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Winter 2010 Chapter 3
Winter 2010
Chapter 3
Winter 2010
Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health AssessmentObjectivesAt the end of this
presentation, you will be able to…
Examine sources that influence culture and beliefs
Discuss components of the health belief system and their influence on health practices and illness expressions
Understand the influence of religion and spirituality on health and illness
Recognize the basic characteristics of culture
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
How do my social, cultural, and professional backgrounds shape my ability to relate to, and my assumptions about, the various people I encounter in my practice?
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
What is culture? Culture is defined as “learned, shared, and symbolically transmitted design for living”
Provides meaning and values to patients lives
Way of living QUESTION?◦ Does culture always include religion?
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Basic components of a culture
Four characteristics of culture is that it is
◦ 1. learned◦ 2. shared◦ 3. adapted◦ 4. dynamic
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
No single definition of culture exists. Culture is defined in generalities as “values, beliefs, customs & practices”
Culture is a universal phenomenon Culturalism: a process of conceptualizing, in fairly narrow terms, that people act in a particular way because of their culture.
Defining culture from a critical cultural perspective helps counter culturalism.
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Ethnicity: Inferring geographic and national affiliation.
Ethnic Group: Shared heritage, culture, language.
Race: A socially constructed category used to classify humans according to common ancestry (Henry et al, 2005).
UNESCO: dismisses race as a biological category.
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Terms race and ethnicity are often used interchangeably and incorrectly.
Racialization: process whereby racial cagtegories are constructed social, economic & political impacts
Discrimination: process by which a member or members of a social or ethnocultural group are treated differently
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Cultural sensitivity: HCP need to be sensitive to people’s values, beliefs, customs and practices AND
Cultural competence: emphasizes a more active HCP role in understanding broader social determinants, power relationships, and inequities in the system.
Ask yourself: What is my personal ethnocultural and social background?
Cultural safety: takes into account social, economic, political and historical perspectives of groups w/i society
Ask yourself: What biases, assumptions, or stereotypes am I drawing on?
How does where I work contribute to these assumptions?
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Terms often confused with cultural assessment Religion
◦ Organized system of beliefs, concerning the cause, nature and purpose of the universe
◦ Belief in the or the worship of God or gods
Spirituality
◦ Shaped by life experiences and refers to finding one’s purpose and meaning in life
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
What is a cultural assessment?
Systematic appraisal of an individuals belief system, values and practices for the purpose of providing culturally competent health care
Includes :◦ Assessing culturally based understandings and practices
◦ Paying attention to social and economic environments in which the patient and family lives.
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
What does a cultural assessment entail? Cont’d…
Before a cultural assessment is provided, you must understand your own beliefs, values and behaviors
Be aware of your own biases, prejudices, and preconceptions towards other religions, cultures, sexual, or socioeconomic groups
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Work to build trust Engage through listening Convey respect for others
Pay attention to the social and economic contexts of patient's and families lives.
Be knowledgeable about the social and economic policies in Canada that influence provision of health provincially and nationally.
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Critical Thinking and ApplicationCase Study
Mr. B is a 62 year old man who is recently admitted to the surgical ward with a diagnosis of “pancreatitis”. Nurse Sally is caring for Mr. B and has decided to provide some health teaching regarding Mr. B’s diet. She is aware he is from India and consumes high fat, high calorie foods so she also decides to provide some diabetic teaching to ensure he is aware of why he developed this condition. She will also discuss the importance of drinking moderately at family gatherings.◦ Is Sally providing culturally competent care? Why?◦ List some of the barriers Sally is exemplifying◦ How would you correct your initial approach?◦ How would you carry out a cultural assessment on Mr. B?
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
33 million people Majority are Canadian-born Population increase attributed to international migration.
70% of immigrants do not speak English or French as primary language.
Live primarily in urban areas. Canada’s population as a whole is aging.
Median age is 39.5 years
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Ethnocultural diversity is part of Canada’s national profile.
Majority of Canadians associate themselves with English or French ancestry.
Aboriginal Peoples of Canada: 3.8% of pop.◦ First Nations◦ Métis◦ Inuit
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Policies affecting Aboriginals
Inequities in Health Status
Indian Act
Residential Schools
Reserves
Geography
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Health of non-European immigrants deteriorates more quickly.
Waiting periods to qualify for provincial health coverage.
Low-paying jobs
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Health inequality Health inequity Poverty Lone-mother families
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
From Special 2006 Run of Statistics Canada Data Using the Statistics Canada CANSIM Tables Generation System, 2006 (Table 202-0802). Toronto, ON: D. Raphael. As reproduced in Raphael, D. (2007). Poverty and policy in Canada: Implications for health and quality of life (p. 61). Toronto, ON: Canadian Scholars’ Press. Reprinted with permission.
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Chapter 3: Cultural and Social Considerations in Health AssessmentChapter 3: Cultural and Social Considerations in Health Assessment
Complementary Alternative Natural health products
Spirituality in Health
