TCN MIDTERMS

•Approach to antenatal care:

•paternalistic approach = doctor or nurse decides what is best for a patient's health, is usually applied only in emergency situations

•Approach to antenatal care:

•paternalistic approach = doctor or nurse decides what is best for a patient's health, is usually applied only in emergency situations

AUSTRALIA

•Approach to antenatal care

•paternalistic approach = women may lack autonomy to make decisions regarding ante-natal tests and modes of delivery

JAPAN

•traditional ANC schedule requires 14 visits in what country?

AUSTRALIA

•WHO: at least _ ANC visits for women in developing countries

4 ANC VISITS

•pregnant women are referred to ANC by GPs STAT after pregnancy confirmation in what country?

AUSTRALIA

COUNTRY:

3-4 cm cervical dilation = required for hospitalization of WIL; if not sufficiently dilated = sent home until labor progresses

ETHIOPIA

COUNTRY:

showering & washing hair after birth is prohibited until after seven days

JAPAN

COUNTRY:

•often attended by a small proportion of women, predominantly due postpartum complications (PPC)

SUDAN

COUNTRY:

there are commercial confinement centers (PPC)

TAIWAN

COUNTRY: •all infants are placed in the neonatal wards separate from their mother, and brought to the mother at feeding time

ETHIOPIA

The following are some of the cause of stress except:

a. Good communication skills

b. Gender of health practitioners

c. Inability to comply with their cultural or religious practices

d. Fasting, specific dietary requirements

e. Awareness of some of the services that assist pregnant women

a&e

a. Good communication skills - Poor

e. Awareness of some of the services that assist pregnant women - Unaware

COUNTRY:

•tend to view CS as posing a great burden to PP woman and may prefer to avoid this intervention

JAPAN

Which of the ff is not the reasons why CALD background women do not seek support?

a. Lack of Knowledge

b. Lack of awareness

c. Doubt

d. Fear

e. Good English language skills

f. Lack of interpreting services

g. Men participants

h. Lack of trust

e. Good English language skills

•aimed at improving maternal and infant outcomes

ANTENATAL INVESTIGATION

•if the ancestry from China & South East Asia, southern Europe, Middle East, Indian sub-continent, Africa, Pacific Islands and New Zealand (Maori)

ALPHA THALASSAEMIA

•if the ancestry is from Middle East, Southern Europe, Indian sub-continent, Central and South East Asia and Africa

BETA THALASSAEMIA

•if the ancestry is from Africa, Middle East, Southern Europe, Indian sub-continent, South America & the Carribean

SICKLE CELL DISEASE

TYPE OF FGM:

•Partial or total removal of the clitoris &/or prepuce [clitoridectomy or suna]

TYPE 1

TYPE OF FGM:

•Partial or total removal of the clitoris + labia minora w/ or w/o excision of the labia majora

TYPE 2

TYPE OF FGM:

•Narrowing of the vaginal orifice w/ creation of a covering seal by cutting and appositioning the labia minora &/or the labia majora w/ or w/o excision of the clitoris [infibulation]

TYPE 3

TYPE OF FGM:

•All other harmful procedures to the female genitalia for non-medical purposes (pricking, piercing, incising, scraping & cauterization)

TYPE 4

•common phenomenon 3-5 days after labor & delivery; experienced by 80% women

POSTPARTUM BLUES

MENTAL HEALTH STRESSORS:

•Psychological issues related to past experiences of war, displacement, rape, torture, survival in refugee camps, death of close relatives

•Post-traumatic stress disorder (fear, nightmares, lack of control over a situation, depression, hopelessness)

•Powerlessness over decision to migrate

Pre-immigration experiences

MENTAL HEALTH STRESSORS:

•Stress related to the loss of job, housing, financial problems, lack of English language skills, lack of knowledge and skills for everyday activities, stress related to lack of knowledge of services

Adjustment

MENTAL HEALTH STRESSORS:

•Feelings of guilt for not contributing enough to family overseas

•Family members may be missing or living in difficult or dangerous circumstances

Wellbeing of overseas family

MENTAL HEALTH STRESSORS:

•Fear of difference in health care and birthing practices in host country

•Inability to navigate the health system due to cultural or language barriers

Lack of knowledge of antenatal care system and birthing practices

MENTAL HEALTH STRESSORS:

•Fear of illnesses due to not practicing traditional practices

•Fear of being cursed by overseas relatives

•Fear to displease relatives and/or ancestral spirits

•Adjustment stress due to practicing traditional practices

Traditional beliefs

MENTAL HEALTH STRESSORS:

•Stigma, feeling different from others, fear of potential procedures, lack of voice

•Confusion. Some women feel proud of being circumcised. When entering western culture, the woman may feel different or incomplete and this may impact on mental health.

Female genital mutilation

MENTAL HEALTH STRESSORS:

•Fear of tests, lack of choice about continuing or terminating a pregnancy due to religious beliefs

Antenatal testing, genetic counselling

MENTAL HEALTH STRESSORS:

•Negative emotions linked to having a female foetus, lack of choice about continuing or terminating a pregnancy due to family pressure

Sex preference

MENTAL HEALTH STRESSORS:

•Hopelessness, lack of personal voice, lack of choice about continuing or terminating a pregnancy, lack of choice about remaining married, or separation or divorce due to family pressure and religious beliefs

Arranged/early marriage, unwanted/unplanned pregnancy

MENTAL HEALTH STRESSORS:

•Post-traumatic stress disorder (fear, emotional distress, lack of control, frequent use of psychotropic medication)

Inflicted violence

MENTAL HEALTH STRESSORS:

•Loneliness, isolation, nostalgic feelings, burden of care for the newborn infant, lack of extended family support in Australia

Lack of support

MENTAL HEALTH STRESSORS:

•Fear that the infant might die due to inadequate care, anxiety and fear that something is not right with the infant, self-blame for inadequate care, fear of reactions to immunization

Lack of knowledge and skills to care for new born child

MENTAL HEALTH STRESSORS:

•Stress related to insufficient lactation, fear that the infant is hungry, stress related to introducing formula and solid foods

Breast feeding problems

was termed the "empty middle" by Bronfenbrenner (1977). A noted developmental psychologist, his use of this term was an indication of Western culture's lack of interest in the adult years.

ADULTHOOD

Society acknowledges this with common terms such as midlife crisis or even empty nest syndrome

ADULTHOOD

view a "midlife crises" as a time of transition that can be a positive experience, including the mastery of new skills and behaviors that helps an individual to change and grow in response to a new environment (Meleis et al., 2000).

MIDLIFE

is usually divided into young adulthood (late teens, 20s, and 30s) and middle adulthood (40s and 50s), but the age lines can be fuzzy.

ADULTHOOD

t in his or her late teens and early 20s struggles with independence and issues related to intimacy and relationships outside the family. Role changes occur when the young adult is pursuing an education, experiencing marriage, starting a family, and establishing a career.

YOUNG ADULTHOOD

most often concentrates on career and family matters. However, as previously mentioned, adulthood is not necessarily an orderly or predictable plateau. Experiences at work have a direct bearing on the middle-aged adult's development through exposure to job-related stress, levels of physical and intellectual activity, and social relations formed with coworkers.

MIDDLE ADULT

occurs when an individual experiences normal and expected challenges that are age appropriate. For example, a young adult may have difficulties separating from his or her parents and establishing independence.

DEVELOPMENTAL CRISES

is accomplished through parenting, working in one's career, participating in community activities, or working cooperatively with peers, spouse, family members, and others to reach mutually determined goals.

GENERATIVITY

CULTURE:

Both male and female children are given a first name. The father's first name is used as the middle name; the last name is the family name. Usually, a person is called formally by the first name, such as Mr. Mohammed or Dr. Anwar.

ARAB

CULTURE:

The family name is stated or written first followed by the given name (the opposite of European and North American tradition). Only very close friends use the given name. Politeness and formality are stressed; always use the whole name or family name. Use only the family name to address men, for example, if the family name is Chin and the man's given name is Wei-jing, address the man as Chin. Women in China do not use their husband's name after marriage.

CHINESE

CULTURE:

The use of surnames may differ by country. Many Latin Americans use two surnames, representing the mother's and father's sides of the family. "Maria Cordoba Lopez" indicates that her father's name is Cordoba and her mother's surname is Lopez. When Maria marries, she will retain her father's name and add the last name of her husband, becoming Maria Cordoba de Recinos.

LATIN AMERICA

CULTURE:

names differ by tribal affiliation. Many tend to follow the dominant cultural norms. In the Navajo culture, a health care provider may call an older Navajo client "grandfather" or "grandmother" as a sign of respect. In the past, some tribes have tended to convert traditional names into English surnames, for example, Joe Calf Looking and Phyllis Greywolf.

NATIVE NORTH AMERICAN

occurs when an unpaid person, usually a family member, helps another family member who has a chronic illness or disease.

CAREGIVING

c has forced society to examine and attempt to alter cultural behaviors and values that were largely ignored in the past. And, as a society, we have not always been comfortable with this frankness.

AIDS EPIDEMIC

•affect eligibility for Medicare [force shorter hospital stays] & state medical assistance programs [gaps in health care srvcs put greater burdens]

SOCIAL & ECONOMIC FACTORS

What are the factors that nurses should consider to serve older clients? SCAI

•Social and economic factors

•Cultural variation

•Available support

•Illness behavior

THEORIES OF AGING:

•Focuses on explaining that older adults whose status is linked to employment perceive less self-worth in retirement when relieved of their roles and responsibilities

DISENGAGEMENT THEORY

THEORIES OF AGING:

•Old must learn to GIVE UP roles, activities

DISENGAEMENT THEORY

THEORIES OF AGING:

•Describes that older adults may substitute recreational and meaningful opportunities to take the place of previous occupations & careers. Active older adults are recognized for contributing as family caregivers & as volunteers for social service organizations among other productive activities

ACTIVITY THEORY

THEORIES OF AGING:

•Old must learn to DEVELOP new roles, activities

ACTIVITY THEORY

THEORIES OF AGING:

•Focuses on supporting adults to remain engaged by adapting pattens of behavior from their younger adulthood to keep them involved into older adulthood

CONTINUITY THEORY

THEORIES OF AGING:

•MAINTAIN the same relationship & activities as they were, when young.

CONTINUITY THEORY

THEORIES OF AGING:

Older adults may struggle w/ the tension bet maintaining the integrity of their experience while facing the reality of declining physical & mental functions

•Erickson's Developmental Theory

Traditional Beliefs or Practices BY:

believe illness is caused by spirit possession

SOMALI PXS

Traditional Beliefs or Practices BY:

•: believe that an illness can be caused by evil spirits if one's own spirit has left the body

HMONG PXS

Traditional Beliefs or Practices BY:

•believe that illness is due to karma - one's actions in past lives

HINDU & SIKH

Traditional Beliefs or Practices BY:

•): follow traditional practices including herbal medicine, massage, acupuncture or dietary therapy

OLDER CHINESE ADULTS

Traditional Beliefs or Practices BY:

•traditional remedies & biomedicine

OLDER VIETNAMESE

Dimensions of Social Support:

•Expressions of respect and love

AFFECTIVE SUPPORT

Dimensions of Social Support:

•Having endorsement for one's behavior & perceptions

AFFIRMATIONAL SUPPORT

Dimensions of Social Support:

•Receiving some kind of aid or physical assistance: accompanying a person to an appointment

TANGIBLE SUPPORT

Types of care:

•Depends on presence of acute & chronic conditions

•Intensive personal health service

Types of care:

•Depends on chronic conditions

•Health maintenance & restorative care

Types of care:

•Provided on an episodic basis for older clients in the community

•Coordinated nursing, social services & ancillary services

•is seen as being central and essential pre-requisite in elderly care & clients might feel less attention is paid to them

COMMUNICATION

•Clients not being able to express wishes, and care preferences not being understood and not being able to understand, might leave clients frustrated and dissatisfied in care outcomes which might lead to isolation at some point.

INABILITY TO EXPRESS SELF

•Creeps in the care giving setup as a result of language barrier in communication. As a result, client might feel they have insufficient information about their care and in effect, might spring up issues of trust and non-compliance.

LACK OF TRUST

•Meeting the needs of the client might be hard as a result of language failure or barrier since client might not be able to express self properly, caregiver not being able to understand client or the other way around.

DIFFICULTY MEETING NEEDS OF CLIENTS

•Gaining deep understanding and building a relationship with elderly might be hard to accomplish in instances where linguistic barriers abound. Appropriate and adequate information transmission between client and caregiver is affected as a result of hindrances caused by barrier in language

LACK OF AWARENESS

•Inadequacy in language by the caregiver affects care delivery and issues such as emergency stuff or matters requiring emergent attention linked to the care of the client might be affected.

DIFFICULTY IN SENSITIVE CARE DELIVERY

•Being culturally competent is vital in elderly care outcomes. As per the results, the caregiver's participation in the daily care of the elderly might be devalued if he/she lacks cultural competence skills. Furthermore, being culturally competent means the caregiver needs to be aware of the challenges that might likely occur as a result of differences in cultural background of caregiver and client.

INABILITY TO UNDERSTAND AND NEGOTIATE DIFFERENCES

•Caregiving is likely to be affected by cultural sensitive defined issues such as values, norms, and roles. Caregivers need to understand that different cultures have varying needs and belief about health, illness, disease and treatment

INABILITY IN PROVIDING SPECIFIC CULTURAL NEEDS

•Not being knowledgeable about the complexity of cultural difference could lead to the caregiver unintentionally reinforcing stereotypes by assuming some cultural behaviors and norms as universal predictors of people's behavior

LACK OF PROFESSIONALISM

•Caregivers having expert knowledge about other cultures could lead to stereotyped attitudes about other cultures, in effect, affecting care delivery. Culturally competent in elderly care does not necessarily mean having expert knowledge about other cultures, but rather being able to distinguish cultural issues from attitudes among clients, assessing clients as individuals and not making conclusions about clients based on knowledge one has on their cultural background

CULTURAL ISSUES CONFUSED TO ATTITUDE

•How the elderly people perceive diseases and how treatment is carried out might determine how they respond to care. Dietary patterns impact on the care of the client and need to be put into perspective by the caregiver as far as the client's daily feeding is concerned, which could be linked to religious beliefs

CONFLICTING BELIEFS

•Elderly clients from different cultural backgrounds are likely to refuse care assistance coming from caregivers of the opposite sex as a result of their religious and cultural belief

GENDER-SENSITIVE ISSUES

•Elderly clients and caregiver/mainstream care body might not share same care values and importance to preventive care. Medical checkups is a phenomenon common in many cultures but uncommon in others. Clients might turn down mainstream elderly care approach and resort to own cultural approach which might affect care outcome

DIFFERENT HEALTH CONCEPTS ACROSS CULTURES

•Service information might be viewed by clients as confusing and intimidating. Lack of information about various cultural groups could make care delivery quite frustrating

NEGATIVE CARE OUTCOME

•Lack of awareness and ignorance about other cultures could lead to hesitant and non-compliance to care reception, and in effect, leading to inequality in elderly care

NONCOMPLIANCE

•Cultural issues could be misunderstood for attitude issues all as a result of misjudgment. Clients may feel disrespected, intimidated and harbor feelings of being discriminated against. Feelings of detachment may emerge, which may result in caring being less emphatetic and unfriendly, for clients may be viewed as dramatic, abusive, and insensitive depending on the circumstances as a result of non-compliance. In effect, a mutual lack of trust is eminent from both client and caregiver.

MISJUDGEMENT AND STEREOTYPING

•Incompatibility in culture might lead to elderly clients preferring care services mainly from caregivers from own cultural background w/c in most cases might not be taken kindly by the caregiver who may feel looked down on or discriminated against

DISCRIMINATION

• As an effect of generalization, understanding of clients may be hampered. Superiority issues might arise as a result of client and caregiver not sharing same cultural background. Client and family may treat caregiver from a different background worse than they would treat caregivers from same background as them which impacts the health care outcome.

DISRESPECT

•Discrimination and inadequate elderly care are eminent in settings where clients and care givers don't share same cultural background. As a result, racist tendencies might emerge leading to social intolerance, no- integration into mainstream care society, which could lead to more isolation, vulnerability to poor social and health outcomes.

RACIST TENDENCY

•The high demand on caregivers and huge number of elderly needing care services might make it hard for caregivers to provide cultural congruent care.

PERSONNEL CARE ISSUES AND DIVERSITY IN CARE DELIVERY

is biological, describing physical traits inherited from your parents

RACE

Is your cultural identity, chosen or learned from your culture and family.

ETHNICITY

Is termed as a group of people who recognise each other on the basis of shared attributes that distinguish them from other groups such as a common set of traditions, ancestry, language, history, society, culture, nation, religion, or social treatment within their residing area.

ETHNIC COMPOSITION OR ETHNICITY

The practice of chewing the food for young children in the belief that this will facilitate digestion.

PRE-MASTICATE

Pre-Masticate is most frequently reported among ______ and __________ mothers.

BLACK AND HISPANIC MOTHERS

is the practice of a child sleeping with another person on the same sleeping surface for all or part of the night.

BED SHARING

is caused by a frightening experience and is recognized by nervousness, loss of appetite, and loss of sleep.

SUSTO

is an illness manifested by grunting sounds and protrusion of the umbilicus. It is believed to be caused by contact with a woman who is menstruating or by the infant's own mother if she menstruated sooner than 60 days after delivery

PUJOS (GRUNTING)

Is viewed by many cultures as a form of punishment. The child and/or family with a chronic illness or disability might be perceived to be cursed by a supreme being, to have sinned, or to have violated a taboo.

ILLNESS

Among those who believe that chronic illness and disability are caused by an imbalance of hot and cold

LATINO CULTURES

•realizes his or her own abilities

•is able to make a contribution to his or her community",

• can cope with the normal stresses of life

• can work productively and fruitfully, and

•and that this understanding of mental health can be interpreted "across cultures"

WELL-BEING