2.3 ATI Individual Influences

Health disparities

The differences and inequalities in measures of health outcomes that are a result of preventable conditions in specific groups of individuals.

Culture

The way social, racial, or religious groups identify with each other by sharing beliefs, social mores, and social customs/actions.

Subculture

Subgroups within a culture that have distinguishing characteristics from the main culture.

Cultural Influences That May Affect Nursing Care

Health beliefs: Some cultures believe that talking about something negative will cause an event to happen.

Health customs: Family often plays a large and pivotal role in health care decisions.

Ethnic customs: Some cultures are paternalistic or maternalistic when it comes to making decisions about health care.

Religious beliefs: Religious and spiritual beliefs often play a significant role when people are deciding about health care and general health behavior.

Dietary customs: Some cultures have specific dietary restrictions or practices that must be followed and may interfere with health behaviors.

Interpersonal customs: Some cultures only allow same-gender caregivers; others are sensitive to eye contact and physical touch in the presence of others.

Discrimination

Unjust or prejudicial treatment of a person from a different culture, ethnicity, or background.

Racism

Assigning values about people based on how they look, the color of their skin, or their socioeconomic status.

Cultural competence

Having the ability to deliver care that values the differences in others and includes preferences in the care.

AACN five core competencies of cultural competence

1. Apply knowledge of social and cultural factors that affect nursing and health care across multiple contexts.

2. Use relevant data sources and best evidence in providing culturally competent care.

3. Promote achievement of safe and quality outcomes for diverse populations.

4. Advocate for social justice, including a commitment to the health of vulnerable populations and the elimination of health disparities.

5. Participates in continuous cultural competence development.​​​​​​​

Health equity

Equal opportunity to reach optimal health status.

Cultural awareness

Having an informed understanding of one’s own feelings and thoughts and knowing the value that differences in others can have on health and well-being.

Cultural humility

Includes the use of impartial language verbal and nonverbal that mirrors consideration of the differences in others.

Cultural diversity

Differences in physical features, birthplace, resident status, religious, age, gender, politics, educational background, and social status.

Cultural safety

A goal that is achieved when the client deems the interaction as safe. It requires self-reflection and a critique of power imbalances by the health care professional.

Stereotyping

A prejudiced perception held by members of one group about the merits or deficits of a different group. For example, a nurse makes assumptions that all members of a given racial/ethnic/social group have the same flaws and should be treated the same.H

Health literacy

Includes listening and speaking skills, writing and reading skills, the ability to work with numbers, and cultural and conceptual knowledge about all aspects of health care.

Overarching goal of Healthy People 2030

To “eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.”

Cultural competence

Having the ability to understand, communicate, and interact with people across all different cultures.

Embraces diversity and results in improved health outcomes.

Implicit bias

Unconscious attitudes that precede unintentional discrimination

Madeline Leininger’s Sunrise Model

Three phases:

1. Culture maintenance/preservation

   1. Culture negotiation/accommodation

2. Culture restructuring/repatterning

Transcultural assessment model

Six dimensions:

• biological variations

• communication

• space

• time

• social organization

• environmental control

Purnell Model for Cultural Competence

12 cultural domains to incorporate diversity

Provides foundation for providers to learn about client’s culture and reduces health care bias

Campinha-Bucote Model of Cultural Competence

Five components:

1. cultural awareness

2. cultural skills

3. cultural knowledge

4. cultural encounter

5. cultural desire