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Acculturation

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Process of adapting to & adopting a new culture & results in varying degrees of affiliation with the dominant culture.

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Assimilation

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Results when individual gives up his or her ethnic identity in favor of dominant culture.

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Biase/prejudice

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Composed of beliefs & attitudes associating negative characteristics with people who are perceived to be different from oneself.

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Cultural assessment

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Systematic & comprehensive examination of the cultural care values, beliefs, & practices of individuals, families, & communities and how it will effect the pt's willingness to receive care

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Cultural competence

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A ongoing process in which the health care provider continually strives to work effectively with individuals, families, & communities(cultural context).

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Culturally congruent care

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Care that fits people's valued life patterns and values & sets of meanings generated from people themselves rather than a predetermined criteria

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Culture Care Theory

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Emphasizes that central purpose of nursing is to provide culturally congruent care.

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Emic worldview

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Analysis of cultural phenomena from perspective of one who participates in culture being studied. (Insider/narrative perspective)

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Ethnicity

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A shared identity related to social & cultural heritage such as values language, geographical space, & racial characteristics.

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Etic worldview

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Analysis of cultural phenomena from perspective of one who does not participate in culture being studied. (Outsider's perspective)

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Transcultural nursing

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a comparative studies of cultures in order to understand their similarities (culture that is universal) and differences (culture that is specific to particular group) among groups of people.

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Race

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The common biological characteristics shared by a group of people such as skin color.

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Cultural-bound syndromes

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Are illnesses restricted to a particular culture or group of people.

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Health disparities

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Are unequal burdens of disease morbidity & mortality rates experienced by racial & ethnic groups. / a particular type of health difference that is closely linked with social/economic/environmental disadvantage

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Illness

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Is the way that people react to disease.

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Disease

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Is a malfunctioning of the biological process.

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Culture & illness

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Provides the framework in which the meaning of illness is defined.

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Folk healers

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Naturalistic, holistic, & supernatural worldview about causes of illness. Use different methods, combining the spiritual, religious, & supernatural with natural means. Heat massage, acupuncture, & herbs commonly used.

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Impression management:

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Ability to interpret another persons behavior within context of that person's culture & behave in a cultural congruent way.

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Ethohistory:

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Refers to significant historical experiences of a particular group.

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Collectivistic cultures:

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Rely on family to care for sick.

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Cultural care preservation or maintenance:

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Retain &/or preserve relevant care values so that patients are able to maintain well-being, recover from illness, or face handicaps &/or death.

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Cultural care accommodation or negotiation:

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Adapt or negotiate with patient/family to achieve beneficial or satisfying health outcomes.

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Cultural care re-patterning or restructuring:

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Reorder, change, or greatly modify patient's family's customs for new, different, and beneficial health care.

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marginalized groups

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more lidely to have poor health outcomes and die at an earlier age because of complex interactions between individual behaviours, public and health policy , quality of care, community and environmental factors

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culture

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historically associated with norms, values, and traditions passed down through generations.

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social inequality

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groups have unequal access to resources services and positions

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intersectionality model

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suggests that each of us stand at the intersection of two categories: Privilege and oppression.

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privilege and oppression

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organizing principles formed from the building blocks of identity and culture, which include race, class, gender, age, sexual orientation.

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oppression

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formal and informal system of advantages and disadvantages tied to our membership in a social group

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world view

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determines how people perceive others, how they interact and relate to reality and how they process information. / the way people tend to look out upon the world or their universe and forma ti pic or value stance about life or the world around them.

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social determinants of health

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include resources such as access to health care, job opportunities nutritious food, clean air, and transportation

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core measures

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are a key indicator that help health care institutions improve performance, increase accountability , and reduce costs.

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name the 5 components of Campinha Bacote's model of cultural competency

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*cultural awareness * cultural knowledge *cultural skills *cultural encounters *cultural desire

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cultural awareness

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an in depth self examination of one own background, recognizing biases, prejudices and assumptions about other people

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cultural knowledge

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sufficient comparative knowledge of diverse groups, including the values, health beliefs, care practices, world view, and bicultural ecology commonly found within each group

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cultural skills

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ability to assess social, cultural, and biophysical factors that influence pt tx and care

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cultural encounters

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cross-cultural interactions that provide opportunities to learn about toher cultures and develop effective intercultural communication.

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cultural desire

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the motivation and commitment to caring to moves an individual to learn from others, accept the role a s learner, be open to and accepting of cultural differences, and build on cultural similarities.

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ladder of cultural competence

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integrates the ladder of oppression to emphasize how culturally competent organizations and individuals can work to eliminate healthcare disparities.

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when pt access the health care system what are the 2 things they want

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*see their health care provider *feel better

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what are the 8 things the health care provider wants in return

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*make and keep appts * give med hx *give informed consent * follow the discharge instructions * read, understand, and use health care educ. materials * correctly complete insurance forms * pay their bills * go home and manage their bare by taking their meds the right way, eating the right foods, and stop/start changing behaviors

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Linguistic competence

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the ability of an organization and its staff to communicate effectively and convey info in a manner that is easily understood by diverse audiences.

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what are the 5 universal skills required for health care providers to work effectively with pt's from any culture

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* respect the pt's beliefs * shifting a model of understand a pt's experience from a disease happening to their body and organs, to that of an illness occurring on the context of culture (biopsychosocial) context * ability to understand the pt's explanation of the illness * ability to communicate with pt * being able to negotiate and agreeable safe and effective tx plan

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explanatory model

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the ability to elicit a pt's explanation of an illness and its causes

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what type of questions should be used in the nursing assessment

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*open-ended (what do u think caused u to become sick) *focused (Did u have this problem before) *contrast (how different is this problem from the one u had a month ago) *ethnohistory (what is ur ethnic background or ancestry) *social organization (who lives with u) *caring beliefs and practices (what do u do to keep ur self well)

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communication technique mnemonic LEARN

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L - listen with sympathy and understanding E - explain ur perceptions of the problem A- acknowledge and discuss cultural differences and similarities between u and ur pt R- Recommend treatment involving pt N - Negotiate agreement (incorporate aspects of pt's culture)

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communication technique mnemonic RESPECT RES

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R - Rapport (connect socially) seek pt's pov, avoid making judgments E - Empathy - remember that the pt wants help and has come to you for it, seek out pt's rationale for behaviors or illness S-Support - ask and understand barriers to care and compliance , involve family if appropriate, reassure pt

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communication technique mnemonic RESPECT PECT

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P - Partnership - be flexible , negotiate, and stress u will be working with the pt E - explanation - check often for understanding C - Cultural Competence - respect the pt and the pt's culture, don't be bias and be aware of ur bias T - trust - self disclosure may be difficult for some pts, do not assume trust

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communication technique mnemonic ETHNIC

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E -Explanation - pt's explains perception of problem, and u ask what concerns them most T - treatment - what types of tx has the pt tried H - Healers - has pt sought advice from alternate provider N -Negotiate - tr to find option mutually agreed upon I-Intervention -agree on intervention/incorporate alternative tx C - collaboration - include pt, family, healers, comm. resources and other health care providers

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communication technique mnemonic C-LARA

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C - Calm - calm ur self down, take a deep breath, check pulse L - listen - to pt and family's perspective A - affirm - express connection when something is shared(feeling,principe,perspective) R - Respond - to what is said. answer the question A - add - share additional info (in this step - educate )

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what are helpful methods of the teach back method

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*plan your approach * use material to reinforce teaching *clarify *Practice

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in the teach back method, how could the step (plan your approach) be accomplished

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think about how u will ask ur pt to teach back in a shame free way . Keep in mind the some situations are not appropriate for teach back

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in the teach back method, how could the step (use material to reinforce teaching) be accomplished

answer

use handouts, pics, or models

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in the teach back method, how could the step (clarify) be accomplished

answer

it pt can't remember or accurately repeat ur instructions, claridy ur info and allow the pt to teach it back again. Do this until they are able to teach back in their own words without repeating exactly what u say. - Understand teach back is a process of closing the loop

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in the teach back method, how could the step (practice) be accomplished

answer

although it takes time to get ued to teach back, studies have shown that is doesn't take and longer to perform once it becomes a part of ur routine

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