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Exam 6

Terms in this set (50)

Culture
Belief, value, tradition or behavior handed down from generations. Apparent in attitudes and institutions. Defined roles.
Subculture
A large group of people from a cultural group that have certain ethnic, occupational or physical characteristics not in common to the larger (cultural) group
Dominant group (largest group)
Most authority to control values and sanctions of society
Minority group (smaller group)
Physical or cultural characteristic that identifies this group as different from dominant group. They feel discriminated against (race, religion, etc).
Cultural assimilation
Process where a minority group lose their cultural characteristics that distinguished them differently from the dominant group. They end up blending
Culture shock (dramatic difference)
What a person feels when placed in a different culture. May result in discomfort or disturbance
Cultural imposition (ISIS)
Impose that everyone must conform to the majority of their belief system
Cultural blindness
Ignores differences and acts like it never existed (Ex: treat all people the same)
Ethnicity
Sense of identification based on common heritage can belong by birth or adoption (they like it). Used in day-to-day life with family and friends that share the same unique cultural and social beliefs and behavioral patterns (Ex: Food, behaviors etc)
Race
Based on specific characteristics (skin pigmentation, hair texture, facial features, body stature). 6 major categories A) American Indian B) Asian C) black D) Native Hawaiian E) white F) Hispanic
stereotyping
the assumption that all members of a culture or ethnic group act alike. May be positive or negative (Ex of negative are racism, ageism & sexism)
culture conflict
people become aware of differences and feel threatened (ISIS feels threatened by Christians). Response: ridiculing beliefs and traditions of others to make themselves feel more secure.
ethnocentrism
belief that one's ideas, beliefs and practice are the best or superior , or are the most perferred to those of others (EX: Hitler said all Jews are bad, pig valve transplant on a Jewish person is a NO NO)
Cultural competence
Having the desire to learn of the sensitivities of the needs for individuals, families and groups from diverse populations within society. There are three we need to know and those are cultural awareness, cultural knowledge, and cultural skills\sensitivity
Cultural awareness
Being aware of our own values and beliefs, not pushing on to others
-cultural humility
-commitment to self-examination and critique
-commitment to finding greatness in others
-not thinking less of yourself, think of yourself less
-identify projection issues (don't project what they're going to think or behave)
-recognizing the clients need for variances in care
Cultural knowledge
Accepting and respecting cultural differences
-gathering in maintaining current information of: various worldviews, biological variations of cultural groups, pharmacological variations of cultural groups, bio cultural ecology and ethnic pharmacology (may use certain foods or herbs for healing)
Cultural skills\sensitivity
Putting knowledge into action (learning how to serve others better)
-ability to collect culturally relevant data about the clients health history and presenting problem
-ability to perform a culturally based physical assessment
-all in a therapeutic manner!
-don't stereotype - ask! (Ask questions)
Cultural influences on healthcare
Physiologic variations
Reactions to pain
Mental health
Gender roles
Language and communication
Orientation to space and time
Food and nutrition
Family support
Socio economic factors
Elements of cultural competence
-Developing self awareness
-Demonstrating knowledge and understanding of a patient's culture
-accepting and respecting cultural differences
-not assuming that the healthcare providers beliefs and values are the same as the clients
-resisting judgmental attitude such as "different is not as good"
-being open to and comfortable with cultural encounters
-accepting responsibility for one's own cultural competency (my responsibility to know their culture)
Factors that affect culturally diverse interactions
-cultural background of each patient (nurse and patient)
-expectations and beliefs of each person and healthcare
-cultural context of the encounter (why am I seeing the patient? What do I hope to accomplish?)
-degree of agreement between the sets of beliefs and values of the two persons (can we reach a halfway point?)
Guidelines for providing culturally competent nursing care
-develop cultural self awareness
-develop cultural knowledge
-accommodate cultural practices in healthcare
- respect culturally based family roles
-avoid mandating change
-seek cultural assistance
Cultural assessment/areas nurses need to understand
-beliefs, values, traditions and practices of a culture
-culturally defined, health related needs of individuals, families, and communities
-culturally based belief systems of the etiology of illness and disease in those related to health and healing
-attitudes toward seeking help from healthcare providers
African Amerian (SAW)
-Silence indicates lack of trust
-Western medicine, use of folk remedies
- hypertension, sickle cell, keloids, lactose intolerance, stroke
-personal space 1-2 feet
- black dialect
-clergy is held high, church is important, prayer for healing
-mental illness is a spiritual imbalance or punishment for sin
-strong family support
-talk loudly, handshake for greeting
Northern European Americans (BEANS)
-blonde hair, blue eyes
-personal space 18"-3feet
-stroke
-time oriented
-education valued
-take good care of their health
-strong work ethic
-like to get into arguements or battles (value confrontation)
Native Americans (I Phlegm)
AKA indians
-slow communicantion
-private and quiet
-harmony of environment
-little concern over time
-view eye contact as aggressive
-mental illness s due to ghosts
-medicine bag is carried with them and is to not be removed
Arab Americans (FAMS)
-all about family
-male dominate (it goes in order such as father, eldest son, uncle, husband as spokesperson etc)
-mental illness has stigma and will only seek out treatment if all other remedies fail
Latino Americans (TLC)
-touchy touchy
-curandero(a) (herbs, prayer, magic)
-family is important
-male dominated
-present time oriented
cubans (CODE)
-outgoing
-direct eye contact
-extended family all live under one roof or they all live within the same community
-mental illness is hereditary
Haitians (HHHSSS)
-handskae as greeting
-home fold remedies used first
-shy
-smile even when they don't understand
-supernatural causes for illness
Mexican Americans (I Maths)
-imbalance between person and environment
-avoid direct eye contact with authority figures
-time is felxible
-handshake is acceptable (touching is among family not with strangers)
-silence is often a sign of disagreement
Puerto Ricans (Perch)
-elders have less eye contact
-religious
-enjoy cooking, if you turn away their food it is considered disrespect
-hereditary <- physical illness & mental illness (highly stigmatized)
Western Europeans Americans (WWWM)
-warm
-wine
-myths
all about religion, family, and food. A lot of fun to be around, lots of celebrations
Russians (not really in a rush)
-greet with a handshake, use eye contact
-bed rest for illness
-home remedies first, reluctant to take meds
-mental illness is due to stress or moving to a new environment
Asia/Pacific Americans (clayed)
-cancer of the liver, hypertension, lactose intolerance, thalassemia
-time is Circular (if they miss something it will come around again)
-Loyal to family, touch is not accepted by others
-Yin (-) Yang (+)
-Education is valued
-Distant emotionally
Japanese Americans (OJ Lip)
-open ended questions, self disclosure unlikely
-light touch
-illness is shameful and reluctant to seek help (due to evil spirits)
-Promptness is important!
South Asians (DOTS)
-direct eye contact
-oral greetings, gestures: handshakes among men
-touching not common
-silence indicates approval
-mental illness due to spirits
Cambodians (CHIPP)
-handshake or bow is appropriate, fingers must be pointed upward: other than that no contact with person being greeted
-inappropriate to touch their head without permission
-politeness is highly valued: silence is common: eye contact acceptable (lowering of the eyes by women to be polite)
-Passive rols when ill:due to war or brutalities, family is present for decision making
Vietnamese (VAITH instead of Faith)
-Avoid eye contact
-Ill person is passive and its because of disharmony or punishment spirits for past bad behavior
-touch is limited, they will greet with a smile or bow
-head is sacred, feet is profane
Filipinos (Fashed)
-animated facial expressions
-smile for greeting (won't shake hands)
-Harmonious function of the ill person, mental illness due to religious or mystical causes
-Eye contact is very little with authority figures
-decision maker will be the eldest male after conferring with the family
Chinese (CISTED)
-illness is due to disharmony of emotions or evil spirits
-shy in unfamiliar surroundings
-time is not highly valued; respectful distance is important
-eye contact is avoided with authority figures; silence is respectful; asking questions is a sign of disrepect
-decision maker will be the eldest male, spokesperson
Immigrant status (came here on their own)(risk factors for mental illness)
difficulty in acculturation, culture shock, intergenerational conflict
reugee status (forced to leave their country)(risk factors for mental illness)
entry into a new culture not by active choice, trauma by experiences in homeland, vulnerable to PTSD
Culture and Mental health care
diagnoses, symptomatology (they describe symptoms in different ways), expression of emotion, meaning attributed to behavior (is it punishment for past life), health language terms (think of how their talking to you), miss diagnosing is common
culture and physical assessment
in groups of other skin color, how do we assess
Jaundice - liver disorder (look at eyes, palms of hands and feet)
Ashem or gray - cardiac
Blue - deoxygenation (nail beds)
flushed - fever
copper - Addison's disease
Erythema of stage 1 pressure ulcer
Listen, Explain, Acknowledge, recommend, negotiate
What is the L-E-A-R-N model?
Risk factors for mental illness
-minority status ( socioeconomic disadvantage, poverty, limited opportunities for education and jobs, residence in disadvantaged neighborhoods)
-higher incidence of mental health problems in minority groups is related to poverty and other social factors, not ethnicity
impaired verbal communication r/t
nursing DX for language barrier
anxiety r/t
nursing DX for unfamiliar health care system or differing expectations of health care
nutrition less than body requirements r/t
nursing DX for unfamiliar foods
spiritual distress r/t
nursing DX for unfamiliar culture
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