Cultural Assessment in Nursing
Advent Health UNIVERSITY NURS 225: Cultural Assessment Notes
Chapter 2: Module 3b
Importance of Cultural Awareness
Increased understanding of cultural diversity
There is a necessity for health care professionals to be self-aware and knowledgeable about their own cultural backgrounds.
This knowledge enhances the understanding and interaction with diverse patient populations.
Awareness as a process
Cultural awareness is an interactive and ongoing process.
Continuous learning and adaptation are required in the health care profession.
Cultural Self-assessment
Performing cultural self-assessment is crucial for developing cultural competence.
It allows health care professionals to reflect on their biases and attitudes towards different cultures.
Cultural Assessment
Key Interview Topics
Primary Language: Determining the main language spoken by the patient to facilitate effective communication.
Preferred Name: Acknowledging how patients wish to be addressed fosters respect.
Health Practices: Understanding cultural beliefs about health and healing.
Family Roles: Recognizing the dynamics within the patient's family structure that may influence care.
Nutrition: Assessing dietary restrictions or preferences based on cultural practices.
Childbirth: Understanding cultural customs surrounding childbirth.
Death: Exploring beliefs related to death and dying.
Healthcare Providers: Identifying the types of healthcare professionals respected or preferred by the patient.
Religion and Spirituality
Spirituality
Defined as a broader term that encompasses beliefs in something larger than oneself, which includes the belief in transcendence.
Religion
Refers to an organized system of beliefs, contributing to a shared experience that aids individuals in meeting their personal spiritual needs.
Relationship Between Spirituality and Religion
While spirituality and religion can interrelate, they do not have to coexist simultaneously.
Individuals have unique ways of defining their beliefs and feelings about spirituality and religion.
Spiritual Assessment
Assessment Questions
Example: “Do you have any religious or spiritual preferences we can support?” which aims to engage the patient in discussions regarding their spiritual needs.
Core Values
Recognize and respect the core values held by the client that may influence their health care decisions.
FICA Tool
A framework used for assessing patients’ spirituality, which stands for:
Faith: What is your faith or belief?
Implications: How does your faith influence your health?
Community: Are you part of a spiritual or religious community?
Address: How would you like your health care team to address these issues?
Case Study - Recognizing Cues
Scenario Overview
A home care nurse visits a 68-year-old Vietnamese woman post-hospitalization for congestive heart failure (CHF).
Patient expresses limited English proficiency; hence, her daughter interprets during the visit.
Clinical Observations
Elevated Blood Pressure: BP recorded at 160/80.
Vital Signs: T 98.6, P 76, R 20, O2 saturation at 94%.
Lung Assessment: Scattered rhonchi in upper lung fields; clear in lower fields, improved with cough.
Edema: Bilateral +2 in lower extremities.
Patient expresses preference for herbal remedies over prescribed medications.
Case Study - Questions & Answers
Q1: Likely Cause of Symptoms
The son's input indicates non-compliance with prescribed medications, particularly diuretics and beta-blockers, as evidenced by the patient's choice to prioritize herbal remedies.
Rationale: Cultural variations influence health perceptions, where the patient may associate wellness with alternative remedies, leading to potential pulmonary edema from untreated CHF.
Q2: Nursing Interventions
Suggest conducting a health beliefs and practices assessment to evaluate the herbal remedies currently used and their frequency.
Assess the patient's understanding of their prescribed medications and their purpose.
Rationale: It's vital to evaluate the potential interaction between herbal remedies and prescribed medications for effective treatment management.
Q3: Steps to Cultural Competence
Step 1: Understand one's own heritage, values, beliefs, and attitudes related to health.
Step 2: Identify what health means to the patient from their cultural viewpoint.
Step 3: Understand the health care delivery system’s nuances.
Step 4: Be knowledgeable about the social backgrounds of clients.
Step 5: Familiarize oneself with the language of clients and available resources for interpretation.
Rationale: Self-awareness aids understanding of other cultures, allowing for tailored care that aligns with the patient’s needs and promotes adherence to health care regimens.
Q4: Acceptance of Client's Health Practices
Provide interpretation services for clients with limited English proficiency.
Supply written materials in both English and the patient’s native language.
Document the heritage assessment in the medical records to inform all health care providers involved in the patient's care.
Offer education using layman’s terms to ensure comprehensibility, especially regarding prescribed drugs.
Research the herbal remedies the patient is using to determine their safety and efficacy in relation to prescribed treatments, ensuring that alternatives do not conflict with medical prescriptions.
Rationale: Accessibility to interpretation and documentation of cultural assessments enhances patient understanding and compliance, promoting client-centered and culturally competent care.