What is the relationship of the human to nature (person-nature orientation)? Cultural Perspectives and Healthy People 2020, Developed a set of national health targets…eliminating racial and ethnic disparities in health, Embraced and focused on ways to close the gaps in health outcomes, Focused on disparities among racial and ethnic minorities, women, youth, older adults, people of low income and education, and people with disabilities. 2. You can track the progress of the order through our customer support team. Poverty is another factor that dramatically influences health and well-being. The family remains the basic social unit in the United States. Lineal relationships: These exist by virtue of heredity and kinship ties. In the course of a nursing career, it is possible to encounter foreign visitors, international university faculty members, international high school and university students, family members of foreign diplomats, immigrants, refugees, as well as members of more than 130 different ethnic groups, and Native Americans from more than 557 federally recognized tribes. Cultural imposition is a person’s tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture. Uses world view, social structure, language, ethnohistory, environmental context, and the generic or folk and professional systems to provide a comprehensive and holistic view of influences in cultural care and well-being. Leininger’s Sunrise Model (Figure 13-1) depicts the theory of cultural care diversity and universality and provides a visual representation of the key components of the theory and the interrelationships among its components. Since 2010, we have offered professional writing services to clients all over the world. Expression of pain is culturally determined. If collateral relationships are valued, decisions about the client may be interrelated with the influence of illness on the entire family or group. Nevertheless, aggregate dietary preferences among people from certain cultural groups can be described (e.g., characteristic ethnic dishes and methods of food preparation, including use of cooking oils); the reader is referred to nutrition texts on the topic for detailed information about culture-specific diets and the nutritional value of ethnic foods. Do you need a literary essay? A nurse is preparing to deliver a food tray to a Jewish client. Our mission is to promote academic success by providing students with superior research and writing, produced by exceptional writers and editors, each of whom has specific academic credentials related to the content fields in which they write. However, they commonly consume pork bones and shells, providing adequate quantities of calcium to meet daily requirements. By developing a set of national health targets, which includes eliminating racial and ethnic disparities in health, U.S. health officials, together with state and local officials and members of the private sector, set goals to increase the quality and years of healthy life for all Americans (U.S. Department of Health and Human Services [USDHHS], 2009). Include the client’s beliefs about the cause of illness: Understand the role and value of folk or religious healers. Subcultures based on age include adolescents and older adults, and those based on sex or sexual preference include women, men, lesbians, and gay men. Nurses’ knowledge of culture and cultural concepts improves the... Population trends. Growing, in which the person is self-contained and has inner control, including the ability to self-actualize, 3. What is the temporal focus of human life (time orientation)? Some believe that life is a struggle to overcome a basically evil nature; they consider human nature to be unalterable or able to be perfected only through great discipline and effort. 2. First effort at treatment is often self-care. In the United States, metaphors such as melting pot, mosaic, and salad bowl describe the cultural diversity that characterizes the population. Currently about 81.8% of registered nurses (RNs) in the United States are white/non-Hispanic. For the first time in U.S. history, minorities will make up a majority of the total population. Although various ways exist to categorize families, the following are commonly recognized types of constellations in which people live together in society: • Nuclear (i.e., husband, wife, and child or children), • Nuclear dyad (i.e., husband and wife alone, either childless or with no children living at home), • Single parent (i.e., either mother or father and at least one child), • Blended (i.e., husband, wife, and children from previous relationships), • Extended (i.e., nuclear plus other blood relatives), • Communal (i.e., group of men and women with or without children), • Cohabitation (i.e., unmarried man and woman sharing a household with or without children), • Gay (i.e., same-gender couples with or without children). Know the customary days of religious worship. Essays have traditionally been sub-classified as formal and informal. 2. Religious beliefs may influence a client’s belief about the cause of illness, perception of its severity, choice of healer, and source of consolation. Culture care repatterning and restructuring. Being, in which a spontaneous expression of impulses and desires is largely nondevelopmental in nature, 2. Cultural diversity is a multifaceted and complex concept that refers to the differences among people, especially those related to values, attitudes, beliefs, norms, behaviors, customs, and ways of living. In contrast, those from low SES groups (i.e., those without health insurance or with Medicaid) tend to receive less health care. Leininger’s theory of culture care diversity and universality. Appalachians, the Amish, Cajuns, and other subgroups are also examples of whites who have cultural roots that are recognizably different from those of the dominant cultural group. Although the overall health of the U.S. population has improved during the past several decades, research reveals that all people have not shared equally in those improvements. 3. Table 13-1 provides an overview of the poverty thresholds according to size of family and number of related children under age 18 years residing in the home. 3. What is the temporal focus (i.e., time sense) of human life (time orientation)? Cultural food preferences are often interrelated with religious dietary beliefs and practices. A) Be sure to use appropriate images in the handouts. Nursing is inherently a transcultural phenomenon, in that the context and process of helping people involves at least two people who often have different cultural orientations or intracultural lifestyles. The challenge facing healthcare today is the requisite for an organized commitment to support and embrace diversity while promoting concepts of inclusion, cultural competence, and clinical excellence. The following three models of nursing decisions and actions may be useful in providing culturally congruent and competent care (Andrews and Boyle, 2008; Leininger, 1978, 1991, 1995; Leininger and McFarland, 2002): 1. Cultural Diversity and Community Health Nursing. The U.S. population has traditionally been divided into the following three social classes: upper, middle, and lower. Doing, in which the person actively strives to achieve and accomplish something that is regarded highly. According to Kohls (1984), the dominant U.S. cultural group chooses to believe the best about a person until that person proves otherwise. The family constellations associated with teen parenting are unique and provide a special socialization context for infants. Currently about 81.8% of registered nurses (RNs) in the United States are white/non-Hispanic. The population of the United States is becoming increasingly diverse. In addition, children under 6 years of age are particularly vulnerable to poverty, with 20.8% of all U.S. children in this age-group being poor. Recognize political issues of culturally diverse groups. In some black families, the grandmother may be the decision maker and primary caregiver of the children. For many years, health care settings have been the subject of study and concern regarding distribution of resources, with members of racial and ethnic minority groups compellingly pointing out the inequalities. An argumentative essay? Educational attainment is perhaps the single most important factor. Nurses also should understand the culture of institutions that influence the health and well-being of communities. What is the mode of human activity (activity orientation)? Nurses who have knowledge of, and an ability to work with, diverse cultures are able to devise effective interventions to reduce risks in a manner that is culturally congruent with community, group, and individual values. The ANA has … Etiquette during meals, use of hands, type of eating utensils (e.g., chopsticks or special flatware), and protocols governing the order in which food is consumed during a meal all vary cross-culturally. The guidelines are a simplification of the poverty threshold for administrative purposes, such as determining financial eligibility for federal programs (e.g., Head Start, National School Lunch, Medicaid, Aid to Families with Dependent Children) (U.S. Census Bureau, 2007). However, the culture that develops in any given society is always specific and distinctive, encompassing the knowledge, beliefs, customs, and skills acquired by members of that society. Black Americans who have diabetes are seven times more likely to have amputations and renal failure than are whites with diabetes. It is a means of measuring inequalities based on economic differences and the manner in which families live as a result of their economic well-being. Upon completion of this chapter, the reader will be able to do the following: 1. Disparities can be reduced or eliminated when adults have: “…a formal area of study and practice focused on a comparative analysis of different cultures and subcultures in the world with respect to cultural care, health and illness beliefs, values, and practices with the goal of using this knowledge to provide culture-specific and culture-universal nursing care to people.”, Culture specific refers to the “particularistic values, beliefs, and patterning of behavior that tend to be special, ‘local,’ or unique to a designated culture and which do not tend to be shared with members of other cultures”, Culture universal refers to the “commonalties of values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyles and form the bases for formulating theories for developing cross-cultural laws of human behavior”, Transcultural Nursing Terminology (Cont.). Cancer mortality rates are 35% higher in black Americans than in whites. Assuming that current trends continue, the U.S. Census Bureau (2009) projects that, by 2025, more than half of all children will be minorities and that, by 2050 minorities will account for 54% of the total population. For example, 24.5% of the black population, 10.2% of the Asian population, and 21.5% of the Hispanic population live in poverty. Although the nursing profession has representatives from diverse groups, minorities are generally underrepresented. Management of Health Problems: A Cultural Perspective. One of the major challenges that community health nurses face in working with clients from culturally diverse backgrounds is overcoming individual ethnocentrism, which is a person’s tendency to view his or her own way of life as the most desirable, acceptable, or best and tendency to act in a superior manner toward individuals from another culture. Destiny, in which people are subjugated to nature in a fatalistic, inevitable manner, 2. As in many nations, people in the United States who come from various racial, ethnic, cultural, and socioeconomic backgrounds often experience marked disparities in health care. Ardoin & Wilson (2010), as previously noted, argue that the lack of cultural diversity and competency amongst nurses often put the patient at risk. A comparison essay? According to Tylor (1871), culture refers to the complex whole, including knowledge, beliefs, art, morals, law, customs, and any other capabilities and habits acquired by virtue of the fact that one is a member of a particular society. The economic status of most individuals, especially children, is better reflected by the pooled resources of family or household members than by their individual earnings or incomes. One of the components considered in determining SES is educational level. Developing programs to increase public awareness about health problems. Brief history of ethnic and racial origins of the cultural group with which the client identifies, U.S. Department of Health and Human Services and Public Health Service, Disadvantaged Minority Health Improvement Act of 1990, National Center on Minority Health and Health Disparities (NCMHD), Federally Sponsored Initiatives to Improve Health of Minority Groups, HRSA Health Disparity Collaboratives (HDC), Racial and Ethnic Approaches to Community Health (REACH 2010), National Breast and Cervical Cancer Early Detection Program (NBCCEDP), Ryan White Comprehensive AIDS Resources Emergency (CARE) Act B. Recognize culturally based health problems. Another source of error may originate from the cultural patterns of eating. From US Department of Health and Human Services: Healthy People 2020 : 2009 draft objectives. In recent years, the populations within the federally defined minority groups have grown faster than the population as a whole. … between a nurse and client attempts to understand the other’s point of view from a cultural perspective. Remember that various religions have shared beliefs. Nurses also must beware of cultural imposition, which is a person’s tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture. Populations Affected by Mental Illness, A Family Perspective in Community/Public Health Nursing, CommunityPublic Health Nursing Promoting the Health of Population, PHI–11: Increase the proportion of all degrees awarded to members of underrepresented racial and ethnic groups among the health professions, allied and associated health profession fields, the nursing field, and the public health field, BDBS–2: Reduce hospitalizations for sickle cell disease among children age 9 years and under, CKD–1: Reduce the rate of new cases of end-stage renal disease (ESRD), D–4: Reduce the rate of lower extremity amputations in persons with diabetes, FP–8: Reduce pregnancy rates among adolescent females, HDS–1: Reduce coronary heart disease deaths, HIV–17: Reduce HIV incidence among adults and adolescents, IID–18: Achieve and maintain effective vaccination coverage levels for universally recommended vaccines among young children, MICH–7: Reduce low birth weight (LBW) and very low birth weight (VLBW), NWS–2: Reduce the proportion of adults who are obese, SA–6: Reduce past-month use of illicit substances. Cultural Diversity and Community Nursing. SES may be calculated by considering a variety of factors, but it is customarily determined by examining factors such as total family income, occupation, and educational level. All animals must be ritually slaughtered by a shochet (i.e., quickly with the least pain possible) to be kosher. The outcome of social stratification is social inequality. For example, among extended families, kin residence sharing has long been recognized as a viable alternative to managing scarce resources, meeting child care needs, and caring for a handicapped or older family member. Cultural competency is a critical factor in nursing, and throughout the healthcare system, to best serve the needs of all patients. Pork, certain seafood (including shellfish), and fermented beverages are prohibited. In 1959, Madeleine Leininger, a nurse-anthropologist, used the term transcultural nursing to define the philosophical and theoretical similarities between nursing and anthropology. Fill in the order form, making all writer instructions clear. An increasing expectation exists among members of certain cultural groups that health care providers will respect their “cultural health rights,” an expectation that frequently conflicts with the unicultural, Western biomedical worldview taught in most U.S. educational programs that prepare nurses and other health care providers. Black Americans (16%) and Hispanic Americans (13%) are more likely to rely on hospitals or clinics for health care than are whites (8%). We are here to help you write any paper on our new website 24/7. Decision making about health and illness is often an individual matter, with the client being responsible, although members of the nuclear family may participate to varying degrees. What is the relationship of the human to nature (person-nature orientation)? Determined by comparing pretax cash income with the poverty threshold adjusted for family size and composition issued annually by USDHHS. Most families with racially or ethnically diverse backgrounds have a lower SES than the population at large, with a few exceptions (e.g., Cuban Americans and subgroups of Asian Americans). The dominant U.S. cultural group chooses to believe the best about a person until that person proves otherwise. The current state of cultural diversity in healthcare. Philosophers have suggested the following three perspectives: 1. The population of the United States is becoming increasingly diverse. Growing, in which the person is self-contained and has inner control, including the ability to self-actualize. Nurses have failed to consider cultural diagnosis while dealing with patients. Among those foreign born, 53.3% were born in Latin America, 25% in Asia, 13.7% in Europe, and the remaining 8% in other regions of the world (U.S. Census Bureau, 2004). • Thirty percent of Hispanics and 20% of black Americans lack a usual source of health care (compared with fewer than 16% of whites). What is the mode of human relationships (social orientation)? Among the strengths of Leininger’s theory is its flexibility for use with individuals, families, groups, communities, and institutions in diverse health systems. In this paper seven enabling principles are identified and their application to diverse groups discussed. Hispanic children are nearly three times as likely as non-Hispanic white children to have no usual source of health care. The poverty guidelines are issued each year by the USDHHS. 4. 30% of Hispanics and 20% of African Americans lack a usual source of health care (compared with less than 16% of whites). For example, nursing students may call faculty members by their first names, clients may call nurses by their first names, and employees may fraternize with their employers. Relationships that may seem apparent sometimes warrant further exploration by nurses interacting with clients from culturally diverse backgrounds. This values orientation concerns activity. Culturally competent community health nursing requires that nurses understand the lifestyle, value system, and health and illness behaviors of diverse individuals, families, groups, and communities. Leininger used worldview, social structure, language, ethnohistory, environmental context, and the generic or folk and professional systems to provide a comprehensive and holistic view of influences in cultural care and well-being. Mobilizes client’s social support network. Recent scientific advances, such as the advent of stem cell research and genome studies, have necessitated consideration of ethical quandaries regarding human nature. In 1968, Leininger proposed her theory-generated model, and, in 1970, she wrote the first book on transcultural nursing, Nursing and Anthropology: Two Worlds to Blend (Leininger, 1970). Standard dietary handbooks may fail to provide culture-specific diet information because nutritional content and exchange tables are usually based on Western diets. A recent study by the Commonwealth Fund (2007) found that disparities in health care can be reduced or even eliminated when adults have health care insurance and a medical home, which is defined as “a health care setting that provides patients with timely, well-organized care and enhanced access to providers.” According to the survey, when adults have insurance and a medical home, “their access to needed care, receipt of routine preventive screenings, and management of chronic conditions improve substantially.”. Alcohol, tobacco, and beverages containing caffeine (e.g., coffee, tea, colas, and select carbonated soft drinks) are prohibited. Innate human nature may be good, evil, or a combination of good and evil. What is the mode of human relationships (social orientation)? It is essential that all nurses understand how cultural groups view life processes, how cultural groups define health and illness, how healers cure and care for members of their respective cultural groups, and how the cultural background of the nurse influences the way in which care is delivered. - Respecting and understanding others values, beliefs, health and illness behaviors … one of the major challenges that community health nurses face in working with clients from culturally diverse backgrounds is: ethnocentrism person's own tendencies to view his or her own way of life as the most desirable, acceptable, or best and to act in a superior manner towards individuals from another culture Environmental Health. Learn about special days of observance or celebration. Selected Proposed Objectives Related to Cultural Health. For any questions, feedback, or comments, we have an ethical customer support team that is always waiting on the line for your inquiries. What is the mode of human activity (activity orientation)? According to a study by Garcia Coll (1990), mothers who had received more years of formal education inquired and praised their children more often than did mothers with less education. In contrast, the lower the mother’s level of formal education, the more often she used modeling as a teaching strategy. Discuss various theories of health promotion, including Pender’s Health Promotion Model, The Health Belief Model, the Transtheoretical Theory, and the Theory of Reasoned Action. Describes, explains, and projects nursing similarities and differences focused primarily on human care and caring in human cultures. Hispanic children are nearly three times as likely as non-Hispanic white children to have no usual source of health care. For example, among the Amish, the entire community is affected by the illness of a member because the community pays for health care from a common fund. Estimates for each minority group are as follows: black, 4.2%; Hispanic, 1.7%; Asian and Pacific Islander, 3.1%; and Native American and Alaska Native, 0.3% (, proposed objectives embrace and focus on ways to close the gaps in health outcomes. What is the mode of human activity (activity orientation)? During the past two decades, health disparities have become the focus of numerous federal, state, and local government studies, and one of the major goals of Healthy People 2020 is to achieve health equity, eliminate disparities, and improve the health of all groups (USDHHS, 2009). The economic status of most individuals, especially children, is better reflected by the pooled resources of family or household members than by their individual earnings or incomes. Individual relationships: These refer to personal autonomy and independence. Examples of U.S. subcultures based on ethnicity (e.g., subcultures with common traits such as physical characteristics, language, or ancestry) include blacks, Hispanics, Native Americans, and Chinese Americans. Given the multicultural composition of the United States and the projected increase in the number of individuals from diverse cultural backgrounds, concern for cultural beliefs and practices of people in community health nursing is becoming increasingly important. Health-Related Beliefs and Practices (Cont.). All your payments are processed by a secure payment system. This group has an optimistic faith in what the future will bring. Know the difference between religion and spirituality. This study contributes to an understanding of the ways in which educational level attained by people from culturally diverse backgrounds affects the didactic aspects of the child-rearing environment. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. https://nurse.org/articles/how-to-deal-with-patients-with-different-cultures Nurses in community health settings also need to understand the diversity or differences that occur in families, groups, neighborhoods, communities, and public and community health care organizations. In a less formalized examination of SES, factors such as age, sex, material possessions, health status, family name, location of residence, family composition, amount of land owned, religion, race, and ethnicity may also be considered. Collateral relationships: Focus primarily on group goals—and family orientation is important. Research suggests that differences between white and Mexican-American children’s home educational development can be accounted for by differences in levels of formal schooling rather than by cultural differences or economic indices. The origins of people in Canada, Australia, New Zealand, and South Africa can ultimately be traced to western Europe. The term subculture is used for fairly large aggregates of people who share characteristics that are not common to all members of the culture and that enable them to be a distinguishable subgroup. The focus may be on the future, with progress and change highly valued. … between a nurse and client attempts to understand the other ’ s or father ’ theory. Interviewed healthcare professionals and reviewed the latest research to gather some insight on these important.... Some black families, the more often she used modeling as a community health nurse, need. An adaptation for survival and protection, middle, and mentally challenged salad bowl describe the cultural values orientation also. Entity, 3, dropout rates for both blacks and Puerto Ricans, the family remains basic. 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