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Chapter 6


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[Front]


Understanding Various Cultural Practices and Applying Them to Nursing Care
[Back]


Transcultural Nursing

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4 Common characteristics of all cultures
1)Culture is learned, beginning at birth, through language and socialization. 2)Culture is dynamic and everchanging and may act as a stabilizer for a culture. 3)Members of the same cultural group may share patterns that are present in every culture such as communication, means of economic and physical survival, social customs and mores, and religious systems. 4)Culture is an adaptation to specific factors or conditions in a specific location. When people are removed from that location, their customs continue even though they are no longer called for in the new setting
8 Reasons for which variations within a cultural group occur
1)Age 2)Amount and type of interaction between age groups 3)Degree to which values in current country are adopted 4)Dialect or language spoken 5)Gender identity roles 6)Geographic location of country of origin or current residence 7)Religion 8)Socioeconomic background
Common interview questions for cultural assessment(16)
1)Who will make decisions about your treatment? 2)Who is the person in the family who must be involved with health care decisions? 3)Will members of your community be asked to help with making decisions about your care? 4)Can you describe what is wrong? 5)What do you thin has caused your problem? 6)Why do you think this has happened at this time? 7)Why did it happen to you? 8)Why did it affect your(body part)? 9)How long have you had this problem? 10)Why did you come for help now? 11)What do you think will help to resolve your problem? 12)Who else do you think can help you? 13)Have you gone to this person for help?(If so what did the person do?) 14Did this treatment help? 15)What results do you hope to get from your care? 16)How will your illness affect your family?
Cultural Data Necessary to Collect Through Interview(8)
1)What language is used?(How well do they understand English? Do they need a translator?) 2)What cultural practices have the potential to interfere with receiving health care? 3)Differences in health care beliefs 4)Difficulty with care being performed by members of the opposite sex 5)Modesty and privacy concerns 6)Personal space practices 7)Use of folk medicines or treatments 8)What dietary practices have the potential to interfere with treatment for this illness?
Differences between race and ethnicity
Race is related to biologic factors such as physical characteristics and hereditary factors, while ethnicity refers to a group who shares a common social and cultural heritage based on shared traditions, national origin, and physical and biologic characteristics
Strategies for communication with patient from different cultures(12)
1)Take time to establish patient-nurse relationship and comfort level 2)Ask questions in a calm unhurried manner. Rephrase and ask again if patient answer is inconsistent with prior information 3)Observe cultural differences in communication and honor those differences 4)Ask patient about the meaning of health and illness and their understanding of treatments and planned care. Investigate how the illness is likely to affect their life, relationships, and self-concept. Find out what patients consider the cause of their illness and how they prefer to manage the illness 5)Listen to the patients perception of their needs and respect them 6)Listen actively and attentively(Try not to anticipate patient responses) 7)Talk to Patients in an unhurried manner that considers social and cultural amenities 8)Give patients time to answer 9)Use validation techniques to verify that the patient understands(Be cautious of head nodding and smiles may indicate wanting to please the nurse and not necessarily understanding 10)Sexual concerns may be difficult for patients to discuss(Consider nurse of same gender to facilitate communication 11)Use alternative communication methods such as phrase books, an interpreter or pictures for non-english speaking patients 12)Learn key phrases of languages that are commonly spoken in your community
Biomedical Health Belief System
Life is regulated by physical processes and may be manipulated by mechanical means. Health is absence of disease or signs and symptoms of disease. Disease is an alteration of the structure and function of the body. Disease has a specific cause, onset, course and treatment and is cause by trauma, pathogens, chemical imbalance or failure of body parts. Treatment focuses on the use of physical and chemical intervention
Folk Health Belief System
(Third World)Classifies illness or diseases as natural or unnatural. Natural illnesses occur within the world as god made it and intended. Unnatural implies events that interrupt Gods plan and may represent evil. They have no predictability and are beyond the control of mortals. Treatment is done by carrying out rituals or repentance or giving in to the supernatural forces wishes
Holistic Health Belief System
Religious experiences are based on the cultural beliefs and may include thing such as blessings from spiritual leaders, apparitions of dead relatives and miracle cures. Healing powers may be ascribed to animate or inanimate objects. Religion dictates social, moral and dietary practices designed to assist an individual in maintaining a healthy balance and in playing a vital role in illness prevention. Treatment is designed to restore balance with physical, social, and metaphysical worlds. It may extend beyond treating the person to treating the environment(eg decreasing pollution, preventing world hunger)
Alternative/Complementary Belief System
Use of nonmedical forms of therapy to treat an illness.(eg acupuncture, aromatherapy, meditation). Most do so without informing their health provider. Treatments address the whole patient as viewing symptoms as means of the body to communicate to the mind that something must be changed, removed or added to ones life. Mind and body are seen as a unit
Eye contact indicates rudeness or agression
Some Asian and Native American cultures
Views time as elastic
Mexican American
Health practice believed by western culture
Biomedical Health Belief System
Any intervention to hasten death is forbidden
Muslim American and American Indian
Touch is often used
Mexican American
T/F: You can have more than on race but only one ethnicity
False: You may only have one race even if mixed race. You may however have multiple ethnicities
Sickle Cell Anemia prone
African Ancestry
Have belief that adjusting diet for hot or cold foods can treat illness
Chinese, Korean, Vietnamese, Mexican and Puerto Rican
Punctuality is high priority
US, Japan and Northern European
Present Oriented Cultures
African American, Hispanic and American Indian