3016: CHAPTER 10 FINAL

CHAPTER 10

What is culture?

Learned, shared beliefs, values, and behaviors that guide worldview and decisions

Examples of cultural characteristics?

• Religion

• Nationality

• Urban vs rural living

• Language

What is spirituality?

Connection to meaning, purpose, or higher power

What indicates spiritual distress?

Questioning meaning of life or God during illness

What is social assessment?

Evaluates environment + social determinants affecting health

What are biases?

Personal prejudices that affect care

First step to reduce bias?

Self-reflection

What is cultural competence?

Ability to provide safe, effective care that meets cultural, social, and language needs

What does CLAS stand for?

Culturally and Linguistically Appropriate Services

What are CLAS standards?

Guidelines for culturally & linguistically appropriate care

MAIN GOAL of CLAS?

Provide equitable, respectful, understandable care

Key rule about interpreters? (CLAS)

Use trained interpreter (NOT family/minors)

Cost of interpreter services?

FREE to patient

What is culturally competent care?

Care that aligns with patient’s beliefs and values

Why is cultural assessment important?

Patients will NOT follow care plans that conflict with their beliefs

Key nursing behaviors for providing quality care (multiple cultures)?

• Active listening

• Respect beliefs

• Avoid assumptions

What is the MOST important first step in cultural care?

Assess patient’s beliefs and preferences (do NOT assume)

How do you provide quality care for diverse cultures?

• Individualize care

• Ask about beliefs

• Use interpreters

• Adapt plan of care

What should the nurse NEVER do?

Assume all patients from a culture have the same beliefs

What is a key focus in rural communities?

• Limited access to care

• Transportation barriers

What are secondary building blocks?

Local clinics linked to larger systems

What is Leininger known for?

Transcultural nursing theory

Goal of Madeleine Leininger’s theory?

Culturally congruent care

What does Anderson and McFarlane’s Community Assessment model assess?

Community as a whole (demographics, values, history + resources)

Primary building blocks? (Anderson and McFarlane’s Community Assessment Model)

Schools, Police, Parks

Potential building blocks? (Anderson and McFarlane’s Community Assessment Model)

Outside resources (politicians, corporations)

Goal of cultural assessment?

Understand patient beliefs + practices

What is included in cultural assessment?

• Diet practices

• Religious beliefs

• Health beliefs

• Treatment preferences

Goal of social assessment?

Identify barriers to care (housing, safety, finances)

Goal of transcultural assessment?

Compare individual vs cultural norms (avoid stereotypes)

Cultural diet examples?

• Fasting (Ramadan)

• Kosher/Halal diets (fat baby)

Nursing priority with cultural diet?

Respect beliefs + adjust care safely

Example accommodation?

Provide basin for ritual washing (Muslim)

Key question in end-of-life care?

“Who is the decision-maker/spokesperson?”

Cultural factors to assess?

• Family closeness

• Spiritual beliefs

• Pain expression

Nursing priority with end-of-life

• Respect cultural death practices

Why must nurses assess beliefs?

Beliefs may conflict with treatment

Example of harmful belief?

“Pain means I don’t need meds”

Nursing action?

Educate + respect + collaborate

What is important for Jehovah’s Witness?

May refuse blood transfusions

Clinical Judgment Case Study: Mr. Farhan

• Patient: 54-year-old Somali Muslim immigrant with Type 2 Diabetes.

• The Issue: He wants to fast for Ramadan but had a hypoglycemic episode (loss of consciousness) during his last fast.

• Nursing Priority: Risk for hypoglycemia during fasting.

• Action: Respect the religious desire to fast, but collaborate with the Imam to seek a medical exemption and adjust medication/exercise timing