Nursing Chapter 18 Homework Clients Will Expect Pill Treatment Surgery Cure

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Describe concepts related to culture such as race, ethnicity, and acculturation.

Concepts for Lecture

1.

Culture

is the thoughts, communications, actions, customs, beliefs,

values, and institutions of racial, ethnic, religious, or social groups

(Office of Minority Health [OMH], 2005). It has been described as the

2. A

subculture

is usually composed of people who have a distinct iden-

4.

Diversity

refers to the fact or state of being different. Many factors

account for diversity: sex, age, culture, ethnicity, socioeconomic sta-

5.

Race

is a term with many definitions, often used interchangeably

with the terms ethnicity and culture. The Office of Management and

Budget (OMB), which determines federal standards for reporting

race, states that racial categories should not be interpreted as being

6.

Ethnicity

is a term often interchangeably used with race. Although

the OMB differentiates between race and ethnicity by excluding the

term Hispanic from racial categories, it does not define how these

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CULTURALLY RESPONSIVE NURSING CARE

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Nationality

is sometimes used interchangeably with ethnicity or

8.

Religion

may be considered a system of beliefs, practices, and ethical

values about divine or superhuman power worshipped as the crea-

9.

Ethnocentrism

is the belief in the superiority of one’s own culture and

lifestyle.

11.

Racism

refers to assumptions held about racial groups, which include

12.

Discrimination

refers to the differential and negative treatment of

13.

Generalizations

are statements about common cultural patterns. Gen-

14.

Stereotype refers to the assumption that an individual reflects all charac-

teristics associated with being a member of a group.

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Examine factors that contribute to health disparities among racial and ethnic

groups.

Concepts for Lecture

1.

Health disparities

are the differences in care experienced by one pop-

ulation compared with another population. Although everyone

should receive high–quality health care, the National Healthcare Dis-

parities Report (AHRQ, 2012) shows that in the United States, some

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Describe the role of federal agencies, initiatives, and laws on provision of

cultural health care.

Concepts for Lecture

1. The U.S. Department of Health and Human Services (DHHS) houses

the Office of Minority Health “to improve and protect the health of

racial and ethnic minority populations through the development of

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• Discuss the Office of Minority Health stand-

ards for culturally and linguistically appropri-

ate health care for health care organizations

(www.omhrc.gov).

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• Invite a staff nurse to discuss how the institu-

The purpose of the National Center on Minority Health and

Health Disparities (NCMHD) in the National Institutes of Health “is

to promote minority health and to lead, coordinate, support, and

access the NIH effort to reduce and ultimately eliminate health

disparities.”

groups entering the nursing profession.

Current nursing practice has been influenced by the National

Healthcare Disparities Report, which is a comprehensive overview

of disparities in health care among racial, ethnic, and socioeconomic

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Describe cultural models of care, such as cultural competency.

Concepts for Lecture

1. According to Campinha–Bacote (2007),

cultural competence

is a life-

long process in which the nurse continuously strives to achieve the

ability and availability to effectively work within the cultural context

of a client (individual, family, community). There are five constructs

2. Another model in providing culturally responsive care is to view health

holistically, as a complex, interrelated, threefold phenomenon, that is,

the balance of all aspects of the person—the body, mind, and spirit. The

CHAPTER 18 / Culturally Responsive Nursing Care 93

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Describe health views from culturally diverse perspectives.

Concepts for Lecture

1. Three views of health beliefs include magico–religious, scientific,

and holistic. In the magico-religious health belief view, health and

illness are controlled by supernatural forces. Individuals may believe

2. Scientific or biomedical health belief is based on the belief that life

and life processes are controlled by physical and biochemical pro-

3.

The holistic health belief holds that the forces of nature must be main-

tained in balance or harmony. Human life is one aspect of nature that

must be in harmony with the rest of nature. When the natural balance or

harmony is disturbed, illness results.

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Differentiate culturally influenced approaches to healing and treatment.

Concepts for Lecture

1. Sociocultural forces, such as politics, economics, geography, reli-

2. Many persons have special teas or “cures” (such as chicken soup)

3. Why do individuals use traditional healing methods? Folk medicine

is thought to be more humanistic than biomedical health care. The

consultation and treatment take place in the community of the

4.

It is important for the nurse to obtain information about folk or family

healing practices that may have been used before or while the client used

Western medical treatment. Often clients are reluctant to disclose the use

of home remedies with health care professionals for fear of being

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Invite members of diverse cultures within the

community to discuss health beliefs.

•

Show videotaped interviews of people dis-

cussing various health beliefs.

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Describe ways culture influences communication patterns and how to

provide linguistically appropriate care.

Concepts for Lecture

1. Cultural values greatly influence communication patterns within the

family group, the norm for family size, and the roles of specific fam-

ily members. In some families, the man is considered the provider

2. The National Standards for Culturally and Linguistically Appropri-

ate Services in Health Care (CLAS) standards are intended to ad-

vance health equity, improve quality, and help eliminate health care

disparities by establishing a blueprint for health and health care or-

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Create self-awareness of your own culture, beliefs, biases, and assumptions.

Concepts for Lecture

1. The heritage assessment tool on page 290 is

a set of questions to be

used to describe a given client’s—or your own—ethnic, cultural, and

religious background. In performing a heritage assessment it is help-

2. Self–awareness of personal biases can enable nurses to develop mod-

3. In learning how to provide culturally responsive care, the nurse must

first understand his or her own culture, beliefs, and assumptions.

There are many models documented in the literature to deepen this

self-exploration. Campinha–Bacote (2007) offers the ASKED mne-

monic model to develop cultural consciousness:

A

wareness: Am I aware of my biases and prejudices, as well as

racism and other “isms”?

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Ask the students to assess their own cultural

traditions using the Cultural Assessment Tool

found in the textbook and submit a paper

discussing the results.

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CHAPTER 18 / Culturally Responsive Nursing Care 95

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kill: Do I have the skill in conducting a cultural assessment in a

sensitive manner?

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nowledge: Am I knowledgeable about the worldviews of diverse

cultural and ethnic groups?

4. Other self-identity questions may include the following (Tochluk,

2010):

•

When did you first realize you were a member of your

race/ethnicity? What did it mean to you at that time?

•

How did your culture/race/ethnicity play a role in your childhood

and/or adolescence?

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Identify methods of cultural assessment.

Concepts for Lecture

1. The process of cultural assessment is important. How and when

questions are asked requires sensitivity and clinical judgment. The

timing and phrasing of questions need to be adapted to the individu-

2. Before conducting a cultural assessment, determine what language the

client speaks and the client’s degree of fluency in the English language.

3. Always address clients, support people, and other health care

4. When meeting a person for the first time, introduce yourself by your

full name, and then explain your role.

6. Use language that is culturally sensitive.

8. In creating a plan of care that is culturally responsive, there are many

assessment tools that can be used. The tools are a way of interviewing

9. The Heritage Assessment Interview depicts the questions to ask

when conducting a heritage assessment. It is designed to enhance the

process in order to determine if clients are identifying with their

96 CHAPTER 18 / Culturally Responsive Nursing Care

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Create a culturally responsive nursing care plan.

Concepts for Lecture

1. Nursing diagnoses developed by NANDA are based on Western

cultural beliefs. Nurses must provide appropriate care to clients of

any culture. This is accomplished through developing cultural sensi-

tivity and considering how a client’s culture influences his or her

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Provide the students with a list of NANDA

nursing diagnoses. Ask the students to provide

examples of how suggested goals and inter-

ventions for these diagnoses may be altered to

reflect various cultural beliefs.

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