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Stack #153693
Culture & Communication
| Question | Answer |
|---|---|
| Culture | A sacred system of beliefs, values and behavioral expectations that provide social structure for daily living |
| People's views of self, expectations and behaviors are influenced by | Culture |
| Culture is transmitted primarily by | Language |
| Culture is learned | through formal and informal experiences |
| What is transcultural Nursing? | Nursing care that is planned and implemented in a way that is sensitive to the needs of individuals, families and groups representing the diverse cultural populations within our society |
| What are Cultural Concepts? | Ethnicity and Race |
| Ethnicity | A sense of identification that a cultural group collectively has |
| Race | A way of categorizing people into subgroups according to specific PHYSICAL characteristics |
| Cultural Concepts | Cultural Assimilation; Culture Shock; Stereotyping; Ethnocentrism; Cultural Imposition |
| Cultural Assimilation | members of a minority group live within a dominant group, and lose the characteristics that made them different. (It takes 3 generations to assimilate); Children assimilate much easier to another culture and the elderly are the hardest to assimilate |
| Culture Shock | Acute experience of not comprehending the culture in which one is situated |
| Cultural Conflict | Feeling threathened and uncomfortable by something you do not understand and so you ridicule and put down that group |
| Stereotyping | assuming all members of a culture, subculture or ethnic group act alike |
| Ethnocentrism | Judge other people based on the standards and practices of your own culture |
| Cultural Imposition | Belief that everyone should conform to the majority belief system |
| Cultural Influences Affecting Healthcare | Physiologic & Psychological characteristics, Reactions to pain, Mental health norms, Gender roles, Health beliefs & practices, Language & Communication, Orientation to space & time, Food & nutrition, Family structure & roles, Socioeconomic Factors |
| Cultural Beliefs | Attitudes based on faith as opposed to fact |
| Cultural Competence | A process in which the nurse strives continuously to achieve the ability and availablity to effectively work within cultural context of the individual, family, or community; View the patient as an unique individual with own ethnic and cultural background |
| Cultural Competence | Develop cultural self-awareness; Devlop Cultural knowledge, Accomodate cultural practices in healthcare |
| Develop cultural self-awareness | Understand your own culture and biases; Become sensitive to culture of others; Appreciate differences |
| Develop Cultural Knowledge | Values & Health Practices |
| Accommodate Cultural Practices in Healthcare | Cultural assessment, Communication, Respect culturally based family roles, Modify care, Avoid mandating change, Patient advocate |
| Spirituality | Anything that pertains to a person's relationship with a nonmaterial life force or higher power |
| Spiritual needs | Need for meaning and purpose; need for love and relatedness; need for forgiveness |
| Spirituality in Life Cycle: Children | ages 4-12 - may perceive God as frighteningly powerful, works through human interconnectedness, causes positive transformations |
| Spirituality in Life Cycle: Adolescents | may question values/practices in forming identity |
| Spirituality in Life Cycle: Young Adults or Later | individualize spirituality in line with own commitments, beliefs and attitudes |
| Spirituality in Life Cycle: Adulthood | expands concept of spirituality to include other faiths, focus on love... |
| Factors Affecting Spirituality | Developmental considerations, family, ethnic background, formal religion, life events |
| Spiritual Development | has different characteristics depending upon the stage of development that an individual has achieved. |
| Infants and Toddlers (Spiritual Development) | Infants and Toddlers have no sense of right or wrong, spiritual beliefs, or convictions to guide activities; Toddlers may follow rituals in imitation of their parents and attend church or nursery school |
| Preschoolers (Spiritual Development) | Parental attitidues toward moral codes and religion convey to children what is good and bad; May copy what they see instead of what they are told; Often ask questions about morality and religion (e.g. what is heaven?) |
| Preschoolers also (Spiritual Development) | Follow religion not because they understand it, but because it is part of daily life; Five year olds may make up prayers themselves; Believe that God or humans are responsible for natural events as rain adn wind |
| School-age children and Adolescents -1. (Spiritual Development) | Young school-aged children expect that their prayers will be answered, good rewarded and bad punished; During pre-puberty, there is awareness of spiritual disappointments |
| School-age children and Adolescents -2.(Spiritual Development) | Some may drop or modify certain religious practices; Adolescents compare standards of their parents with others, and select the ones they wish to incorporate in their lives; By age 16 many adolescents have decided whether to accept the family religion; |
| School-age children and Adolescents -3.(Spiritual Development) | When parents have different faiths, adolescents may choose either or neither; for some adolesents, a firm faith provides strength in these turbulent years |
| Adults | Young adults who need to answer the religious questions of children may find that early teachings of childhood are more acceptable; during the middle eyars, adults often find that they have more time for religious activities. |
| Spritual Distress | Refers to a disturbance in or a challenge to a person's belief or value system that provides strength, hope and meaning to life. |
| Spiritual Distress Problems | Spiritual pain, alienation, anxiety, guilt, anger, loss, despair |
| Cause of spiritual distress | the inability to resolve life situation with spiritual beliefs. |
| Nursing Interventions to Promote Spiritual Health | Offer supportive presence; facilitate patient's practice of religion; pray with patient; nurture patient spirituality; promote love and relatedness, encourage patient verbalization, encourage visits of acceptable family and friends; promote forgiveness, |
| Determining whether spiritual needs have been met | Verbalizes satisfaction with relationship with God (if relevant); Moves toward a healthy acceptance of the current situation; Develops mutually satisfying relationships; Reconciles interpersonal differences causing patient anguish |
| Religious Beliefs Affecting patient Care | medications, dietary practices, prayers, Holy days, rituals, interventions or treatments, birth practices, death practices |
| What is Communication? | A means of exchanging information or feelings between two or more people |
| Forms of Communication | Verbal and Nonverbal |
| Verbal Communication | Exchange of information using words |
| Nonverbal Communication | Touch, Gestures, Posture, Eye Contact, Personal appearance, Facial expression, Sounds, Silence |
| Factors Influencing Communication | Developmental level, gender, sociocultural differences, role responsibilities, space and territoriality, physical, mental, and emotional state, values, environment |
| Therapeutic Relationship | Helping relationship established for the benefit of the client; social vs therapuetic relationship (professional) |
| Therapeutic Relationship is | Purposeful & goal directed; Client centered; Time-limited |
| Phases of Helping Relationship | Orientation, Working phase, Termination phase |
| Orientation | Sets the tone, introduce self, clarifies roles, establish agreement or contract, orient to facility, establish trust, discuss confidentiality, establish, locatin, and length of meeting |
| Working Phase | Provides care to meet needs/goals; thoughts, understanding, and feelings are explored; promotes problem-solving and coping skills; client teaching; longest phase |
| Termination Phase | examine progress and attainment of goals; prepare client for next phase of care; support emotional response |
| Promoting Effective Communication | Effective communication requires interpersonal skills |
| Interpersonal skills for effective communication are: | Rapport, warmth and friendliness, trust & honesty, genuineness, respect, empathy, caring |
| Communication Skills | Rapport and Trust |
| Rapport | Warmth and friendliness; convey acceptance and interest |
| Trust | Basis of therapeutic relationship; confidence in nurse's ability; responsible and competent |
| Genuineness | Open and honest; congruent communication with verbal matching nonverbal behavior; self disclosure - reveal own feelings, life events for the client's benefit; how should you respond to personal questions? |
| Respect | Belief in the dignity and worth of a person; non-judgmental of client's lifestyle, values, and behaviors; positive regard, how do we show respect? |
| Empathy | Ability to see things from client's perspective; communicate understanding of their feelings |
| Sympathy | Nurse shares what the client is feeling; can decrease objectivity |
| Caring | Demonstrate behavior that is nurturing; provides a means of comfort & promote self-actualization; don't be "task oriented", be client focused! |
| Humor | Decreases stress; Increases positive feelings |
| Criteria for Humor: | Timing, receptivity, content |
| Assertiveness Skills | Express thoughts in direct, positive manner; shows respect for self and others; Aggressive: abuses rights of others; non-assertive: does not stand up for own rights |
| Self-Awareness | Conscious of your own values and feelings and how these affect interactions with others; Thoughts influence behavior; sensitive to and accepting of client's values |
| Communication Skills | Listening is the most important communication skill! |
| Active Listening (attending skills) | Giving the client your complete attention: Sit facing the client; open posture; lean forward; establish appropriate eye contact; relax |
| Interview Techniques | Purpose of the interview; what is an appropariate setting and seating arrangement? what should be included in the introduction? |
| Communication Skills | Therapeutic techniques and Non-therapeutic communication |
| Therapeutic techniques | verbal & non-verbal responses that facilitate nurse-client interactions; help client to express feelings, gain insight & clarify their thinking |
| Non-therapeutic communication | Hinder or block effective communication |
| Questioning | Purpose: Gather specific information; Assist clients in identifying & exploring ideas & feelings; Over use limits client ineraction & disrupt flow of ideas |
| Types of Questioning | Open, Closed, Indirect |
| Open ended questions | Require more than a one word or yes/no response; begin with what, how, could; indirect statements |
| Closed questions | answered in yes-no or one word response; useful when immediate and specific information is needed; non-therapeutic when you want the patient to elaborate; begin with Do, Is, Are |
| Communications Techniques | Paraphrasing, reflecting, offering general leads/minimal encouragers, summarizing, seeking clarification, restating, exploring/focusing, making observations, giving information, presenting reality, Silence |
| Paraphrasing | Restating in the content of the message to clarify your interpretation |
| Reflecting | Encourages client to elaborate on their feelings; nurse describes feelings or emotions that are implied. ex. You feel scared about being pregnant at your age |
| Offering general leads/minimal encouragers | Encourages client to continue; allows client to determine direction of the interaction; Go on... and then?; Non-verbal: Nod Head |
| Seeking Clarification | Further describe or explain what has been said. e.g. do I understand correctly that you siad...? |
| Restating | Repeat portion of what was said e.g. Pt: my doctor wants me to go home N: go home? |
| Exploring Focusing | examine topics in more details |
| Making Observations | verbalizing what you observe; encourages client to take note of behavior |
| Giving Information | Facts the client needs to know |
| Presenting Reality | Orient client to the environment e.g. Today is October 4th; I see no one else in the room |
| Silence | Causes: Time to think, embarrassment, resistance, exhausted topic; Helpful: Waiting for client to speak; Unhelpful: Respond too quickly or change the subject |
| Non-therapeutic Techniques | Advising, Giving False reassurance, Probing, defending or judgmental, asking why, requesting an explanation; changing the topic |
| Advising | Telling the client what the nurse thinks should be done; fosters dependency; giving advice is different than giving information |
| Giving false reassurance | indicates that the client's feelings are not important. e.g. Don't worry |
| Probing | questioning not related to problem |
| Defending or Judgmental | Objections to client's remarks, feelings or opinions; imposing nurese's view on client; explore the client's perspective; complaints may be related to anxiety |
| Asking Why; Requesting an explanation | Client may become defensive or feel threatened; can imply criticism |
| Process Recording | Verbatim account of the verbal & non-verbal communication between nurse & client |
| Purpose of Process Recording | It is a learning tool |
| Five Components of Process Recording | Nurse verbal, nurse non-verbal, patient verbal, patient non-verbal, communication technique used |
| IPR Rules | Do not take notes, do not tape conversation, maintain confidentiality |
| Communication with the elderly | Presbycusis, presbyopia, dementia, |
| Presbycusis | Speak clearly in a low to normal tone, avoid shouting, face the person, use gestures |
| Presbyopia | Loss of peripheral & night vision: Front approach, exaggerate gestures, indirect lighting, speak before touching, large print items |
| Dementia Communication Techniques | Identify self, don't quiz; calm, low-pitch voice' decrease stimulation; short, simple sentences; one step commands; closed questions |
| Reminiscence Therapy (Patients with Dementia) | Review of life events; increases self-esteem & socialization; decreases depression; stimulates memory & recollection |
Created by:
howardccnurs
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