Cultural Diversity and Religion in Nursing

Exam Information

  • Exam 2 will cover cultural diversity and religion, including concepts from presentations.

  • Exam 1 focuses on therapeutic communication.

  • A blueprint for Exam 2 will be posted in announcements to aid studying.

Key Reminders

  • Vulgar Language: Never appropriate therapeutically, according to textbooks, though mental health settings may present exceptions.

  • Touch: Use cautiously with patients experiencing mental illness or altered reality.

  • Nursing Process:

    • Act if you have sufficient information.

    • Assess if information is lacking.

Cultural Diversity

Learning Objectives

  • Define terms related to cultural diversity.

  • Explain Joyce Geiger's six factors of cultural assessment.

  • Discuss how nurses should respond to patient's cultural practices.

  • Identify variables influencing healthcare delivery.

  • Consider beliefs/perceptions of specific cultural groups impacting healthcare perceptions and preferences.

Concepts of Culture

  • Culture encompasses shared beliefs, values, and behavioral expectations.

  • Applies to ethnic, regional, organizational (Davis Tech), and familial contexts.

  • Influences dress, behavior, beliefs, likes, and dislikes.

  • Provides structure for daily living.

  • Important to consider cultural norms when assessing mental health; deviations from the norm may indicate a disorder.

  • Cultures define roles and interactions; attitudes, beliefs, customs, and rituals are often passed down.

  • Deviations from normal behavior are assessed according to culture and age appropriateness.

  • Practices, beliefs (dress, food) often originate from historical factors like nomadic, agricultural lifestyles, or climate.

  • Impacts views on healthcare.

  • Assessments and health histories are crucial due to varying cultural/religious practices and use of holistic approaches (herbal supplements, tinctures, teas).

Cultural Considerations in Healthcare

  • Family involvement is critical; hospitalization practices vary.

  • Some cultures prioritize family care over professional care, viewing it as a sign of respect.

  • In North America, long-term care facilities are common, but other cultures may view this as disrespectful.

  • Cultural beliefs impact parenting, labor/delivery, and death practices.

  • Recognizing and accommodating cultural/religious needs is vital during significant life events.

Nursing Culture

  • Nursing has its own evolving culture.

  • Historically, nursing was dominated by middle-class white females with strict rules (dress codes, curfews).

  • Practices evolved over time with influences leading to diversity in gender, age, and ethnicity.

  • Cultural practices adapt as needs change.

  • North American cultural practices are disseminated globally through the Internet.

Cultural Influences

  • Culture shapes self-perception, expectations, and behavior, especially in healthcare.

  • Traits are generally considered for first-generation individuals, adapting with further cultural exposure.

Individualistic vs. Collectivist Cultures

  • Individualistic: Values independence, individual rights and voice, and uniqueness.

  • Collectivist: Values avoiding conflict, group loyalty, and group-based decisions.

  • Both have strengths and weaknesses when taken to extremes.

Cultural Identification

  • Identification with a cultural group is based on common heritage.

  • Membership occurs through birth or adoption.

  • Traits include shared language/dialect, religious practices, literature, folklore, music, and food preferences.

  • Religious practices show crossover between Hindi, Indian, Muslim and Arab cultures.

  • Employment patterns may impact healthcare access.

Understanding Cultural Traits

  • Ethnic cultures share traits, but individuals may not embrace all.

  • Generalizations are necessary, but avoid stereotyping.

  • Stereotyping, both positive and negative, can hinder patient care.

  • Stereotyping assumes uniform traits, leading to discrimination.

Joyce Geiger’s Six Factors of Cultural Assessment

The following factors are important to consider during your presentations.

Communication

  • Recognize language differences; use a medical interpreter.

  • Consider verbal and nonverbal communication (gestures, eye contact).

  • Nonverbal communication varies across cultures; gestures are not universal.

Social Organization

  • Examine family structure, social rules, and decision-making patterns.

  • Determine if it's a nuclear or extended family.

  • Impacts expectations during birth or death, involving family or community.

Physical Distance/Space

  • Understand personal space preferences.

  • There are intimate and personal spaces.

  • Comfort levels vary; closeness may indicate attention or interest, especially among the same gender.

  • Cultural norms influence touch and physical closeness.

Time Orientation

  • Predominant views of time (future, present, past).

  • Past orientation values customs and traditions.

  • Present orientation focuses on the moment.

  • Future orientation plans for the future.

Environmental Control

  • Beliefs about control over health and outcomes.

  • Internal: Belief in influencing health outcomes through personal actions.

  • External: Belief in fate, God's will, or karma.

  • Impacts motivation for preventive care.

  • Assess attitudes toward modern healthcare and traditional healing.

Biologic Variations

  • Genetic differences (skin color, hair color).

  • Genetic predispositions to diseases.

  • Drug metabolism differences among cultures.

  • Nutritional preferences and traditional diets.

  • Consider healthcare access and insurance.

Additional Considerations

  • Socioeconomic Factors: Income, access to healthcare, housing, and education.

  • Family Support: Respect for family and elders.

  • Physical/Mental Health: Beliefs and attitudes toward mental and physical well-being.

Cultural and Religious Health Practices

  • Efficacious Practices: Scientifically proven to improve health (e.g., Mediterranean diet).

  • Neutral Practices: Neither harmful nor beneficial but psychologically supportive (e.g., prayer, blessings, religious objects).

  • Uncertain Practices: Require further research to determine their impact.

Key Takeaway

  • Routinely ask patients what matters most to them in their illness and treatment.

Respect and Understanding

  • Approach all cultures and religions with respect and without judgment.

  • Recognize the beauty and value in diverse beliefs and practices.

Presentation Guidelines

  • Submit the final slide by 3 PM the day before your presentation.

  • Include the website or source for your reference.

Upcoming Dates

  • Therapeutic communication quiz due Tuesday night.

  • Final paragraph due Tuesday night.

  • Handout slide due by 3 PM on Tuesday.

  • Presentations: June 14th and 21st.

  • Exam: Next week, starting at 7:40 AM.

Seventh Day Adventist Presentation

Core Beliefs

  • Believe in the Holy Trinity and the Old and New Testaments.

  • Value the writings of Ellen G. White as a prophetess.

  • Believe the dead are in an unconscious state awaiting resurrection.

  • The second coming of Jesus Christ will bring resurrection and God's kingdom.

Ellen G. White Quote

  • “Christlike love places the most favorable construction on the motives and acts of others…”

Healthy Lifestyle

  • The body is the tabernacle of the Holy Spirit; treat it as a temple.

  • Abstain from tobacco and alcohol.

  • Usually follow a vegetarian diet, avoiding pork.

  • May avoid caffeine.

  • Take care of the body and exercise regularly.

Spiritual Practices

  • Sabbath observance from dusk Friday to dusk Saturday.

  • Daily prayer for guidance and gratitude.

  • Community work and Bible study.

  • Sharing the message of salvation, service, and humanitarian aid.

Supporting Patients

  • Allow time and space for Sabbath worship and prayer.

  • Provide access to ministers or hospital chaplains.

  • Support religious support groups and access to religious texts.

Daily Schedule

  • Morning devotion: prayer, Bible reading, meditation.

  • Support Sabbath preparation: cleaning, meals, and plans.

Cultural and Social Aspects

  • Community engagement and volunteerism.

  • Embodying Christian love principles.

  • Gender roles may vary.

  • Value family time and worship together.

  • Social support is essential.

Summary Slides

The rest of the presentation includes slide that summarize all these points into the categories discussed earlier.

Case Study: Rachel

Rachel is a Seventh-day Adventist admitted for pneumonia. She is 80 years old and is from Phoenix, Arizona. She likes to pray different times of the day to make sure she does not interrupt this activity. What are they and how do you apply this in your career?