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Cultural Assessment
Question | Answer |
---|---|
Transcultural Considerations in Assessment | (blank) |
Cultural Assessment | Definition: “The systematic appraisal of an individual’s beliefs, values and practices conducted for the purpose of providing culturally competent health care” |
Cultural Assessment | “Integration of knowledge, attitudes and skills which enhance communication, promote meaningful interactions with patients and enable one to provide culturally appropriate, congruent and relevant care.” |
Cultural and linguistic competence | “Cultural and linguistic competence refers to an ability by health care providers and health care organizations to understand and effectively respond to the cultural and linguistic needs brought by patients to the health care setting” |
Obstacles to cultural assessment | (blank) |
Ethnocentrism | tendency to view your own way of life as the most desirable, acceptable or best and to act in a superior manner toward another’s culture’s lifeways. |
Cultural imposition | the tendency to impose your beliefs, values and patterns of behavior on individuals from another culture |
Basic Characteristics of Culture | (blank) |
Four basic characteristics | Learned,Shared,Adapted,Dynamic |
Culture is specific, distinctive and encompassing all the knowledge, beliefs, customs, and skills acquired by members of the society | (blank) |
Within a culture | variation in ethnicity, religion, education, occupation, age and gender (subculture) |
Cultural Values | Learned in childhood |
Values | a desirable or undesirable state of affairs, Types and expressions of values differ |
Norms | rules by which human behavior is governed,Result from cultural values of the culture, Specifies appropriate behavior |
Dominant Value Orientation | Definition: A basic value orientation that is shared by the majority of its members as a result of early common experiences |
Five common human problems (Kluckhohn, 1990): | Innate human nature of people, Relationship to nature, Time dimension, Purpose of existence, Relationship with others |
Innate Human Nature | Good, evil or a combination |
Relationship to Nature | (genetics vs. change) |
Destiny | subjugated to nature in a fatalistic inevitable manner |
Harmony | exist together as a single entity |
Mastery | people intended to overcome natural forces and use them for the benefit of mankind |
Time Dimension | perception / focus of time |
Past | traditions and ancestors playing an important role in life |
Present | concerned with “now”, Future is vague and unpredictable, Preventive medicine difficult |
Future | progress and change valued, Discontent with past and present, Desire the “latest greatest” |
Being | emphasis on the spontaneous expression of impulses and desires, Perceived as an integral component of personality |
Being-in-becoming | inner control, meditation and detachment to achieve self-realization |
Doing | active striving and accomplishment competing against externally applied standards of achievement |
Relationship with Others (3) | Lineal relationships, collateral relationships, individual relationships |
Lineal relationships | relationships follow an ordered succession and have continuity through time (heredity and kinship ties) |
Collateral relationships | focus on group goals, Family orientation is all-important |
Individual relationships | refers to personal autonomy and independence, Individual goals dominate; group goals become secondary |
Family | consists of individuals living together as a unit |
Types of family | Nuclear (husband, wife, and children), Extended family (nuclear plus blood relatives and even people who are not biologically related), Blended (husband, wife, and children from previous relationships), Single parent (either mother or father and at least |
Family members may not follow stereotypical assumptions | (blank) |
Relationships that may seem apparent sometimes warrant further exploration when interviewing people from culturally diverse backgrounds | (blank) |
Religious Beliefs and Practices | In times of crisis religion may be a source of consolation for the person and for his or her family |
Religious dogma and spiritual leaders may exert considerable influence on the person's decision making concerning acceptable medical and surgical treatment, choice of healer(s), and other aspects of the illness. | (blank) |
Religion and Spirituality | Searching for spiritual meaning for illness or disability, |
Sometimes a difficult point of assessment for nurses | Comfort with your own spiritual beliefs is foundational |
Spirituality | purpose in life |
Religion | organized system of beliefs concerning the cause, nature, and purpose of the universe |
Religious identification | Culture and religion are interconnected |
Childhood | spiritual needs vary with development |
Parental perceptions about illness | Caused by transgression, Prayer tried first before medicine, Cultural taboos, Blood products, caffeinated medications, pork |
Main task is to achieve sense of integrity and sense of accomplishment | (blank) |
With integrity | aging is a positive experience |
Health and Culture Step 1 | understand your own culturally based values, beliefs and practices, Biases, preconceptions, prejudices about racial, ethnic, religious, sexual or socioeconomic groups |
Step 2 | identify the patient’s meaning of health, What is “health”? |
WHO: | “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." |
Symptom labeling - What is a symptom? | Depends on: Individual’s behavior, Cultural definition of normal, Beliefs about causation, Level of stigma, Prevalence of pathology, Meaning of illness |
Biomedical | based on the assumption that all events in life have a cause and effect, human body functions more or less mechanically, all life can be reduced or divided into smaller parts (reductionist), all of reality can be observed and measured |
Naturalistic (Holistic) | believe that human life is only one aspect of nature and a part of the general order of the cosmos, People from these groups believe that the forces of nature must be kept in natural balance or harmony, Found most frequently among Native Americans and A |
Magico-Religious | the world is seen as an arena in which supernatural forces dominate, Voodoo, witchcraft, Faith-healing, Healing rituals, |
Folk healers Hispanics: | a curandero(ra), espiritualista (spiritualist), yerbo (herbalist), or sabedor (healer who manipulates bones and muscles). |
Folk healers Blacks: | a hougan (a voodoo priest or priestess), spiritualist, or "old lady" (an older woman who has successfully raised a family and who specializes in child care and folk remedies). |
Native Americans: | a shaman or medicine (wo)man |
Asians: | herbalists, acupuncturists, or bone setters. |
Amish: | braucher refers to folk healers who use herbs and tonics in the home or community context. (massage; foot treatments; acupressure; reflexology; or, less frequently, iridology) |
Transcultural Expressions of Illness | Perception, diagnosis, labeling and treatment vary between cultures, Do not assume that perceived symptoms are equivalent to recognized disease , Bodily symptoms reported in various ways, Chinese and “sadness” |
Transcultural Expressions of Pain | Pain is a very private, subjective experience that is greatly influenced by cultural heritage. Expectations, manifestations, and management of pain are all embedded in a cultural context. The definition of pain, like that of health or illness, is cultural |
Silent suffering | self-control is better than open displays of strong feelings |
Nurses preconceive that Jewish and Spanish patients suffer the most and that Anglo-Saxon, German, and Asian patients suffer the least | (blank) |
Nurses who infer relatively greater patient pain tended to report their own experiences as more painful | (blank) |
Nursing years of experience, current position, and area of clinical practice are unrelated to inferences of suffering | (blank) |
Culture-Bound Syndromes | Condition which is culturally defined and may have no correlating “western diagnosis” |
Alternative or complementary interventions | Acupuncture, acupressure, therapeutic touch, massage, musical therapy, biofeedback, relaxation techniques, herbal remedies |
Cultural assessment | a systematic appraisal or examination of individuals, groups, and communities in relation to their cultural beliefs, values, and practices to determine explicit health care needs and intervention practices within the cultural context of the people being |