1. Copyright © 2006 Elsevier, Inc. All rights reserved Chapter 21 Cultural and Spiritual Awareness

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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