Chapter 21: Culture and Spirituality

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Chapter 21 Culture and Spirituality
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Learning Objectives

• Cite cultural demographic trends in United
  States.
• Discuss the importance of assessing health
  literacy and usage of translation services.
• Discuss various interventions to provide
  culturally aware care to elders from culturally
  diverse groups.
• Differentiate between religiosity and
  spirituality.

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Learning Objectives

• Identify how nurses attitudes and beliefs about
  spiritually impact nursing practice in relation
  to holistically caring for the older client.
• Identify strategies that could assist the nurse
  to be productive in conducting a spiritual
  assessment with the older client.
• Recognize resources available to the professional
  nurse working with an older client assessed and
  diagnosed with a loss of spiritual integrity.

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Culture and Cultural Awareness

• Cultural diversity in the U.S.
• Patients have better outcome when their culture
  is considered
• Characteristics of the five major ethnic groups
  in the united states
• European Americans
• African Americans
• Hispanic Americans
• Asian Americans
• Native Americans

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European Americans

• Presenting a stoic attitude about illness not to
  be a burden on others.
• The top five health disparities (white
  non-Hispanic)
• smoking by pregnant women
• drug-induced deaths
• deaths from poisoning
• deaths from melanoma
• deaths from chronic lower respiratory disease
  before age 45

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African Americans

• The second largest minority
• The role of religion and spirituality plays an
  important part in wellness belief system.
• Have less control over their health than God.
• The top five are
• 1, 2. new cases of gonorrhea
• 3. congenital syphilis
• 4. new cases of AIDS
• 5. deaths due to HIV infection

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Hispanic Americans

• The second largest population in the U.S.
• The top five health disparities are
• congenital syphilis
• new cases of tuberculosis
• new cases of AIDS
• exposure to particulate matter
• cirrhosis deaths (Keppel, 2007)
• Diabetes and Heart disease are two health
  problems that have an increased prevalence and
  mortality in Hispanic Americans.

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Asian Americans

• The top five are
• new cases of tuberculosis
• congenital syphilis
• no Papanicolaou (Pap) test among females older
  than 18
• exposure to particulate matter
• carbon monoxide exposure

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Native Americans

• Naturalistic approach to health and illness
• Health is a balance of the mind, body, spirit
• The top five health disparities are
• fetal alcohol syndrome
• smoking by pregnant women
• alcohol-related motor vehicle deaths
• cirrhosis deaths
• new cases of gonorrhea

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Culture and Cultural Awareness

• English language proficiency
• Limited English Proficiency (LEP)
• Speak only English 79.4
• Speak language other than English 20.6
• Speak English very well 11.9
• Speak English less than very well 8.7
• Translation services required for LEP patients
  inadequate interpretation is a form of
  discrimination

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Culture and Cultural Awareness

• Culture and nursing care history
• Transcultural Nursing Society (TNS)
• Awareness of cultural patterns and factors is
  essential for evidence-based care of older adults
  (Ethnogeriatrics)

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Culture and Cultural Awareness

• Care interventions and cultural awareness
• Cultural congruence understand different
  cultural and religious preferences, customs, and
  restrictions use this knowledge in planning and
  providing care.
• Dietary needs
• Economic diversity
• Religion and faith practices
• Health care

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Interventions

• To promote diversity in the Health Care Team
• Avoid stereotyping
• Learn about other cultures
• Learn from each others strengths
• Overcome racism
• Decrease language barriers
• Educate self and others

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• Racist comments from Patients
• Reporting
• Educating
• Redirecting
• Providing culturally competent care
• Educate self about the culture that is unfamiliar
• Provide culturally appropriate care.

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Spirituality and Religiosity

• Spirituality and the nursing profession
• Facilitating the clients spiritual well-being
• Holistic nursing practice mandates addressing
  clients spiritual needs
• Nurses must make time to first assess their own
  personal attitudes, values, and beliefs regarding
  spirituality.

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Spirituality and Religiosity

• Providing spiritually competent care
• Spirituality related to a sense of well being in
  the elderly
• Many use prayer and faith as successful coping
  strategies
• Provide opportunity to practice religion
• Incorporate spiritual leader into the team if
  needed
• Religiosity is religious activity, dedication and
  belief.

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Summary

• Holistic nursing practice requires a complete
  client picture through careful assessment
• Culture and spirituality reflect clients core
  values
• Cultural assessments, spiritual screening,
  spiritual health histories, focused spiritual
  assessments help identify spiritual strengths
• Plan with client for spiritual needs that impact
  health