NR 222-Health and Wellness-Exam 2 Questions and Answers

culture - ANSWER an element of ethnicity, refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups values - ANSWER beliefs about the worth of something and serve as standards that influence behavior and thinking. value orientation - ANSWER learned and shared through the socialization process, reflect the personality type of a particular society folk healing systems - ANSWER embodies the beliefs, values, and treatment approaches of a particular cultural group that are products of cultural development. Folk health practices are seen in a variety of settings, including community groups, kinship groups, private homes, and healers' shrines professional care systems - ANSWER characterized by specialized education and knowledge, responsibility for care, and expectation of remuneration of services rendered emerging population: arabs - ANSWER *Health Issues* Diabetes Coronary Artery Disease Adolescent Smoking *Culture Considerations* Role of Religion - what accommodations do we need to make Male Dominance Female Chastity - many women will request female doctor/nurse. Ex. Indian woman delivering (cover up head to toe) Present Orientation *Barriers* Religious belief and practices Cultural norms/modesty Gender issues regarding providers Communication difficulty Folk remedies Lack of culturally competent providers emerging population: asians - ANSWER *Health Issues* Heart disease, cancer, Highest level of Tuberculosis (airborne) *Cultural considerations* Dependence on family network esp. when sick, they really rely on each other. This is something we can work with. So, we want to involve the family and teach the family that sometimes we want the pt to be independent and move around for circulation. PCA pumps must be delivered by patient only. *Barriers to care* Poverty Stress in intergenerational relationships Cultural norms that prevent health care seeking Loss of social networks Poor access to services Hesitant to use early diagnosis /screening emerging population: Latino/Hispanics - ANSWER *Health Issues* Stomach cancer - due to diet Diabetes mellitus Cardiovascular disease HIV *Cultural Considerations* Very family oriented ...any decisions must be made by family members Family individual needs Spiritual strength important Hot & cold concept of disease Disease related to supernatural or psychological causes Folk remedies used along with Western medicine *Barriers* Highest number of uninsured Use/receive less preventative health care Lack of interpreter services in health care Lack culturally appropriate health care services Reliance on folk systems of healing emerging population: black - ANSWER *Health Issues* High blood pressure (key health issue) and stroke; key place to go is a church to do blood pressure screening. Higher cancer deaths HIV Obesity Mental health Sickle Cell disease *Cultural Considerations* Family Central Religion Central Family involved in care Churches important in health care delivery Traditional healing *Barriers* Poverty Lack of trust in health care providers Lack of health insurance Inadequate or unsafe environments Limited access to health services emerging population: Native American - ANSWER *Health Issues* Smoking, substance abuse; Unintentional injuries, Alcoholism and Cirrhosis; Homicide/Suicide, Pneumonia Diabetes High Blood Pressure and Stroke HIV Poverty *Cultural Considerations* Present-oriented Cooperation competition Share resources Value families Health =person in harmony with nature Traditional health practices important (shaman) *Barriers* Difficult access to care Mistrust of providers Underserved population Poverty emerging population: homeless - ANSWER *Health Issues* Basic survival Respiratory Disease Infectious Diseases Dental and Vision problems Mental health concerns Drug and alcohol abuse *Characteristics* Instability of place Instability or absence of connections to family Instability or absence of housing Increase in homeless families, adolescents, and veterans *Barriers* Access Affordability Lack of transportation Poverty emerging population: HIV/AIDS - ANSWER *Health Issues* 1 million persons infected in US Affects all ethnic groups, sexual orientation Adults over 50 years old fastest growing cohort African American most severely affected *Cultural Considerations* Fatalistic Outlook Family Prevention *Barriers* Communication gap Socioeconomic factors --poverty Personal values of caregivers-- attitudes, behaviors Political influences Healthy People 2020 - ANSWER *Overarching Goals* Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups. Ideally, providing the highest level of health for all people Values Clarification - ANSWER A method for discovering one's values and the importance of those values communication process - ANSWER the forum for all thought and relationships shared among people the foundation for any professional relationship Nurse-patient communication plays a vital role in the formation and development of the nurse-patient relationship therapeutic relationship - ANSWER follow sequential phases, which may overlap, vary in length, or involve issues that appear over time rather than in a set sequence. Orientation (introductory), working, and termination phases have been identified by researchers and clinicians Orientation (introductory) phase - ANSWER begins when the nurse and individual meet. This meeting typically involves some feeling of anxiety; neither party knows what to expect. working phase - ANSWER emerges when the nurse and the individual collaborate as partners in promoting the person's health. may last for an established number of sessions, as in brief psychotherapy, or it may extend over a longer period if the nurse is the primary care provider or long-term caregiver in any setting or context for an individual or family termination phase - ANSWER marks the end of the relationship established in the therapeutic contract or negotiated in accordance with the limits of the contract. Ending a relationship can cause anxiety for both the individual and the nurse. Forms of Communication - ANSWER *verbal* Vocabulary Word meaning Pacing Intonation Clarity and brevity Timing and relevance *nonverbal* Posture and gait Facial expressions Eye contact Gestures Sounds Territoriality and personal space Personal appearance Communication Techniques - ANSWER *Open-ended questions* questions that required more of an explanation *Closed-ended questions* yes or no questions Therapeutic Communication - ANSWER *factors* Rapport Empathy Trust Proxemics *techniques* Active listening Sharing Touch Silence Clarifying Reflecting Focus Paraphrase Summarize Humor Proxemics: Personal Space - ANSWER *Intimate distance* 0.0 - 1.5 feet *Personal distance* 1.5 - 4.0 feet *Social distance* 4.0 - 12.0 feet *Public distance* 12.0 - 25.0 feet Barriers to Effective Communication - ANSWER can originate with the nurse, the individual, or both. The most obvious barrier is the nurse's failure to use the types of therapeutic techniques just described. Lack of knowledge or experience can limit the nurse's ability to assess the individual's needs and repertoire of skills. Anxiety, attitudes, noise, activity, distance, language, beliefs, touch, eye contact, appearance, emotion, body language, gestures, interruptions, distractions, illness, medications Techniques - ANSWER *Therapeutic* silence accepting giving recognition offering self making observations restating reflecting giving information seeking clarification summarizing *Non-Therapeutic* giving premature advice minimizing feeling falsely reassuring making vague judgements asking "why" questions asking excessive questions