Health and Wellness Week 3 Study Guide: Part 2/2

eclampsia

hypertension poses specific risks to an unborn child, which puts the mother at risk for things like _________.

justice (everyone receives the same care, no matter what)

identifying and being aware of our biases is part of the ethical responsibility of the nurse and is related to the ethical principle of ______.

emic

if you are trying to develop an intervention for a patient, you would to use an _____ worldview to try to understand why their culture leads to certain practices or beliefs.

stereotypes, generalizations

in order to develop our cultural knowledge, we have to avoid ______ and _______ about certain groups; everyone has unique characteristics and world views

cultural competency

in order to provide culturally congruent care, we must first assess our own level of.....

cultural encounters

interventions that involve a nurse directly interacting with patients from culturally diverse backgrounds, have the potential for conflict, enable new forms of community and collective identity, provide the opportunity to show compassion

skills and interventions

involve collecting a culturally based nursing history, performing a culturally based physical assessment, and using teach-back with plan language; these take practice and require you to apply your cultural awareness and knowledge

culture

shared experiences and commonalities that have developed and continue to evolve in relation to changing social and political contexts based on multiple social group memberships

teach-back, plain

the ______ method and the use of _______ helps confirm that the client understands what you have explained

therapeutic relationship

the ___________ is the foundation of all nursing care, if you don't develop a relationship with your client, they won't trust or listen to you

linguistic competence

the ability to communicate effectively and convey information in a manner that is easily understood by diverse audiences

cultural skills

the ability to conduct a cultural assessment of a patient to collect relevant cultural data about a patient's presenting problem, as well as accurately conducting a culturally based physical assessment. ability to assess social, cultural, and biophysical factors that influence patient care

balance, harmony

the belief in the importance of _______ and ______ to stay healthy are seen in many cultures such as Hispanic, Native American, Asian, and Middle Eastern groups

health literacy

the degree to which individuals have the ability to obtain, process, and understand basic health information and the services needed to make appropriate decisions , directly affects patient outcomes

mutually acceptable, culturally relevant

the goal of the cultural assessment model is to obtain accurate information to develop a ______ and _____ plan of care

cultural desire

the most important aspect of cultural competency, the motivation of a health care professional to "want to" and not "have to" engage in the process of becoming culturally aware, knowledgeable, and skillful in seeking cultural encounters

cultural knowledge

the process in which a healthcare professional seeks and obtains a sound educational base about culturally diverse groups, and in acquiring this knowledge, health care professionals must focus on the integration of three specific issues: health-related beliefs and cultural values, care practices, and disease incidence and prevalence. involves looking at other cultures and comparing them based on your knowledge of those cultures

cultural awareness

the process of conducting a self-examination of one's own biases toward other cultures and the in-depth exploration of one's cultural and professional background, also involves being aware of the existence of documented racism and other "isms" in healthcare delivery; the first thing we need to do is examine ourselves and recognize our biases

communicate, verbal, nonverbal, validate, refine, modify, values, beliefs, practices

the two goals of cultural encounters are to _______ in a way that generates a wide variety of responses/send and receive both ______ and ________ communication accurately and appropriately in each culturally different context AND to continuously interact with patients from culturally diverse backgrounds to ____, ____, or _____ existing ____, _____, and _____ about a certain cultural group

observed behavior

the visible sign of a person's worldview, the part of the iceberg that sits above the surface of the water

ethnicity, gender identity

today, the cultural model has expanded, and it is not just about __________. culture now encompasses things such as _________.

medication errors

In addition to the publication of Crossing the Quality Chasm, the IOM also published something on ______ that led to a lot of practice changes

therapeutic relationship, patient-centered

using cultural assessment to understand how the patient looks at the world is important if you are trying to develop a ______ with the patient and to provide _______ care.

marginalized

we don't just focus culturally competent care on immigrants; now, we focus on all _________ groups

transcultural communication

we must use __________ skills to interpret a patient's behavior and to behave in a culturally congruent way

open-ended, focused, contrasted

we need to ask ________, ____, and _______ questions when conducting a cultural assessment

cross-cultural

we need to see every patient encounter as ____________; we must look at things holistically and take into account other beliefs that are different than our own

CHF, acute MI, stroke

what are 3 conditions that are commonly seen in practice and have core measures associated with them?

accountable care organizations, patient-centered medical homes, and primary care, cardiology, gastroenterology, HIV and Hep C, medical oncology, obstetrics and gynecology, orthopedics, pediatrics, CHF care, acute MI care, stroke care

what are some examples of issues that have core measures in place?

Crossing the Quality Chasm (IOM, 2001) and Unequal Treatment (Smedley et al., 2003)

what are some landmark reports that highlighted the importance of patient-centered care?

LEARN, RESPECT, ETHNIC, C-LARA

what are some mnemonics used to provide culturally competent care?

difficulty filling out forms or histories, failing to make follow-up appointments, asking few questions, responding simply "yes" when asked if questions are understood

what are some patient behaviors that might reflect a literacy deficit?

do you understand? do you have any questions?

what are some questions that you shouldn't ask a patient when using the teach-back method?

discomfort, lack of time, other priorities

what are some reasons why people may avoid cultural interactions with others?

cultural assessment, mnemonics, assess linguistic competence and health literacy, teach-back method and use of plain language

what are some skills and interventions we can use to provide culturally competent care?

advocate for patient based on their worldview, avoid stereotyping and generalizations, treat the individual, see every patient encounter as cross-cultural, don't interpret through your own worldview

what are some ways that you can develop cultural knowledge about others' world views?

build a relationship with the other, work outside usual practice framework, reinvent practice often

what are the 3 dimensions of Blanchet and Pepin's model of cultural competency?

cultural awareness, cultural knowledge, cultural skills, cultural encounters, cultural desire

what are the 5 parts of Campinha-Bacote's model of cultural competency?

etiology, time and mode of onset of symptoms, patho, course of illness, treatment for an illness episode

what are the five things that you should ask questions about when using the explanatory model during a cultural assessment?

calm, listen, affirm, respond, add

what does C-LARA stand for?

explanation, treatment, healers, negotiate, intervention, collaboration

what does ETHNIC stand for?

listen, explain, acknowledge, recommend, negotiate

what does LEARN stand for?

rapport, empathy, support, partnership, explanations, cultural competence, trust

what does RESPECT stand for?

why do you think your illness is happening?

what is a question that you can ask a patient to assess their health beliefs?

further clarifies what the patient needs or wants so that we can provide them with the best care possible

what is the purpose of asking a patient a contrast question?

immigrants

what was the early focus of cultural competency in the healthcare field on?

open-ended

when using the teach-back method, you should ask ______ questions to your patient

b

you are in the process of admitting an ethnically diverse patient. to plan culturally competent care, you will conduct a cultural assessment that includes: a. biocultural history b. ethnohistory c. negotiation d. ethnocentrism

LEARN

a mnemonic used to conduct cultural assessment and is used to practice cultural desire, listen to the patient's perception of the problem, explain your perception of the patient's problem, acknowledge differences and similarities between the two perceptions, recommendations must involve the patient, negotiate a treatment plan that incorporates aspects of the patient's culture

Capinha-Bacote's model of cultural competency

a model of cultural competency that has 5 interrelated constructs, provide a framework for you to practice in a culturally competent manner and says that cultural competency is a developmental and ongoing process that has 5 steps: cultural awareness, cultural knowledge, cultural skills, cultural encounters, cultural desire

Blanchet and Pepin's dimensions of cultural competence

a model of cultural competency that was developed for registered nurses and undergraduate student nurses, involves building a relationship with the other person, working outside of the usual practice framework, and reinventing practice often

explanatory model

a patient's views about health and illness and its treatment, you can use questions about etiology, time and mode of onset of symptoms, pathophysiology, course of illness, and treatment for an illness episode to better gauge where your patient is at

bias

a predisposition to see people or things in a certain light, either positive or negative

cultural encounters

a process that encourages health care professionals to directly engage in face-to-face cultural interactions and other types of encounters with patients from culturally diverse backgrounds, aims to modify a health care provider's existing belief about a cultural group and to prevent possible stereotyping

Core Quality Measures Collaborative

a set of core measures which aim to hold health care providers accountable for considering patients' unique cultural perspectives to provide safe and quality care

core measures

a set of evidence-based, scientifically researched standards of care, key quality indicators that help health care institutions improve performance, increase accountability, and reduce costs, monitored by the Joint Commission, measures apply to all patients, are consistent with national health disparities, and are intended to reduce health disparities around particular core measures

iceberg analogy

a tool that helps you to visualize the visible and invisible aspects of your own and others' world views, most of an iceberg lies beneath the surface of the water = most aspects of a person's worldview are hidden and lie outside of his or her awareness or from your view, all you can see is observed behavior

world view

is shaped by historical and social realties, determines how people perceive others, how they interact with and relate to reality, and how they process information; a set of assumptions that begins to develop during childhood and guides how one sees, thinks about, experiences, and interprets the world; creates a lens through which we view all of our life's experiences

native language

it is a patient's right to receive healthcare in their.....

worldview

it is important not to interpret the behaviors of patients through your own ______, because it can cause conflict.

individual

it is important that we treat the _______; approach each patient individually and ask questions to gain a better understanding of the patient's perspectives and needs

advocate, world views

it is important to ______ for the patient based on their _______, this requires ongoing assessment, flexibility, and planning partnership with each patient

interpersonal skills, marginalized groups, prejudice/stereotyping/bias, health system, communities, institutions

many of the current approaches to cultural competency are expanding the original focus on __________ to also focus on things like _________, not just immigrants, _________, and _____________.

world views

nurses need to understand the ______ of others in order to deliver the best care

native language, low literacy, language barrier

part of linguistic competence is providing care in the _________ of the client; this also refers to patients who have ________ levels. when there is a ________, this effects clear communication with your patient

similar, quality

patient-centered care and cultural competence are very ______, but each emphasizes different aspects of _______.

unconscious bias

bias we are unaware of and that happens outside of our control, is influenced by our personal background, cultural environment, and personal experiences, typically directs one to make quick judgments and assessments of people and situations

individualized, personal relationships, cultural competence

patient-centeredness provides ________ care and restores an emphasis on _____________. it includes ________ because the patient is the center of anything in practice. the patient can be a family or community as well, not just an individual

prejudice, seek help

patients who have subjected to ______ are less likely to ______ in the future, and likely won't engage in preventative medicine.

the Joint Commission

Core measures are monitored by the.......

healthcare regulatory agencies

ensure that we are delivering culturally competent care, make sure that nurses know how to access language access services, aim to improve patient safety and care

biases

everyone holds ____ about human behavior that are culturally driven

plain language

grammatically correct language that includes complete sentence structure and accurate word usage, makes any information you provide to a patient easy to read, understand, and use

d

health disparities are unequal burdens of disease morbidity and mortality rates experienced by racial and ethnic groups. these disparities are often exacerbated by..... a. bias b. stereotyping c. prejudice d. all of the above

patient education

health literacy is important in planning _________ approaches

cultural competence, cultural encounters

healthcare organizations are increasingly integrating __________________ principles into everyday organizational processes and practices; there is often specific training related to ___________.

help seeking, treatment, recovery

healthcare providers gain cultural knowledge by taking time to better understand the populations they serve and obtaining specific cultural knowledge as it relates to _____, ____, and ______.

socialization (family, friends, community, peers, schooling, media, work, religion, government, legal system, healthcare system, etc.)

how do we develop our worldview?

LGBTQ population

population that is less likely to come in for care and more likely to be diagnosed with chronic diseases as a result of lack of care early on, more likely to die of things like strokes, don't engage in preventative medicine

stereotype

an assumed belief regarding a particular group

cupping, abuse

an example of interpreting a cultural practice with a Western worldview that can lead to conflict is that in some cultures, ______ is a traditional practice that leads to marks on the bodies of children. this can be interpreted as ________ by Western medical professionals who are not culturally knowledgeable

cultural assessment

an extremely important thing that we do as nurses, the goal is to obtain accurate information to develop mutually acceptable and culturally relevant plans of care, we should use open-ended, focused, and contrasted questions because these give patients an opportunity to express their cultural beliefs

teach-back method

an ongoing process of asking patients for feedback through explanation or demonstration and of presenting information in a new way until you feel confident that you communicated clearly and that your patient fully understands the information provided, a continuous cycle that can help to identify gaps in a patient's knowledge

emic

approach of studying a culture's behavior from the perspective of an insider, is not always possible to do

etic

approach of studying a culture's behavior from the perspective of an outsider

communication, misperceptions

_____ is extremely important when talking to your patients because they may have ______ about a health condition.

misunderstandings

__________ may occur due to inappropriate communication between a healthcare provider and a client and are a barrier to accessing healthcare

cultural assessment

a comprehensive assessment that helps us to understand the patient's ethnohistory, caring beliefs and practices, health beliefs, religion, etc. and is used to understand how their values will affect his/her willingness to receive care and their worldview, is important if you are trying to develop a therapeutic relationship with the patient

Unequal Treatment (Smedley et al., 2003)

a landmark report focused on patient-centered care, discussed cultural competency and eliminating health disparities

Crossing the Quality Chasm (IOM, 2001)

a landmark report focused on patient-centered care, talks about patient-centered care being one of the big 6 claims of healthcare practice

performance, accountability, costs

core measures help health care institutions improve ______, increase _______ and reduce _______.

intrusive, time

cultural assessment is ______ and may take way more _____ to conduct; this is why we have to start asking questions early because we don't have a lot of time with our patients

trusting

cultural assessment requires building a _________ between participants

self-examination, cultural, professional

cultural awareness requires _______ of one's biases toward other cultures an an in-depth exploration of one's own _____ and _____ background.

health equity, disparities

cultural competence aims to increase __________ and reduce _______ by concentrating on people of color and other disadvantaged populations, is an expansion of patient-centered care, and is a necessary set of skills that you have to develop in order to be an effective nurse

dynamic, time

cultural competency is ______ and takes ______ to develop; the more you engage with members of other cultures, the more you will learn

negotiation

cultural competency is a _______; we always want to discuss with our patients to create a plan that is best with them

open, flexible, differences, similarities

cultural desire includes a genuine passion to be ____ and ____ with others, to accept ______ and build on _________, and to be willing to learn from others as cultural informants

caring

cultural desire involves the concept of __________; it requires you to enter into the patient's worldview in order to best help them and understand them

explain new concept, assess patient recall and comprehension, clarify and tailor explanation, reassess patient recall and comprehension

describe the steps of the teach-back method of patient education

education level

despite ________, 90 million Americans have limited health literacy

yes/no

do not ask ___ questions during a cultural assessment

yin

A Chinese concept that represents "cold"

yang

A Chinese concept that represents "hot"

complementary therapy

A variety of therapeutic or preventive health care practices, such as homeopathy, naturopathy, chiropractic, and herbal medicine, that do not follow generally accepted medical methods and may not have a scientific explanation for their effectiveness; using cultural practices and beliefs as a complement to traditional Western medicine

reinvent

Blanchet and Pepin's model of cultural competency says that we need to _____ practice often because as you learn and develop your cultural competency and understanding, you will need to _____ your nursing as a culturally competent team member

practice framework

Blanchet and Pepin's model of cultural competency says that we need to work outside of the usual _____________ because not every client will be the same when they present with a disease, and we need to develop interventions that are particular to a certain patient to make sure that they are effective

developmental, ongoing

Campinha-Bacote's model of cultural competency says that cultural competency is a ________ and ______ process.

health-related beliefs and values, care practices, and disease incidence and prevalence

according to Campinha-Bacote, acquiring cultural knowledge requires focusing on three specific issues. what are they?

patient-centered care

according to Campinha-Bacote, cultural competence is an expansion of......

self-examine, biases

according to Campinha-Bacote, the first thing we need to do to develop cultural competency is to _________ ourselves and recognize any _______.

hidden, visible

according to the iceberg analogy of understanding one's worldview, most aspects of a person's worldview are ______ and are not ______ to others, such as beliefs, attitudes, knowledge, and experiences that guide behavior

biases, attitudes

becoming more self-aware of your _____ and _____ about human behavior is the first step in providing patient-centered care

implicit bias

bias that we aware of, impacts our behavior, decisions, and patient-centered care

delay care

clients who do not speak English will often _______ because of a lack of cultural competency in healthcare institutions

national health disparities

core measures are consistent with and are intended to reduce _______________.