Chapter 14 Cultural and Spiritual Aspects of Patient Care
<ul><li>Chapter 14 </li></ul><ul><li>Lesson 14.1 </li></ul>
Learning Objectives <ul><li>Theory </li></ul><ul><li>Describe how culture influences health and health care choices </li><...
Learning Objectives <ul><li>Clinical Practice </li></ul><ul><li>Demonstrate cultural competence when caring for a cultural...
Culture <ul><li>Culture:  shared values, beliefs, and practices by the majority within a group </li></ul><ul><li>Includes ...
Culture <ul><li>Culture influences lifestyle choices related to: </li></ul><ul><ul><li>Nutrition </li></ul></ul><ul><ul><l...
Religion and Spirituality <ul><li>Religion and spirituality often used interchangeably but are different </li></ul><ul><li...
Major Religions in the U.S.  and Canada <ul><li>Christianity —most people identify themselves as Christian </li></ul><ul><...
Christianity <ul><li>The largest religion in the world </li></ul><ul><ul><li>Three main divisions: Roman Catholic, Eastern...
Catholic Beliefs and Health Care <ul><li>Birth: infants must be baptized soon after birth.  </li></ul><ul><li>Holy Communi...
Catholic Beliefs and Health Care <ul><li>Birth control: natural family planning is the only acceptable method of birth con...
Eastern Orthodox <ul><li>Birth: the baby must be baptized by 40 days after birth by a deacon or priest, who must baptize w...
Eastern Orthodox <ul><li>Sacrament of the sick: priest does this at bedside </li></ul><ul><li>Diet: hospitalized patients ...
Protestant Beliefs  Affecting Health Care <ul><li>Christian Science </li></ul><ul><ul><li>Do not normally seek traditional...
Protestant Beliefs  Affecting Health Care <ul><li>Jehovah’s Witness   </li></ul><ul><ul><li>Abortion is forbidden </li></u...
Protestant Beliefs  Affecting Health Care <ul><li>Church of Jesus Christ of Latter-day Saints  </li></ul><ul><ul><li>A chu...
Protestant Beliefs  Affecting Health Care <ul><li>Seventh-Day Adventist  </li></ul><ul><ul><li>The Sabbath is observed on ...
Protestant Beliefs  Affecting Health Care <ul><li>Unitarian Universalist Association  </li></ul><ul><ul><li>Strong belief ...
Islam <ul><li>One of the fastest growing religions in the world  </li></ul><ul><li>Emphasizes equality of the races and so...
Muslim Beliefs and Health Care <ul><li>Birth: After birth, the baby is bathed immediately and then given to the mother. Ci...
Muslim Beliefs and Health Care <ul><li>Death: Patients must face Mecca and confess sins and beg forgiveness of the family....
Muslim Beliefs and Health Care <ul><li>Birth control: Many believe that artificial birth control interferes with God’s wil...
Muslim Beliefs and Health Care <ul><li>Other practices: Washing is required at prayer time. Privacy must be provided for p...
Judaism <ul><li>Orthodox, Conservative, Reform, and Reconstructionist  </li></ul><ul><li>Strict rules regarding hygiene, d...
Jewish Beliefs and Health Care <ul><li>Birth: Babies are named by the father. Children are named 8 days after being born, ...
Jewish Beliefs and Health Care <ul><li>Diet: Kosher rules include no mixing of milk and meat and using separate utensils f...
Jewish Beliefs and Health Care <ul><li>Death: when there are no respirations and no circulation, and this cannot be correc...
Jewish Beliefs and Health Care <ul><li>Birth control: birth control is discouraged and vasectomies are forbidden; abortion...
Jewish Beliefs and Health Care <ul><li>Hats: orthodox men may wear skull caps (yarmulkes) all the time and women cover the...
Reformed Judaism <ul><li>Birth: Orthodox practices may or may not be observed; circumcision may be practiced </li></ul><ul...
Reformed Judaism <ul><li>Organ transplant: allowed with the rabbi’s approval </li></ul><ul><li>Hats: praying is usually do...
Eastern Religions <ul><li>Hinduism </li></ul><ul><ul><li>Many are vegetarians because most believe that eating meat involv...
Eastern Religions <ul><li>Buddhism </li></ul><ul><ul><li>Do not believe in healing through faith </li></ul></ul><ul><ul><l...
Transcultural Nursing <ul><li>Care that recognizes cultural diversity and is sensitive to the cultural needs of the patien...
Cultural Group Characteristics <ul><li>Characteristics that separate groups from one another are: </li></ul><ul><ul><li>Na...
Major Cultural Groups in the  U.S. and Canada <ul><li>European Americans </li></ul><ul><li>American Indians </li></ul><ul>...
Developing Cultural Competence <ul><li>Nurses must develop cultural awareness and cultural sensitivity  </li></ul><ul><li>...
<ul><li>Chapter 14 </li></ul><ul><li>Lesson 14.2 </li></ul>
Learning Objectives <ul><li>Theory </li></ul><ul><li>Describe how religious beliefs and practices may affect health and he...
Learning Objectives <ul><li>Clinical Practice </li></ul><ul><li>Discuss ways to protect patients’ rights when their cultur...
Cultural and Ethnic Differences <ul><li>Communication </li></ul><ul><li>View of time </li></ul><ul><li>Organization of the...
Cultural Aspects to Consider: Communication <ul><li>An obvious cultural difference among people is language  </li></ul><ul...
Common Values and Beliefs: View of Time  <ul><li>Orientation to time varies from one culture to another, and attitudes abo...
Common Values and Beliefs: Organization of the Family <ul><li>Family households may be male dominated, female dominated, o...
Common Values and Beliefs: Nutrition <ul><li>Food has much symbolic and social meaning </li></ul><ul><li>People learn from...
Common Values and Beliefs: Death and Dying <ul><li>Important to know rituals about death and bereavement so cultural taboo...
Common Values and Beliefs: Health Care Beliefs <ul><li>Beliefs about health, disease, illness, and treatment are culturall...
Common Values and Beliefs:  Asian/Pacific Islander Americans <ul><li>Value self-control, age, authority, and harmony </li>...
Common Values and Beliefs: Asian/Pacific Islander Americans <ul><li>May believe that misdeeds lead to illness </li></ul><u...
Common Values and Beliefs: Hispanic Americans <ul><li>Family is valued over the individual </li></ul><ul><li>Family system...
Common Values and Beliefs: Hispanic Americans <ul><li>May believe in the use of “hot” and “cold” foods to restore equilibr...
Common Values and Beliefs:  African Americans <ul><li>Health and illness may be intertwined with religion and good and bad...
Common Values and Beliefs: Susceptibility to Disease <ul><li>Certain diseases are passed from parent to child through the ...
Common Values and Beliefs: Susceptibility to Disease <ul><li>African or Mediterranean ancestry </li></ul><ul><ul><li>Sickl...
Culturally Sensitive  Nursing Interventions <ul><li>Use an interpreter for history taking or important teaching </li></ul>...
Upcoming SlideShare
Loading in …5
×

L&E Chapter 014

2,492 views

Published on

Published in: Health & Medicine, Education
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,492
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
45
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide
  • Worldviews vary from one culture to another and influence cultural practices, including health care practices or beliefs. The views of a culture regarding what is good and useful are known as values. What are the predominant values of your culture?
  • Health and health care choices are heavily influenced by lifestyle choices. What cultural beliefs or practices may pose health risks? (excessive tattoos and body piercings, smoking ceremonial pipes with tobacco or other substances, etc.)
  • Religion is an organized practice of beliefs and traditions based on values. Can a person be spiritual but not religious? (Yes; a person may not belong or practice an expressed religion but still be concerned with issues of the spirit.) Can a person be religious without being spiritual? (usually no, because most religions are built around issues of the spirit)
  • Because practices and beliefs vary among religions, it is important to inquire about the patient’s religion or religious background (or if he or she is no longer active in the faith). Most organized religions have rituals and traditions built around significant life events: birth, death, illness, and even for specific illnesses. Faith-based rituals or healing prayers may be used as remedies for disorders, illnesses such as cancer, or something as common as a headache. What are some examples of faith-based healing rituals?
  • Why is it essential to perform a spiritual assessment to ascertain what needs and concerns the patient might have? Beliefs of individuals within each denomination vary, and specific spiritual assessment regarding the various issues relevant to health care is essential.
  • Even within a single religion such as Christianity, many variations in worship and practices may be exhibited. Catholicism is only one type of Christian worship. Ethnicity or culture can also affect the practices and traditions within a type of worship, such as Catholicism. What are some examples of how ethnicity or culture influences religious practices?
  • Religious beliefs can greatly influence the health choices of the patient as well as others. In what ways could beliefs about birth control or organ donation affect a patient’s long-term health and well-being?
  • If the baby is ill, baptism should occur as soon as possible. If death is imminent, an abbreviated sacrament may be done in the hospital setting by a priest or deacon. Only an ordained Orthodox priest or deacon can administer the sacrament of Holy Communion.
  • The sacrament of the sick is also known as Holy Unction, which consists of the application of oil (that has been blessed with prayers) to the face and hands of the patient. At times, this may be done by a layperson. The application of Holy Water to the face of the patient may also be done. Sometimes the Holy Water is applied to the actual afflicted part of the body or is ingested for spiritual cleansing. Many Orthodox groups now follow the Julian calendar, matching holidays such as Christmas and New Year with those of Catholicism and other religions.
  • How would you expect these beliefs to affect health, illness, and the healing process of an individual?
  • These traditions are strictly adhered to by Jehovah’s Witness believers. How might the nursing staff’s role conflict with the religious beliefs of a Jehovah’s Witness or another religion?
  • Even among Protestant sects, many ritual differences exist between denominations. In addition, individual differences and practices may occur within a specific denomination.
  • What implications might these practices have within a health care setting? (Patient food tray may arrive with unacceptable choices for the patient, etc.) What other practices or beliefs are associated with Seventh-Day Adventists?
  • What are some other Protestant denominations? An individual spiritual assessment should be done to best understand the views of each patient. What would you do if the patient were unable to answer important questions regarding faith and practices? (Ask a spouse or other immediate family member, if available. A close friend may also be able to provide some insights.)
  • Most prevalent in the Middle East, Africa, South Asia, and parts of Eastern Europe. Muslims are required to pray five specific times throughout the day. The body is usually kept covered in front of members of the opposite sex. This can make health care delivery challenging. A female should not be touched by a male who is not part of her family. How can care be properly delivered when adhering to strict Muslim traditions?
  • Dietary restrictions of Muslims are also influenced by ethnicity and culture, not just religion. The Muslim faith is practiced in many countries with a variety of cultures such as Morocco, Indonesia, and Saudi Arabia. Each of these ethnic cultures is also integrated into the specific faith practices.
  • It is particularly important to adhere to strict Muslim traditions in the case of death. If the practices surrounding death are not followed, they can be a source of great stress, guilt, and conflict for the family members.
  • The worldwide population of Muslims is growing rapidly. What are some reasons for this growth? Because the religion is growing, it is more common to encounter practicing Muslims within a U.S. health care setting.
  • Muslims are required to pray five specific times throughout the day. The body is usually kept covered in front of members of the opposite sex. This can make health care delivery challenging. A female should not be touched by a male who is not part of her family. How can care be properly delivered when adhering to strict Muslim traditions?
  • The religious leader in Judaism is called a rabbi, and the main place of worship is the synagogue. What is a circumcision? Males can only be circumcised by a practicing mohel. Some Jewish physicians are also trained as mohels and can perform the ritual within the health care setting. The modern U.S. birthing center with family-centered care and the practice of incorporating the husband in the caregiving tasks can be at odds with those that practice traditional Judaism.
  • Males can only be circumcised by a practicing mohel. Some Jewish physicians are also trained as mohels and can perform the ritual within the health care setting. The modern U.S. birthing center with family-centered care and the practice of incorporating the husband in the caregiving tasks can be at odds with those that practice traditional Judaism.
  • Rules surrounding the Sabbath are taken very seriously by Orthodox Jews. How would these rules affect the delivery of care? How would these rules affect staffing decisions?
  • What should be done with the body of an Orthodox Jewish patient who dies on the day before the Sabbath?
  • In preparing an Orthodox Jewish patient for surgery, it is important to remember the rules regarding shaving. Hair must be clipped, not shaved. This information should be conveyed to the OR staff as well.
  • Can a patient’s head be kept covered at all times? What allowances can be made in the health care environment? How do you facilitate a quiet environment and privacy for prayer in a health care setting?
  • These religious guidelines are much more lenient or relaxed than those practiced by an Orthodox Jew. It is difficult to know which traditions and guidelines are practiced unless you ask the patient (or the patient’s spouse, family members, or guardian) in specific terms. Some Reformed Jews may still observe a kosher diet; others may not.
  • Rules about organ transplantation apply not only to the organ recipient but to the organ donor as well. In the case of death or imminent death of a potential organ donor, it is important that a rabbi be contacted to be available for the family.
  • There is a strong belief that life is controlled by God and that the individual has little control over what happens.
  • There is a strong belief that life is controlled by God and that the individual has little control over what happens.
  • Dr. Leininger described human caring as what all people need most to grow, remain well, avoid illness, and survive or face death.
  • How does race differ from skin color among groups? (Race is a biologic way of categorizing people. It includes color, as well as skin texture, facial features, and body proportions.) How does race compare to ethnicity? (Race includes various ethnic groups within each category.)
  • Subcultures also exist within each of these major cultural groups. What are some examples of subcultures for each of these cultural groups?
  • Cultural competence involves knowledge of one’s own values, beliefs, and attitudes first. Some values, beliefs, and attitudes are driven by religion, some by ethnicity, some by race. What else might influence values, beliefs, and attitudes? (gender, age, family traditions, education level, life experiences)
  • An orientation toward the future and change is not valued or held by all cultures. Some may value the past more than the future. It is important to understand the patient’s view of time and how this may conflict with the view of time in the health care setting. In some cultures, forces associated with illness may not be in congruence with the traditional medical model. What are some cultural beliefs involving forces or influences that affect health and illness? (Chinese yin and yang, Middle Eastern evil eye, etc.)
  • Language and communication traditions are important to understand. In which cultures is eye contact considered impolite? The concept of personal space can also become a barrier to care if the patient perceives the health care professional as being rudely within the patient’s space.
  • An orientation toward the future is a European American dominant cultural value in the United States. There is a sense of time urgency (not enough time), and importance is placed on punctuality and schedules. What cultures focus on the here and now and without a feeling of urgency to be someplace on time?
  • Cultural differences must be respected without trying to impose an egalitarian viewpoint, which is prevalent in the United States. In some cultures , the elderly are considered wise and are revered.
  • Each culture has its own set of foods that are viewed as “hot” or “cold.” That effect is used to counteract illness or disease—cold foods are used to treat “hot” illnesses or diseases, and hot foods are used to treat “cold” illnesses or diseases.
  • How would strict visitation rules affect different cultures?
  • How might a matriarchal family structure affect health or health care delivery?
  • Many Asian Americans and Pacific Islanders follow their traditional practices for healing and restoring well-being. Some of these practices are thousands of years old and highly respected by followers. Herbal and traditional remedies are also used for illness and are usually specific to the ailment. Western medicine does not always respect or incorporate these practices.
  • A growing number of Muslims are included in this group. Members of this ethnic group may not express feelings or complaints readily. They might consider it disrespectful to disagree with their caregivers, and might give consent for care or procedures even when they don’t really agree.
  • Hispanic Americans includes people of many different national and cultural backgrounds. Not all of their health beliefs are the same. Use of traditional herbs and concoctions often relied on heavily. These are not always compatible with the medication regimen prescribed by physicians. What should the nurse do if the patient is using an herbal preparation, such as a brewed tea, that the family brought? (Ask the patient or family to identify the preparation. Talk with the pharmacist about it. The pharmacist can determine if it is compatible with the patient’s medications.)
  • Men are usually encouraged to be stoic and not vocalize pain or complaints. Women may actually be encouraged to readily vocalize their pain, issues, etc. This varies by ethnicity and by individual or family.
  • This group includes people of many different ethnic heritages. Traditions may vary widely. How might a matriarchal family structure affect health or health care delivery?
  • Numerous diseases are genetically transmitted or associated with a genetic predisposition. In addition, many more conditions occur predominantly in one specific population. The scientific connection between these conditions and ethnicity is not always known.
  • What are some other examples of diseases or conditions that occur with greater frequency in a specific population? (thalassemia, etc.)
  • It is not always practical or possible to find an interpreter for the patient. When privacy issues are considered, the use of an interpreter can become even more limiting. How do you resolve a language barrier with a patient who speaks an obscure language or dialect?
  • L&E Chapter 014

    1. 1. Chapter 14 Cultural and Spiritual Aspects of Patient Care
    2. 2. <ul><li>Chapter 14 </li></ul><ul><li>Lesson 14.1 </li></ul>
    3. 3. Learning Objectives <ul><li>Theory </li></ul><ul><li>Describe how culture influences health and health care choices </li></ul><ul><li>Identify three beliefs or values affecting health care that might be found among Hispanic American, Asian American, American Indian, African American, and European American patients </li></ul><ul><li>Plan ways to support patients’ spiritual needs of various religions </li></ul><ul><li>Compare ethnic differences of Hispanic Americans and Middle Eastern Muslims </li></ul><ul><li>Discuss how poverty often impedes adequate health care within our country </li></ul>
    4. 4. Learning Objectives <ul><li>Clinical Practice </li></ul><ul><li>Demonstrate cultural competence when caring for a culturally different patient </li></ul><ul><li>Plan nursing interventions for a patient whose culture is different from your own </li></ul>
    5. 5. Culture <ul><li>Culture: shared values, beliefs, and practices by the majority within a group </li></ul><ul><li>Includes attitudes, roles, behaviors, and religious or spiritual practices </li></ul><ul><li>Practices carried from generation to generation </li></ul><ul><li>Immigration has brought great cultural diversity to the U.S. and Canada </li></ul>
    6. 6. Culture <ul><li>Culture influences lifestyle choices related to: </li></ul><ul><ul><li>Nutrition </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Stress management </li></ul></ul><ul><ul><li>Smoking </li></ul></ul><ul><ul><li>Alcohol or drug use </li></ul></ul>
    7. 7. Religion and Spirituality <ul><li>Religion and spirituality often used interchangeably but are different </li></ul><ul><li>Religion: formalized system of belief and worship; its rituals related to health, illness, birth, death, and behavior are part of the organized religion </li></ul><ul><li>Spirituality concerns the spirit or soul and is an element of religion </li></ul>
    8. 8. Major Religions in the U.S. and Canada <ul><li>Christianity —most people identify themselves as Christian </li></ul><ul><li>Islam —second largest religious group </li></ul><ul><li>Judaism —third largest religious group </li></ul><ul><li>Eastern religions— Buddhism, Hinduism, Confucianism, Taoism (Daoism) </li></ul>
    9. 9. Christianity <ul><li>The largest religion in the world </li></ul><ul><ul><li>Three main divisions: Roman Catholic, Eastern Orthodox, and the Protestant faiths </li></ul></ul><ul><li>Believe in eternal life </li></ul><ul><li>Death is viewed as a transition to a life with God </li></ul><ul><li>A priest or a religious leader should be called if the patient desires a sacrament </li></ul><ul><li>Prayer, reading of scripture and devotionals, and attendance at church services are the main religious activities of Protestant patients </li></ul>
    10. 10. Catholic Beliefs and Health Care <ul><li>Birth: infants must be baptized soon after birth. </li></ul><ul><li>Holy Communion: patients receiving communion must not eat or drink anything 15 minutes before receiving the host </li></ul><ul><li>Sacrament of the sick: administered by the priest to patients who are ill and conscious; may also be performed after death </li></ul><ul><li>Death: the dying must receive the sacrament of the sick and make a confession; all body parts must be cremated or buried </li></ul>
    11. 11. Catholic Beliefs and Health Care <ul><li>Birth control: natural family planning is the only acceptable method of birth control. Nurses may teach family planning. Sterilization is forbidden unless for medical reasons. </li></ul><ul><li>Organ donation: donation and transplants are acceptable </li></ul><ul><li>Religious articles: rosary beads, medals, and other objects such as statues of the saints should be kept visible and secure </li></ul>
    12. 12. Eastern Orthodox <ul><li>Birth: the baby must be baptized by 40 days after birth by a deacon or priest, who must baptize with holy water or by moving the baby in the air in the sign of the cross </li></ul><ul><li>Holy Communion: the priest should be called if the patient wants to receive communion </li></ul>
    13. 13. Eastern Orthodox <ul><li>Sacrament of the sick: priest does this at bedside </li></ul><ul><li>Diet: hospitalized patients excused from fasting from meat and dairy products on holy days </li></ul><ul><li>Holidays: Christmas is celebrated on January 7 and New Year’s Day on January 14 </li></ul><ul><li>Death: priest must be called while the patient is conscious for the patient to receive last rites. The Orthodox church discourages assisted deaths, autopsy, cremation, and organ donation. </li></ul>
    14. 14. Protestant Beliefs Affecting Health Care <ul><li>Christian Science </li></ul><ul><ul><li>Do not normally seek traditional health care. </li></ul></ul><ul><ul><li>Believe that sickness, evil, and sin are not from God but of the mind. Illness and sin can be changed by altering the thoughts rather than by medical intervention. </li></ul></ul><ul><ul><li>Do not take medications </li></ul></ul>
    15. 15. Protestant Beliefs Affecting Health Care <ul><li>Jehovah’s Witness </li></ul><ul><ul><li>Abortion is forbidden </li></ul></ul><ul><ul><li>Taking blood into the body is prohibited </li></ul></ul><ul><ul><li>Transfusion is not permitted </li></ul></ul><ul><ul><li>Organ transplant may be accepted, but organ must be cleansed with non-blood solution before transplantation </li></ul></ul><ul><ul><li>Only meat that is drained of blood may be eaten </li></ul></ul><ul><ul><li>The body must be buried with all its parts, which prevents organ donation </li></ul></ul>
    16. 16. Protestant Beliefs Affecting Health Care <ul><li>Church of Jesus Christ of Latter-day Saints </li></ul><ul><ul><li>A church elder must be notified in the event of a death </li></ul></ul><ul><ul><li>Natural means of birth control are recommended </li></ul></ul><ul><ul><li>Cleanliness is of vital importance. A sacred undergarment may be worn that should be removed only in an emergency. </li></ul></ul>
    17. 17. Protestant Beliefs Affecting Health Care <ul><li>Seventh-Day Adventist </li></ul><ul><ul><li>The Sabbath is observed on Saturday </li></ul></ul><ul><ul><li>Many are vegetarians </li></ul></ul><ul><ul><li>Most avoid eating pork </li></ul></ul>
    18. 18. Protestant Beliefs Affecting Health Care <ul><li>Unitarian Universalist Association </li></ul><ul><ul><li>Strong belief in woman’s right of choice regarding abortion </li></ul></ul><ul><ul><li>Advocate donation of organs for transplant and research </li></ul></ul><ul><li>Mennonite </li></ul><ul><ul><li>Women may wish to wear head covering while hospitalized </li></ul></ul>
    19. 19. Islam <ul><li>One of the fastest growing religions in the world </li></ul><ul><li>Emphasizes equality of the races and social classes and attempts to promote brotherhood for all </li></ul><ul><li>Some women may not be allowed to make decisions about their health </li></ul><ul><li>Sometimes the woman’s husband or father must be present to give consent for treatment </li></ul>
    20. 20. Muslim Beliefs and Health Care <ul><li>Birth: After birth, the baby is bathed immediately and then given to the mother. Circumcision is performed before puberty. A baby born prematurely but at least 130 days’ gestation is treated the same as a full-term infant. </li></ul><ul><li>Diet: No pork or alcoholic beverages are allowed. All meat must be killed and blessed in a special way. Many may not eat traditional African American foods such as cornbread or collard greens. </li></ul>
    21. 21. Muslim Beliefs and Health Care <ul><li>Death: Patients must face Mecca and confess sins and beg forgiveness of the family. If family is unavailable, any practicing Muslim can provide this support. After death the body must not be touched until the family has washed it, prepared it, and positioned it facing Mecca. Burial is performed as soon as possible. Cremation is forbidden. Autopsy is forbidden except for legal reasons. Organ donation is not permitted. </li></ul>
    22. 22. Muslim Beliefs and Health Care <ul><li>Birth control: Many believe that artificial birth control interferes with God’s will. Others believe that the woman should have only as many children as the husband can afford, and contraception is permitted. </li></ul><ul><li>Abortion: prohibited </li></ul>
    23. 23. Muslim Beliefs and Health Care <ul><li>Other practices: Washing is required at prayer time. Privacy must be provided for prayer. The Koran should not be touched by anyone ritually unclean, and nothing must be placed on top of it. Muslim women usually wear clothing that covers the entire body. </li></ul>
    24. 24. Judaism <ul><li>Orthodox, Conservative, Reform, and Reconstructionist </li></ul><ul><li>Strict rules regarding hygiene, diet, sexual mores, and religious ceremony </li></ul><ul><li>Food prepared according to Jewish dietary laws during slaughter, processing, and packaging and is then labeled kosher </li></ul><ul><li>Important to consult with the patient to be sure that nursing care does not cause spiritual distress </li></ul><ul><li>There are rituals regarding care of a dead body and burial, and a rabbi should be consulted </li></ul>
    25. 25. Jewish Beliefs and Health Care <ul><li>Birth: Babies are named by the father. Children are named 8 days after being born, when circumcision is performed. Female babies are named during the reading of the Torah. </li></ul><ul><li>Care of women: The woman is thought to be unclean during her menses or after the birth of a child until she has bathed in a pool called a mikvah. The Orthodox Jewish man cannot help the woman with her care. </li></ul>
    26. 26. Jewish Beliefs and Health Care <ul><li>Diet: Kosher rules include no mixing of milk and meat and using separate utensils for milk and meat. Only animals slaughtered according to Jewish law may be eaten. </li></ul><ul><li>Sabbath: From sunset Friday to sunset Saturday, Jews may not ride in cars; smoke; or use lights, money, or television. Surgery or medical treatments or care are avoided until a later time if possible. </li></ul>
    27. 27. Jewish Beliefs and Health Care <ul><li>Death: when there are no respirations and no circulation, and this cannot be corrected </li></ul><ul><ul><li>Orthodox Jews forbid assisted death </li></ul></ul><ul><ul><li>Nurses must allow family to be with the patient when he or she dies and when the soul leaves the body. The body must be buried within 24 hours. The body may not be touched for 8 to 30 minutes and then only by an Orthodox person. </li></ul></ul><ul><ul><li>On the Sabbath, a body must not be handled </li></ul></ul><ul><ul><li>All body parts removed during autopsy must be buried with the body </li></ul></ul>
    28. 28. Jewish Beliefs and Health Care <ul><li>Birth control: birth control is discouraged and vasectomies are forbidden; abortion is allowed only to save the mother’s life. </li></ul><ul><li>Organ transplant: may be allowed with a rabbi’s approval </li></ul><ul><li>Shaving: no blade must touch the skin; scissors or electric razor may be used </li></ul>
    29. 29. Jewish Beliefs and Health Care <ul><li>Hats: orthodox men may wear skull caps (yarmulkes) all the time and women cover their hair after marriage </li></ul><ul><li>Prayer: Prayer to God is required. Nurses need to allow a quiet environment for prayer. </li></ul>
    30. 30. Reformed Judaism <ul><li>Birth: Orthodox practices may or may not be observed; circumcision may be practiced </li></ul><ul><li>Care of women: beliefs do not follow the rules about touching women </li></ul><ul><li>Diet: kosher diets are usually not observed </li></ul><ul><li>Sabbath: there is worship in temples on Friday but no other rules </li></ul><ul><li>Death: beliefs allow life support but no heroic measures; cremation is allowed </li></ul>
    31. 31. Reformed Judaism <ul><li>Organ transplant: allowed with the rabbi’s approval </li></ul><ul><li>Hats: praying is usually done without yarmulkes </li></ul>
    32. 32. Eastern Religions <ul><li>Hinduism </li></ul><ul><ul><li>Many are vegetarians because most believe that eating meat involves harming a living creature </li></ul></ul><ul><ul><li>Illness or disease is seen as the result of the misuse of the body or a consequence of sin committed in a previous life </li></ul></ul><ul><ul><li>Eldest woman is considered the authority on health and healing matters </li></ul></ul><ul><ul><li>Ayurvedic medicine follows principles of “hot” and “cold” to balance the diet as needed for the season and the disease state </li></ul></ul>
    33. 33. Eastern Religions <ul><li>Buddhism </li></ul><ul><ul><li>Do not believe in healing through faith </li></ul></ul><ul><ul><li>Believe spiritual peace and liberation from anxiety through following Buddha’s teachings are important in promoting health and recovery </li></ul></ul><ul><li>Taoism </li></ul><ul><ul><li>Believe that illness or disease is due to an imbalance in yin and yang </li></ul></ul>
    34. 34. Transcultural Nursing <ul><li>Care that recognizes cultural diversity and is sensitive to the cultural needs of the patient and family </li></ul><ul><li>Based on the fact that although there is diversity or differences among cultures, there are also universal patterns of behavior </li></ul>
    35. 35. Cultural Group Characteristics <ul><li>Characteristics that separate groups from one another are: </li></ul><ul><ul><li>Nationality </li></ul></ul><ul><ul><li>Race </li></ul></ul><ul><ul><li>Color </li></ul></ul><ul><ul><li>Gender </li></ul></ul><ul><ul><li>Age </li></ul></ul><ul><ul><li>Religious affiliation </li></ul></ul>
    36. 36. Major Cultural Groups in the U.S. and Canada <ul><li>European Americans </li></ul><ul><li>American Indians </li></ul><ul><li>African Americans </li></ul><ul><li>Hispanic Americans </li></ul><ul><li>Asian/Pacific Islander Americans </li></ul><ul><li>Arab Americans </li></ul>
    37. 37. Developing Cultural Competence <ul><li>Nurses must develop cultural awareness and cultural sensitivity </li></ul><ul><li>Cultural awareness </li></ul><ul><ul><li>Know a people’s history/ancestry and an appreciation for their artistic expressions, foods, and celebrations </li></ul></ul><ul><li>Cultural sensitivity </li></ul><ul><ul><li>Refrain from using offensive language, respect patterns of communication, and refrain from speaking in ways that are disrespectful of a person’s cultural beliefs </li></ul></ul><ul><li>Cultural competence </li></ul><ul><ul><li>Know yourself; examine your own values, attitudes, beliefs, and prejudices </li></ul></ul>
    38. 38. <ul><li>Chapter 14 </li></ul><ul><li>Lesson 14.2 </li></ul>
    39. 39. Learning Objectives <ul><li>Theory </li></ul><ul><li>Describe how religious beliefs and practices may affect health and health care choices </li></ul><ul><li>Incorporate major differences in dietary and nutritional choices among cultural and religious groups into patients’ plans of care </li></ul>
    40. 40. Learning Objectives <ul><li>Clinical Practice </li></ul><ul><li>Discuss ways to protect patients’ rights when their culture does not permit the use of a medical intervention </li></ul><ul><li>Identify signs of spiritual distress in a patient and plan three interventions to relieve it </li></ul><ul><li>Discuss boundaries of professional care for a patient whose religious beliefs are different from yours </li></ul>
    41. 41. Cultural and Ethnic Differences <ul><li>Communication </li></ul><ul><li>View of time </li></ul><ul><li>Organization of the family </li></ul><ul><li>Nutrition </li></ul><ul><li>Death and dying </li></ul><ul><li>Health care beliefs </li></ul><ul><li>Susceptibility to disease </li></ul>
    42. 42. Cultural Aspects to Consider: Communication <ul><li>An obvious cultural difference among people is language </li></ul><ul><li>Nonverbal communication patterns differ among cultural groups </li></ul><ul><ul><li>Personal space and eye contact </li></ul></ul><ul><li>Learning key phrases in other languages frequently encountered, or using translation lists of common questions or symptoms, is helpful </li></ul><ul><li>Most health agencies have interpreters available </li></ul>
    43. 43. Common Values and Beliefs: View of Time <ul><li>Orientation to time varies from one culture to another, and attitudes about time can cause misunderstanding </li></ul><ul><li>A second consideration of time is whether the culture is mostly concerned with the past, present, or future </li></ul><ul><li>It is important to know the patient’s view of time </li></ul>
    44. 44. Common Values and Beliefs: Organization of the Family <ul><li>Family households may be male dominated, female dominated, or share equality between men and woman </li></ul><ul><li>The position of the elderly varies considerably from one culture to another </li></ul>
    45. 45. Common Values and Beliefs: Nutrition <ul><li>Food has much symbolic and social meaning </li></ul><ul><li>People learn from their family culture what foods are “good for you” or should be avoided or used for specific illnesses or diseases </li></ul><ul><li>Foods are categorized in some cultures as “hot,” “cold,” or “cool,” based not on their temperature, but on their effect in the body </li></ul>
    46. 46. Common Values and Beliefs: Death and Dying <ul><li>Important to know rituals about death and bereavement so cultural taboos can be avoided </li></ul><ul><li>Learn cultural views about autopsy before approaching a family on this issue </li></ul><ul><li>There may be cultural rituals for preparing the body for burial </li></ul><ul><li>Expressions of grief are also culturally based </li></ul>
    47. 47. Common Values and Beliefs: Health Care Beliefs <ul><li>Beliefs about health, disease, illness, and treatment are culturally based </li></ul><ul><li>Religion is an integral part of culture and often plays very important part in patient’s treatment </li></ul><ul><li>All cultures have an element of folk or home remedy medicine that is handed down through families for treating common illnesses </li></ul>
    48. 48. Common Values and Beliefs: Asian/Pacific Islander Americans <ul><li>Value self-control, age, authority, and harmony </li></ul><ul><li>Maintain a holistic view of health and illness, in which nature is a dominant force </li></ul><ul><ul><li>Yin (negative, dark, cold, feminine) </li></ul></ul><ul><ul><li>Yang (positive, light, warm, masculine) </li></ul></ul><ul><ul><li>Acupressure, acupuncture, acumassage </li></ul></ul>
    49. 49. Common Values and Beliefs: Asian/Pacific Islander Americans <ul><li>May believe that misdeeds lead to illness </li></ul><ul><li>Consider it disrespectful to disagree with those in authority </li></ul><ul><li>Reluctant to express emotions to others </li></ul><ul><li>Tend to be stoic about pain </li></ul><ul><li>May be overly agreeable to maintain harmony </li></ul><ul><li>Buddhism, Taoism, Hinduism, and Christianity are the prominent faiths </li></ul>
    50. 50. Common Values and Beliefs: Hispanic Americans <ul><li>Family is valued over the individual </li></ul><ul><li>Family system is patriarchal </li></ul><ul><li>Health is seen as a gift from God </li></ul><ul><li>Equilibrium achieved through prayer, religious objects, rituals, and use of herbs and spices and by treating others fairly and with respect </li></ul><ul><li>Often seek help within the family first or may see a curandero </li></ul>
    51. 51. Common Values and Beliefs: Hispanic Americans <ul><li>May believe in the use of “hot” and “cold” foods to restore equilibrium </li></ul><ul><li>May be superstitious (e.g., mal de ojo) </li></ul><ul><li>May wear religious objects or bring them in from home </li></ul><ul><li>It is acceptable to be vocal about illness or pain </li></ul><ul><li>Touch is comforting and promotes rapport </li></ul><ul><li>Health requires being in harmony with God </li></ul>
    52. 52. Common Values and Beliefs: African Americans <ul><li>Health and illness may be intertwined with religion and good and bad forces </li></ul><ul><li>Families often multigenerational, and members of the church may be considered family </li></ul><ul><li>Family is often matriarchal </li></ul><ul><li>African Americans may believe that illness is preventable if they are attentive to their relationship with God and other people </li></ul>
    53. 53. Common Values and Beliefs: Susceptibility to Disease <ul><li>Certain diseases are passed from parent to child through the genes that determine a person’s characteristics </li></ul><ul><li>Be alert for signs of disorders that are common to a particular culture or race </li></ul><ul><li>Learn about disorders that are predominant in a particular group </li></ul>
    54. 54. Common Values and Beliefs: Susceptibility to Disease <ul><li>African or Mediterranean ancestry </li></ul><ul><ul><li>Sickle cell anemia </li></ul></ul><ul><li>Eastern European and Jewish ancestry </li></ul><ul><ul><li>Tay-Sachs disease, lactase deficiency </li></ul></ul><ul><li>Hispanic, American Indian ancestry </li></ul><ul><ul><li>Hypertension, diabetes </li></ul></ul>
    55. 55. Culturally Sensitive Nursing Interventions <ul><li>Use an interpreter for history taking or important teaching </li></ul><ul><li>Use flash cards or a phrase book in the patient’s language for common phrases </li></ul><ul><li>Assist in designing a therapeutic diet with culturally preferred foods </li></ul><ul><li>Involve the family in formulating treatment plans </li></ul><ul><li>Advocate for the patient to choose or refuse treatment </li></ul><ul><li>Provide quiet time for prayer or meditation </li></ul>

    ×