture

Answer 8

a) Culture is a social construction - norms, behaviour and values are learned through socializing
b) culture is integrated and embedded in everyday life - beliefs and healthcare practices are consistent with overall paradigms used to make sense of the world
c) Culture is shared - beliefs are shared by a group (cultural values) that guide members about what to believe and how to act
d) culture shapes us at an unconscious level
e) culture is fluid and dynamic (always adapting and changing)

Question 9

Culture

Answer 9

language, gesture, tools, customs & traditions defining a groups’ values and organize social interactions

Question 10

Racism

Answer 10

A response to: skin colour, ethnic group or religion
May also occur from other aspects of culture: (cultural celebrations, traditional food, traditional dress)
Two Types
- overt (individual racism) or systemic (institutional) racism

Question 11

CHNs and Culture: CHNs Require

Answer 11

awareness of possible cultural variations among clients
acquire the skills to work comfortably and effectively with persons from diverse cultural groups

Question 12

Cultural Competence

Answer 12

An ongoing process not an outcome
Process of respect, accept, and apply knowledge and skill appropriate to client interactions without allowing their personal beliefs to influence the clients’ differing views

Question 13

Examples of Cultural Competency

Answer 13

paying attention to:
- dietary practices
- attitudes towards pain
- beliefs about death and dying
- modesty
- eye contact
- closeness and physical contact

Question 14

Developing cultural competence

Answer 14

1. maintain a broad, objective, and open attitude toward individuals and their cultures
2. not all individuals are alike

Question 15

The key attributes of cultural competence

Answer 15

a) cultural awareness
b) cultural knowledge
c) cultural understanding
d) cultural sensitivity
e) cultural interaction
f) cultural skill

Question 16

Eurocentrism

Answer 16

values, attitudes, or beliefs that are based on or reflect the European frame of mind

Question 17

Colonialism

Answer 17

acquiring political control over a country or group of people and exploiting them economically

Question 18

Stereotype

Answer 18

a preconceived idea of a particular group or person

Question 19

Prejudice

Answer 19

preconceived opinions based on stereotype which results in consistent interconnected ways of thinking and understanding

Question 20

Racism

Answer 20

discrimination directed at a particular group because of their racial or ethnic identification

Question 21

Cultural Safety

Answer 21

Gaining an understanding of others’ health beliefs and practices so that one’s actions demonstrate working toward equity and the avoidance of discrimination, through recognition of and respect for cultural identitiy, so that a power balance does not exist between the CHN and client

Question 22

Three premises of cultural safety

Answer 22

1) analysis by health professional of his or her cultural self and its influence on client interaction
2) acknowledgement of the power imbalance favouring the health professional, and addressing this so that the client’s cultural environment is safe
3) HCP learning and applying new foundational skills

Question 23

Cultural awareness: a step towards cultural safety

Answer 23

an initial understanding that variations exist

Question 24

Cultural sensitivity: a step towards cultural safety

Answer 24

showing respect and valuing cultural diversity

Question 25

Cultural humility

Answer 25

A commitment to actively taking responsibility for seeking to understand the culture and experiences of others
Being comfortable not being the expert
Knowing one can never fully understand the experience, history, and background of another

Question 26

Cultural Nursing Assessment

Answer 26

A systematic way to identify people’s beliefs, values, meanings, and behaviours, while considering their history, life experiences, and the social and physical context in which they live.
- CHNs must conduct a cultural assessment for all clients when they come into contact with them
- when conducting a cultural assessment, consider: communication, space, social organization, time and environment.

Question 27

Applying Cultural Competence to Community Health Nursing: Culturally competent CHNs:

Answer 27

• use cultural brokering (bridging the difference)
• know if there are specific risk factors for a given cultural population
• understanding that context may adjust one’s culture
• understand client’s healing practices
• are aware of cultural values, beliefs, and practices to guide them in delivering culturally appropriate care

Question 28

Cycle of Oppression

Answer 28

Oppression (discrimination backed up by systemic power) ->
Stereotype (exaggerated beliefs, fixed images) ->
Prejudice (a whole way of thinking based on stereotypes) -> Discrimination (actions of inactions based on prejudice) -> back to oppression

Question 29

Toward Anti-Oppression in CHN practice

Answer 29

Seeing -> Understanding and mapping -> Confronting oppression, racism: acting for change

Question 30

Digital Health

Answer 30

• Internet to access health information
  Limitations: Digital divide -> not equitable access for all users. lack of computers or access
  Strengths: motivation to use resources if: suited to needs, life stage, interaction with others, self-paced

Question 31

Population Health and Technology: Technology as Health Promotion and Prevention

Answer 31

Supports community empowerment and capacity building
- interactive website
- social media
- epidemiology monitoring, surveillance
- detect outbreaks, promote disease awareness