NURS 330: Culture and Diversity Lecture Capture pt 2

Culture and Diversity - Week 12 Pre-Class Lecture Part Two

Introduction

  • Discussion of models and theories related to cultural humility, as well as presentation guidelines.

  • Learning objectives are consistent across both pre-class lectures.

Model for Cultural Humility by Campinha-Bacote

  • Components of the Model:

    • Cultural Awareness: Self-examination of biases and exploration of personal cultural and professional backgrounds.

    • Cultural Knowledge: Acquiring education about beliefs and values of diverse ethnic groups; identifying health-related beliefs, disease prevalence, and treatment efficacy.

    • Cultural Skills: Skills necessary to collect patient histories, assess health literacy, improve communication, and work with interpreters.

    • Cultural Encounters: Purposeful interactions to validate, refine, or modify beliefs and practices.

    • Cultural Desire: Internal motivation to engage with patients from a cultural perspective.

Importance of Cultural Competence

  • Professionals who are culturally competent lead to better client care and satisfaction.

  • Engaging effectively with individuals, families, and communities can overcome barriers in cultural understanding.

Cultural Awareness and Knowledge

  • Cultural Awareness:

    • Definition: Self-examination of one's biases and exploration of personal cultural background.

  • Cultural Knowledge:

    • Definition: Gaining knowledge about various cultural beliefs and values.

    • Benefit of storytelling in understanding health-related issues; encourages patients to share their experiences (surgery, childbirth, chronic illness).

Iceberg Analogy for Worldview

  • Overview of the Iceberg Model:

    • Surface Level (Top): Expressed behaviors based on feelings or norms.

    • Learned Behavior (Under the Surface): Behavior shaped by learning or social conditioning.

    • Subconscious Beliefs (Deepest Part): Core convictions that form an individual's worldview.

  • Key Difference: Understanding the distinction between expressed, learned, and subconscious behaviors is crucial for effective communication.

Cultural Skills

  • Components of Cultural Skills:

    • Collecting a patient history and assessing health literacy.

    • Conducting a physical assessment while respecting cultural needs.

    • Effective communication techniques:

    • Use open-ended questions.

    • Simplify language to ensure understanding.

  • Importance of assessing whether a language barrier exists; use of translators if necessary.

Diagram on Patient Understanding

  • Step-wise Process:

    1. Introduce New Concepts (health information, changes in management).

    2. Assess recall and comprehension of instructions.

    3. Clarify and tailor the response based on patient needs.

    4. Reassess to confirm understanding, ensuring adherence to instructions.

Cultural Encounters and Desire

  • Definition of Cultural Encounters:

    • Goals include generating diverse responses and purposeful learning.

  • Definition of Cultural Desire:

    • Internal motivation to understand and engage with patients from diverse cultural backgrounds.

  • LEARN Model:

    • Steps: Listen, Explain, Acknowledge, Recommend, Negotiate.

Madeleine Leininger’s Theory

  • Overview of Theory:

    • Known as Transcultural Nursing Theory.

    • Aims to provide culturally congruent nursing care based on cultural values, beliefs, and norms.

    • Importance of understanding caring behaviors associated with various cultures.

  • Sunrise Model Representation:

    • Illustrates flow of cultural and social factors influencing health and individual healthcare practices.

Presentation Guidelines

  • Presentation incorporates models of cultural care with a focus on:

    • Cultural preservation or maintenance.

    • Cultural accommodation or negotiation in care plans.

    • Cultural repatterning or restructuring to educate clients on optimal health practices.

Interprofessional Theory of Social Suffering by Kleinman

  • Core Idea: Relationships, past traumas, and cultural beliefs influence illness experience and understanding of suffering.

  • Importance of recognizing the cultural interpretation of suffering to tailor care effectively.

  • Illustrative Examples of Cultural Differences:

    • Different attitudes toward silent endurance versus vocal expression of distress.

    • Variations in community health priorities and inequities.

Cultural Assessment in Healthcare

  • Assessment Guide Reference: Box 9.4 in the Fundamentals Book provides guiding questions covering key areas such as:

    • Health decision-makers within families.

    • Patients' faith-based influences.

    • Language communication dynamics in the household.

    • Decision-making structures in families.

    • Support systems beyond the family unit.

    • Dietary preferences in family (e.g., halal food considerations).

Transcultural Assessment Model

  • Characteristics to Assess:

    • Communication styles, social organization, orientation to time, and environmental control.

    • Emphasizes the uniqueness of each client’s cultural background and worldview.

Consequences of Ignoring Cultural Humility

  • Importance of Cultural Humility:

    • Enhances communication, promotes patient safety, and leads to better understanding and trust between provider and patient.

  • Negative Impacts of Cultural Incompetence:

    • Miscommunication leading to unsafe care.

    • Incomplete medical histories and medical errors.

    • Increased patient distress and longer hospital stays.

Conclusion

  • Cultural humility is critical for equitable healthcare, requiring:

    • Openness, self-awareness, and lifelong learning.

    • Embracing diversity strengthens cultural humility and the quality of care provided.