Copyright © 2006 Elsevier, Inc. All rights reserved Chapter 21 Cultural and Spiritual Awareness
Copyright © 2006 Elsevier, Inc. All rights reserved Culture and Spirituality What is meant by cultural competence? Code of Ethics states—When planning health care, should consider lifestyles, values, and religious beliefs Cultural competence Awareness of own existence, sensations, thoughts, and environment Having no undue influence on others Understanding others’ cultures; accepting and respecting cultural differences
Copyright © 2006 Elsevier, Inc. All rights reserved Culture and Spirituality (cont’d) What is meant by cultural competence? “The process in which the healthcare professional continually strives to achieve the ability and availability to work within the cultural context of a client—individual, family, or community” (Campinha-Bacote, 2003) Cultural awareness Cultural knowledge Cultural skill Cultural encounter Cultural desire
Copyright © 2006 Elsevier, Inc. All rights reserved Culture and Spirituality (cont’d) What practice issues are related to cultural competence? Barriers to cultural competence Provider barriers—for example, lack of information about a culture Systems barriers—exist within an agency, for example, structure and policies not designed to support cultural diversity
Copyright © 2006 Elsevier, Inc. All rights reserved Culture and Spirituality (cont’d) What practice issues are related to cultural competence? Health and health care disparities Inequalities in disease morbidity and mortality, due to: Interaction among genetic variations Environmental factors Health behaviors Inequalities in income and education Low income and education levels
Copyright © 2006 Elsevier, Inc. All rights reserved Culture and Spirituality (cont’d) What is the meaning of spirituality? No clear definition Not to be confused with religion Spiritual nursing care Intuitive Interpersonal Altruistic Integrative Contingent on nurse’s awareness of transcendent dimension of life, reflects the patient’s reality
Copyright © 2006 Elsevier, Inc. All rights reserved Cultural and Spiritual Assessment What are cultural and spiritual beliefs about illness and cures? Complementary Alternative Integrative modalities Nurse needs to have basic understanding of various therapies
Copyright © 2006 Elsevier, Inc. All rights reserved Cultural and Spiritual Assessment (cont’d) How do you assess spiritual need? Use specific spiritual assessment tools Integrate tools into assessment document Seven spiritual dimensions Experience of God or transcendence Spirit-enhancing practices or rituals Involvement in a spiritual community Sense of meaning Giving and receiving love, or connectedness to self Sources of hope and strength Linkage between spirituality and health