Chapter%2021:%20Culture%20and%20Spirituality

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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.
• Tend to rely on science rather than rely on God.
• Individualistic
• Tend to follow advice of healthcare providers
• 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 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
• None of the above top 5 diseases are even in the
  top 10 for European Americans. health disparity

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Hispanic Americans

• Hi value on family, religion, and community
• 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

• Silence is gold.
• Avoid eye contact since it means disrespect
• Hardly say no. Nodding head doesnt mean he/she
  agree but etiquette.
• 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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Special groups (P.786 -791)

• Mormon avoid coffee tea, alcohol, caffeine
  apply olive oil to patient
• Islam Fasting during certain times Ramadan-holy
  month of fasting
• Orthodox Judaism Hold Tx schedule on Saturday
  Kosher food Avoid eating milk and meat together
  Avoid leave dead body alone and family will stay
  Avoid eating pork, crab, lobster, shell, octopus
  Avoid autopsy

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Special groups

• Christian science Sickness is an illusion
• that can be corrected by prayer alone.
• - Avoid medical care prayer is most
  effective
• See Appendix A, pp.786 791 Spirituality and
  culture Roman Catholics, Buddhist, Christian
  Science, Islam, Jehovahs Witnesses, Judaism

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Culture and Cultural Awareness

• English language proficiency do not ask family
  member, specially a child, to interpret
• 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. Needs interpreter or sign
  language, or phone interpretation.

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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 (faith, values, ethics, rituals,
  religion,)
• 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