Culturally Sensitive Care Changing Populations and Health

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Culturally Sensitive CareChanging Populations
and Health

• 2005 version

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The Nacirema - Horace Miner (1956)

• What are your impressions of the Nacirema?
• How does the Nacirema culture differ from ours?

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What is Canadian Culture? How do Canadians feel
about

• Person
• Family
• Health care
• Religion
• Time orientation
• Age

• Sexuality
• Action assertiveness
• Value of material possessions
• Cleanliness hygiene

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Who defines what Canadian culture is?
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Who are Canadians?
Stats Canada 2001Census Data - http//www.statcan.
ca/start.html
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Who are Canadians? In 1996

• 17 Cdns were immigrants 5 million people
• Earlier immigrants mostly from Europe now
  newcomers from Asia, the Middle East Africa
• 226,000 newly landed immigrants in 1996 1 in
  6 were refugees
• 47 of 1996 immigrants were 25 - 44 yrs
• ¾ settled in Ontario BC
• New immigrants in better health than Cdn born
• Longer in Canada gt likelihood their health issues
  resemble that of Canada-born residents.

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What is Culture?

• Thoughts, communications, actions, customs,
  beliefs, values institutions of racial, ethnic,
  religious or social groups Office of Minority
  Health (2001) - AB pg. 267
• Culture refers to the learned values, beliefs,
  norms way of life that influence an
  individuals thinking, decisions actions in
  certain ways. Leininger (1991) - CNO Guide to
  Nurses for Providing Culturally Sensitive Care
  pg. 3

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Culture is

• a community concept
• a dynamic, psychosocial concept
• a guide to ethical perspectives
• Affects all aspects of health care!

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Definitions to know

• Multiculturalism
• Acculturation
• Assimilation
• Subculture
• Cultural diversity

• Cultural relativism
• Ethnicity
• Race
• Ethnocentricity
• Stereotyping

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Cultural Competence

• Includes set of cultural behaviours/attitudes
  integrated into practice methods
• Includes substantive knowledge base ability to
  adapt individualized clinical nursing skills to
  fit cultural context of each client
• Requires culturally appropriate ways of speaking
  knowledge of culturally congruent ways to
  manage intercultural health care events
• It includes ability to form, foster improve
  relationships with members of a culture different
  from ones own.
• Starts with self-awareness self-reflection

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Intercultural Communication

• Communication in which the sender of an intended
  message is a member of one culture the receiver
  of the message is from a different culture
• Involves understanding that
• different languages create express different
  personal realities
• language shapes the personalized meaning
  experience of illness and health
• paralanguage nonverbal language are culturally
  determined

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Providing Culturally Sensitive Care Assessment

• Assessment - Giger Davidhizars Transcultural
  Assessment Model uses 6 criteria
• Communication
• Space
• Social organization
• Time
• Environmental control
• Biological variations

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Providing Culturally Sensitive Care Nursing
Diagnosis Planning

• Dont use diagnoses with negative connotations
  related to cultural differences
• Whose problem is it, when there is a language
  barrier? Or when cultural values differ from the
  nurses?
• Care planning must be collaborative, goal setting
  must be mutual, nurse needs to see problem
  through clients perceptions approach it from
  the clients perspective.

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Providing Culturally Sensitive Care -
Considerations in Planning

• Language barriers
• Role relationships
• Level of family involvement
• Time orientation
• Health beliefs, values, practices
• Religious beliefs practices

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Providing Culturally Sensitive Care -
Interventions include

• Continuous use of active listening strategies
  frequent validation regarding the cultural
  appropriateness of your conclusions
• Empowering clients
• Use culturally based teaching strategies and
  tools
• Use interpreters

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Assessing the four largest cultural groups in
Canada with respect to 6 cultural phenomena

• Aboriginal peoples
• Chinese peoples
• Peoples of South Asian origins (Indo-Pakistani)
• Black peoples

• Communication
• Space
• Social orientation
• Time orientation
• Environmental control
• Biological variations

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Summary Questions??