2. Culture & Ethnicity

3. Culture Socially transmitted knowledge of values, beliefs, norms, and lifeways of a particular group that guides their thoughts and behaviors— (Purnell and Paulanka, 1998 & Leininger 2002a)

4. Visible and Invisible Components Visible — easily seen Clothing, jewelry, charms, hairstyles Invisible — less observable Value belief system that drives visible practices

5. Cultural Processes Enculturation Acculturation Assimilation Biculturalism

6. Transcultural Nursing Comparative study of cultures to understand similarities and differences across human groups— (Leininger,1991, 2002a)

7. Cultural Competence Cultural awareness Cultural knowledge Cultural skills Cultural encounters Cultural desire

8. Cultural and Life Transitions Pregnancy Childbirth Newborn care Postpartum Grief and loss

9. Cultural Assessment Cultural identity/ethnohistory Biocultural history Social organization

10. Cultural Assessment (cont.) Language and communication Religion and spirituality Caring beliefs and practices Experience with health care system

11. Nursing Decision and Action Modes Cultural care preservation or maintenance Cultural care accommodation or negotiation Cultural care repatterning or restructuring

12. Self-Concept

13. How one thinks and feels about oneself Development of self-concept is a complex, lifelong process

14. Components Identity Body image Role performance Self-esteem

15. Role Performance Behaviors Reinforcement-extinction Inhibition Substitution Imitation Identification

16. Self-Concept Stressors Identity stressors Body image stressors Role performance stressors Conflict Ambiguity Strain Overload Self-esteem stressors

17. Effects on Self-Concept Family Nurse

18. Assessment Coping behaviors Significant others Client expectations

19. Nursing Diagnoses Examples Impaired adjustment Ineffective coping

20. Planning Goals and outcomes Priorities Continuity of care

21. Implementation Health promotion Acute care Restorative care

22. Evaluation Client care Client expectations

23. The Experience of Loss, Death, and Grief

24. Grief Mourning Bereavement

25. Theories of Grief Kubler-Ross’s stages of dying Bowlby’s phases of mourning Worden’s four tasks of mourning Application of theories to other types of loss

26. DENIAL ANGER BARGAINING DEPRESSION ACCEPTANCE Kubler-Ross Stages of Dying

28. Types of Grief Anticipatory grief Complicated grief Disenfranchised grief

29. Assessment Type and stage of grief Grief reactions Factors that affect grief End-of-life decisions Nurse’s experiences Client expectations

30. Factors Influencing Loss and Grief Human development Psychosocial perspectives Socioeconomic status Personal relationships Nature of the loss Culture and ethnicity Spiritual beliefs

31. Nursing Diagnoses Anticipatory grieving Dysfunctional grieving Hopelessness Powerlessness Spiritual distress

32. Planning Goals and outcomes Setting priorities Continuity of care

33. Implementation Therapeutic communication Promoting hope Facilitating mourning Postmortem Care

34. Palliative Care Symptom control Maintaining dignity and self-esteem Preventing abandonment and isolation Providing a comfortable and peaceful environment

35. Supportive Care Support for the grieving family Hospice care Care after death (postmortem care) Grieving nurse

36. Evaluation Client care Client expectations

37. Sexuality

38. Sexual Development Infancy and early childhood School-age years Puberty/adolescence Young adulthood Middle adulthood Older adulthood

39. Sexual Response Cycle Desire Arousal Orgasm

40. Sexual Orientation Heterosexual Homosexual Bisexual

41. Contraception Nonprescription methods Abstinence Barrier methods Timing methods

42. Contraception (cont'd) Prescription/health care intervention methods Hormonal Intrauterine devices Diaphragm/cervical cap Sterilization

43. Sexually Transmitted Diseases Syphilis Gonorrhea Chlamydia Trichomoniasis Human papillomavirus (HPV) Herpes simplex virus (HSV)

44. Sexually Transmitted Diseases (cont'd) Human immunodeficiency virus (HIV) AIDS Transmission Exposure categories Education

45. Sociocultural Influences on Sexuality Pregnancy and menstruation Discussing sexual issues

46. Decisional Issues Related to Sexuality Contraception Abortion STD prevention ARE WE HONEST WHEN WE TALK ABOUT THIS!!!!

47. Alterations in Sexual Health Infertility Sexual abuse Personal and emotional conflicts Sexual dysfunction

48. Assessment Factors affecting sexuality Sexual health history Sexual dysfunction Physical assessment Client expectations Nursing diagnosis

49. Planning Goals and outcomes Priorities Continuity of care

50. Implementation Health promotion Acute care Restorative care

51. Evaluation Client care Client expectations

52. Spiritual Health

53. Caring for the whole person Accepting beliefs and experiences Helping with issues surrounding meaning and hope

54. Framework of Systemic Organization Maintenance Change Coherence Individuation

55. Traditional Concepts Spirituality Faith Religion Hope

56. Problems—Spiritual Distress Acute illness Chronic illness Terminal illness Near-death experience

57. Assessment JAREL spiritual well-being scale Faith/belief Life and self-responsibility Life satisfaction Culture Fellowship and community Ritual and practice

58. Assessment (cont’d) Vocation Client expectations

59. Nursing Diagnoses Spiritual distress Readiness for enhanced spiritual well-being Fear Hopelessness

60. Planning Goals and outcomes Setting priorities Continuity of care

61. Implementation Establishing presence Supporting a healing relationship Support systems Diet therapies Supporting rituals Prayer Meditation Supporting grief work

62. Evaluation Client care Client expectations

63. Loss Actual loss Perceived loss Maturational loss Situational loss