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Ch. 9Cultural Diversity and
Values
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Culture
Definition
Knowledge, values, practices, customs,and beliefs of a group.
Properties
Dynamic, not static
Shared, not private Learned not inherited
One is not born with culture, it is
learned from parents and siblings
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Cross-Cultural Nursing
Aka transcultural nursing
Definition
Any nursing encounter in which theclient and nurse are from differentcultures
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Cultural Competence
Definition
Openness to others ideas and ways oflife, respect, curiosity, patience, and self
awareness of ones own culture andculturally mediated ideas
Principles of Cultural Competence
All of the above
Humility
Cultural competence is notmemorizin a list of cultural traits
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Cultural Safety
Definition
Culturally appropriate health services todisadvantaged groups while stressing
dignity and avoiding institutional racism,assimilation (forcing people to adapt toa dominant culture) and repressivepractices.
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Cultural Humility
Definition
Ask open ended questions about beliefsand practices ask about traditions
Requires continual self-evaluationand critique their own culturalassumptions and advocate for their
clients in a nonpaternalistic way.
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Ethnocentrism
Definition The assumption that others believe
and behave as the dominant culture
does or the belief that the dominantculture is superior to others
Example
A woman drives to work and has anoffice job and she forgets that manyother people commute on foot or hasa physically active job.
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spec s o u ure rec yAffecting Health and
Healthcare Attribution of Illness differentcultures have different ideas of whatcauses disease
Diet more acculturated Latino withDM tend to have healthier diets andare less likely to have diets high in
fiber and low in saturated fat. Communication interpretation
should never be conducted by a
family or friends of client
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Cultural Health Assessment
Individual Clinicians
Kleinman explanatory model
Individualist method mini-ethnography tailored to each client
Set of questions that explore the clientsview of illness and tx
What does the client think caused disease
How serious does client think diagnosis is
What does client fear about dx and current tx
Healthcare Organizations
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Chapter 10: CommunityAssessment
Community assessment is acomprehensive evaluation of thestatus of a community.
Identifies vulnerable populations
Determines unmet needs
Documents community resources
The approach that is used forcommunity assessment depends on thetype and characteristics of community
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Defining the Communityand its Boundaries
Geopolitical communities
Community
Definition A group of people sharing common interests,
needs, resources, and environment; aninterrelating and interacting group of ppl withshared needs and interests
Geopolitical community
Definition
Group of ppl who live within identifiedboundaries and governing systems
City town neighborhood, locales
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PhenomenologicalCommunities
Definition
Group of people who have interpersonaland intrapersonal connections
Common interests, boundaries not asidentified
Example
Neighbors interested in enhancing theirproperty to maintain the unique qualities ofa neighborhood (common interest but noformal structure)
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Communities of Solution
Definition
Formed by an aggregate specifically toaddress health concerns within a
particular area
phenomenological communities
Can form in response to a health threat,
such as contaminated water or industrialair pollution
Social connections between members
are likely to be loose and not integrated
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Societal, National, orInternational Communities
National Communities
Ex: The United States
Compositions differ Common federal government
International or Global Communities
Compositions differ
Similar characteristics with sharedinterests and goals, including members
health and safety
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Nursing Process
Assessment: evaluate status of thecommunity
Windshield survey
Definition Observation of a community while driving a car or
riding public transportation to collect data for acommunity assessment
Census Diagnosis
Identify populations and determine
unmet needs/problems
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Frameworks for CommunityAssessment
Epidemiologic models
Definition
A process used to assess a community usingdata collected from descriptions andstatistical relationships to evaluate the levelof health and well-being within a communityto address identified healthcare needs
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Epidemiologic Approach toCommunity Assessment
Finds the health needs of thecommunity
Guided by Healthy People 2020
Uses Report Cards
Provide a snapshot of overall health and
well-being of a community through theuse of indicators or measurements oflocal social and health trends
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Describing the Disease orDisability
Before engaging in any datacollection, the members of thecommunity must be defined.
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e erm n ng eRelationships that can
Predict Health Status Data can be analyzed in a way thatrelationships that predict healthstatus can be defined.
Example
Statistical information has beentransferred graphically so that
assessment can be seen asconcentrations on maps of cities, town,counties, and states.
Relationship is portrayed visually
ssessmen an
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ssessmen anInterventions in the
Community Health Needs Assessment Windshield survey
Key informants interview Focus group
Surveys
Types of Interventions Focus on prevention
Workshops
Coalition
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Frameworks for CommunityAssessment
Epidemiological Approach
Community as Partner
Functional Health Status (Gordon's) Developmental Models
Community Assessment Assets-
based
Collaborative
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Functional Health PatternsApproach
Definition
A systematic and deliberate approach tocommunity assessment, evaluating
patterns of behaviors of communitydwellers that occur sequentially acrosstime.
Assessment broken into 11patterns or areas of focus:
Health perception
Nutrition/metabolic
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Collaborative Model
Definition
An approach to assessment that beginswith planning that includes
representative parties of a populationincluding service organizations,corporations, and gov. officials.
Emphasizes interdisciplinaryteamwork
A we can do it together mentality
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Collaborative Model
Advantages
Professionals learn to work amongst keycommunity leaders
Develop appreciation for each othersviewpoints
Disadvantages
Time-consuming
Need for clarity amongst all involved in