Culture, Spirituality & Diversity

• Assessment


  • Describe the rationale for the National Standards for Culturally and  Linguistically Appropriate Services in Health Care.
  • Perform a sexual assessment using suggested interview questions.
• Communication


  • Identify factors related to communication with culturally diverse patients and colleagues.
• Managing Care


  • Assess how your personal beliefs and values about human sexuality affect your ability to deliver competent ,compassionate, and respectful care to patients with challenges, differences, or problems with sexuality.
  • Plan culturally sensitive, appropriate, and competent nursing interventions.
  • Describe the concepts of sexuality, gender, gender identify, sexual orientation, and sexual health.
• Caring Interventions


  • Describe nursing interventions to support clients’ spiritual and cultural beliefs and practices.
• • Shared behavior or social characteristics particular to a specific group and passed from generation to generation or from one to another within the group
• Culture


  Shared behavior or social characteristics particular to a specific group and passed from generation to generation or from one to another within the group
• • Spirituality


  Anything that pertains to a person’s relationship with a nonmaterial life force or higher power
• Religion


  Organized system of beliefs about a higher power; often includes set forms of worship, spiritual practices, and codes of conduct
• Cultural diversity 


  The coexistence of different ethnic, sex assigned at birth, racial, and socioeconomic groups within one social unit. These groups include, but are not limited to, people of varying religion, language, physical size, sexual orientation, age, disability, occupational status, and geographic location
• Providing culturally Respectful care


  1. Develop cultural self-awareness.
  2. Demonstrate cultural knowledge.
  3. Accommodate cultural practices in healthcare.
  4. Respect culturally based family roles.
  5. Avoid mandating change.
  6. Seek cultural assistance/education.
• The culture iceberg

  
• Cultural Diversity

  • Varying Cultures
  • Racial and ethnic origin
  • Religion
  • Physical size, age, gender
  • Sexual Orientation
  • Disability
  • Socioeconomic and occupational status
  • Geographical location
• Culture


  • Acculturation/Assimilation
  • Ethnocentrism
  • Cultural sensitivity
  • Culture Shock
• Acculturation/Assimilation

  When a minority group lives within a dominant group, many members may lose the cultural characteristics that once made them different, and they may take on the values of the dominant culture
• Ethnocentrism

  belief that one’s own ideas, beliefs, and practices are best, superior, or most preferred to those of others; using one’s cultural norms as the standard to evaluate others’ beliefs
• Cultural sensitivity


  Being aware that cultural differences and similarities between people exist without assigning them a value – positive or negative, better or worse, right or wrong.
• Culture Shock


  those feelings, usually negative, a person experiences when placed in a different culture
• Providing culturally competent care


  Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.
• Cultural influences on healthcare


  • ➢Physiologic variations
  • ➢Pain
  • ➢Mental Health
  • ➢Biological Sex Roles
  • ➢Language & Communication
• Communicating Effectively


  • Language difference is a communication problem-not a hearing problem
  • Variability of non-verbal communication
  • Transcultural Assessment of Communication
  • Clients native language
  • Ability to speak/write in English
  • Is an interpreter needed?
  • How to address?
• Common cultural influences on healthcare


  • ➢Space & Time 
  • ➢Food & Nutrition 
  • ➢Family Support
  • ➢Socioeconomic Factors
• Potential barriers to culturally competent care


  • Stereotyping
  • Bias
  • Prejudice
  • Discrimination
  • Racism
  • Sexism
  • Language
  • Lack of Knowledge
• Health disparities 


  • ➢Prevalence of Chronic Illness 
  • ➢Socioeconomic Factors
  • ➢Health Literacy and Patient Safety
• spirituality


  Belief in a higher power/divine being/energy source

  Wholeness and harmony within one’s self, others, and/or a higher power
• • Faith- a confident belief in something for which there is no proof or evidence
• • Hope- ingredient in life responsible for a positive outlook
• • Love-connectedness with others-Basic Human Need
• Spiritual Dimension


  • Spirituality, faith, religion, and the influence of these elements on everyday living, health & illness and self care behaviors.
  • Source of Support during stressful times
  • Source of Strength and Healing
  • Source of Conflict
• • Spiritual Health- when the person’s universal spiritual needs for meaning and purpose, love, and belonging, and forgiveness are met
• • Guide to Daily Living Habits

  • Dietary requirements/restrictions
  • Birth control practices
  • Medical treatments
• Factors affecting Spirituality


  • Developmental Considerations 
  • Family
  • Ethnic background 
  • Formal Religion
  • Life events 
• Beliefs and Healthcare Practices of Major Traditions in the U.S.


  • Diet
  • Dress
  • Prayer & Meditation
  • Birth
  • Death
• Nursing Diagnoses for Spiritual Problems


  • Readiness for enhanced spiritual well-being/Hope
  • Spiritual distress
  • Hopelessness
  • Impaired Religiosity
  • Spiritual Despair
  • R/T : illness, death, divorce, life situation
• Patient Goals/Outcomes


  • Identify spiritual beliefs that meet needs for meaning and purpose, love and relatedness, and forgiveness.
  • Derive strength, hope, and comfort from these beliefs.
  • Develop spiritual practices that nurture communion with inner self, God, and the world.
  • Express satisfaction with compatibility of spiritual beliefs and everyday living.
• Implementing Spiritual Care


  • Offering supportive/compassionate presence
  • Facilitating patients practice of religion
  • Nurturing spirituality
  • Praying with or for a patient
  • Counseling the patient spiritually
  • Contacting a spiritual counselor
  • Resolving conflicts between treatment and spiritual activities
• Sexual Orientation


  • Heterosexual
  • Gay or Lesbian
  • Bisexual
  • Transgender- includes: transsexual, intersex, non-binary, no/multiple genders
  • Asexual
  • Questioning
• Sexual Identity


  • Self Identity
  • Biological Sex
  • Gender Identity
  • Gender nonconformity
  • Gender dysphoria
  • Gender role behavior or expression
  • Cisgender
  • Transgender
  • Sexual Orientation
• Health Disparities in the LGBT Population


  Healthy People 2020 identified significant LGBT health disparities and seeks much-needed collaboration from health care professionals and policy makers to address them. 

  • Developmental Considerations
  • Substance Abuse
  • Mental Health
  • Physical Health
• Implementing Inclusivity


  • Refrain from making assumptions about a person's sexual orientation or gender identity based on appearance
  • Be aware of misconceptions, bias, stereotypes, and other communication barriers
  • Recognize that self-identification and behaviors do not always align
  • Use neutral and inclusive language when speaking with clients
  • Listen and reflect client's choice of language when they describe their own sexual orientation and how they refer to their relationship or partner
  • Become familiar with online and local resources available for LGBTQ individuals
  • Seek information and stay up to day on LGBTQ health topics