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