Ch04 (6)

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Arizona Western College *

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LPN

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Medicine

Date

Dec 6, 2023

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43

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Copyright ©2023 F.A. Davis Company Book cover for Understanding Medical-Surgical Nursing, Seventh Edition. Chapter 4 Cultural Influences on Nursing Care
Copyright ©2023 F.A. Davis Company Learning Outcomes Define common concepts related to culture and spirituality. Describe attributes of culturally diverse patients and their families and how they affect nursing care. Identify data you should collect from culturally diverse patients and their families. Apply a holistic approach to patient care that respects cultural and spiritual characteristics and attributes.
Copyright ©2023 F.A. Davis Company Culture The socially transmitted behavior patterns, beliefs, values, customs, arts, and all other characteristics of people that guide their view of the world This Photo by Unknown Author is licensed under CC BY-SA-NC
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Copyright ©2023 F.A. Davis Company Culture Culture influences daily habits that affect health, such as the foods we select as part of our diet, how we dress, how we raise children, and how we cope with stress.
Copyright ©2023 F.A. Davis Company Cultural Terms to Know Cultural sensitivity • Using culturally appropriate language and not offending another person’s cultural beliefs Cultural awareness • An appreciation for and attention to a culture’s celebrations, foods, and traditional arts and clothing Cultural competence • The skills and knowledge required to provide effective nursing care
Copyright ©2023 F.A. Davis Company Cultural Terms to Know Cultural humility • A lifelong process of thinking about one’s own cultural beliefs and identities while learning about others Ethnocentrism • Thinking that one culture’s ways of thinking, acting, and believing are the only right and natural ways Stereotype • An opinion or belief about a group of people that is ascribed to an individual
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Copyright ©2023 F.A. Davis Company Spirituality Simply defined, it is the essential connections that provide meaning and purpose in life. These essential connections may include a belief in God or a higher power. Addressing spirituality • Improves patients’ comfort levels emotionally and physically • Has a positive effect on patients’ response to illness and treatments
Copyright ©2023 F.A. Davis Company *Spirituality * Being aware of your own spirituality and where your own sense of meaning, purpose, and value come from. Listening for cues and being attentive to patients raising issues of what their illness means. Promoting patient-centered care rather than task-centered care.
Copyright ©2023 F.A. Davis Company Nurse’s Role Pay attention to and document patient or family spiritual practices. Verify that the practices assist in managing stress of their illness. Encourage the spiritual practices in the future.
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Copyright ©2023 F.A. Davis Company HEALTH-CARE VALUES, BELIEFS, & PRACTICES Some therapies may conflict with prescription medications or cause a toxic effect. For example, garlic supplements can cause very low blood pressure when combined with antihypertensive medications and interact with multiple other medications If patient’s sense that you do not accept their beliefs and practices, they are less likely to share information or adhere to prescribed treatment
Copyright ©2023 F.A. Davis Company Cultural Self-Assessment What is your cultural background? How do you define spirituality for yourself? What language do you speak at home? Who is the head of your family? What foods do you eat that are unique to your family or community? What kinds of health-care providers (HCPs) do you see? How is grief expressed in your family? “What types of things have helped you to cope with great stress or big life changes in the past?”
Copyright ©2023 F.A. Davis Company Characteristics of Cultural Diversity Primary characteristics • Nationality • Race • Ethnicity • Skin color • Gender • Age • Spirituality and religious affiliation This Photo by Unknown Author is licensed under CC BY-SA
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Copyright ©2023 F.A. Davis Company Characteristics of Cultural Diversity Secondary characteristics • Marital status • Parental status • Physical characteristics • Sexual orientation • Gender roles • Socioeconomic status • Education • Occupation • Military experience • Political beliefs
Copyright ©2023 F.A. Davis Company Cultural Phenomena Across All Cultural Groups Communication styles Space Time orientation Social organization Environmental control/health beliefs Choice of HCP Biological variations Death and dying issues
Copyright ©2023 F.A. Davis Company Communication Styles Verbal Spoken language Dialects Voice volume Nonverbal Eye contact Perception of time Physical closeness Ask the following questions of your patients: • What name do they prefer to be called? • What language do they speak at home?
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Copyright ©2023 F.A. Davis Company Nursing Communication Assessment and Strategies Speak slowly and clearly. Provide written instructions in patient’s preferred language. Use professional interpreters. Avoid appearing rushed. Ask patient to restate what they heard. Explain why specific questions are asked.
Copyright ©2023 F.A. Davis Company Space Space refers to one’s “personal space.” Personal space tends to be different when speaking with close friends versus strangers. It differs across cultures. The need for space is important for the patient’s privacy, autonomy, security, and self-identity.
Copyright ©2023 F.A. Davis Company Space Nursing assessment and strategies • Make sure your patient is comfortable before interviewing them. • Make sure patient’s physical environment is arranged to ensure safety, security, and familiarity. • Maintain appropriate physical distance (observe for cues).
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Copyright ©2023 F.A. Davis Company Time Orientation Clock time versus social time Orientation • Past • Present • Future This Photo by Unknown Author is licensed under CC BY-NC
Copyright ©2023 F.A. Davis Company Time Orientation Nursing assessment and strategies • Have a clock in patient’s room. • Assess for orientation; reorient to time as needed. • Give time options as appropriate. • Ask about usual routines. • Ask about routine around meals and personal care. • What time do you usually eat your meals? Take a shower or bath?
Copyright ©2023 F.A. Davis Company Social Organization Patriarchal, matriarchal, or egalitarian Gender roles and elder roles vary across families and cultures. Extended family may be important.
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Copyright ©2023 F.A. Davis Company Social Organization Nursing assessment and strategies • Ask who lives in the patient’s household and how they are related. • Ask who they discuss decisions with. • Ask what their responsibilities are at home. • Observe family interactions. • Let family members decide where they want to stand or sit for comfort.
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Copyright ©2023 F.A. Davis Company Environmental Control Three concepts • Perception of ability to control what happens to one’s health • Beliefs about health and illness • Beliefs in alternative health-care therapies The nurse should consider the patient’s cultural values and beliefs.
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Copyright ©2023 F.A. Davis Company Environmental Control Nursing assessment and strategies • Never stereotype. • Perform a cultural assessment of all patients. • Ask about religious beliefs and practices. • Ask how patient has managed illness to date, including home remedies.
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Copyright ©2023 F.A. Davis Company Choice of Health-Care Providers HCP choices are made based on the patient’s perceived health status and previous experiences. • Physicians versus traditional healers • Religious influences • Respect modesty and assign same-gender providers when requested.
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Copyright ©2023 F.A. Davis Company Choice of Health-Care Providers Nursing assessment and strategies • Ask what HCP patient sees when ill. • Ask if patients object to male or female HCP. • Observe for alternative care providers who may visit the patient.
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Copyright ©2023 F.A. Davis Company Biological Variations Biological variations refer to ways in which people are different from one another physiologically and genetically. • Body structure • Skin color • Susceptibility to certain diseases • Intolerances to particular foods or substances
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Copyright ©2023 F.A. Davis Company Biological Variations Nursing assessment and strategies • Teach about biological variations that may pertain to patient. • Determine and respect the patient’s eating pattern. • Support the patient’s choice to avoid foods. • Teach good nutritional habits, paying attention to preferences.
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Copyright ©2023 F.A. Davis Company Death and Dying Issues & End-of-Life Issues Death rituals of cultural groups are the least likely to change over time. Become knowledgeable about rituals surrounding death and bereavement. • Burial practices • Autopsy beliefs • Expression of grief • Provide a private space for families to grieve.
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Copyright ©2023 F.A. Davis Company Death and Dying and End-of-Life Issues Nursing assessment and strategies • Support family in their expression of grief. • Observe for differences in the expression of grief among family members. • Offer to obtain a religious counselor/spiritual leader if the family wishes.
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Copyright ©2023 F.A. Davis Company Racial and Ethnic Groups Indian/Alaskan Native Arab American Asian Native Hawaiian or other Pacific Islander This Photo by Unknown Author is licensed under CC BY
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Copyright ©2023 F.A. Davis Company Culturally Responsive Care Recognize value that patients and families bring to the care team. Acknowledge the diverse beliefs and values of patients and families. Integrate cultural practices into care. Learn about cultural groups. Acknowledge your own beliefs and biases.
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Copyright ©2023 F.A. Davis Company Health Disparities Health disparities are preventable differences in disease burden, injury, or opportunities to achieve optimal health. This occurs when culturally responsive care is not in place.
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Copyright ©2023 F.A. Davis Company Nurse’s Role Nurses are best positioned to help ensure that patients receive optimal care. • They can integrate the patients’ beliefs, values and traditions as much as possible. • They play a critical role as front-line care providers. • They are often the first person and last person that patients and families interact with on the health-care team. • They can make a big difference in the quality of life and overall health of the patients they serve.
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Copyright ©2023 F.A. Davis Company Review Question #1 Which of the following means “to have an appreciation for and attention to a culture’s celebrations, foods, and traditional arts and clothing”? 1. Cultural sensitivity 2. Cultural competence 3. Cultural awareness 4. Cultural diversity
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Copyright ©2023 F.A. Davis Company Review Question #1 Answer Correct Answer: 3
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Copyright ©2023 F.A. Davis Company Review #2 Question Which is the most prominent value in Western medicine? 1. Spiritual focus 2. Tradition 3. Balance with nature 4. Research base
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Copyright ©2023 F.A. Davis Company Review Question #2 Answer Correct Answer: 4
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Copyright ©2023 F.A. Davis Company Review Question #3 Which interpreter is best to use with an ill patient who has limited English proficiency? 1. Patient’s child 2. Patient’s parent 3. Patient’s friend 4. Hospital employee
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Copyright ©2023 F.A. Davis Company Review Question #3 Answer Correct Answer: 4
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Copyright ©2023 F.A. Davis Company Review Question #4 What are actions the nurse can take to provide spiritual care for patients? Select all that apply. 1. Provide religious counseling. 2. Follow patients’ cues. 3. Be aware of one’s own spirituality. 4. Ask how the patient is coping. 5. Turn on religious programming.
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Copyright ©2023 F.A. Davis Company Review Question #4 Answer Correct Answer: 2, 3, 4
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Copyright ©2023 F.A. Davis Company Cultural humility Cultural humility is the idea that learning about culture with the intention to improve care and services is a lifelong process that requires self-reflection of your own cultural beliefs and identities while learning about others
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