NUR 102, Module G: Culture and Spirituality in Healthcare

Reading Assignment: Potter & Perry, Chapters 9, and 29

Culture

A. Consists of socially transmitted knowledge of values, beliefs, norms, and

lifeways of a particular group that guides their thoughts and behaviors-
Leninger, and colleagues

B. Caring for the whole person looking at the person as a whole

C. Accepting beliefs and experiences understanding culture can help make us

more understanding and accepting.

D. Helping with issues surrounding meaning and hope sometimes quality and
meaning of life are different for people of different cultural backgrounds.

Visible and Invisible Components

A. Visible—easily seen

a. Clothing, jewelry, charms, hairstyles

B. Invisible—less observable

a. Value belief system that drives visible practices

Cultural Processes

A. Enculturation-

a. Socialization into one’s primary culture as a child.

B. Acculturation-

a. The process of adapting to and adopting a new culture.

C. Assimilation-

a. Results when an individual gives up his/her ethnic identity for a new

culture. Trying to fit in.

D. Biculturalism-

a. Also called multiculturalism. Individual identifies equally with two or

more cultures at same time.

Transcultural Care

A. Dr.M.Leininger
 a. theorist/researcher/doctrine in anthropology; pioneered transcultural
nursing

B. Transcultural nursing is a comparative study of cultures to understand

similarities and differences across human groups; the focus is on how
patterns of behavior in health, illness, and caring are influenced by
values/beliefs of specific cultural groups developed first undergraduate
courses in the subject.

Transcultural Nursing Care

A. The goal of transcultural nursing is to provide culturally congruent care-

a. Culturally congruent is care that fits the people’s valued life patterns
and set of meanings- which is generated from the people themselves,
rather than based on predetermined criteria taking ideas directly from
the patients themselves

Culturally congruent care

A. Requires:

a. Cultural Awareness being aware that there are other cultures out
there. Need to look inward as well; know how your own culture works.
Examine personal beliefs; “Do I have stereotypes or assumptions?”

b. Cultural Knowledge What do you need to know about other cultures?

Healthcare beliefs, practices, Nutritional beliefs, hygiene practices
etc…

c. Cultural Skills Knowing how to use knowledge to communicate and

interact with diverse groups. Example: eye contact in offensive in some
cultures.

d. Cultural Encounters Facilitate this by getting involved in functions that

facilitate meeting other cultural groups. Can provide you with
opportunities to learn about each other and communicate with one
another.

e. Cultural Desire The desire as a healthcare provider to learn about and

provide culturally considerate care. Allows you to be accepting.

Cultural and Life Transitions

A. Pregnancy

B. Childbirth May have different healers for these times.

C. Newborn care
 D. Postpartum

E. Grief and loss

Cultural Assessment

A. Definition and goal of- to generate from the client’s themselves significant
information and understanding that will enable the nurse to implement
culturally competent care.

B. Components:

a. Cultural identity/ethnohistory significant historical experiences of

ethnicities. Example: Jewish facing Nazis, Native Americans’ trail of
tears, etc…

b. Biocultural history different health risks associated with different

ethnicities. Example: Caucasian women >40 osteoporosis. African
American males heart attack.

c. Social organization The way the groups are organized. Matriarchal,

Patriarchal. Different ideals about elder members of society. Gender
roles.

d. Socioeconomic status sometimes people that are just beginning

enculturation have a lag time in income.

e. Language and communication differences in assertion and things

found offensive. Differences in approaches to conflict. Nonverbal
communication also falls under this.

f. Religion and spirituality these ideas may greatly affect healthcare.

g. Caring beliefs and practices

h. Experience with health care system

Medical Treatments Related to Cultural Beliefs

A. Acceptance of invasive treatments some cultures do not accept blood

transfusions or other invasive procedures.

B. Receiving blood

C. Nutritional choices

D. Usage of medications

E. Personal definition of health

 F. Use of religious symbols

Nursing Decision and Action Modes

A. Cultural care preservation or maintenance

B. Cultural care accommodation or negotiation

C. Cultural care repatterning or restructuring

Spirituality

A. What is meant by spirituality?

B. Spiritual health encompasses:

a. Caring for the whole person

b. Accepting beliefs and experiences

c. Helping with issues surrounding meaning and hope

***Spirituality- is unique to each individual and provides meaning to our lives

Traditional Concepts

A. Spirituality: Spiritual well-being is defined as a sense of harmony,

interconnectedness between self, other/nature, and an ultimate other that
exists throughout and beyond time and space

B. Faith: is described as a relationship with a divinity, higher power, authority, or

spirit that incorporates a reasoning faith (belief) and trusting faith (action).

C. Religion: is associated with a state of doing, or a specific system of practices

associated with a particular denomination, sect, or form of worship.

D. Hope: is a multidimensional concept that provides comfort while enduring life

threats and personal challenges.

Atheist and Agnostic

A. Atheist-individual who either does not believe in the existence of God

B. Agnostic-individual who believes there is no ultimate reality

Spiritual Distress

A. What is spiritual distress? Impaired ability to experience and integrate

meaning in their life through art, spirituality, or someone greater than
their self.
 B. Increased Time of Spiritual Need-

a. Acute Illness anger expressed, working to integrate this illness into life
and cope with it.

b. Chronic Illness may feel like they constantly have to deal with illness.

c. Terminal Illness helps to soothe and find peace in self. Helps to come
to terms with what is to come.

d. Near-Death experience

Spirituality and the Nursing Process

A. Assessment

a. Faith/beliefs

b. Life and self responsibility

c. Life satisfaction

d. Culture

e. Support systems

f. Rituals or practices

g. Client expectations

B. Diagnosis

a. Spriritual distress related to…

b. Ineffective coping related to…

c. Hopelessness related to…

C. Goals

a. The patient will achieve balance between life values, goals,belief

systems, and their relationship within themselves and others

b. The patient will utilize support system

D. Implementation

a. Caring behaviors

b. Careful attention to every request

 c. Mobilizing hope

i. Support Systems

ii. Assessing need for clergy; knowing how to contact hospital

chaplain

iii. Dietary needs (chart on page 561, Potter and Perry)

iv. Support groups

v. Integration of care with family

vi. Prayer and rituals

Evaluation

A. Review specific goals set for patients

B. Determine whether they were met?

a. Did care promote trust

b. Were spirituality needs met?

C. Were clients expectations met?

Future of Nursing and Spirituality

A. Parish Nursing-

a. focuses on the whole person to emphasize wellness, disease

prevention, and health promotion including healthy spirituality; many
roles the integrator of faith and health, educator, counselor, referral
advisor, advocate, developer of support groups and coordinator

Websites:

• Parish Nurses Organization

– www.parishnurses.org

• Transcultural Nurses Society

– www.tcns.org