Transcript CONCEPT: DIVERSITY

CONCEPT:
DIVERSITY
• Definition – Diversity:
• The unique variations among and between individuals, variations
that are informed by genetics and cultural background, but that are
refined by experience and personal choice.
UNIT OBJECTIVES
1.
2.
3.
4.
5.
Explain the concept of Diversity (including definition,
antecedents, and attributes).
Analyze conditions which place a patient at risk for cultural
incompetence.
Identify when cultural incompetence (negative
consequence) is developing or has developed.
Discuss exemplars of common diversity disorders.
Apply the nursing process (including collaborative
interventions) for individuals experiencing cultural
incompetence and to promote normal sleep.
Definition of Culture
• Diversity and Culture are closely linked. To understand the
link, culture is defined as “a pattern of shared attitudes,
beliefs, self-definitions, norms, roles, and values.
• Culture occurs among :
• Those who speak a particular language
• Those who live in a defined geographic region
Patient Education
Coping
• InterrelatedConcepts
Communication
Interpersonal
Patient-Centered Care
• Nursing Care - Those things which must be
known about a diverse population in order
to provide care.
Cultural norms influence how people make
decisions about treatment preferences,
medication adherence, self-care, and
perceptions of illness, which affects nursing
care and healthcare delivery.
Attributes
A pattern of shared attitudes, beliefs, selfdefinitions, norms, roles, and values that occur
among those who speak a particular language
or live in a defined geographical region.
Examples:

Enculturation,
Acculturation,
Biculturalism,
Application/Use of: Diversity implications
when interacting/educating/providing care.
Antecedents – Individual
Differences and Similarities in:
• Age
• Religious/Spiritual
• Ethnic/Race
• Cultural
• Sexual Orientation
• Education
• Life Experiences
Related Terms and Examples of
Attributes
Enculturation:
Process by which a person learns norms,
values, and behaviors of another culture
Example:
A high school student from the United
States spends a summer abroad with a
family in Switzerland
Related Terms and Examples of
Attributes
Acculturation:
Process of acquiring new attitudes, role,
customs, or behaviors
Example:
An immigrant from China develops a
preference for Western foods and music

Assimilation:
Process by which a person gives up his or her
original identity and develops a new cultural
identify by becoming absorbed into the dominant
cultural group
Example:
A Native American loses his Native identity after
living in Chicago for 10 years
Biculturalism:
Duel pattern of identification
Example:
A woman of Christian faith married to a
Muslim adopts Muslim practices and also
maintains some traditional Christian
practices
Other Related Terms
Ethnicity and ethnic identity
Influenced by culture and common ancestry
Race
Influenced by physical or biologic characteristics
Consequences
Negative
• Culture specific illness
• Breakdown in
communication
• Non compliance
• Stress, no hope
• Fearful patient
Positive
• Culturally congruent care
• Patient satisfaction
• Appropriate child rearing
practices
• Culture identity
• Inner peace and strength
• Faith and hope
Subconcepts
Nursing Diagnoses
• Attachment, Risk for Impaired
• Anxiety
• Body Image, Disturbed
• Coping: Defensive
• Coping: Family, Compromised
• Decisional Conflict
• Family Processes, Interrupted
• Fear
• Health Maintenance, Ineffective
• Moral Distress
• Social Interaction, Impaired
EXEMPLARS
• Hispanic Traditions
• Maternity w Complementary/Alternative Medicine
• Jehovah’s Witnesses
• Use of blood products
• Traditional Islamic
• Ritual dying patient
• Spirituality
• Spiritual distress
Exemplars to include Race, Gender, Sexual Orientation, Age,
Education, Abilities & Life Experiences
APPLICATION OF DIVERSITY
IN THE CONTEXT OF
NURSING AND HEALTH CARE
Health Care Disparities
• Collaborative Learning
• In your learning group, discuss the term health care
disparities.
• What does this term mean?
• How is it linked to the concept of diversity?
• How can this be minimized by nurses?
Competence: Diversity in Nursing
• Expected component of professional
nursing practice
• Requires Underlying acceptance of
patient’s health beliefs
• Requires adapting care to meet unique
needs and perspectives of individuals
BIAS
• All people are biased
• Examples include:
• Stereotyping people
• Tendency to act, think, or feel in a
certain way toward other people.
• How do biases affect nursing care?
• Assessment (Norm/Deviations &
implications for concept)
• Comprehensive History (focused
assessment questions and review of
symptoms)
• Physical & Psychological (Clinical
Manifestations)
• Diagnostic Test (s)
Clinical Management
• Nursing Interventions
• Learn and use a few phrases of greeting in
the patient’s native language
• Use an interpreter; share this with the
patient and stop periodically
• When speaking or listening, watch the
patient, not the interpreter
Clinical Management
• Nursing Interventions
• Repeat important information more than once
• Always give the reason or purpose for a
treatment or prescription
• Make sure the patient understands by having
them explain it themselves
• Teach patients their options and let them
decide
• Collaborative Interventions (Interprofessional partnerships)
• Massage
• Heat Treatment
• Sweat bath
• Yucca Root
• Accupuncture
• Chiropractic Medicine
• Complementary and alternative medicine
Conveyed Acceptance and
Nonacceptance
• Verbal and nonverbal communication
demonstrates acceptance or nonacceptance of
others
• What are examples of verbal and nonverbal
communication by a nurse that could
demonstrate acceptance and nonacceptance
toward a patient who has not followed a
prescribed treatment plan?
Interrelated Concepts
• Collaborative Learning
• In your learning group, discuss the concepts
interrelated to diversity. What is the link to the
concept? What additional concepts can you
think of that link to diversity?
Interrelated Concept
Communication
Family Dynamics
Coping
Link to Diversity
REFERENCES
• Carpentino, L.J. Nursing Diagnosis: Application to Clinical
Practice. 12th Ed. Lippincott.
• Spector, M. Cultural Diversity in Health and Illness. New York:
Appleton, Century, & Crofts, 1979
• Ignatavicius, D.D., Workman, M.L. Medical Surgical Nursing:
Patient-Centered Collaborative Care. 7th Ed. St. Louis: Mosby
Elsevier, 2013.
• Giddens, J.F. Concepts for Nursing Practice. 1st Ed. St. Louis:
Mosby Elsevier, 2013.