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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.