Acculturation/Cultural Assimilation
When an individual shifts his or her identity from the minority group to the dominant group and adopts the values, attitudes, and behaviors of the dominant culture. Losing the cultural characteristics that once made the minority group different.
Beliefs
How a person perceives situations and other people which are influenced by: cultural beliefs, social beliefs, religious beliefs, and personal connections.
Cultural diversity
A group of people whose members are characterized by a wide range of distinctions.
What are distinctions of cultural diversity?
Race, national origin, religion, language, physical size, gender, sexual orientation, age, disability, socioeconomic status, occupational status, geographical location.
Culture
A shared system of beliefs, values, and behavioral expectations that provide structure for daily living. It influences people’s roles and interactions with others and is revealed in the attitudes, customs, and institutions unique to particular groups.
What is culture influenced by/rooted in?
Aspects of human society, including: beliefs, habits, likes, dislikes, customs, rituals.
Culture shock
Feelings of psychological discomfort or disturbance caused by living in a dominant culture that differs from one’s own. Often produces feelings of stress, foolishness, fear, inadequacy, embarrassment, humiliation, inferiority, frustration, anxiety, and low self-esteem.
Dominant group
The group within a society that tends to control that society’s values, and while it is usually the largest group in the society, it does not have to be.
Ethnicity
A sense of identification with a group based on a common heritage. Belonging to it means being born into it or adopting the group’s characteristics.
What are characteristics i people within the same ethnic group?
Language and dialect, religious practices, literature, folklore, music, political interests, food preferences.
Ethnocentrism
The belief or assumption that a particular social or cultural group is superior in some way.
Folk medicine
A form of prevention and treatment that uses old-fashioned remedies and household medicines handed down from generation to generation within a particular culture.
Hereditary
Inherited genetically; being more prone to developing particular diseases, characteristics, and conditions, sometimes based on racial or ethnic groups.
Immigrate
Settling in a new country.
Minority group
Usually has some physical or cultural characteristics that identify the people within it as different from the dominant group, such as: race, religion, beliefs, customs or practices.
Race
Normally based on specific physical characteristics, such as skin pigmentation, body stature, facial features, and hair texture.
Subculture
A group of people who are members of a larger cultural group, but whose attitudes and behaviors reflect different beliefs and values from those of the larger culture.
Stereotypes
Mistaken perceptions that are typically rooted in strong feelings and lack of knowledge.
Name examples of ethnicities
African American, Asian American, European American, Hispanic American, Middle Eastern/Arabic American, Native American
What is the importance of cultural competency?
Health care workers need to be aware of, and sensitive to, cultural diversity, life situations, and other various factors that shape a person’s identity.
Is it possible to erase all biases?
No it is not possible. But they can be set aside for the purpose of the medical case.
What is cultural competency?
An ability to interact effectively with people of different cultures.
What is bias?
A preference that inhibits impartial judgment of others.
Territorial space
The distance people require to feel comfortable when interacting with others.
Difference between spirituality and religion
Spirituality is based on one’s own beliefs and has no rules but religion is group based and has rules.
What is a nuclear family?
A nuclear family is a family with a mom and dad with children who are usually in a middle-income home.
Give an example of a non-nuclear family
Examples: two women/men with a child/children, single mother/father, two people with no kids
What is holistic care?
The treating of both the mind and body through medicine.
List 3 ways to overcome bias, prejudice, and stereotyping.
Understand that all people are different, educating yourself, interact with other cultures
What is prejudice?
Preconceived opinion that is not based on reason or actual experience.
What is sensitivity?
Understanding a person’s perspective when it comes to certain topics.
Compare and contrast “Western” or biomedical health care and alternative medicine.
Western medicine is more focused on healing the body but alternative medicine is more focused on healing the mind
What is an atheist?
A person who does not believe in any deity or higher power.
True or False: Maintaining direct eye contact always is a sign of respect
False: In some cultures, maintaining direct eye contact is seen as rude and disrespectful. Some cultures which believe in the evil eye see it as a curse to look a baby in the eye.
True or False: Traditional Muslim culture permits women to wear whatever they choose and not wear a head covering
False: In traditional Muslim culture, while it is not forced, it is encouraged to wear the hijab or burqa and wear modest clothing.
True or False: Many Latin American cultures believe in the need to keep the body in balance
True
True or False: Culture is defined as the thoughts, beliefs, and values of a social group
True
True or False: As a nursing assistant, you will typically work only with coworkers of the same culture and religion as you
False: A nursing assistant will work with people of all religions and cultures.
True or False: Nursing assistants need to provide care for patients and residents and if they are modest, they just need to get over it so you can get your job done
False: No, modesty should try to be maintained to its fullest capacity such as not taking off the hijab or allowing something to be worn under the hospital gown.
True or False: When speaking to patients or residents, it is a good idea to use slang term or jargon because it helps develop rapport
False: No because there is no guarantee that the person will understand what is being said.
True or False: Having a family member translate what you are saying is a great way to communicate
False: It is not the best way because there is no guarantee that they are saying the correct thing
True or False: Telling jokes are a fun way to break the ice with patients and family members of a different culture
False: Some cultures could be offended by this as they are dealing with health issues at the moment
True or False: Ablution is the practice of praying at regular times during the day
False: No it is the practice of washing oneself
True or False: Spirituality is an organized system of belief in a higher power
False: Spirituality is more individual not group based
True or False: People who do not speak English are mentally confused
False: Just because a person does not speak english does not mean they are mentally confused
True or False: Every culture and religion believe that conducting an autopsy of the deceased is necessary
True
True or False: The Sacrament of the Sick may be administered to Christian Scientists who are very ill or just before death
False: No this is for roman catholics
True or False: Some patients or residents may not have formal religious affiliations; however, they may still have spiritual needs
True
True or False: A prayer rug is special to the Islamic, who pray multiple times a day in the direction of Mecca. However, in the hospital, they will not be permitted to continue this practice
False: They are able to continue practicing in the hospital
True or False: Using gestures like “thumbs up” can be an effective way to communicate
True
True or False: Even though a person may be part of an identifiable culture, he or she should still be recognized as a unique individual
True
True or False: If the clergy is visiting with a patient or resident, you should continue with your care or tasks with that person.
False: No, giving the patient time with the clergy is best since they are trying to spiritually connect with their religion.
True or False: Although some religious groups may avoid certain types of food, that is something that can only be maintained at home, not in an acute or long term care setting
False: No, adjustments can be made such as providing them with vegetarian options or allowing other people to bring food in for the patient.
True or False: Some cultures use amulets, which are charms used to ward off evil
True
True or False: Attitudes about death are closely related to religion
True
True or False: Touch is a sign of affection and people of all cultures love to be touched
False: Not all cultures like to touched some do not liking touching between different sexes
True or False: A patient from another culture may answer “yes” to all questions
True
True or False: If a person does not understand English, it may be helpful to speak very loudly
False: Speaking loudly does not rid the fact that they can’t understand you.
True or False: A picture board may be used as a communication tool with people who do not speak English
True
True or False: The nursing assistant should share their own religious beliefs with their patients and residents as it will help to develop a deep bond
False: Sharing their personal beliefs should not be done as it is not the patient’s business and they may not agree with the beliefs.
True or False: In some cultures, the left hand is used for eating and the left hand is always used for personal hygiene after using the toilet
False: It is actually the right hand for eating not the left hand that is used.
True or False: An interpreter is a communication specialist who can mediate between speakers of different languages
True
The home health nurse prepares to teach a Hispanic patient who neither speaks nor reads English how to measure and administer insulin. The most helpful teaching tools would be:
An alarm clock, magazine pictures showing sunrise and sunset, several clean insulin syringes, and insulin bottles filled with colored water.
The nurse is cleaning the bedside area to give a bed bath to a Muslim woman the day after a cesarean section. The culturally sensitive nurse would:
Be especially protective of her modesty.
A severely injured adult male is brought into the ER following an auto accident and is given 2 units of O negative blood while waiting for a crossmatch to be completed for the other 4 units of blood that the doctor has ordered. The nurse discovers a card identifying the man as a Jehovah's Witness, The nurse should:
Inform the doctor that the patient is a Jehovah's Witness
A nurse leading a discussion group of Jewish long-term care facility residents to discuss dietary law and other religious practices anticipates that the most prominent need of these patients would be
Having a quiet time for prayer provided before and after all meals
A Filipino man is admitting his elderly mother to a long-term care facility for custodial care During the intake interview, the man is alternately tearful and defensive. The culturally competent nurse assesses the labile behavior as being related to the Filipino belief that.
families should care for the elderly at home.
A patient of Chinese descent is in the community clinic for treatment of his arthritis The patient tells the nurse that his disease is a hot disease. The nurse assesses that he is referring to the 'hot-cold theory, which holds that hot diseases are caused by:
Excess of blood and yellow bile.
The nurse has scheduled a specific time for a group of Latino diabetics to come for diabetic teaching, but the group does not come until almost an hour later The culturally competent nurse is aware that
their culture places little significance on time concepts
Transcultural nursing care is expected for every patient. To provide this type of care, the nurse needs to understand the practices of the predominant cultures of those groups in the health care geographic area that would require the nurse to be aware that:
Culture influences beliefs about health, illness, and health practices
As breakfast trays are served, a Catholic patient asks the nurse to take it away, because a priest is coming to administer Communion. The response by the nurse should be:
"I will leave the tray in the kitchen and you may call me to bring it back when it is time"
A practicing Hindu patient is dying, but has orders for a full diet, however, the patient will accept only soups. The nurse should order which of the following from the kitchen?
Puréed tomatoes, carrots, celery, and potatoes in a vegetable stock
Buddhism
Beliefs: Spiritual enlightenment through conscious living and meditation
Death: Avoid mind altering drugs, chanting, state of mind at death influences rebirth (calm and peaceful)
Diet: Usually vegetarian, No alcohol, tobacco or coffee
Health: Mental cures are important
Pregnancy: Artificial insemination and birth control are acceptable
Rituals:Ceremony around baby blessings, marriage, and death. Monthly atonement ceremony on the full moon
Clinical Issues: blood products are acceptable. Avoid mind altering drugs
Christian Science
Beliefs: Bible based christian religion
Christian Scientists generally view disease and illness as a mental error, not a physical problem
Death: No church policy on burial, but body should be prepared for burial by same sex
Diet: Avoid tobacco, alcohol and sometimes caffeine
Health: Spiritual means for preventing and healing diseases
Pregnancy:
Rituals: Praying
Clinical Issues: Usually do not seek immediate medical care
Church of Jesus Christ of Latter-day Saints
Beliefs:Daily prayer and reading of holy book. Family oriented
Death:Autopsy ok, believes in resurrection, euthanasia is not allowed, organ donation permitted
Diet: Fasting once a month, ill people not required, alcohol, coffee, tea and tobacco are discouraged
Health: Blood and blood products ok
Pregnancy: Abortion forbidden except in rape or mothers life in danger, artificial insemination OK, Birth control is for couples to decide.
Rituals: 2 elders are required for blessing of sick
Clinical Issues:Known for healthy lifestyles
Hinduism
Beliefs:Karma, Duties to god, parents, society and teachers
Death: Must be peaceful,autopsy and burial ok,cremation is common day of death, euthanasia forbidden,family wash body immediately after death,prefer to die at home
Diet: Fasting on holy days,right hand used for eating, left hand toileting
Health: Bathing after meal could cause stomach upset,Blood and products ok,patriarch, hot water to cold but cold can’t be added to hot, daily bath
Pregnancy:anti abortion unless mothers life in danger, circumcision is uncommon, may bot name immediately, exact time of birth important
Rituals:Several holy days, sit at lower elevation than the deity image, barefoot during worship, meditation, respect for elders, 10 -11 days priest performs naming ceremony Look at elders feet for respect
Islam
Beliefs: Submission to God, Muhammad God’s messenger,Pray 5 times a day,life after death,Pilgrimage to Mecca at least once,Ramadan, One God is Allah
Death: Autopsy for legal reasons,euthanasia prohibited, organ donation ok, prayer for deceased led by male within 72 hours of death
Diet: Children, ill and pregnant women exempt from fasting, eat with right hand, use only vegetable oil
Health:Handshakes or any contact between genders is usually not allowed, Females may want a female provider
Pregnancy:Abortion is situationally prohibited
Rituals: Fridays are the holiest days (prayer at noon). Prayer 5 times a day facing Mecca. Wash feet, face and hands before prayer
Clinical Issues: Women may wear a hijab or a burqa. Respect modesty
Judaism
Beliefs:Torah is religious book, pray 3 times a day
Death:life after death, burial as soon as possible, family may want to stay with body,
Diet:kosher certified food
Health: amputated limb buried in ground, sick exempt from fasting
Pregnancy:abortion to save mother,may not believe in birth control
Rituals: Married women may wear wig
Roman Catholic
Beliefs:Emphasis on sacraments including baptism and anointing of the sick
Death:Life after death,Last Rites by priest
Diet: Lent, no meats on Fridays, fast before communion
Health:Blood and blood products is ok
Pregnancy: Natural birth control only, no abortion
Rituals: Daily communion and prayer with priest, confession with priest,rosary
Seventh Day Adventist
Beliefs:Body is temple of God and should be kept healthy
Death:Death is a state of unconsciousness with a return to consciousness
Diet:May practice fasting, alcohol, coffee, tea is personal choice,Usually vegetarian
Health: Rehab and therapeutic encouraged, avoid narcotics or stimulants, Sat is sabbath
Pregnancy:Abortion is discouraged, no baptism
Rituals:Ill anointed with oil
Sikhism
Beliefs:Reincarnation is a cycle of rebirth,
Death:Body is bathed, dressed and then cremated, floor is washed and covered with white sheets; no shoes worn in the room
Diet:No restrictions
Health:May not cut hair on any part of body
Pregnancy:Drop of honey to newborn to give character later in life
Rituals:turban may be worn as responsibility to others
Clinical Issues:hair removal for surgery may be an issue
Jehovah’s Witnesses
Abortion is opposed, eat nothing to which blood has been added, can eat animal flesh that as been drained of blood, autopsy a private matter to be decided by the persons involved, cremation is acceptable
Can Jehovah’s witnesses accept blood?
Absolutely opposed to blood transfusion, whole blood, platelets, fresh & frozen plasma