Culture and Diversity
Emic
perspective that focuses on the local, indigenous and insiders culture.
Respect T
Theraputic
Developmental-
how relationships are developed, risks, stressors, stability, life events both positive and negative, abuse, illness.
Family dynamics are
interrelationships between and among individual family members or the forces at work within a family that produce particular behavior or symptoms.
Enculturation
is the process whereby a culture is passed from generation to generation.
Functionalism
language barriers, cultural needs, familial roles, individual physical capabilities and correlation to family.
Cultural openness
A lifelong stance that promotes cultural self-awareness and continuing development of transcultural skills.
What is family?
A primary unit of socialization, basic structural unit within a community.
diversity
(n.) difference, variety; a condition of having many different types of forms
A 50-year-old client has difficulty communicating because of expressive aphasia after a cerebrovascular accident (CVA, also known as a "brain attack"). When the nurse inquired about the client's feelings, the spouse responded. Which communication strategy would the nurse use to address this behavior?
Acknowledge spouse but wait for client response
Which of these clients seen at a health fair will be most at risk for hypertension?
62 yr old African American male
Respect C
Concerns
The nurse leader is teaching the staff that the health care provider strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining?
Cultural competence
Respect E
Explanatory model
Regarding the past experiences of clients who have immigrated, which consideration would the nurse incorporate when planning care?
It is important to first assess immigrants' values and beliefs
Which statement by a new mother observing her preterm infant in the neonatal intensive care nursery indicates that she has not yet begun the bonding process?
It's such a tiny baby
Describe how culture influences the three categories:
People who grow up in a particular culture often have shared values, beliefs, ideals, and expectations. These shared attributes are absorbed and transmitted through generations of teaching and sharing ideas, traditions. culture is the "common denominator" that makes the actions of a person intelligible to other group members. One shared element found in all cultures is an understanding of gender roles, the roles that a particular culture assigns to men and women. Although the world is changing, certain values and beliefs regarding gender roles remain unchanged in many cultures.
Which key factor assists the nurse in assessing how a client will cope with the body image change after an above-the-knee amputation?
Personal perception of change
The nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. Which action would the nurse manager take to address this problem?
Plan a workshop that offers opportunities to learn about the cultures the nurses might encounter while at work.
The home health care nurse visits a client who lives with her two grandchildren. Which term would the nurse use to define this family form?
Skip generation family
Social structure
Social structure determines how people interact with one another (Yoost p. 381). · Social structure is 1 of 3 components that most work together to keep a culture strong.
Race
A socially constructed concept that tends to group people by common descent, heredity, or physical characteristics. It has been a practice in the United States to use the rule of descent to categorize people by race. Race is thought by many to have a biological basis. However, this assumption is not true.
Racism
An unfounded belief that race determines a person's character or ability and that one race is superior or inferior to another. Scientific evidence indicates that no one race is culturally or psychologically superior to another, and past studies that have reached other conclusions have been found to be seriously flawed in their methodology or inherently biased. Health care professionals play a vital role in counteracting racism by providing unbiased, equal access, and culturally sensitive care to people of every race and culture
Rule of decent
Arbitrarily assigns a race to a person on the basis of a societal dictate that associates social identity with ancestry
Which of these cultural groups adopts a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness?
Asian indian
Which statement is true for attachment in the newborn?
Attachment is the I interaction between parents and child
Ethnocentrism
Belief that one's culture is superior to that of another
Which question is the most therapeutic to ask the parents of a 3-year-old child who has just died?
Can I be of any help with traditional practices that are important to you?"
Which behavior is seen in children at the undifferentiated stage of spiritual development, as propounded by Fowler?
Children have no concept of right or wrong to guide their behaviors.
Which initial purpose would value clarification serve?
Client becomes aware of personal values
A Spanish-speaking client is being cared for by English-speaking nursing staff. Which communication technique would be correct for the nurse to use when discussing health care decisions with the client?
Contact hospital interpreter
In what ways are they dependent upon one another? Shared beliefs values and behaviors
Culture is an attribute of essentially all members of a group, not just individuals. People who grow up in a particular culture often have shared values, beliefs, ideals, and expectations. These shared attributes are absorbed and transmitted through generations of teaching and sharing ideas, traditions, and rituals
A child who has newly arrived from Latin America attends a nursery school where everyone speaks English. The mother is concerned the child is no longer outgoing and has become passive in the class. Which is the probable reason for the child's behavior?
Culture shock
Which factor increases an adolescent's risk for injury in the community?
Distracted driving
Which would the nurse consider to be the center of decision-making when providing client care?
Ethics
Which statement defines the term "family resiliency"?
Family can cope with stressors
Etic
Focus on outsider's world and especially on professional views.
Which theory proposes that older adults experience a shift from a materialistic to cosmic view of the world?
Gerotranscendence
At which stage of Kohlberg's theory does an individual want to fulfill the expectations of one's immediate group?
Good boy nice girl
Several hours after delivery, a new mother expresses ambivalence regarding her infant. How will the nurse promote bonding between this mother and her newborn?
Having mother feed infant
Which is the primary focus of nursing care in the "family as context" approach?
Health and development of individual
A client who is in the advanced stages of illness asks the nurse to contact pastoral services for support. According to the Macmillan model, which is the correct nursing intervention in this situation?
Immediately involve pastoral services while caring for the client
The nurse is assessing a middle-aged client whose children have left home in search of work. The client is trying to adjust to these family changes. Which family life-cycle stage is the client going through?
Launching children's and moving on
Which culturally based behavior would the nurse expect to observe in an Asian client who has symptoms of anxiety and panic?
Minimal eye contact
A new mother says to the nurse, "I would like to care for my baby independently rather than depending on the baby's grandparents." From this information, which culture would the nurse infer that the new mother belongs to?
North American culture
Which member of the interprofessional team in a palliative care setting serves as the client advocate, evaluating the physical, emotional, and spiritual needs of the client?
Nurse
The nurse working in a Catholic hospital discourages clients from using contraceptives per hospital policy. Which category of ethics is the nurse following?
Organizational ethics
The practice of separating parents from their newborn immediately after birth and limiting their time with the infant during the first few days after delivery contradicts studies related to which?
Parent child attachment
Which relationship is the most important to the formation of personality?
Parent child relationships
Respect P
Power
Identify factors associated with an increased incidence of abuse within a family.
Pregnancy, drug abuse, sexual orientation
Prejudice
Process of devaluing an entire group because of assumed behavior, values, or attributes. (Yoost 382) A preformed opinion, usually an unfavorable one, about an entire group of people that is based on insufficient knowledge, irrational feelings, or inaccurate stereotypes. (Yoost 22) There is no room for prejudice in professional nursing practice. Unchecked prejudicial thoughts and actions may lead to discrimination and unequal care of individual patients. (Yoost 382)
Respect R
Respect
Which concept of death would the nurse expect a 4-year-old child to have?
Reversible separation
The nurse is developing a plan of care for the client who has activity intolerance. Which intervention would the nurse do to obtain the desired client outcomes?
Set priorities and outcomes using the client's and family input
Respect S
Sociocultural context
Stereotype
Stereotype is a set of fixed ideas, often unfavorable, about members of a group. The difference in stereotype and generalization lies not in the content but in the usage of the information.
superstructure
Superstructure or worldview, provides a belief system that helps people identify themselves, their society, and the world around them.
symbols
Symbols are signs, sounds, clothing, tools, customs, beliefs, rituals, and other items that represent meaningful concepts. Language is the most important symbolic aspect of culture because words are used to represent objects and ideas. Nonverbal symbols are images, such as flags of countries, that represent shared ideas or beliefs. Another example of a symbol is a single red cross and red crescent side by side on trucks and armbands for the international federation of red cross and red crescent societies.
Which rationale supports the use of family therapy when a child has a terminal illness?
The entire family is involved because what happens with one member affects them all
Socialization
The family has been viewed traditionally as the primary unit of socialization, the basic structural unit within a community. · Socialization is the process of being reared and nurtured within a culture and acquiring its characteristics · This process can and does occur on many different levels: within families, communities, schools, and spiritual or religious groups. Socialization usually occurs within the structure of a group that influences the health care behaviors and beliefs of its members and can directly and indirectly affect the administration of health care by the nurse
Biculturalism
The individual has a dual pattern of identification and chooses which aspects of the new culture he or she wishes to adopt and which aspects of the individual's original culture he or she wishes to retain.
Assimilation
The process by which individuals from one cultural group merge with, or blend into a second group
How are healy care despairities linked to the concept of culture?
This can be tied to the concept of culture in that culture can sometimes be the reason that healthcare is lacking. Care providers are sometimes influenced by generalizations, stereotypes, and personal experiences that may cause them to provide minimal care to a patient of a different culture, leading to a disparity in the health care that the patient is getting compared to the patient in the next room with which the provider may have a shared culture.
What does health care despairity mean?
This term means that, due to various reasons (age, race, religion, gender, income, physical location etc.), health care is not granted equally to all persons. Ulitimately, it is a type of discrimination, wheather intentional, or not.
Which risky adolescent behavior has increased in occurrence in recent years?
Using electronic vapor products
Which surgeries are associated with permanent contraception?
Vasectomy and tubal litigation
List the questions associated with the RESPECT model.
What do you call the problem? What do you think has caused the problem? Why do you think it started when it did? What do you think the sickness does? How does it work? How severe is the sickness? Will it have a long or short course? What kind of treatment do you think you should receive? What are the chief problems the sickness has caused? What do you fear most about the sickness?
Questions regarding RESPECT model
What do you call the problem? What do you think caused the problem? Why do you think this started ?When? What kind of treatment do you think you should receive? What are the chief problems the sickness caused? What do you fear most about the sickness?
A client is dying. Hesitatingly, his wife says to the nurse, "I'd like to tell him how much I love him, but I don't want to upset him." Which is the correct response by the nurse?
You should share your feeling with him while you still can
Attributes -
family involves, people the family have relational obligations, verbal and nonverbal communication, interactions among family members must be flexible and changeable
transcultural nursing
focuses on human caring-associated differences and similarities among the beliefs, values, and patterned life ways of cultures to provide culturally congruent, meaningful, and beneficial health care. It is both a specialty and a general practice area that focuses on worldwide cultures and comparative cultural caring, health, and nursing phenomena.
Which description of family-centered care is correct?
A collaborative plan of care is developed to achieve optimal health.
Which education would the nurse provide the parent of a preschool-age child about how preschoolers view death?
A form of sleep
Which internal variable influences health beliefs and practices?
Intellectual background
The nurse hired to work in a metropolitan hospital provides services for a culturally diverse population. One of the nurses on the unit says it is the nurses' responsibility to discourage these people from bringing all that alternative medicine stuff to their family members. Which response by the nurse is correct?
Nontraditional approaches to health care can be beneficial."
A client does not take his or her medication regularly and is depressed. Which inference can the nurse make about the client's motivational level?
Not motivated
What concepts are interrelated with family dynamics -
function ability, stress,reproduction,spirituality, culture, development
Culture
the enduring behaviors, ideas, attitudes, values, and traditions shared by a group of people and transmitted from one generation to the next
Cultural sensitivity
the recognition that there are differences among cultures.
Describe the concepts interrelated to culture that are presented in the text. & What is the link to the concept?
Generalization: a statement, idea, or principle that has a broad application, and is applied when traits are fairly consistent across cultures and can be identified within a particular group, while keeping the importance of individual differences in mind. Stereotypes: a set of fixed ideas, often unfavorable, about the members of a group Prejudice: process of devaluing an entire group because of an assumed behavior, value, or attribute. Discrimination: refers to policies and practices that harm a group and its members. Race: a socially constructed concept that tends to group people by common descent, heredity, or physical attributes The link that ties these concepts together is that they are a general perceived notion and/or trait that has been passed down through generations. Our idea of culture is the totality of socially transmitted behavioral patterns, beliefs, values, customs, lifeways, and art that has shaped our worldview. Although certain behaviors may be anticipated and understood by using generalizations and the differences are invariably present among individuals within cultures, a lot of these perceived notions and/or traits can be offensive especially if acted upon. Often times this leads to negative results in health.
Define the term health care disparities.
Health care disparity is the inequality related to access, use, and quality of care
A chronically ill, older client lives with their daughter. The client reports the daughter, who has three small children, seems run-down, coughs a lot, and sleeps all the time. Which statement supports the need for the nurse to pursue the daughter's condition as a potential case
Older adults with chronic illness are more susceptible to tuberculosis.
The parents of a critically ill child constantly blame each other for their child's illness. Which parental response suggests that the nurse's intervention has been successful?
Parents make appointment with family counselor
In providing effective nursing care to clients from different cultural backgrounds, which strategy would the nurse follow?
Providing care that fits the clients cultural beliefs
How can health care despairities be minimized by nurses?
The first step for nurses is to not let their prejudices affect the care that is provided to each patient equally. In addition, nurses can practice cultural competence,which is demonstrating intentional effort to learn about other cultures and providing indifferential care, a process that begins with a personal cultural self-assessment.
Family configurations include
nuclear family, single parent families, blended families, widowed families, family related by blood and also not related by blood.
Structural-
who lives in the home? Quality of relationship? Familial roles?
Discrimination
policies and practices that harm a group and its members.
Acculturation
A mechanism of cultural change achieved through the exchange of cultural features resulting from firsthand contact between groups.
Ethnicity
A person's identification within a group and observation of the groups customs, beliefs and language
Describe specific ways the nurse can develop and improve in Greater cultural knowledge
Acculturation, or firsthand contact between different group would greatly expand the nurses knowledge, as well as time and experience. Each patient is an individual with different life experiences and culture should be viewed as more of a spectrum.
Describe specific ways the nurse can develop and improve in Greater cultural skill
Along with knowledge, skill will also be improved with time and experience. The nurse should be practicing culturally congruent care, by creating safe and meaningful ways to promote health within their cultural boundaries.
The nurse is assessing a child who is accompanied by a parent and a stepbrother. Which kind of a family does this child belong to?
Blended
What family dynamics place a family as risk for dysfunction?
Blended families /role change, Low income/socioeconomic status Age of family members Family classification Family Hx Illness Culture Norms Trauma Conflict Relocation Substance abuse Addiction Domestic violence
There are several concepts that link to culture. Such as:
Ethnocentrism since it's a certain belief and perceived notion that one's culture is superior than another. Assimilation is a transmitted behavioral pattern were individuals leave their cultural identity in order to blend into a new one. Socialization is socially transmitted behavior(s) that is geared toward individuals acquiring certain characteristics. Family is the basic unit for developing customs and values
The nursing student is learning about the realms of family life. Which component would be included while learning about integrity processes?
Family rituals
How are they similar? Shared beliefs, values and behaviors
Four basic elements of culture are recognized: Culture is (1) learned, (2) symbolic, (3) shared, and (4) integrated. culture may be viewed as a complex whole in which all parts are related. Culture has a family and group component, but it is not transmitted biologically. The values, beliefs, and traditions of a group must be learned by each person within the family and social community. Culture includes social constructs such as knowledge, beliefs, art, morals, and customs, as well as law. One shared element found in all cultures is an understanding of gender roles, the roles that a particular culture assigns to men and women. Although the world is changing, certain values and beliefs regarding gender roles remain unchanged in many cultures
Generalization
Generalization is a statement, idea, or principle that has a broad application. Often applied regarding common beliefs, behaviors, and patterns shared by a particular culture--certain behaviors may be anticipated and understood by using generalizations. They typically infer or draw conclusions from many factors. They are a beginning point; one should gather more information to ascertain whether a generalized statement is appropriately applied to an individual or group. The difference in stereotype and generalization lies not in the content but in the usage of the information
Infrastructure
Infrastructure provides the basic necessities of life. It is one of the three (social structure and superstructure are the other two) structural elements that works together to keep culture strong.
A child wants to be on time for a family dinner. According to Kohlberg's theory, which stage of development is the child experiencing?
Instrumental relativist orientation
Describe specific ways the nurse can develop and improve in Greater cultural desire
Many people become nurses because they care about others and want to help them. Caring for patients is individual and includes meeting their needs with which their culture greatly affects. Nurses should strive to be transcultural to provide all of their patients with the best possible care
Describe specific ways the nurse can develop and improve in Greater cultural awareness
Nurses can develop and improve on cultural awareness by avoiding stereotypes, prejudice, and discrimination, as well as being cautious with generalizations. The nurse must be free of ethnocentrism and understand how diverse our society is. Also, by practicing cultural sensitivity, the nurse is recognizing differences among cultures.
Rituals
Rituals are formal, stylized, and repetitive actions performed in special places at special times. These actions convey information about participants and are used to inform others about the beliefs and traditions of a culture. Examples include praying, dancing, fasting, singing, meditating, and reading sacred texts. Rituals can sustain and provide support for patients during a time of illness or suffering. In caring for patients, nurses need to be aware of their own beliefs and feelings regarding certain rituals, as well as understand how these rituals may affect their patients and families.
What is the RESPECT model?
The RESPECT model of cultural assessment is based on a series of eight questions developed by Kleinman A blueprint to develop skills needed to become culturally competent. RESPECT is an acronym: Respect, Explanatory model, Sociocultural context, Power, Empathy, Concerns and fears, and Therapeutic alliance/trust.
cultural competence
The ability to interact with and appreciate people of different cultures and beliefs. To attain this ability is a lifelong process. It requires intentional effort to more fully understand individuals of different cultures and ethnicities.
Shared beliefs, values and behaviors. How are they different?
The art, literature, costumes, customs, language, religion, and religious rituals of a particular group of people are manifested by their culture. Thus people and their patterns of life make up the culture of a particular region or country, and cultures vary throughout the world. Such differences extend across geographic boundaries, and this diversity in cultures results in the diversity of people everywhere. Because culture consists of a system of beliefs held by the people of a region as well as their principles and moral values, behavioral patterns of people from a particular geographic region of the world contribute to the region's culture.
A community health care nurse is conducting a survey about homeless children in the community. Which finding helps the nurse distinguish absolute homelessness from relative homelessness?
The children do not have a physical shelter and may sleep outdoors or in vehicles.
Ethnicity
The person's identification with or membership in a particular racial, national, or cultural group and observation of the group's customs, beliefs, and language. It is based on cultural similarities and differences within a society or nation. Similarities occur with members of the same group; differences occur between members of the group and others.
Culturally congruent care
The use of culturally based knowledge in sensitivity, creative, safe, and meaningful ways to promote the health and well being of individuals or groups.
Which concept would the nurse consider when caring for school-aged children who are obese?
There are familial influences on childhood eating habits
How do these cultural norms influence nursing and health care delivery?
These cultural norms influence nursing and healthcare delivery because you have your own set of thoughts about how something is done or should be done or handled. Like in some cultures women don't make their own decisions about their health. In these cultures, the man in the family would make these decisions and we as nurses have to be able to recognize that and know that even though that is not how decisions are made for us it is that way for this culture. Another way these cultural norms would influence nursing is knowing the patients beliefs, like in terms of jehovah's witnesses who don't accept blood transfusions.
Family dynamics are negative when
caregivers don't agree or lack of care or caregiver, family members don't know role, 1st time parents unsure of new situation, stress, social isolation, inaccurate perceptions, faulty personal interpretations. Places extra stress in families. This affects nursing care by not being able to give adequate care, family centered care is difficult, nurse will provide sxtra support, need t provide extra resources
How would you characterize family-
dysfunctional, supportive, blood, live together, family is whatever the patient says it is. Some families are very close and some do not speak to each other. Healthy families know their roles, are loving and respectful, and offer support. Daughters growing and assuming the role of mother or caretaker. Older siblings step up to help around the house and with younger children.
Risk factors for negative family dynamics are
expanding family, illness, partner violence, addiction, death, sexual health can all affect stress tension, fighting, disagreement, dishonest, end of relationships, recovery slowed.
Family dynamics are positive when
families adapt to change, are involved, have good communication, and support one another. This affects nursing care because nurse has access to familial port, focus on patient safety, and get a clearer picture f impact of illness.
bias
is an inclination or tendency to favoritism or partiality. Bias may be related to a preconceived notion or prejudice. For example, a nurse may consistently postpone care of elderly patients on the assumption that their care will take more time than caring for younger patients, without considering the actual acuity of the individual patients.
