Topic 8 Flashcards
culture
a complex social concept that encompasses inherited and shared beliefs both religious and political beliefs ad practices, habits, customs, language, and rituals
communication styles
include the ethnic identity rituals and language used by a particular group of people
cultural diversity
variations that occur among cultural groups, both with in and across cultures but diversity can also be more broadly defined to encompass differences I have, health, status, gender, sexual orientation. Racial or ethnic identity geographical location brother aspects
why must we understand culture and diversity in healthcare?
culture and diversity shape how people view the world and how the function in the world. it can also determine what is perceived as health vs illness
since the US is very diverse “a mixed salad” what does this mean?
it is a challenge to become culturally competent and hoe nurses incorporate cultural diversity in their care
paternalism
a concept where health care providers believe there know more about what is best fir the clients than the clients themselves
ethnicity
a membership of a person in a particular cultural group.. common racial, geographic, ancestral, religious of historical bonds
ethnocentrism
the belief that ones own culture is superior to another culture
cultural relativism
a concept where each culture is determined to be unique and only judged on it own values, standards, and beliefs
health disparities
can exit where there are margins of society that are undeserved for medical care being given (healthcare may be unavailable or person may not have the awareness)
acculturation
where a person from a different culture learns behaviors and values of the dominant culture and adopts the norms and values including language
cultural competence
a set of cultural behaviors and attitudes integrated into the practice methods of a system, agency, or its professionals that enables them to work effectively in cross cultural situations
what is the theoretical framework revolving around culture?
leningers transcultural nursing
transcultural nursing
emphasizes the commonalities and differences among worldview of diverse health systems
focus on comparative culture care examined through holistic and multidimensional lens
what is the purpose of transcultural nursing
provide culturally congruent, safe, and meaningful care to clients from different or similar cultures
Campinha-Bacote
provided an interactional dynamic model of cultural competence the requires achievement of all five identified constructs
what are Campinha-Bacote’s five identified constructs of cultural competence
cultural awareness
cultural skill
cultural knowledge
cultural encounters
cultural desire
cultural awareness
occurs when nurse is able to examine his or her own values biases and stereotypes. it also requires the nurse to examine the potential cultural biases (racism) that may exist within the health care system
cultural skill
occurs when the nurse can conduct a relevant cultural assessment. Hence it is achieved when cultural data are used to develop and implement a culturally relevant treatment plan
cultural knowledge
occurs when nurses educate themselves about the worldview of other cultures and ethic groups, this cultural knowledge may include learning how disease processes and management may vary depending on the cultural group
cultural encounters
encourage the nurse to engage directly with patient from a different ethnic and cultural backgrounds to modify existing beliefs about a cultural groups and prevent potential stereotyping
cultural desire
addresses the motivation of the health care provider to acquire new knowledge about different cultures (pivotal construct with spirituality at the core)
cultural competence is achieved by addressing what 8 domains?
governance
leadership
workforce
communication
language assistance
engagement
continuous improvement
accountability
US Heath resources services administration
enhanced national culturally and linguistically appropriate services (CLAS) in Health and Health Care standards (US department of Health and Human Services)
values that shape health care and nursing
predominately Eurocentric, middle class, christian, and androcentric (human centered) in view
American culture tends to value personal freedom independence and individual achievement over the common good
“everyone should be treated exactly the same”
“healthcare providers know more”
communication goals
communicate effectively with individuals of other cultures while recognizing your OWN personal culture biases and prejudices
actions to promote multicultural communication
BECOME KNOWLEDGABLE- understanding theory and culturally congruent safe meaningful care
RECOGNIZE BARRIERS- interpersonal communication barriers and language barriers
DEVELOP TECHNIQUES TO FOSTER COMMUNICATION AND UTILIZE RESOURCES
therapeutic communication
MUST BE GOAL ORIENTED HEALTH CARE
occurs as an individual has a specific needs no matter what their cultural lifestyle to religious status and a person who is skilled in techniques that can identify, resolve to satisfy that need
managing diversity
sensitivity to differences and similarities
identity own prejudices and biases
sensitivity to differences and similarities
knowledge in expected behaviors
skill at integrating knowledge and sensitivity
verify own perception
identity own prejudices and biases
self awareness or cultural awareness
intrinsic biases
why do cultural barriers exist?
lack of knowledge
fear & distrust
language
racism, bias, prejudice
ethnocentrism
stereotyping
healthcare rituals
economics
perceptions & expectations
lack of knowledge
health care professionals must understand & take cultural differences into consideration
fear & distrust
be aware of language or dialect unfamiliar surroundings may make patients feel subordinate, confusion
language
use of interpreters
racism, bias, prejudice
implies racial discrimination
slant towards particular belief
judgment before the fact
stereotyping
belief that all people or things with particular characteristics are the same
healthcare rituals
standardized procedures or protocols consider rationale make exceptions as appropriate
economics
poor & under deserved populations, vulnerable populations (immigrants, homeless, mental illness, elderly)
perceptions & expectations
perceptions: becoming aware through senses
expectations: anticipate events based on experience
what are ways to overcome language barriers in the healthcare setting
use of hospital or agency interpreter (during assessment, when consent is needed for procedure, pt. education)
other tools (google translate, translate, Facetime, Skype)
CANNOT USE FAMILY MEMBERS AS INTERPRETERS
“color blind” and other oxymorons
health care disparities
- incidence of HIV & SIDS
- access to health care and poverty
colorblind approach and disparity
- use of hospice services
effective therapeutic communication skills for diverse clients w unique needs
learn about your clients cultural traditions
pay close attention to body language, lack of response or expressions of anxiety may indicate the patient or family is in conflict but hesitant to tell you
remain non-judgemental
follow advice given by patient about appropriate ways to facilitate communication w families and other providers
what are the communication principles
Listen carefully
Explain what the client needs to understand
Acknowledge cultural differences
Recommend what the clients should do (take a shower, but not surgery)
Negotiate mutually agreeable strategies (take meds before or after you eat)
cultural sensitivity and competence
always follow legal and ethical riles of confidentiality (HIPPA)
ask client who is involved in their care (fam members) and decision making
find out what needs are needed for language and interpreters
cultural assessment
desire and strategies to acquire knowledge of a different culture
cultual competence (Campinha Bacote)
cultural competency and sensitivity
hispanic/latino
strong family loyalty
father head of household and primary decision maker
religion: Roman Catholic believe illness id falling out of favor w God
high incidence of diabetes
not uncommon fro these clients to share meds
LOOKING FOR WARMTH RESPECT AND FRIENDLINESS FROM HCP
african american
value “caring for ones own”
women often head of household, backbone, assume responsibility for parents and children
history of oppression , HTN, stroke, diabetes, heart disease
history of suffering from health care disparities especially w lower income groups
TRUST MUST BE ESTABLISHED so that clients will participate in their own treatment
males tend to use recommended preventivce services and suffer more health issues because of it
asian American
very hard working and education is high valued
metal respect and honesty
male with male and female with female nurses
smile in agreement even if hey disagree
religion: hinduism, buddhism, muslim- rituals for prayer, modest, dietary restrictions
use herbal medicines and treatments like accupunctr e
STOIC less likely to request pain meds
DO NOT believing mental health illness, as it brings shame to family and can result in suicide
native american
health practicies are ties into spiritual practices
value nature and earth
blue respect, story telling and humor
direct eye contact is disrespectful
private shoe little to no emotion
will not participate in teaching back
culture of poverty
associated with health disparities
DESERVE SAME RESPECT AS OTHERS
