CULTURAL/SPIRITUAL CULTURAL/SPIRITUAL PRESENTATIONPRESENTATION

Sheryl Super RNSheryl Super RNMetropolitan State University of DenverMetropolitan State University of Denver

RN to BSN Role Transition, Nursing 3800RN to BSN Role Transition, Nursing 3800Fall 2012Fall 2012

INTRODUCTIONINTRODUCTION

• Appalachians

• 27 million people

• Overlooked as an American ethnic minority

• Not awarded the status of a federally defined ethnic/minority group

• Poverty rate is 15.3%

CULTURAL CHARACTORISTICSCULTURAL CHARACTORISTICS

• Independence

• Ethic of Neutrality

• Familism

• Personalism

INDEPENDENCEINDEPENDENCE

• Personal space• Solitude• Live in the moment, are not concerned

with exact times• Unhurried adaptive patterns• Focus on being, rather than doing

ETHIC OF NEUTRALITYETHIC OF NEUTRALITY

• Avoid assertiveness and aggression

• Mind their own business

• Avoid domineering behavior

• Seek agreement and avoid arguments

FAMILISMFAMILISM

• A sense of family, nuclear and extended• A love of the land• Rarely move more than 30 miles from family• Patriarchal, but mothers and grandmothers

make health care decisions• Children have a sense of belonging• Elders are respected and pass on cultural values

PERSONALISMPERSONALISM

• Person focused

• Trust with outsiders must be established

• Interpersonal relationships are more important than individual accomplishments

ETHNIC BACKGROUNDETHNIC BACKGROUND

• Settlers from northern Europe

• 1% Native American

• 8% African American

• Recent increase in African American and Hispanic population

NURSING INTERVENTIONNURSING INTERVENTION• Take time to “sit and talk a spell”, establish trust

• Direct eye contact is rude or aggressive

• Allow personal space

• Solicit advice from family members, and incorporate into plan of care

• Use a direct approach, offering the facts

NURSING INTERVENTIONNURSING INTERVENTION

• Family education

• Promote collaboration

• Avoid confrontation

• Make use of healthcare and church partnerships

BARRIERS TO CAREBARRIERS TO CARE

• Lack of heath care resources

• Lack of education

• Lack of telephones/reception

• Lack of transportation

HIGH RISK BEHAVIORSHIGH RISK BEHAVIORS

• High fat, high carbohydrate diets

• High rate of tobacco use

• Lack of regular exercise

• Low rate of seat belt use

• Poor oral health

COMMON HEALTH PROBLEMSCOMMON HEALTH PROBLEMS

• Black lung disease• Brown lung disease• Hearing loss• Traumatic injuries• Coronary artery disease• Heart disease and • Cancer• High infant mortality rate

HEALTH BELIEFSHEALTH BELIEFS

• High Blood and Low Blood indicate blood viscosity and blood volume

• Nerves indicate distress, anxiety, sleeping disorders

• Running off indicates diarrhea

• Sweet Blood and Sugar Blood indicate diabetes

HEALTH PRACTICESHEALTH PRACTICES

• Folk healers and Granny healers

• Herbal medicine

• Personal responsibility for health (diabetes is caused by eating sweets)

• Many do not believe in illness prevention

• Manage illness well, adaptive acceptance

NURSING INTERVENTIONNURSING INTERVENTION

• Encourage healing folk remedies

• Encourage taking personal responsibility for health

• Educate illness prevention and offer health screenings

NURSING INTERVENTIONNURSING INTERVENTION

• Patients become interdependent during illness

• Family surrounds the patient and provides care. Family stays in close proximity.

• Educate the family and enlist their help

SPIRITUALITYSPIRITUALITY

• Local nondenominational churches

• Believe in the authority of the Bible

• Prayer requests concerning health

• Anointing for health

• Church/healthcare partnerships

QUALITY AND SAFETY QUALITY AND SAFETY EDUCATIONEDUCATION

• Establish trust with the patient and family• Listen to the patient and family and identify

their concerns• Educate the patient and family, speaking

in clear terms• Encourage them to be part of the

healthcare team and ask for feedback

PROFESSIONAL VALUESPROFESSIONAL VALUES• Be aware of my own personal values and

understand they are not better than others, just my own

• Be considerate and respectful of values that differ from my own

• Respect cultural values• Respect societal values• Practice culturally appropriate and

competent nursing care

REFERENCESREFERENCES

• Chitty, Kay Kittrell and Black, Beth Perry (2011). Professional nursing Concepts & challenges. Maryland Heights, Missouri: Saunders Elsevier.

• http://www.ffne.org/file_library/Integratring_QSEN_concepts_Sim_conf_HO.pdf