NRSG 2200 unit 11

health promotion and cultural diversity

Culture

integration of human behaviors including communication, language, actions, beliefs, values, customs, and institutions of reclaim religious, social, and ethnic groups

Culture has the ability to impact what

impact the way out pt lives their life and how they perceive and receive health, illness, and healthcare

Characteristics of culture

this can help shape what is acceptable behavior for people in a specific group. Shares and provides a identity for members of the same culture group

Culture is learned by

learned by each new generation thru formal and informal life experiences

True or false, language is the primary means of transmitting culture

true

Cultural diversity

coexistence of different ethnic biological sex, racial and socioeconomic groups in one social unit

Cultural diversity groups include

people of varying religion, language, physical size, sexual orientation, age, disability, occupational status, and geographic location

Somethings to be aware of when there is a culture conflict is

• Pt not making eye contact (can be seen as disrespectful and rude in one culture but can be seen as good communication in another culture)

• Short abrupt sentences/answers to ?’s

• Requesting a male or female caretaker

• Spouse or patent talking for pt (pt deferring all responses to others is normal in some cultures but can be assumed as a sign of abuse in other cultures)

Cultural awareness

being able and willing to investigate and understand differences between perceptions, beliefs, traditions, and values within nurses own culture and as well as cultures different form their own

Culture competence

appreciating, accepting, and respecting all people, cultural influences, beliefs, customs, and values. this is a necessity to provide the best care possible.

Culture competence includes

positive and open communication between nurses and clients and open feedback

TRUE or FALSE, can we modify care plans to go along with someone’s beliefs and culture?

TRUE

Elements of cultural competence

• Self-awareness

• Develop cultural awareness

• Demonstrate knowledge and understanding of who we are before providing culturally competent care

• Accept and respect cultural differences

• Make no assumptions (don’t assume that ours or healthcare providers views are the same as the pt)

• Resist judgmental attitudes

• Be open to cultural encounters

• Educate yourself 

What can help nurses understand the cultural needs and views of pts regarding their culture

emic and etic knowledge

Emic knowledge

a cultural insiders viewpoint of a culture (M for I’m IN the culture)

Etic knowledge

an outsiders viewpoint of a culture (T for tower aka sitting in a tower and watching a culture but not in it)

What to ask in a cultural assessment

when caring for pt form and culture it is important to ask how they want to be treated based on their values and beliefs. “Are there any cultural or religious practices you would like us to incorporate into your care”

Cultural assessment includes

beliefs, values, traditions, and practices of a culture, culturally defined and health related needs of individuals, families, and communities, culturally based belief system of the etiology of illness and disease and those related to health and healing, and attitudes toward seeking help from healthcare providers

Bias

an inclination or preference that interferes with impaired judgement. 

Example of bias

A nurses strong preference for a specific racial/ethnic group that does not allow viewing other pt form other groups objectively

Stereotype

an oversimplified conception, opinion, or belief about some aspect of a individual or group of people 

Example of stereotype

simplified ideas of how a specific ethnic or racial group will behave

Prejudice

an irrational intolerance or hostility towards members of a certain race, religion, or group

Example of prejudice

Hostile feelings against a specific racial or ethnic group

Race

a local geographic or global human population distinguished as more or less distinct group by genetically transmitted physical characteristics. A group of people united or classified together on the basis of common history, nationality, or geographic distribution

Ethnicity

the characteristic of a group of people that share a common and distinctive national, linguistic, or cultural heritage

Assumption

something taking for granted or accepted as true without proof 

Example of assumption

a limited English proficiency pt comes in to get health care and is unable to communicate in English, we may make assumptions about her or his education or intelligence. But the pt may be highly educated and read and write well in their own native language

Discrimination

treatment or consideration based on class or category rather than individual merit that results in unfair treatment

Ethnocentrism

a belief that one’s way of life and view of the world are inherently superior to others and more desirable. This in nursing may prevent nurses from working effectively with a pt whose beliefs or culture does not match their own ethnocentric worldview

Power differences

reflect the power imbalance in pt-provider relationships. Those w power are often not aware of its daily effects. Pt past experiences of power differences, coupled w perceptions that providers have power over their current condition, have an impact on communication. Recognizing the power differences that pt may perceive is important to improving communication

Cultural assimilation

when a minority group lives within a dominant group, many members may lose the cultural characteristics that once made them different, and they may take on the values of the dominant culture

Cultural blindness

occurs when one ignores differences and proceeds as though they do not exist

Cultural diversity

coexistence of different ethnic, biological sex, racial, socioeconomic groups within one social unit

Cultural imposition

the belief that everyone else should conform to your own belief system

Cultural respect

enables nurses to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse pt

Subculture

a large group of people who are members of the larger cultural group but who have certain ethnic, occupational, or physical characteristics that are not common to the larger culture

Culture conflict

people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values

Culture shock

a person may experience this when placed in a different culture they perceive as strange

Equality

giving everyone the same thing (ex. Everyone got the same exact bike)

Equity

giving everyone what they need (ex. Giving a bike to a pt that gets their body size and shape)

Health equality

distribution of the same resources, including opportunities to all individuals in a population

Health equity

attaining the highest level of health for all individuals

Health disparities

health outcomes that may be greater or lesser among different socioeconomic populations

Vulnerable populations and underserved populations both are what

populations at risk

Those who are at risk of health disparities

immigrants, veterans, chronic illnesses, older adults, liver in rural areas, children, racial and ethnic minorities, those w physical or intellectual disabilities, poverty, homelessness, pregnant women, those w trauma/abuse, mental health and substance abuse issues, HIV/AIDS, lesbian/gay, etc

Characteristics of those who are apart of vulnerable populations are

have a high risk for health care problems, face significant hardships (financial, educational, and housing), have a limited ability to understand or give informed consent out the assistance of language services, lack skills to communicate effectively in English

What biological factors influence a persons health

genetics, age, sex, ethnicity, family health history, lifestyle

Non modifiable risk factors

risk factors that we CAN’T change and that increase the risk of developing a disease 

Examples of non modifiable risk factors

genetics, ethnicity/race, gender, age, family health history, 

Modifiable risk factors

behaviors and exposures that can raise or lower a persons risk and measures that can be taken to reduce that risk

Examples of modifiable risk factors

diabetes, being overweight, obesity, high blood pressure, smoking, high cholesterol, etc

Health promotion

process of enhancing peoples influence over an improvement of their health (we want a pt to take ownership of their health)

Disease prevention

implementing preventative measures aimed at reducing burden of disease and associated risk factors

Health promotion + disease prevention =

health outcomes

Health outcomes

result of health promotion and disease prevention measures

wellness

a positive state of health

Health communication

requires verbal and written approaches to control, inspire, and make healthier choices. Promote positive attitude and behaviors and needs to be evidence based, culturally sensitive understandable, easily accessed and delivered thru variety of media

Health education

learning experiences designed to improve health of a person or a community thru increased knowledge or by influencing attitudes. 

Health education strategies include

notifying individuals of groups at risk, benefits, behaviors to change, and tools needed to make changes

Levels of prevention are

primary, secondary, tertiary, and quaternary prevention

Primary prevention

providing care to decrease or PREVENT the risk for a health condition to happen at all

Primary prevention examples

exercise, diet, lifestyle, wear a seatbelt and helmet, vaccines, safe sex devices

Secondary prevention

providing care to detect or SCREEN a health condition 

Secondary prevention examples

screenings for HTN, cancer, getting blood work done, a colonoscopy, Pap smear, etc

Tertiary prevention

providing care to control or TREAT a health condition and education

Tertiary prevention examples

taking meds for a condition (diabetes), group therapy, speech therapy, meet with provider, etc

Quaternary prevention

protecting client form care that is excessive or might cause harm aka it is QUALITY

Quaternary prevention examples

too much testing to look for results, overexposure to blood work, radiation, X-rays, MRIs, etc

Healthy people initiatives/2030

national health promotion and disease prevention objectives developed every 10 years to improve the health of all Americans. og focus was reducing preventable death and injury. In 5th edition.

What healthy people initiatives promote

help promote national health and disease prevention to improve health of all Americans

Social Determinants of Health

conditions in environment where people are born, live, learn, work, play, worship, and age that affect a wide range of health functioning and quality of life outcomes and risks

5 parts of the social determinants of health

education access and quality, healthcare access and quality, neighborhood and built environment, social and community context, and economic stability

Seven pillars of self care

developed by international self care foundation. Believes that self care is a fundamental pillar of overall health

Seven pillars of self care mission

promote self care as a essential component of overall health and wellbeing

Components of the seven pillars of self care

• Knowledge and health literacy

• Mental wellbeing

• Physical activity

• Healthy eating

• Risk avoidance (vaccines, safe sex practices, no smoking, alcohol in moderation, use sun protection)

• Good hygiene (decrease spread of communicable diseases)

• Rational use of products and services 

It is of the utmost importance that clinicians/nurses engage in

self-care practices to maintain their emotional wellbeing, and prevent burnout, moral distress, or lack of compassion

Self-care

is a inclusive group of activities used to promote ones mental health and overall well being 

Burnout

a progressive loss of idealism, energy, and purpose experienced by people in the helping professions as a result of the conditions of their work