NR 503 FINAL EXAM REVIEW WEEK 5-7

NR 503 FINAL EXAM REVIEW WEEK 5-71. How does culture influence the decisions a provider may make when selecting an intervention? Healthcare professionals should provide care that is respectful to the patient’s culture and should be culturally sensitive. Healthcare professionals need to gain knowledge about the patient’s culture, traditions, religion, and beliefs in order for the healthcare interventions to meet all of the patient’s needs and be satisfactory to the patient. The Leininger’s Theory of Culture Care and Universality involves knowing and understanding different cultures with respect to nursing and health-illness caring practices, beliefs, and values with the goal to provide meanings and efficacious nursing care services to patients according to their culture. 2. Explain how culture impacts provider attitudes. Does it? How will you assess your own attitudes about various cultures/races/groups? Culture impacts provider attitudes by requiring providers to focus on cultures other than their own, being culturally sensitive, having cultural awareness and avoiding stereotyping. Providers need to understand that patients may have traditions and beliefs different from theirs, may have health disparities, and may have language difficulties or may lack health literacy. Providers need to provide care and communicate with a patient in a way that the patient will understand and provide a certified interpreter or use the health phone line in cases of language barriers. The provider needs to be aware of their culture, religion and beliefs first, in order for him or her to be comfortable and understanding of other cultures, races, or religions. Cultural competence in nursing consists of four principles: • Care is designed for the specific client. • Care is based on the uniqueness of the person's culture and includes cultural norms and values. • Care includes self-employment strategies to facilitate client decision making to improve health behaviors. • Care is provided with sensitivity and is based on the cultural uniqueness of clients. Accommodation -to create an environment that accommodates health practice and ritual from other cultures within a plan of care Acculturation -degree two which an individual from one culture has given up the traits of that culture and adopted the traits of the dominant cultural in which they now reside Assimilation -the social, economic, and political integration of a cultural group into a mainstream society to which it may have emigrated Cultural Humility – a lifelong commitment to self-evaluation and self-critiques, redressing the power of imbalances in the patient- physician dynamic, developing mutually. Beneficial relationships. Cultural Knowledge - obtaining a sound educational foundation concerning the various worldviews of differences cultures. Obtaining knowledge regarding biological variations, disease and health conditions and variation in drug metabolism. Cultural Skill - ability to collect culturally relevant data regarding the client's health history and presenting problem. Ability to conduct culturally based physician assessments. Conducting these assessments in a culturally sensitive manner. Cultural Desire - motivation of the healthcare provider to "want" to engage in the process of cultural competence, characteristics of compassion, authenticity, humility, openness, availability, and flexibility, commitment and passion to caring, regardless of conflict. 3. Review the terms for this week and apply them to population health; for instance: cultural competence, cultural awareness, norms, values, Kleinman Explanatory Model, socioeconomic status, disparities, minorities, food dessert. Cultural Competence -respect for, and understanding of, diverse ethnic and cultural groups, their histories, traditions, beliefs, and value systems. A dynamic, fluid, continuous process whereby an individual, system, or healthcare agency find meaningful and useful care delivery strategy based on knowledge of the cultural heritage, beliefs, attitudes, and behavior of those to whom they render care. To assist healthcare providers in achieving cultural competency and provide appropriate care, the APN must take responsibility to acquire about the necessary skills Cultural Awareness - self-examination of one's own prejudices and biases toward other cultures. An in-depth exploration of one's own cultural/ethnic background Cultural Norms – normal, usual, and typical cultural practices Cultural Values – the core principles and ideals upon which an entire community exists; it is composed of customs which are traditions and rituals, values which are beliefs, culture which is a group’s values Kleinman Explanatory Model – give the provider knowledge about the patient’s beliefs of their illness, personal and social meanings to the sickness, what the patient thinks will happen to him, and therapeutic goals. The model proposes that instead of simply asking patients “where does it hurt?” the provider should focus on eliciting the patient’s answers to “why”, “when”, “how”, and “what next”? why do you think the problem started?, what do you think caused your problem?, what do you think this sickness does to you?, how severe is your sickness, what are your chief problems?, what do you fear most about your sickness?, what kind of treatment do you think you should receive?, what are the most important results you hope to get from your treatment? Socioeconomic Status – the social standing or class of an individual in a group. It is often measured as a combination of education, income, and occupation. There are often socioeconomic inequalities in access to resources, privileges, power, and control Disparities – inequalities in the way healthcare is delivered and received, preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health. HP 2020 want to eliminate health disparities Minorities – a smaller group, the largest racial minority in US is African Americans 12.7%, Hispanics are largest ethnic minority 17.8% Food Dessert – 10 miles or more to the nearest market, 23 million people, mostly low income 4. What are the social determinants of health? How does a provider integrate knowledge of these social determinants of health into their practice? Why are they important? The social determinants of health are: • neighborhood and built environment • health and health care • social and community context • education • economic stability Understanding the social determinants of health enables healthcare professionals and advanced practice nurses to provide care to patients that accommodates not only their physical needs, but also their social, behavioral, and individualized necessities. For patients, the social determinants of health establish their motivation, accessibility, and ability to seek and receive health care. Trying to accommodate each patient’s needs while respecting and understanding their diverse cultures, traditions, and beliefs is a difficult task for every healthcare professional. As future advanced practice nurses, we need to respect and appreciate each patient’s differences and aspire to provide care that is respectful and culturally-sensitive. The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care strive to provide the increasingly diverse population of the US with standards of healthcare that are appropriate and suitable for diverse cultures in order to improve the cultural sensitivity of the healthcare delivered. The standards they provide aspire to improve the quality of care that is delivered to each patient by respecting their culture, traditions, religions, and practices to promote diversity and provide an environment each patient feels comfortable and welcome in. 5. Apply social justice theory to the provision of care. What does social justice mean when applies to health care? The social justice theory (by John Rawls) focuses on the equal distribution of good and care. The four principles of justice are equality, access, participation, and rights. Providing care and treatment that is fair to all people is our priority as healthcare professionals. 6. What data sources are used to access determinant of health? • employment • food insecurity • housing • financial strain • utility needs • education • social support • physical activity • mental health • substance abuse • immigration • exposure to violence • transportation 7. Topic discussed in papers this week: a. Tuberculosis - Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection (LTBI) and TB disease. If not treated properly, TB disease can be fatal. TB is spread through the airborne route through coughing, sneezing, and singing. Symptoms include a bad cough that lasts 3 weeks or longer, pain in the chest, coughing up blood or sputum (phlegm from deep inside the lungs), weakness or fatigue, weight loss, no appetite, chills, fever, sweating at night. Risk factors are patients who have recently been in contact with some with TB, patients with weakened immune systems such as HIV infection (the virus that causes AIDS), substance abuse, silicosis, diabetes mellitus, severe kidney disease, low body weight, organ transplants, head and neck cancer, medical treatments such as corticosteroids or organ transplant, specialized treatment for rheumatoid arthritis or Crohn’s disease or patients who have immigrated from area at high risk for TB. To diagnose, test for TBT (TB test) or a TB blood test. Tx for active or latent TB is isoniazid (INH), rifampin (RIF), ethambutol (EMB). And pyrazinamide (PZA) for 6 to 9 months.