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Countless assessments can be conducted on patients, but they may not be useful. In order to ensure that health assessments result in the necessary care, health assessments should take into account the impact of factors such as cultures and developmental circumstances.

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Analyze diversity considerations in health assessments

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Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment  

To prepare:

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Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

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Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.

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Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

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Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

CASE STUDY

Mono Nu, a 44 year-old Filipino patient comes to the clinic today to have his “blood thinner” labs drawn since he started them two weeks ago. Upon assessing the labs the nurse practitioner notes that he is still out of range. When assessing the patients compliance both stated that he had been taking them just as prescribed. He has been doing well and eating a diet rich in fish and tofu. He doesn’t understand why his medications are not working.

Post an example of the specific  socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you are assigned. explain the issues that you would need to be sensitive to when interacting with the patient and why, Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

22

CHAPTER

2 Cultural Competency

Achieving cultural competence is a learning process that
requires self-awareness, reflective practice, and knowl-

edge of core cultural issues. It involves recognizing one’s
own culture, values, and biases and using effective patient-
centered communication skills. A culturally competent
healthcare provider adapts to the unique needs of patients
of backgrounds and cultures that differ from his or her
own. This adaptability, coupled with a genuine curiosity
about a patient’s beliefs and values, lay the foundation for
a trusting patient-provider relationship.

A Definition of Culture
Culture, in its broadest sense, reflects the whole of human
behavior, including ideas and attitudes, ways of relating to
one another, manners of speaking, and the material products
of physical effort, ingenuity, and imagination. Language is
a part of culture. So, too, are the abstract systems of belief,
etiquette, law, morals, entertainment, and education. Within
the cultural whole, different populations may exist in groups
and subgroups. Each group is identified by a particular
body of shared traits (e.g., a particular art, ethos, or belief;
or a particular behavioral pattern) and is rather dynamic
in its evolving accommodations with internal and external
influences. Any individual may belong to more than one
group or subgroup, such as ethnic origin, religion, gender,
sexual orientation, occupation, and profession.

Distinguishing Physical Characteristics
The use of physical characteristics (e.g., gender or skin
color) to distinguish a cultural group or subgroup is inap-
propriate. There is a significant difference between distin-
guishing cultural characteristics and distinguishing physical
characteristics. Do not confuse the physical with the cultural
or allow the physical to symbolize the cultural. To assume
homogeneity in the beliefs, attitudes, and behaviors of all
individuals in a particular group leads to misunderstandings
about the individual. The stereotype, a fixed image of any
group that denies the potential of originality or individuality
within the group, must be rejected. People can and do
respond differently to the same stimuli. Stereotyping occurs
through two cognitive phases. In the first phase, a stereotype
becomes activated when an individual is categorized into

a social group. When this occurs, the beliefs and feelings
(prejudices) come to mind about what members of that
particular group are like. Over time, this first phase occurs
without effort or awareness. In the second phase, people
use these activated beliefs and feelings when they interact
with the individual, even when they explicitly deny these
stereotypes. Multiple studies have shown that healthcare
providers activate these implicit stereotypes, or unconscious
biases, when communicating with and providing care to
minori