Ch 9 Cultural Awareness
Communication Techniques Using Mnemonics: RESPECT?
Rapport Empathy Support Partnership Explanations Cultural Competence Trust
a predisposition to see people or things in a certain light, either positive or negative.
a bias
What is a marginalized group?
a group who's looked at as inferior or not apart of the dominant class
What is a health disparity?
a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.
stoic?
a person who can endure pain or hardship without showing their feelings or complaining.
Emic vs Etic world view
- inside my world (emic) - in their world (etic)
An in-depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people
cultural awareness
defined as the enabling of health care providers to deliver services that are respectful of and responsible to the health beliefs, practices, and cultural and linguistic needs of diverse patients.
cultural competency
is the motivation of a health care professional to "want to"—not "have to"—engage in the process of becoming culturally competent
cultural desire
The motivation and commitment to caring that moves an individual to learn from others, accept the role as a learner, be open to and accepting of cultural differences, and build on cultural similarities.
cultural desires
Cross-cultural interactions that provide opportunities to learn about other cultures and develop effective intercultural communication
cultural encounters
is an intervention that involves a nurse directly interacting with patients from culturally diverse backgrounds
cultural encounters
Sufficient comparative knowledge of diverse groups, including the values, health beliefs, care practices, world view, and bicultural ecology commonly found within each group
cultural knowledge
Ability to assess social, cultural, and biophysical factors that influence patient treatment and care
cultural skills
care that fits a person's life patterns, values, and system of meaning
culturally congruent care
Ethnicity, race, nationality, and language, gender, sexual orientation, location, class, and immigration status
culture
Norms, values, and traditions passed from generation to generation
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
culture (how we develop our world view)
—his or her views about health and illness and its treatment.
explanatory model
New Standards have been put into place to address health care disparities. What is the main focus?
focus on cultural competency, health literacy, and patient-and family-centered care.
Which people have a significantly increased risk for depression, anxiety, and substance use disorders and are four times as likely as others to make suicide attempts that require medical attention?
gay, lesbian, and bisexual young people
What is social inequality?
groups having unequal access to resources, services, and positions
Which organizations have responded to the complexities by implementing new standards focused on cultural competency, health literacy, and patient- and family-centerd care?
the Joint Commission (TJC), the National Quality Forum (NQF), and the National Commission on Quality Assurance (NCQA)
What are 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.
focus on cultural competency, health literacy, and patient-and family-centered care.
the main focus of health care disparity (new) standards
What do you think has caused your problem? Why do you think it started when it did?
time and mode of onset
Who is more likely to postpone medical care because of lack of insurance and encounters with discrimination than people who do not identify as such?
transgender
Culture is about which two things?
values and beliefs
In which cultures is the infant mortality rate 60% higher than in non-HIspanic whites?
American Indian and Alaska Native populations
Which groups of people have the highest national poverty rates?
African Americans, Hispanics, and Native Americans
_________of your biases and attitudes about human behavior is the first step in providing patient-centered care.
Becoming more self-aware
Difference between cultural competence and patient-centered care?
Both patient-centeredness and cultural competence aim to improve health care quality, but each emphasizes different aspects of quality. The primary goal of the patient-centeredness movement has been to provide individualized care and restore an emphasis on personal relationships. It aims to elevate quality for all patients. Alternatively, the primary aim of the cultural competence movement has been to increase health equity and reduce disparities by concentrating on people of color and other disadvantaged populations (p. vii).
Communication Techniques Using Mnemonics: C-LARA?
Calm Listen Affirm Respond Add
aspects of your worldview lie deep inside.
Conduct a thorough assessment
identifies patient-centered care as one of six "aims" for high quality health care,
Crossing the Quality Chasm (Landmark reports)
Cultural competency is developmental. Campinha-Bacote's model has 5 interrelated components. What are they?
Cultural Awareness " Knowledge " Skills " Encounters " Desire
Communication Techniques Using Mnemonics: ETHNIC:
Explanation Treatment Healers Negotiate Intervention Collaboration
T or F. Social location does not have an effect on social groups and health care disparities.
F. It absolutely does
T or F. It is important to understand that Teach Back is intended to test a patient but not to confirm the clarity of your communication
F. It is important to understand that Teach Back is not intended to test a patient but rather to confirm the clarity of your communication
T or F. Most aspects of a person's world view are visible.
F. are hidden
consent has to be in english no matter what. T or F.
F. consent has to be in their language (according to the TJC).
People of certain ethical backgrounds suffer from unique things. E.g., AFrican Americans suffer more from Lupus (made up example). What is this an example of?
Health disparity
To provide culturally congruent care, you need to understand the difference between disease and illness. Define.
Illness: the way that individuals and families react to disease Disease: a malfunctioning of biological or psychological processes.
Why do cultural encounters have the potential for conflict?
LACK OF CULTURAL DESIRE, AMONG MANY OTHER THINGS
Communication Techniques Using Mnemonics: LEARN?
Listen Explain Acknowledge Recommend Negotiate
Instead of thinking about race, gender, immigration status, class, and other axes of identity as descriptive categories only, it is important to understand them within the context of the larger system of power and privilege that permeates society.
Matrix of Domination
Recognize that valuing each patient's unique needs improves the overall safety and quality of care and helps to eliminate heath disparities.
New Standards that address health care disparities
is an intervention that helps you to confirm that you have explained what a patient needs to know in a manner that the patient understands.
Teach Back
What is the goal of a cultural assessment?
The goal of a cultural assessment is to obtain accurate information from a patient that allows you to formulate a mutually acceptable and culturally relevant plan of care for each health problem of a patient
stresses the importance of developing cultural competence among health care providers to eliminate racial/ethnic health care disparitie
Unequal Treatment (Landmark reports)
Views about patients and care: West vs Nonwest
West: more medical approach; medicine is the focus Non-west: more holistic
How do health care providers and health care systems contribute to the problem of health disparities?
because health care often focuses on cost-effecting and time-saving things
What is intersectionality?
belonging simultaneously to multiple social groups
Race is limited to what?
biological attributes shared amongst a group, such as skin color
What will happen to you? What do you fear most about your sickness? What are the chief problems your sickness has caused for you?
course of illness (symptoms, etc)
What is oppression
can be formal or informal; a system of advantages and disadvantages tied to our membership in social groups
Cultural encounters provide the opportunity to show what?
compassion
are key quality indicators that help health care institutions improve performance, increase accountability, and reduce costs
core measures (e.g., screening for depression)
Transcultural nursing?
defines by Leininger as a comparative study of cultures to understand their similarities and the differences among them your culture vs my culture
What are health care disparities?
differences among populations in the availability, accessibility, and quality of health care services
What contributes to health and health care inequities?
discrimination
What is culturally congruent care?
equal care for all
What does disparity mean?
equality
What do you call your problem? What name does it have? Which portion of the explanatory model [biomedical] is this?
etiology
What are the 5 questions in most explanatory models?
etiology, time and mode of onset of symptoms, pathophysiology, course of illness (including severity and type 108of sick role), and treatment for an illness episode
+____ refers to the notion that intersecting categories such as race, ethnicity, gender, socioeconomic status, sexual orientation, and other axes of identity contribute to systemic injustice and social inequality (Cho et al., 2013).
intersectionality
What is health literacy?
is the ability to obtain, process, and understand health information needed to make informed health decisions
Lack of diversity in healthcare leads to what?
lack of trust and adherence by the patient = poor outcomes
is the ability of an organization and its staff to communicate effectively and convey information in a manner that is easily understood by diverse audiences.
linguistic competence
Groups are left out
marginalization
People in these groups are more likely to have poor health outcomes and die at an earlier age because of a complex interaction between individual genetics and behaviors; public and health policy; community and environmental factors; and quality of health care.
marginalized groups
Cultural encounters enable new forms of what?
new forms of community and collective idenetity
Which type of questions will you use for a cultural assessment? (helps you keep focus on what will be important for the care of your patient)
open-ended, focused, and contrasted questions
What do you think your sickness does to you? How does this illness work inside your body?
pathophysiology
Overinclusion and underinclusion?
pretty self explanatory; many groups are overlooked in research and the design for interventions.
How should your sickness be treated?
recommended treatment
What do all cultures value?
reproduction; continuity is promoted.
What is ethnicity?
sense of identity to a group
though family, friends, community, peers, schooling, medkia, work, religious institutions, governments, legal system, health care system, etc.
socialization (how we develop our world view) For example, a Korean woman requests seaweed soup for her first meal after giving birth. This request puzzles her nurse. The nurse has an insider's view of professional postpartum care but is an outsider to the Korean culture. As such, the nurse is not aware of the significance of the meal to the patient. Conversely the Korean patient has an outsider's view of American professional postpartum care and assumes that seaweed soup is available in the hospital because, according to her cultural beliefs, the soup cleanses the blood and promotes healing and lactation
Who is more future oriented? Who is more present oriented?
west - future non-west - present
Sometimes dual headsets are used when?
when translators aren't available
What happens when we provide culturally congruent care?
you bridge cultural gaps to provide meaningful and supportive care for all patients
According to Blanchet and Pepin. What are the 3 dimensions of cultural competencies?
• Building a relationship with the other • Working outside the usual practice framework • Reinventing practice in action
According to the NCC, culturally competent organizations: Value _____ Conduct a _____ Manage the _______ of difference Institutionalize ______ Adapt to ______
• Value diversity • Conduct a cultural self-assessment • Manage the dynamics of difference • Institutionalize cultural knowledge • Adapt to diversity
