Theoretical Foundations of Community Health Nursing Flashcards
Theory for Community Health Nursing (For CHNs)
- guides practice in situations where rigorous research-based evidence is not available
- theories can support understanding of why things are the way they are
- integrated with theories developed in public health and the social sciences to guide the practice, research, and education of CHNs
- 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.
The problem is Narrow Understanding of Culture
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’
the snapshot problem
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
Visible minority
People of colour; people who are neither Indigenous nor Caucasian
Racially visible
Terminology more commonly used to indicate “visible minority” status. Includes Indigenous people
Diversity
Refers to the uniqueness of the client within the cultural context
Focuses on client assets that build capacity
Two types
- Visible diversity
- Invisible diversity
Types of Diversity
- Ethnic diversity
- Linguistic diversity
- Religious diversity
- Sexuality and gender diversity
- Disability/diverse abilities
Assumptions & Characteristics of Culture
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)
Culture
language, gesture, tools, customs & traditions defining a groups’ values and organize social interactions
Racism
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
CHNs and Culture: CHNs Require
awareness of possible cultural variations among clients
acquire the skills to work comfortably and effectively with persons from diverse cultural groups
Cultural Competence
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
Examples of Cultural Competency
paying attention to:
- dietary practices
- attitudes towards pain
- beliefs about death and dying
- modesty
- eye contact
- closeness and physical contact
Developing cultural competence
- maintain a broad, objective, and open attitude toward individuals and their cultures
- not all individuals are alike
The key attributes of cultural competence
a) cultural awareness
b) cultural knowledge
c) cultural understanding
d) cultural sensitivity
e) cultural interaction
f) cultural skill
Eurocentrism
values, attitudes, or beliefs that are based on or reflect the European frame of mind
Colonialism
acquiring political control over a country or group of people and exploiting them economically
Stereotype
a preconceived idea of a particular group or person
Prejudice
preconceived opinions based on stereotype which results in consistent interconnected ways of thinking and understanding
Racism
discrimination directed at a particular group because of their racial or ethnic identification
Cultural Safety
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
Three premises of cultural safety
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
Cultural awareness: a step towards cultural safety
an initial understanding that variations exist
Cultural sensitivity: a step towards cultural safety
showing respect and valuing cultural diversity
Cultural humility
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
Cultural Nursing Assessment
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.
Applying Cultural Competence to Community Health Nursing: Culturally competent CHNs:
- 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
Cycle of Oppression
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
Toward Anti-Oppression in CHN practice
Seeing -> Understanding and mapping -> Confronting oppression, racism: acting for change
Digital Health
- 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
Population Health and Technology: Technology as Health Promotion and Prevention
Supports community empowerment and capacity building
- interactive website
- social media
- epidemiology monitoring, surveillance
- detect outbreaks, promote disease awareness
