TRANSCULTURAL NURSING (NUR 4001)By:Christopher EkpoINFLUENCE OF CULTURE ON PATIENT CARECulture .There is no single definition..The sum total of socially inherited characteristics of a human group that comprises everything which one generation can tell, convey or hand down to the next( Fejos in Spector, 2009).Culture .The sum of the beliefs, practices, habits, likes, dislikes, norms, customs, rituals and so forth that we learned from our families during the years of socialization( Spector, 2009).Culture An image of the culture of India: Courtesy, sscnet.ucla.eduhttp://www.sscnet.ucla.edu/southasia/Culture/culture.jpgCulture .The thoughts, communications, actions, customs, beliefs, values and institutions of racial, ethnic, religious or social groups(Office of minority health, 2001).Culture .A model of the manifestation of culture at different levels of depthhttp://www.tamu.edu/faculty/choudhury/culture/culture1.jpgCulture .A collective programming of the mind that distinguishes the members of one group or category of people from another..The sum of total of the learned behaviour of a group of people that are generally considered to be the tradition of that people and are transmitted from generation to generation.Culture Artistic display of Jamaican culture: Courtesy, jamaica-vacations.nethttp://www.jamaica-vacations.net/culture.jpgCulture .A culture is a way of life of a group of people--the behaviours, beliefs, values, and symbols that they accept, generally without thinking about them and that are passed along by communication and imitation from one generation to the next.Culture Sports especially athletics is part of Jamaican culture: Courtesy, jamaican.comhttp://www.jamaicans.com/bm~pix/jamaica-culture~s600x600.jpgCulture Dancehall music is part of Jamaican culture: Courtesy, parisdj.comhttp://www.djouls.com/souljazz/images/Various-Dancehall_The_Rise_Of_Jamaican_Culture_b.jpg.Patients beliefs and response to healthPatients beliefs and response to health.Professional health care must be developed to be culturally sensitive, culturally appropriate and culturally competent..This is necessary to meet the complex-culture bound health needs of a given person, family and community.Patients beliefs and response to health.Transcultural nursing provides nursing care across cultural boundaries..Takes into account the context in which the patient lives as well as the situations in which the patients health problems arise.Patients beliefs and response to healthCulturally competent care:.The nurse must understand and attend to the total context of the patients situation and this is a complex combination of knowledge, attitudes and skills.Patients beliefs and response to healthCulturally appropriate care:.The nurse must apply the underlying background knowledge that must be possessed to provide a patient with the best possible nursing/health care.Patients beliefs and response to healthBeliefs influence a patients response to health: Courtesy,allworldreligion.comhttp://allworldreligion.com/userfiles/2010/4/15/images/Religion%20at%20work%20%20A%20growing%20number%20of%20discrimination%20cases%20center%20on%20employees%20beliefs.jpgPatients beliefs and response to healthCulturally sensitive care:.The nurse must possess some basic knowledge of and constructive attitudes toward the health/health traditions observed among the diverse cultural groups found in the setting in which he or she is practicing.Patients beliefs and response to health.Our beliefs and expectations are very powerful..Our beliefs can either improve our health or damage it..Beliefs cause behaviour that affects physical health..Beliefs cause endocrine and immune changes.Patients beliefs and response to health.The placebo effect describes how a substance with no medical properties causes a patient to improve, just because they believe in its efficacy..Certain cultures have beliefs similar to the placebo effects..Level of education and response to healthLevel of education and response to health.There is a well known, large and persistent association between education and health .This has been observed in many countries and time periods and for a wide variety of health measures .The differences between the more and the less educated are significant(Cutler & Lleras-Muney, 2011).Level of education and response to health.The more educated report having lower morbidity from the most common acute and chronic diseases (heart condition, stroke, hypertension, emphysema, diabetes, asthma attacks, ulcer). Level of education and response to healthLevel of education influences response to health: Image courtesy,talentsearchsparc.orghttp://www.talentsearchsparc.org/images/happinesscake.gifLevel of education and response to health.More educated people are less likely to be hypertensive or to suffer from emphysema or diabetes. .Physical and mental functioning is also better for the better educated.Level of education and response to health.The better educated are substantially less likely to report that they are in poor health, and less likely to report anxiety or depression..Finally, better educated people report spending fewer days in bed or not at work because of disease, and usually have fewer functional limitations.Level of education and response to health.Those with more years of schooling are less likely to smoke, to drink heavily, to be overweight or obese, or to use illegal drugs. .Interestingly, the better educated report having tried illegal drugs more frequently, but they gave them up more readily..Economic status and response to healthEconomic status and response to health.A large body of evidence indicates that socioeconomic status (SES) is a strong predictor of health. .Better health is associated with having more income, more years of education, and a more prestigious job, as well as living in neighbourhoods where a higher percentage or residents have higher incomes and more education.Economic status and response to healthThere are multiple pathways by which SES may affect health, including: .Access and quality of health care, .Health-related behaviours, .Individual psychosocial processes, and.Physical and social environments.Economic status and response to healthMorbidity rate by socioeconomicstatus, courtesy, annualreviews.orghttp://www.annualreviews.org/na101/home/literatum/publisher/ar/journals/content/psych/2011/psych.2011.62.issue-1/annurev.psych.031809.130711/production/images/medium/ps620501.f1.gifEconomic status and response to healthSES gradients can be seen in pre-disease indicators such as;.Blood pressure,.Cortisol patterns, .Central adiposity, and .Carotid atherosclerosis. This may reflect the wear and tear on the body of exposure to stressors and lifestyle factors associated with lower SESEconomic status and response to health.Socioeconomically disadvantaged men and women have higher overall mortality rates than persons with higher socioeconomic status .Relationships between class and mortality are consistent for almost every cause of death, with only a few exceptions, notably certain cancers(Berkman & Epstein, 2008).Economic status and response to health.Poorer children may be more likely to suffer from chronic conditionssuch as asthma, epilepsy, or heart conditionsthat lead to poorer health status .In addition, their families may be less able to provide the investments necessary to maintain good health status in the presence of a chronic condition(Case, Lubotsky & Paxson, 2002).Economic status and response to health.People with access to wealth, knowledge, and power have the means to take advantage of all the relevant health information available in any specific place or at any given time(Phelan & Link, 2003)..Cultural norms and response to healthCultural norms and response to health.Cultural norms are the shared, sanctioned, and integrated systems of beliefs and practices that characterize a cultural group..They are passed from one generation to the other.Cultural norms and response to health.As prescriptions for correct and moral behaviour, cultural norms lend meaning and coherence to life, as well as the means to achieve a sense of integrity, safety and belonging. Cultural norms and response to health.Normative beliefs(norms), together with related values and rituals, confer a sense of order and control upon aspects of life that might otherwise appear chaotic or unpredictable.Cultural norms and response to health.Cultural norms are woven into interpretations and expressions of health and illness through dynamic, interactive relationships at all levels of influencefrom the gene to the society. Cultural norms and response to healthCultural norms often mediate the relationship between ethnicity and health, even effecting gene expression through such practices as; .Marriage rules, .Lifestyle choices, and .Environmental exposures.Cultural norms and response to healthAt the individual and group levels, cultural norms have a substantial role in health-related behaviours such as;.Dietary practices, .Tobacco use, and .Exercise..Conversely, health can influence cultural norms (ask students to give examples)Cultural norms and response to health.Cultural systems, as adaptive tools, change in response to external cues, as evident in the transmutations that occur in norms as diverse groups interact and influence one another. .Practices are also adapted to new environments as a response to immigration or technology.References Berkman, L. &Epstein, A. (2008).Beyond Health Care-Socioeconomic Status and Health. Retrieved from:http://www.nejm.org/doi/full/10.1056/NEJMe0802773References Case, A; Lubotsky, D. & Paxson, C. (2002).Economic status and health in childhood:the origins of the gradient. Retrieved from:http://www.princeton.edu/rpds/papers/pdfs/casepaxsoneconomicstatuspaper.pdfReferences Cutler, D. & Lleras-Muney, A. (2011).Education and Health: Evaluating Theories and Evidence. Retrieved from:http://www.nber.org/digest/mar07/w12352.htmlReferences Phelan, J. & Link, B. (2003). When Income Affects Outcome:Socioeconomic Status and Health. Retrieved from: http://www.investigatorawards.org/downloads/researchinprofilesiss06feb2003.pdfReferences