Cultural Awareness and Influences on Health Essay

Cultural Awareness and Influences on Health Essay

It’s important for nurses to provide culturally competent care. It’s important to assess the importance of a client’s culture/ethnicity (and their accompanying beliefs and values) when planning, providing, and evaluating care. Nurses’ practice must incorporate cultural needs and beliefs into their nursing practice to provide care that is individualized for the client and appropriate to the client’s needs (Cultural Awareness and Influences on Health: NCLEX-RN, 2020).Cultural Awareness and Influences on Health Essay

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In the Asian culture, there is often a belief that terminally ill patients should not be informed about their prognosis, and many believe that speaking of it may bring bad luck or a poor outcome (Ritter & Graham, 2017, P. 235). Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patient’s knowledge or consent is ethically unacceptable (AMA, 2020). After completing a cultural assessment, if the patient holds this belief, I would respect the cultural practice and withhold the information.Cultural Awareness and Influences on Health Essay

The patient would be encouraged to specify preferences regarding the communication of medical information, preferably before the information becomes available (AMA, 2020); it’s important to honor a patient’s request not to receive certain medical information or to convey the information to a designated surrogate, provided these requests appear to represent the patient’s genuine wishes (AMA, 2020). For the family who believes this, “decisions and communication are often considered the responsibility of the oldest male in the family, and can be seen as a moral obligation for that person to act in that capacity” (Ritter & Graham, 2017, P. 235).

For health care providers to balance the patient’s right to know with respect to the cultural practices and beliefs of the family, it’s important to: assess the amount of information the patient is capable of receiving at a given time, and tailor disclosure to meet the patient’s needs and expectations in keeping with the individual’s preferences; Monitor the patient carefully and offer full disclosure when the patient is able to decide whether to receive the information (AMA, 2020).Cultural Awareness and Influences on Health Essay

In short, each year, the United States becomes more diverse, with people of different races and religions, and with differing beliefs about medicine and medical care. As nurses, we owe it to our patients to provide them with the best care possible in ways they find appropriate (Reed, 2017).

References

AMA. (2020). Withholding Information from Patients. Retrieved from https://www.ama-assn.org/delivering-care/ethics/withholding-information-patients

Cultural Awareness and Influences on Health: NCLEX-RN. (2020). Retrieved from https://www.registerednursing.org/nclex/cultural-awareness-influences-health/

Reed, C. (2017). Cultural Competence. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2017/07000/Cultural_Competence.5.aspx

Ritter, L.A., & Graham, D.H. (2017). Multicultural Health (2nd ed.). Burlington, MA: Jones and

Bartlett Learning. ISBN: 9781284021028

REPLY 2

Health is viewed as a cultural concept, and culture determines how we perceive the world. Therefore, respect for cultural practice in Asia is predetermined because culture helps shape how both the patient and the healthcare provider perceive illness and what they believe to be its cause (Fowler et al., 2011). I will only respect the culture if I lack the knowledge and skills of delivering bad news, the appropriate provision of optimal care to a dying patient, and the compassion to ensure that the patient retains his or her self-worth even at the time of his or her death.Cultural Awareness and Influences on Health Essay

According to Rosenberg et al. (2017), negative information should be briefly relayed to patients. The author recommends that the information be rehearsed to communicate the bad news concisely and how the healthcare team is committed to the patient’s support and treatment at the terminally ill stage. A good example of a prognosis that should be delivered to the patient, especially by word of mouth, is as follows: ‘The tests done on your collected samples have confirmed that your condition arose from a malignant tumor (sad news). Therefore, I have informed a radiotherapist and the oncologist to speak with you about the condition and then advise you further. Once I receive the recommendations from their examinations on you, I will decide on what best treatment to give to you (doing something about it). As things unfold, I will always be around to discuss with you on how we will go on with the treatment.’ Maintaining a silent observation at this point will lead to the patient’s psychological condition’s best results (Sarafis et al., 2014). Therefore, I will respect the culture, but any information that must reach the patient will always be delivered just as the profession prescribes.Cultural Awareness and Influences on Health Essay

Healthcare providers can balance the patient’s right to know their prognosis concerning their cultural practices and beliefs. To achieve such a balance, healthcare personnel should always try hard to become culturally sensitive (Chaet, 2016). Such sensitive care can be achieved through creating awareness, avoiding assumptions, and learning about other cultures. In any social issue, the first step is always to be aware. Any competent healthcare provider must always be endowed with culturally sensitive care. A good nurse or doctor will always strive to become culturally sensitive personnel while letting others understand their line of duty (Swihart & Martin, 2020). Secondly, a good healthcare provider should always avoid making assumptions because it is always important not to assume matters that you are not familiar with. Making such assumptions can cause a breakdown of trust and rapport between the healthcare provider and the patient. Lastly, a good doctor or nurse should always learn about other cultures. Learning a patient’s culture includes their medical history, medications, and current symptoms. Learning different cultures will involve immersing oneself in the culture of others.Cultural Awareness and Influences on Health Essay

In conclusion, it is always essential to have a truthful and open communication between the patient and the medic. Such open communication will enhance trust in the relationship and respect for autonomy. On the other hand, not fully disclosing information to the patient is an ethical breach because it brings the clash between the physician’s duty of promoting the patient’s health and the physician’s respect for the patient’s autonomy.

Culture has been described as an iceberg, with its most powerful features hidden under the ocean surface as illustrated in Figure 1. Explicit cultural elements are often obvious but possibly less influential than the unrecognized or subconscious elements providing ballast below.

Figure 1: Elements of culture
Culture has been described as an iceberg, with its most powerful features hidden under the ocean surface. Explicit cultural elements are often obvious but possibly less influential than the unrecognized or subconscious elements providing ballast below.Cultural Awareness and Influences on Health Essay
Source: Slide 6, Introduction to clinical cultural competence. Clinical Cultural Competency Series. Courtesy of the Centre for Innovation & Excellence in Child & Family Centred Care at SickKids Hospital.
The cultural continuum
Culture is commonly divided into two broad categories at opposite ends of a continuum: collectivistic or individualistic. Most cultures fall somewhere between the two poles, with characteristics of both. Also, within any given culture, individual variations range across the spectrum. Still, being familiar with characteristics of collectivistic and individualistic cultures is useful (see Table 1) because it helps practitioners to ‘locate’ where a family falls within their cultural continuum and to personalize patient care.Cultural Awareness and Influences on Health Essay

Collectivistic and individualistic cultures can give rise to different views on human health, as well as on treatment, diagnoses and causes of illness. Depending on where a patient ‘fits’ along their cultural continuum, including extended family in discussions about disease origin, diagnosis and treatment may be helpful. Consent for certain diagnostic and therapeutic interventions may be needed from extended family members.Cultural Awareness and Influences on Health Essay

Table 1: Characteristics of collectivistic and individualistic cultures
Collectivistic

Individualistic

Focus on “we”

Focus on “I”

Promote relatedness and interdependence

Value autonomy

Connection to the family

View ability to make personal individual choices as a right

Value respect and obedience

Emphasize individual initiative and achievement

Emphasize group goals, cooperation and harmony

Lesser influence of group views and values, and in fewer aspects of life

Greater, broader influence of group views and values

Source: Adapted from slide 11, Cross-cultural communication.Clinical Cultural Competency Series. Courtesy of the Centre for Innovation & Excellence in Child & Family Centred Care at SickKids Hospital, Toronto.Cultural Awareness and Influences on Health Essay
Indecision or decision-making?
You might expect a 26-year-old mother to make a decision regarding her child’s treatment alone. Having just completed an evaluation of her 6-year-old, you present 2 options for investigation. The mother shies away from making a firm decision and answers you in vague terms. She seems to speak in circles, almost dancing around the choice, even after hearing all the information needed to decide which care path to follow. You know that she has finished high school, and note impatiently that you have already spent an hour with her. The following week she returns. You worry about the length of the visit and falling behind with other patients. To your surprise, she is decisive. She confides, with some prompting, that she discussed treatment options with her husband and mother-in-law, and together they have arrived at the best solution. She can now confidently pursue the investigation of her child’s condition.Cultural Awareness and Influences on Health Essay

Learning points:
The health care provider’s culture is individualistic, while the mother’s is more collectivistic. The mother needed to consult before she could provide an answer.
Communication styles differ. The mother feared shaming the provider by doubting advice, but also didn’t feel comfortable admitting that she would have to bring the choice home to decide.
Education level is not an issue: it’s a red herring.
Impact of culture on health
Health is a cultural concept because culture frames and shapes how we perceive the world and our experiences. Along with other determinants of health and disease, culture helps to define:Cultural Awareness and Influences on Health Essay

How patients and health care providers view health and illness.
What patients and health care providers believe about the causes of disease. For example, some patients are unaware of germ theory and may instead believe in fatalism, a djinn (in rural Afghanistan, an evil spirit that seizes infants and is responsible for tetanus-like illness), the ‘evil eye’, or a demon. They may not accept a diagnosis and may even believe they cannot change the course of events. Instead, they can only accept circumstances as they unfold.
Which diseases or conditions are stigmatized and why. In many cultures, depression is a common stigma and seeing a psychiatrist means a person is “crazy”.
What types of health promotion activities are practiced, recommended or insured. In some cultures being “strong” (or what Canadians would consider “overweight”) means having a store of energy against famine, and “strong” women are desirable and healthy.Cultural Awareness and Influences on Health Essay
How illness and pain are experienced and expressed. In some cultures, stoicism is the norm, even in the face of severe pain. In other cultures, people openly express moderately painful feelings. The degree to which pain should be investigated or treated may differ.
Where patients seek help, how they ask for help and, perhaps, when they make their first approach. Some cultures tend to consult allied health care providers first, saving a visit to the doctor for when a problem becomes severe.
Patient interaction with health care providers. For example, not making direct eye contact is a sign of respect in many cultures, but a care provider may wonder if the same behaviour means her patient is depressed.
The degree of understanding and compliance with treatment options recommended by health care providers who do not share their cultural beliefs. Some patients believe that a physician who doesn’t give an injection may not be taking their symptoms seriously.Cultural Awareness and Influences on Health Essay
How patients and providers perceive chronic disease and various treatment options.
Culture also affects health in other ways, such as:

Acceptance of a diagnosis, including who should be told, when and how.
Acceptance of preventive or health promotion measures (e.g., vaccines, prenatal care, birth control, screening tests, etc.).
Perception of the amount of control individuals have in preventing and controlling disease.
Perceptions of death, dying and who should be involved.
Use of direct versus indirect communication. Making or avoiding eye contact can be viewed as rude or polite, depending on culture.
Willingness to discuss symptoms with a health care provider, or with an interpreter being present.
Influence of family dynamics, including traditional gender roles, filial responsibilities, and patterns of support among family members.
Perceptions of youth and aging.
How accessible the health system is, as well as how well it functions.
What health professionals can do
Health care providers are more likely to have positive interactions with patients and provide better care if they understand what distinguishes their patients’ cultural values, beliefs and practices from their own.Cultural Awareness and Influences on Health Essay

The following suggestions may help you care for and communicate with patients who are new to Canada:3,4

Consider how your own cultural beliefs, values and behaviours may affect interactions with patients. If you suspect an interaction has been adversely affected by cultural bias – your own or your patient’s – consider seeking help.
Respect, understand and work with differing cultural perceptions of effective or appropriate treatment. Ask about and record how your patients like to receive health care and treatment information.
Where needed, arrange for an appropriate interpreter.
Listen carefully to your patients and confirm that you have understood their messages.
Make sure you understand how the patient understands his or her own health or illness.Cultural Awareness and Influences on Health Essay
Recognize that families may use complementary and alternative therapies. For appropriate, specific conditions, remind them that complementary and alternative medicine use can delay biomedical testing or treatment and potentially cause harm.
Try to ‘locate’ the patient in the process of adapting to Canadian culture. Assess their support system. What are their language skills?
Negotiate a treatment plan based on shared understanding and agreement.
In Canada, health information is typically print-based. Find out whether a patient or family would benefit from spoken or visual messaging for reasons of culture or limited literacy.
Read more about cultural competence, including specific strategies for delivering culturally competent care. Helpful tools and resources are available from other sources. SickKids Hospital in Toronto has created a series of e-learning modules. You may wish to complete two modules in particular: Cross-Cultural Communication and Parenting Across Cultures.Cultural Awareness and Influences on Health Essay

Providing health care to different cultural groups
Developing a guide to help health professionals understand cultural preferences and characteristics around the world would be a mammoth undertaking. Also, any such document would be biased by the authors’ own cultural perspectives. Culturally, health professionals in Canada are increasingly diverse, viewing the world and the people they see through many different lenses.

However, health care providers should learn skills around cultural competence and patient-centred care. Such skills can be a compass for exploring, respecting and using cultural similarities and differences to improve quality of care and patient outcomes.Cultural Awareness and Influences on Health Essay

Why are Culture Health Beliefs so Important in a Health Care Setting? Why are Culture Beliefs so Important in a Health Care Setting? There are many cultures out in the world today that practice beliefs different than those in the United States. America is based off Western Culture and traditional medicine practices which focus on preventative and curative medicine. Most cultures around the world practice folk medicine, which focus more on the person as a whole with remedies and ceremonies rather than medicine and treatment. Even though each one believes in a different practice, all medical professionals should have the knowledge and awareness of each culture’s health beliefs to properly treat their patients in a respectful and kind…show more content…
Adapted from Culture Clues, University of Washington Medical Center (2004), American Indians and Alaskan Natives believe that the head and hair are sacred and touching either is very personal and disrespectful. Symbolic items like hair, jewelry, or ornaments need to be kept close to the patient at all times because they have spiritual meaning. A second culture that a medical professional should be aware of is the Vietnamese, handshakes are appropriate between men not women (Culture Clues, 2001). They also believe that the head is the most sacred part of the body, so avoid touching it unless necessary. To show respect to the patient someone would avoid direct eye contact and bow the head because it shows that the individual is not being disrespected (Giger and Davidhizas, 2008). The patient’s norms are always something to remember so the beliefs are not offended. By having awareness on beliefs it will also help to get a grasp on what the religion traditions in healing. When understanding the many beliefs that cultures have, helps grasp an understanding the healing practices a family may have. In today’s society, “religious practices are usually rooted in culture” (Giger and Davidhizas, 2008). Typically each culture has a set of beliefs that they use to explain their health and manners that prevent or treat illnesses and diseases. When a family member is ill, a culture uses rituals to get rid of the disease.Cultural Awareness and Influences on Health Essay