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CH12 Caring in Multicultural Health Care Environments

Wilkinson's Fundamental of Nursing

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920 views

CH12 Caring in Multicultural Health Care Environments

Wilkinson's Fundamental of Nursing

Uploaded by

vallerie1l2m3
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 33

Chapter 12

Caring in Multicultural
Health
Care Environments

Copyright ©2024 F.A. Davis Company


Culture and Ethnicity

 The United States is a multicultural society.


 You will care for clients who are not from
your culture.

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Culture Characteristics

 Cultural beliefs provide identity and a sense


of belonging.
 Culture is both universal and dynamic.
 Cultural values, beliefs, and traditions are
passed down from generation to generation.
 Cultural assumptions and habits are
unconscious.
 Culture is diverse.

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Ethnicity, Race, Religion

 Ethnicity
• Members share a common social and
cultural heritage
 Race
• Based on biological similarities
 Religion
• Ordered system of beliefs

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Concepts Related to Culture

 Socialization
 Acculturation
 Assimilation
 Dominant culture
 Subcultures
 Underrepresented (minority) groups

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Vulnerable Populations as Subcultures

 People experiencing homelessness


 People experiencing economic instability
 People experiencing mental illness
 People with physical disabilities
 Young
 Older adults
 Some ethnic and racial minority groups

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ClickerCheck

The most important concept about vulnerable


subcultures guiding nursing care is that persons
belonging to these groups

A. Receive different healthcare


B. Have difficulty complying with their therapy
C. Never have insurance
D. Often have limited access to healthcare

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Correct Answer: D

Lack of access to healthcare is common to all


vulnerable populations for various reasons.

Copyright ©2024 F.A. Davis Company


ClickerCheck

The student nurse is assigned an undocumented immigrant who


was injured while crossing the border into the United States. The
student tells you, “I do not know what to put for race, and they
probably can’t tell me.” What is your best response?

A. “Leave it blank and I will try to get this information.”


B. “Your response demonstrates that you do not understand the
difference between race and ethnicity.”
C. “You should be able to determine race from their skin color.
Let’s discuss race, skin color, and appearances.”
D. “Let’s discuss approaches to obtaining data on race from
patients.”

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Correct Answer: D

The most appropriate response would be:


“Let’s discuss approaches to obtaining data on
race from patients.”

Copyright ©2024 F.A. Davis Company


Culture Universals and Specifics

 Culture universals are values, beliefs, and


practices that people from all cultures share.
 Culture specifics are values, beliefs, and
practices that are special or unique to a culture.
 Archetypes are something recurrent, based
on facts.
 Stereotypes are widely held but oversimplified
beliefs that have no basis in fact.

Copyright ©2024 F.A. Davis Company


Cultural Specifics That Affect Health

 Communication
 Space
 Time orientation
 Social organization
 Environmental control

Copyright ©2024 F.A. Davis Company


Cultural Specifics That Affect Health (cont’d)

 Biological variations
 Religion and philosophy
 Education
 Technology
 Politics, law
 Economy

Copyright ©2024 F.A. Davis Company


ClickerCheck

The nurse notes that the client’s grandmother is


looked to for input whenever questions arise about
the client’s care choices. Which cultural specific will
guide the nurse’s plan of care?

A. Communication
B. Social organization
C. Environmental control
D. Biological variations

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Correct Answer: B

The social organization of the client’s family


will influence what treatment will be
acceptable to the client.

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Culture of Healthcare

 Indigenous healthcare system


 Conventional healthcare system

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Health and Illness Beliefs

 Scientific/biomedical
 Magico-religious
 Holistic

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Nursing as a Subculture

 Nursing is the largest subculture in health-


care culture.
 Nursing values
• Silent suffering as a response to pain
• Caring
• Nursing autonomy
• Use of nursing process
• Knowledge
• Critical thinking

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Traditional and Alternative Healing

 Folk medicine
 Complementary medicine
 Alternative medicine

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Holistic Health Care

 Complementary medicine
 Alternative medicine
 Ayurveda
 Traditional Chinese medicine

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Culturally Competent Care (cont’d)

Leininger’s Culture Care Theory

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Barriers to Culturally Competent Care

 Bias
 Ethnocentrism
 Cultural stereotypes
 Prejudice
 Discrimination

Copyright ©2024 F.A. Davis Company


Barriers to Culturally Competent Care (cont’d)

 Racism
 Language barrier
• Street talk, slang, jargon
 Lack of knowledge
• Emotional responses
 Self-knowledge

Copyright ©2024 F.A. Davis Company


ClickerCheck

The charge nurse of a unit tries, as a rule, to admit


Hispanic clients to a room at the end of the hall so
that “the noise from the family will not disturb
others.” This nurse is exhibiting

A. Racism
B. Prejudice
C. Discrimination
D. Sexism

Copyright ©2024 F.A. Davis Company


Correct Answer: C

Discrimination is the behavior that results from


a prejudice.

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Assessment

 Health history
 Physical assessment

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Analysis/Nursing Diagnosis and Planning
Outcomes/Evaluation
 Nursing diagnoses
 Outcomes

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Possible Effects of a Patient’s Cultural
Health Practices
 When the practice is efficacious
 When the practice is neutral
 When the effects of a practice are unknown
 When the practice is dysfunctional

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Nursing Strategies for Responding to a Client’s
Cultural Health Practices
 Responding to a client’s cultural
health practices
• Negotiation
• Repatterning/restructuring

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Communicating With Clients Who Speak a
Different Language
 Interpreter
 Internet and computer translation software
 Translator

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Developing Strategies

 Reflect and know yourself.


 Keep learning.
 Accommodate and negotiate.
 Collaborate.
 Respect.
 “Take a trip to BALI.”

Copyright ©2024 F.A. Davis Company


Becoming Culturally Competent: LIVE and LEARN
Model (Carballeira, 1997)

Like Listen
Inquire Evaluate
Visit Acknowledge
Experience Recommend
Negotiate

Copyright ©2024 F.A. Davis Company


Socratic Reasoning

A 67-year-old patient is brought to the emergency room at


0230 for injuries received in a motor vehicle accident. Her
husband died in the accident. She is alert, oriented, and only
speaks Russian. No one at the hospital speaks Russian. Several
diagnostic tests are needed immediately to determine the
extent of her injuries. Internal bleeding and other potential
life-threatening injuries are suspected (BP 98/60, P120).

 Discuss whether informed consent can be waived.


 What options are available to assist the patient?
 What should be your initial actions?

Copyright ©2024 F.A. Davis Company

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