P&P Chapter 9: Culture Competence

During a nursing assessment a patient displayed several behaviors. Which behavior suggests the patient may have a health literacy problem? A. Patients difficulty completing a registration form at a medical office B. Patients asks for written information about a health topic C. Patient speaks Spanish as primary language D. Patient states unfamiliarity with a newly ordered medicine

A

stereotype

A assumed belief about a group of people

Balance of "HOT" and "COLD" Cold conditions: Cancer, Cold/flu, earaches, headaches, joint pain, menses, pneumonia, stomach cramps

Hot Treatments: Foods - Beef, Cereals, Chili pepper, Chocolate, Eggs, Liquor, Onions Medicines and Herbs: Anise, Aspirin, Castor oil, Cinnamon, Garlic, Ginger root, Iron, Penicillin, Tobacco

ethnic identity

are both components of self-concept that place the focus on being part of a cultural group. Although racial identity and ethnic identity demonstrate the differences between race and ethnicity, they have a shared history, values, and bonds. Research frequently treats racial and ethnic identities as interchangeable

marginalized groups

are more likely to have poor health outcomes and die earlier because of a complex interaction among their individual behaviors, environment of the communities in which they live, the policies and practices of health care and governmental systems, and the clinical care they receive

implicit bias

attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner

Oppression

is a formal and informal system of advantages and disadvantages tied to membership in social groups, reinforced by societal norms, biases, interactions, and beliefs

Racial identity

is based on one's self-identification with one or more social groups in which a common heritage with a particular racial group is shared

Assimilation

is the process in which the individual adapts to the host's cultural values and no longer prefers the components of the origin culture

Acculturation

occurs when an individual or group transitions from one culture and develops traits of another culture

Unconscious bias

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

Culture

refers to the learned and shared beliefs, values, norms, and traditions of a particular group, which guide our thinking, decisions, and actions

social determinants of health

The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels

9. Which statements made by a nursing student about the teach-back technique show understanding of the technique? (Select all that apply.) 1. "After teaching a patient how to use an inhaler, I need to use the teach-back technique to test my patient's ability to use the inhaler correctly." 2. "The teach-back technique is an ongoing process of asking patients for feedback." 3. "Using teach-back will help me identify explanations and communication strategies that my patients will most commonly understand." 4. "Using pictures, drawings, and models can enhance the effectiveness of the teach-back technique." 5. "When doing my patient teaching, I will use plain language to make the material easier to understand for the patient."

1, 2, 3, 4, 5

A nurse desires to communicate with a young woman who is Serbian and who has limited experience with being in a hospital. The nurse has 10 years of experience caring for Serbian women. The patient was admitted for a serious pregnancy complication. Apply the LEARN model and match the nurse's behaviors with each step of the model. ____ 1. L. a. The nurse notes that she has learned that fathers can visit mothers at any time in both Serbia and the United States. ____ 2. E. b. The nurse shares her perception of the woman's experiences as a patient. ____ 3. A c. The nurse asks the patient how she can maintain bed rest when she returns home. ____ 4. R. d. The nurse attends to the patient and listens to her story about hospitals in Serbia. ____ 5. N e. The nurse involves the patient in a discussion of the treatment options for her condition

1. D. (Listen) 2. B (Explain) 3. A (Acknowledge) 4. E (Recommend) 5. C (Negotiate)

8. Which explanation provided by the nurse is the most accurate meaning for "providing culturally congruent care"? 1. It fits the patient's valued life patterns and set of meanings. 2. It is the same set of values as those of the health care team member providing daily care. 3. It holds one's own way of life as superior to those of others. 4. It redirects the patient to a more socially expected set of values.

1. It fits the patient's valued life patterns and set of meanings.

6. A nurse working in a large occupational health clinic knows that many of the workers at her company are marginalized and at risk for poor health outcomes. Which of the following individuals are most likely to be marginalized? 1. Wives of the employees 2. The head supervisors of the company 3. Workers who have a high school education 4. Workers employed for less than a year at the company

3

7. A mother is concerned about her child's flulike symptoms. You learn from the health assessment that the mother practices the use of "hot" and "cold" foods to treat ailments. Which of the following foods do you expect the mother to use to treat her child? 1. Chicken 2. Yogurt 3. Fresh fruits 4. Eggs

4. Eggs

Cultural Encounter

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. A cultural encounter aims to modify a health care provider's existing belief about a cultural group and to prevent possible stereotyping.

Intersectionality

A research and policy model for studying the complexities of people's lives and experiences

A nurse is seeing all of these patients in the community health clinic. The nurse identifies which patient(s) as having a health disparity? (Select all that apply) A. A patient who has a homosexual sexual preference B. A patient unable to access primary care services C. A patient living with chronic schizophrenia D. A family who relies on public transportation E. A patient who has a history of hypertension

A, B, C

5. Health care agencies must provide which of the following based on federal civil rights laws? (Select all that apply.) A. Provide language assistance services at all points of contact free of charge. B. Provide auxiliary aids and services, such as interpreters, note takers, and computer-aided transcription services. C. Use patients' family members to interpret difficult topics. D. Ensure that interpreters are competent in medical terminology. E. Provide language assistance to all patients who speak limited English or are deaf.

A, B, D, E

A 35-year-old woman has Medicaid coverage for herself and 2 young children. She missed an appointment at the local health clinic to get an annual mammogram because she has no transportation. She gets the annual screening because her mother had breast cancer. Which of the following are social determinants of the woman's health? (Select all that apply) A. Medicaid insurance B. Annual screening C. Mother's history of breast cancer D. Lack of transportation E. Woman's age

A, D, E

Balance of "HOT" and "COLD" HOT Conditions: Constipation, Diarrhea, Fever Infection, Kidney problems, Rash, Sore throat, Ulcers

COLD Treatments: Foods - Barley water, Chicken, Dairy products (bottled milk), Fresh vegetables, Tropical fruits, Honey Medicines and Herbs - Bicarbonate of soda, Milk of Magnesia, Orange flower water, Sage

10. Match the cultural concepts on the left with the correct definitions on the right. ____ 1. Etic worldview a. Factor that shapes how people perceive others and how they relate to reality ____ 2. Worldview. b. Insider's perspective in an intercultural encounter ____ 3. Cultural desire. c. A policy model that describes factors and power structures that shape and influence life ____ 4. Intersectionality. d. An outsider's perspective in an intercultural encounter ____ 5. Emic worldview. e. The motivation of a health care professional to "want to" engage in cultural competence

Etic worldview - d. An outsider's perspective in an intercultural encounter Worldview - a. Factor that shapes how people perceive others and how they relate to reality Cultural desire. - e. The motivation of a health care professional to "want to" engage in cultural competence Intersectionality. - c. A policy model that describes factors and power structures that shape and influence life Emic worldview. - b. Insider's perspective in an intercultural encounter

Cultural skill

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.

Culture Desire

The motivation of a health care professional to "want to" (and not "have to") engage in the process of becoming culturally aware, culturally knowledgeable, and culturally skillful in seeking cultural encounters.

Cultural knowledge

The process in which a health care professional seeks and obtains a sound educational base about culturally diverse groups. 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.

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. It also involves being aware of the existence of documented racism and other "isms" in health care delivery.

health disparity

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage