NR-503 EPIDEMIOLOGY FINAL
Kleinman6explanatory6Model6-6ans--
Eliciting6the6patient's6(explanatory)6model6gives6the6physician6knowledge6of6the6beliefs6t
he6patient6holds6about6his6illness,6the6personal6and6social6meaning6he6attaches6to6his6di
sorder,6his6expectations6about6what6will6happen6to6him6and6what6the6doctor6will6do,6and6
his6own6therapeutic6goals
Cultural6competence6-6ans--
Cultural6competence6is6defined6as6"a6dynamic,6fluid,6continuous6process6whereby6an6ind
ividual,6system6or6health6care6agency6find6meaningful6and6useful6care6delivery6strategies
6based6on6knowledge6of6the6cultural6heritage,6beliefs,6attitudes,6and6behavior6of6those6to6
whom6they6render6care"
Cultural6Awareness6-6ans--:Self-
examination6of6one's6own6prejudices6and6biases6toward6other6cultures.6An6in-
depth6exploration6of6one's6own6cultural/ethnic6background.
Cultural6humility6-6ans--A6lifelong6commitment6to6self-evaluation6and6self-
critiques,6redressing6the6power6of6imbalances6in6the6patient-
6physician6dynamic,6developing6mutually.6Beneficial6relationships.
Cultural6Knowledge6-6ans--
Obtaining6a6sound6educational6foundation6concerning6the6various6worldviews6of6differen
ces6cultures.6Obtaining6knowledge6regarding6biological6variations,6disease6and6health6c
onditions6and6variation6in6drug6metabolism.
Cultural6Skill:6-6ans--
Ability6to6collect6culturally6relevant6data6regarding6the6client's6health6history6and6presenti
ng6problem.6Ability6to6conduct6culturally6based6physician6assessments.6Conducting6thes
e6assessments6in6a6culturally6sensitive6manner.
Cultural6Desire6-6ans--
Motivation6of6the6healthcare6provider6to6"want"6to6engage6in6the6process6of6cultural6comp
etence,6characteristics6of6compassion,6authenticity,6humility,6openness,6availability,6and6
flexibility,6commi6tment6and6passion6to6caring,6regardless6of6conflict.
ethnicity6-6ans--
as6"the6aggregate6of6cultural6practices,6social6influences,6religious6pursuits,6and6racial6ch
aracteristics6shaping6the6distinctive6identity6of6community"
, Cultural6competence6in6nursing6consists6of6four6principles.6-6ans--
Care6is6designed6for6the6specific6client.
Care6is6based6on6the6uniqueness6of6the6person's6culture6and6includes6cultural6norms6an
d6values.
Care6includes6self-
employment6strategies6to6facilitate6client6decision6making6to6improve6health6behaviors.
Care6is6provided6with6sensitivity6and6is6based6on6the6cultural6uniqueness6of6clients.
The6APN6may6also6use6the6Kleinman6Explanatory6Model6of6Illness6(1978).6Below6are6the
6questions6that6can6be6utilized.6-6ans--What6do6you6call6your6problem?
What6do6you6think6caused6your6problem?
Why6do6you6think6it6started6when6it6did?
What6does6your6sickness6do6to6you?
What6do6you6fear6most6about6your6sickness?
What6are6the6chief6problems6your6sickness6has6caused6you?
What6kind6of6treatment6do6you6think6you6should6receive?
What6is6the6most6important6result6you6hope6to6receive6from6the6treatment?
According6to6Giger6and6Davidhizer6(2000),6although6cultures6differ,6they6all6have6the6sa
me6basic6organizing6factors6that6must6be6assessed6in6order6to6provide6care6for6culturally6
diverse6patients.6These6factors6include6-6ans--communication6(verbal6and6nonverbal);
personal6space;
social6organization;
time6perception;
environmental6control;6and
biological6variations.
The6National6Center6for6Cultural6Competence6(NCCC)6provides6national6leadership6and6
contributes6to6the6body6of6knowledge6on6cultural6and6linguistic6competency6within6syste
ms6and6organizations.6Major6emphasis6is6placed6on6translating6evidence6into6policy6and6
practice6for6programs6and6personnel6concerned6with6health6and6mental6healthcare6deliv
ery,6administration,6education,6and6advocacy.6-6ans--
The6NCCC6uses6four6major6approaches6to6fulfill6its6mission,6including6-6ans--Web-
based6technical6assistance,6(2)6knowledge6development6and6dissemination,6(3)6supporti
ng6a6community6of6learners,6and6(4)6collaboration6and6partnerships6with6diverse6groups.
These6approaches6entail6the6provision6of6training,6technical6assistance,6and6consultation
6and6are6intended6to6facilitate 6networking,6linkages,6and6information6exchange.6The6NCC
C6has6particular6expertise6in6developing6instruments6and6conducting6organizational6self-
assessment6processes6to6advance6cultural6and6linguistic6competency.6-6ans--
Epidemiological6Triad:6-6ans--host,6agent,6environment
Genetics6is6considered6an6agent6in6the6epidemiological6triad6-6ans--
Kleinman6explanatory6Model6-6ans--
Eliciting6the6patient's6(explanatory)6model6gives6the6physician6knowledge6of6the6beliefs6t
he6patient6holds6about6his6illness,6the6personal6and6social6meaning6he6attaches6to6his6di
sorder,6his6expectations6about6what6will6happen6to6him6and6what6the6doctor6will6do,6and6
his6own6therapeutic6goals
Cultural6competence6-6ans--
Cultural6competence6is6defined6as6"a6dynamic,6fluid,6continuous6process6whereby6an6ind
ividual,6system6or6health6care6agency6find6meaningful6and6useful6care6delivery6strategies
6based6on6knowledge6of6the6cultural6heritage,6beliefs,6attitudes,6and6behavior6of6those6to6
whom6they6render6care"
Cultural6Awareness6-6ans--:Self-
examination6of6one's6own6prejudices6and6biases6toward6other6cultures.6An6in-
depth6exploration6of6one's6own6cultural/ethnic6background.
Cultural6humility6-6ans--A6lifelong6commitment6to6self-evaluation6and6self-
critiques,6redressing6the6power6of6imbalances6in6the6patient-
6physician6dynamic,6developing6mutually.6Beneficial6relationships.
Cultural6Knowledge6-6ans--
Obtaining6a6sound6educational6foundation6concerning6the6various6worldviews6of6differen
ces6cultures.6Obtaining6knowledge6regarding6biological6variations,6disease6and6health6c
onditions6and6variation6in6drug6metabolism.
Cultural6Skill:6-6ans--
Ability6to6collect6culturally6relevant6data6regarding6the6client's6health6history6and6presenti
ng6problem.6Ability6to6conduct6culturally6based6physician6assessments.6Conducting6thes
e6assessments6in6a6culturally6sensitive6manner.
Cultural6Desire6-6ans--
Motivation6of6the6healthcare6provider6to6"want"6to6engage6in6the6process6of6cultural6comp
etence,6characteristics6of6compassion,6authenticity,6humility,6openness,6availability,6and6
flexibility,6commi6tment6and6passion6to6caring,6regardless6of6conflict.
ethnicity6-6ans--
as6"the6aggregate6of6cultural6practices,6social6influences,6religious6pursuits,6and6racial6ch
aracteristics6shaping6the6distinctive6identity6of6community"
, Cultural6competence6in6nursing6consists6of6four6principles.6-6ans--
Care6is6designed6for6the6specific6client.
Care6is6based6on6the6uniqueness6of6the6person's6culture6and6includes6cultural6norms6an
d6values.
Care6includes6self-
employment6strategies6to6facilitate6client6decision6making6to6improve6health6behaviors.
Care6is6provided6with6sensitivity6and6is6based6on6the6cultural6uniqueness6of6clients.
The6APN6may6also6use6the6Kleinman6Explanatory6Model6of6Illness6(1978).6Below6are6the
6questions6that6can6be6utilized.6-6ans--What6do6you6call6your6problem?
What6do6you6think6caused6your6problem?
Why6do6you6think6it6started6when6it6did?
What6does6your6sickness6do6to6you?
What6do6you6fear6most6about6your6sickness?
What6are6the6chief6problems6your6sickness6has6caused6you?
What6kind6of6treatment6do6you6think6you6should6receive?
What6is6the6most6important6result6you6hope6to6receive6from6the6treatment?
According6to6Giger6and6Davidhizer6(2000),6although6cultures6differ,6they6all6have6the6sa
me6basic6organizing6factors6that6must6be6assessed6in6order6to6provide6care6for6culturally6
diverse6patients.6These6factors6include6-6ans--communication6(verbal6and6nonverbal);
personal6space;
social6organization;
time6perception;
environmental6control;6and
biological6variations.
The6National6Center6for6Cultural6Competence6(NCCC)6provides6national6leadership6and6
contributes6to6the6body6of6knowledge6on6cultural6and6linguistic6competency6within6syste
ms6and6organizations.6Major6emphasis6is6placed6on6translating6evidence6into6policy6and6
practice6for6programs6and6personnel6concerned6with6health6and6mental6healthcare6deliv
ery,6administration,6education,6and6advocacy.6-6ans--
The6NCCC6uses6four6major6approaches6to6fulfill6its6mission,6including6-6ans--Web-
based6technical6assistance,6(2)6knowledge6development6and6dissemination,6(3)6supporti
ng6a6community6of6learners,6and6(4)6collaboration6and6partnerships6with6diverse6groups.
These6approaches6entail6the6provision6of6training,6technical6assistance,6and6consultation
6and6are6intended6to6facilitate 6networking,6linkages,6and6information6exchange.6The6NCC
C6has6particular6expertise6in6developing6instruments6and6conducting6organizational6self-
assessment6processes6to6advance6cultural6and6linguistic6competency.6-6ans--
Epidemiological6Triad:6-6ans--host,6agent,6environment
Genetics6is6considered6an6agent6in6the6epidemiological6triad6-6ans--
