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Week 13 - Cultural Considerations in Health Promotion and Disease Prevention
Terms in this set (41)
NCLEX Content on Cultural Diversity
Assess importance of client culture/ethnicity when planning/providing/evaluating care
Incorporate client cultural practice and beliefs when planning and providing care*
Respect cultural background/practices of the client (does not include dietary preferences)
Recognize cultural issues that may impact client/family/significant others
understanding/acceptance of psychiatric diagnosis
Identify clients who do not understand English
Document how client language needs were met
Use appropriate interpreters to assist in achieving client/family/significant others' understanding
Why is an understanding of cultural diversity essential to culturally sensitive health promotion and disease prevention strategies?
Definitions of culture
Assess importance of client culture/ethnicity when planning/providing/evaluating care
Respect cultural background/practices of the client
Think Cultural Health - CLAS & the CLAS Standards
CLAS & CLAS Standards
The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards) are intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services. Adoption of these Standards will help advance better health and health care in the United States.
"It is much more important to know what sort of a patient has a disease, than what sort of disease a patient has"
Impetus for teaching Cultural Competence
Nurse -Anthropologist (1960)
Coined term "Transcultural Nursing"
Founder, Transcultural Nursing Society
Wrote book on subject (1978)
Office of Minority Health (1986)
-National Standards (in Health Care) (2000)
IOM: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (2002)
A Global Village of 1000 People
95 East/West Europeans
84 Latin Americans
52 North America
210 Other Religions
165 speak Mandarin
86 speak English
83 speak Hindi/Urdu
65 speak Spanish
58 Speak Russian
200 75% of income
200 2% of income
80 live in substandard housing
10 deaths annually
3 from malnutrition
Of 670 adults-50% illiterate
330 children-50% immunized
60 over 65
70 own 1 or more autos
33% no access to clean water
1 is HIV positive
50% of women have access to contraception
100 control WMD
You are Here - Connecticut
DEMOGRAPHICS (2012) compared to Nation
WHITE, Non-Hispanic-70.3% (63)
AFRICAN AMERICAN-11.2 (13.1)
ASIAN 4.2% (5.1)
NATIVE AMERICAN/ALASKAN NATIVE .5% (1.2%)
PACIFIC ISLANDER 0.1% (0.2%)
Culture, Values, and Value Orientation
Shared patterns of values/behaviors—shaped by cultural group
Unique beliefs about what is valued
Guides decisions and behavior
Learned by socialization by group
Reflect overall beliefs of that group
Components of Culture
Place of Residency
Health Beliefs and Practices
Also called Cultural Plurality
variety of cultural patterns within designated geographic area
100 different ethnic groups in the US (2000)
Sub-cultures and micro-cultures
-special customs that affect everyday life
Bond or Kinship shared by people from the same country
-Do not have to be born there
Sense of collective identity
Sharing of: Customs, Food, Dress, Language
Minority Group: People who receive disproportionately:
Less Social Status
Racism - discrimination
directed toward individuals who are misperceived to be inferior due to biologic differences.
expectation that all people within same racial, ethnic, or cultural group act alike and share same beliefs and attitudes.
Effects of Labeling and Stereotyping
own culture is superior to all others.
rules, modes, and ideals of one group are imposed on another group.
believe that one way of doing things is right
judge others' methods as inferior, ignorant, or irrational
developmental progression along a continuum
Individuals from minority group:
-absorbed by dominant culture, take on its characteristics
-Years in the US
process of learning norms, beliefs, and behavioral expectations of a group.
"Hybridization" - Not single continuum
Development of a new cultural identity
Cultural Nursing Care
Goes beyond cultural boundaries
Considers Client's Culture related to:
Understanding of health and illlness
Knowledge of other cultures
Applies knowledge to care delivery
Understands and addresses entire cultural context of each client
Developing Cultural Competence
Observe without Judgment
Train Self to Empathize
Share what you have learned
Be Alert to Discomfort caused by Cultural Differences
Techniques - Culturally Congruent Care
Preservation-Build on Strengths
Accomodation-Adjusting health care practices to meet cultural practices of client
Repatterning-Assistance with Reordering, Change or Modify significantly
REFRAMING-Seeing the issue from different perspective
CULTURAL HUMILITY-Patient-focused Interviewing fosters self awareness and respect
Pros and Cons
-Client is Expert
Eg., African Americans & Black Immigrants
12% of our total population
28% of whom are below poverty level
Common health problems
-Shorter life expectancy
-Heart disease higher in black women
-Strokes are significantly higher (mortality)
-40% of this population has HTN
General cultural patterns or lifestyle: "typical day"
Norms-cultural standard or rule that guides behavior
Expressions-Verbal, non-verbal; tangible/not
Taboos, Myths, Superstitions
Life-caring rituals and rites of passage
Cross-Cultural Interview Question
What do you call the illness?
What do you think has caused the illness?
Why do you think the illness started when it did?
What problems do you think the illness causes?
How does it work?
How severe is the illness?
Will it have a long or short course?
What kind of treatment do you think is necessary?
What are the most important results you hope to receive from this treatment?
What are the main problems the illness has caused you?
What do you fear most about the illness?
Cultural Health Systems
Overlapping and Simultaneously Used
Individual, Friends, Family
Where most wellness care occurs
FOLK HEALTH Sector
Unlicensed, non-professional specialist in a local community
PROFESSIONAL HEALTH Sector
Examples of "hot" diseases or states are pregnancy, hypertension, diabetes, acid indigestion, susto, ojo and bìlis.
Some "cold" disease examples are menstrual cramps, frio de la matriz, coryza, pneumonia, empacho, and colic
Examples: Folk Health Practices
Pregnancy, birth, and postpartum period
Infants and small children
Folk Healing vs. Professional Care
70% to 90% population;
Professional health care
remuneration for services
Reflect beliefs, values, treatment of cultural group
A warm cup placed up-side-down on skin to suck out stagnant energy.
A medical practice common in Southeast Asian cultures of alleviating pain by rubbing the body with a heated coin.
Who is in charge and must be consulted for decision making?
Involvement of Authority from same Culture
Issues of Confidentiality
Child Birthing and Rearing
The Birthing Process
Meaning of the Placenta
Breast Feeding Practices
Parenting the Child
Roles and Responsibilities
Death and Dying
Location of Death
Who is Involved: Children's Place
Culturally inappropriate Tools and Tests: Misdiagnosis
Ethnic Differences in Drug Metabolism: Genetically Based
Health care barriers for diverse populations
Lack of insurance
Availability of health care facilities/resources
Complexity of health care system
Fragmentation of care
Incongruent beliefs between patients/providers
Relative Distances/Space maintained and defined during human interactions
-Communication and Interaction in the health care system
Level of understanding
Neurological does not mean Developmental
Use of Translators
Family Members and Children:
-Issues of Embarrassment,
-Unfamiliarity with Medical terms,
YouTube - Body language - Gestures
Professional Health Care Practices superior to any others-like folk or popular ones
Patient/client not comfortable with revealing
Some diagnoses may be culturally biased:
Impaired verbal communication
Impaired social interaction
Disturbed thought processes
Health Care Providers Self Assessment of Culture
taught by family of origin-parents, relatives
taught in education/training for current position in health care
supported by organization in which you work
Dominant Values in the U.S.
Dominant culture = group whose values prevail within a society.
English WASP-dominant culture of the U.S.
-Express opinions openly
-Make eye contact when speaking
Way an individual perceives the world
-Unique to each Individual
Sets with similar terms
HSC 210 quiz 1
Cultural Concepts for Nursing Practice
Community Chapter 3
Culture and Nursing Practice
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