Chapter 21
What are economic assessment data helpful for
Determine interventions and community resources available for treatment
Social structure
Determines how people interact with one another
Discrimination
Doing actual harm; arresting someone because of their race not their crime; can be against genders; race tends to be more frequent factor because of the visible difference
How do you assess financial status for a patient
Employment status, insurance coverage, and educational background
Culture is shared
Everyone shares the same understanding, shared values, beliefs, ideals, and expectations
Assessing dark skinned patients for oxygenation
Examine least pigmented areas, examples buccal mucosa, lips, tongue, nail beds, and palms of hands. Always have a baseline skin color
Nurses need to be mindful that certain economic pressures can force patients into a present-time orientation
Example if the finances aren't there they might switch to day to day survival rather than preventative needs
Rituals
Example is prayer or baptism
Barriers to cervical cancer screenings
Fear, fatalistic attitude, lack of health insurance, and language differences
Emic
Focuses on the local, indigenous, and insider's culture
Middle class American, regardless of ethnic or cultural origin tend to be
Future orientated
Community
Group of people coming together; believes a common thing;
Nonverbal symbols
Images
Latinos health beliefs
May not seek medical care because of a mistrust of the medical establishment, poverty, or problems with immigration status. Being either hot or cold. Hypertension is "hot" so treat with cold therapies
Who makes the decisions in typical Indian and Mexican families
Men
Defacto
Not legally;
Gender roles
Nurse needs to understand the roles of women in men in various cultures
Superstructure
Or worldview, provides a belief system that helps people identify themselves, their society, and the world around them
Who requires a Jewish diet
Orthodox and some conservative Jewish patients
Ethnicity
Persons identification with or membership in a particular racial, national, or a cultural group and observation of the groups customs, beliefs, and language
Etic
Perspective focuses on the outsides world and especially on professional views
Sschool
Place where general knowledge is obtained; social norms
Body odor may be a result from
Poor hygiene, the inability to care for oneself, or a cultural acceptance that natural body odors are normal
What may cause a nurse to be viewed as culturally incompetent
Prescribing a diet including pork products to a patient of the middle eastern background
Acculturation
Process of adopting the cultural traits or social patterns of another group;
Infrastructure
Provides basic necessities of life
Racism
Putting your race superior to another
Spirituality
Refers to behaviors and beliefs that strengthen a person and provide meaning to his or her life
Culture
Refers to the learned, shared, and transmitted knowledge of values, beliefs, and ways of life of a particular group that generally are transmitted from one generation to another and influence and the individual persons thinking, decisions, and actions in patterned or certain ways.
Seventh day adventists
Regard the body as a temple and typically do not eat meat or consume caffeine, alcohol, or tobaccco products
Nurse caring for middle class Americans should
Remember to speak of events in the future relation and to stick to the planned schedule
Cultural care repatterining or restricting
Respects values but helps modify to healthier lifestyle
Cultural maintenance
Retain and/or preserve relevant care values. Maintain their sense of well being, recover from illness or face handicaps and/or death
Symbols
Signs sounds clothing tools customs beliefs rituals and other items that represent meaningful concepts
Transcultural nursing
Speciality seeks to address the multifaced aspects of ethnicity and culture
Cervical cancer is common in what groups
Asian Americans, and recent immigrants
Rules of descent
Arbitrarily assigns a race to a person on the basis of societal dictate that associates social identity with ancestry
Culture is integrated
Culture is changing and continues to change
Culturally congruent care
Customized to fit with the patients own values, beliefs, traditions, and lifestyles. Realizes each patient has their own unique experiences, beliefs, values , and language
Prejudice
Thinking bad about a culture because of one encounter; devaluing and entire group; labeling groups or cultures;
The goal of transcultural nursing
To provide culturally congruent care
When the nurse and the patient speak different languages
Use of abbreviations and acronyms should be avoided, Slower speech should be used Yelling does not increase a patients ability to understand you
Who takes care of sick father in Asian cultures
Wives and the children
Cultural competence
Work effectively in cross culture situations
Natural culturally and linguistically appropriate standards
(CLAS) identify methods for providing culturally competent care and guidelines for their implementation
Awareness and interaction of three cultures
1st- personal self, quantities and characteristics of the nurses own culture. 2nd- that of the health care system, nurse must represent the health care system, and allow the family to acquire access to this system 3rd- the patients own culture
African Americans health beliefs
3 categories: impaired relationships, environmental hazards, and divine punishment Folk medicine practitioners rather than traditional health care providers.
Culture openness
A lifelong stance that promotes cultural self awareness and continuing development of transcultural skills
Andrews and Boyle believe that cultural competence is
A process rather than an endpoint, whereby the nurse continuously strives to work effectively within the cultural context of the individual, family, or community
Socialization
Acquire customs attitudes and values of a social group community or culture; can occur on different levels - families, communities, schools, spiritual, or religious groups.
Cultural care accommodation or negotiation
Adapt to or negotiate with others for beneficial or satisfying health outcomes
Stereotypes
Assumptions, should be avoided, unfavorable, ending point. No attempt is made to learn whether a perception is even true
Family
Basic unit in which personality develops; where culture derives;
Cultural sensitivity
Begins with the recognition of the often pronounced differences among cultures
Generalization
Broad, grouping. Infer or draw conclusion from many factors; beginning point
Gilanti 4C's
Call, caused, cope, and concerns
Spiritual and religious institutions
Can have a huge impact on health care; religions may have a set of beliefs that define health and the behaviors that prevent or treat illness
Madeline Leininger
Central leader of transcultural nursing. Was among the first to realize the need to address culture as a critical and missing dimension of care
Assimilation
Changing from one culture to another; example marriage; the melting pot
Race
Common decent or physical characteristics; socially constructed
The Giger and Davidhizar : six cultural domains.
Communication, space, social orientation, time, environmental control, and biological variation
Spirituality for many people
Is a stabilizing force between mind, body, and spirit
Language
Is a structure of verbal symbols used to communicate and share cultural beliefs and ideas that can be manipulated and used as tools by individuals and groups to organize their lives
Enculturation
Is the process whereby a culture is passed from generation to generation
Ethnocentrism
Judging another culture solely by values & standards of ones own culture
Standards of (CLAS) address
Language access, organizational support, diverse and culturally competent staff, existing laws, data collection, and information dissemination
Culture is symbolic
Language is the biggest symbol
Culture is
Learned and it is not biologically inherited
Four basic elements of culture are recognized:
Learned, symbolic, shared, and integrated
Dejure
Legally sanctioned
Cultures oriented to the present
Less likely to embrace preventative health care. "Here and now" often use the way they are feeling during the present time to dictate future health practices
In addition to cultural competencey
Linguistic competence is needed to offer appropriate care and responses to patients with culturally diverse backgrounds
Cultures that are oriented to the past
Tend to look to traditional approaches to health and healing rather than to new approaches, procedures, and medications
The change is representative of
The integration of new beliefs, ideas, attitudes, and behaviors into the previous cultural system Example the nursing cap slowly fading out