Mental Health Mental Health Nursing II Nursing II NURS 2310 NURS 2310 Unit 4 Unit 4 Cultural Cultural Considerations for Considerations for the the Psychiatric/Mental Psychiatric/Mental Health Client
Dec 26, 2015
Mental Health Mental Health Nursing IINursing II
NURS 2310NURS 2310
Unit 4Unit 4
Cultural Considerations Cultural Considerations for the for the
Psychiatric/Mental Psychiatric/Mental Health ClientHealth Client
Objective 1Objective 1
Reviewing the concepts of culture and ethnicity
Culture = shared patterns of belief, feeling, and knowledge that guide conduct and are passed down from generation to generation
Ethnicity = identification with others due to a shared heritage
Race = a class or kind of people unified by shared interests, habits, or characteristics
Prejudice = injury or damage resulting from some judgment or action of another in disregard of one’s rights
Stereotyping = assuming that all individuals who share a culture or ethnic group are identical
Objective 2Objective 2
Analyzing various cultures to determine the impact of
perceptions, practices, and behaviors on mental health
and illness
Northern European AmericansNorthern European Americans
Originating from England, Ireland, Sweden, Norway, Germany, etc
Personal space: 18 inches to 3 feet Less emphasis placed on family and
religion Punctuality and efficiency highly valued Preventive medicine and primary health
care frequently utilized Financially capable of maintaining a
healthy lifestyle
African AmericansAfrican Americans Personal space tends to be smaller than
the dominant culture Large social support systems, primarily
headed by women Little planning for the future due to
encounters with racism and discrimination
Folk medicine used due to unavailability of mainstream medical treatment
High incidence of alcoholism
Native AmericansNative Americans Most involved with the tribe to some extent Consider handshake aggressive May appear silent and reserved as culture
encourages keeping private thoughts to self Need for extended space Wisdom and tradition greatly honored Concept of time is very casual, and tasks
are accomplished within a “present-minded” time frame
Religion and health practices intertwined Alcoholism, depression, & suicide prevalent
Asian/Pacific Islander Asian/Pacific Islander AmericansAmericans
Originating from Japan, China, India, Phillipines, Pacific Islands, etc
Raising one’s voice is interpreted as a sign of loss of control, as is mental illness
Different meaning assigned to nonverbal cues
Touching during communication traditionally considered unacceptable
Eye contact considered rude and disrespectful
Appear shy, cold, or uninterested
Latino AmericansLatino Americans Originating from Mexico, Spain, Puerto Rico Touch is a common form of communication Outwardly agreeable to avoid confrontation Family is the primary social organization,
with large groups of relatives Present-oriented; punctuality not
emphasized Less mental illness than in the general
population, possibly due to strong familial support in times of stress
Western European AmericansWestern European Americans
Originating from France, Italy, and Greece
Warm, affectionate, and physically expressive
Family-oriented; interact in large groups Strong allegiance to cultural heritage Elderly respected and cared for at home Present-oriented; fatalistic view of the
future (God’s will)
Arab AmericansArab Americans Originating from Egypt, Iraq, Jordan,
Morocco, Saudi Arabia, etc Unspoken expectations more important
than spoken words, so communication can pose a problem in health care settings
Speech is loud and expressive; may appear argumentative, confrontational, aggressive
Illness often considered punishment for sins
Mental illness is a major social stigma; somatic complaints most likely
Jewish AmericansJewish Americans Orientation simultaneously to past,
present, and future Respectful toward parents Children loved and cherished; expected to
be grateful to parents forever for gift of life Preventive health care practiced, as well as
maintenance of a healthy mind and body Physicians held in high regard Higher incidence of side effects from the
medication clozapine due to specific gene
Objective 3Objective 3
Differentiating behaviors that are accepted cultural mores
from those that are representative of mental illness
What is considered normal in one culture may be deemed abnormal in another
One may be considered to have boundary issues for standing too close during a conversation, or fear of intimacy for excessive distance
Rituals and practices used by certain cultures may be considered detrimental in the mainstream– “self-harming” behaviors (tattooing, facial
designing)– child “abuse” (coining)
Objective 4Objective 4
Discussing theories related to the provision of culturally competent care
Transcultural Nursing TheoryTranscultural Nursing Theory
Madeleine Leininger founded the world-wide transcultural nursing movement.
The basic tenet of the Transcultural Nursing Theory is as follows:
In order to be culturally competent, the nurseneeds to understand his/her own world viewsand those of the patient, while avoidingstereotyping and misapplication of scientificknowledge.
Provision of Culturally Competent Care
Use of an interpreter Awareness of nonverbal communication Acknowledgement of family support
systems Meeting of spiritual needs, to include
rituals Understanding of altered time concepts Cognizance of different beliefs regarding
health care among various cultures Establishment of trust and rapport
Objective 5Objective 5
Identifying strategies for the nurse in dealing with differing client values
Knowledge formation– Learn about client’s value system– Subjective interpretation of beliefs
Empathy– Imagine yourself in another’s position
Acceptance– Embrace admirable qualities
Objectivity– Focus on client’s needs
Professional distance– Neutral territory
Objective 6Objective 6
Exploring personal values of the nurse that impact nursing
care
Any beliefs the nurse holds that are in conflict with those of the client may interfere with the provision of appropriate and objectively sound nursing care
It is best for the nurse to be aware of potential conflicts to avoid barriers to providing optimal patient care
Objective 7Objective 7
Examining the importance of spirituality in psychiatric/mental health nursing
Spirituality = finding meaning and purpose in life
Faith = acceptance of a belief in the absence of physical or empirical evidence
Hope = positive expectationLove = the projection of one’s own good
feelings onto othersForgiveness = the ability to release from
the mind all the past hurts and failures, all sense of guilt and loss
Religion = a set of beliefs, values, rites, and rituals adopted by a group of people
Objective 8Objective 8
Identifying clients with whom the nurse would avoid the
discussion of religion
The discussion of religion should be avoided specifically with clients who have a religious preoccupation (i.e. paranoid schizophrenic with grandiose religiosity)
Religion, politics, and other controversial issues (i.e. stem cell research, abortion) are typically topics that can be inflammatory and therefore would be best to be avoided as a general rule-of-thumb