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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