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Assessment Health And Illness Beliefs Essay

Assessment Health And Illness Beliefs Essay

Discuss how health and illness beliefs can influence the assessment process.

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– how belief structure might impact how a client responds to an assessment interview

– how culture influence Physical findings.

Number of pages 3 pages

APA style Assessment Health And Illness Beliefs Essay

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INFLUENCE OF HEALTH AND ILLNESS BELIEFS ON ASSESSMENT PROCESS 2 The Influence of Health and Illness Beliefs on Assessment Process The role of a nurse in health institutions is unrivaled. In particular, nurses play a crucial role from the face to face interaction during health assessments with the patient up to and after the discharge. As noted by Dayer-Berenson (2014), a culturally competent nursing health assessment determines a plan of care by recognizing essential needs of the patient and methods of addressing the needs. However, just as registered nurses (RNs) possess own values and cultural beliefs, affecting in their practices that the patients may also maintain essential values is essential in health assessments. Across the globe and the United States immigrants are imminent with assimilation evident making the country a multicultural place with the appreciation of various ethnocultural societies (Napier et al., 2014). Because of the diversity in the USA, it is thus vital that nurses should focus on the provision of culturally sensitive patient care and education. Notably, by understanding one’s values and beliefs, there is the apparent success in needs assessment and solving the issues using the available the healthcare system or a skilled nursing facility. According to Registered Nursing.Org (2017), it is essential for nurses’ to incorporate cultural demands into nursing practice. This consideration is a necessity in providing customized and person-specific care that is appropriate to their needs. The existence of many cultures thus depicts the notion that nurses have a hard task of knowing and learning the dynamic and distinct beliefs and customs of all local Americans and international people. In essence, learning everything about each people’s multiple cultures is impractical thus calling for a well-articulated nursing health assessment tool that meets the needs of all people despite beliefs and values in the culture assessment scope (Dayer-Berenson, 2014). Assessment Health And Illness Beliefs Essay The nurse must assess the client’s and family member’s ideologies, values, beliefs and cultural
INFLUENCE OF HEALTH AND ILLNESS BELIEFS ON ASSESSMENT PROCESS 3 background as well as the current preferences and needs (Hardy, 2016). Once this needs and concerns have gotten identified, the nurse is thus supposed to adjust the plan of care based on the responses and first initial assessment about the client and the family history (Registered Nursing.Org, 2017).). This is important as the culture has a significant influence the overall perceptions of health, sickness, and death, attitude towards the cause illness. One patient may prefer to home therapy and prayer as opposed to being injected with needles. In assessing the patient, the belief structure has various impacts on how the client responds to an assessment questions. It is thus key in the cultural assessment to fully determine how deep the patient is in their distinctive traditional culture before taking next actions (Hardy, 2016). Thus, the overall extent a given admitted patient’s level of cultural embeddedness impacts
on the entire healthcare assessment and teaching plan designed for implementation. It is hence essential to pose questions to the patient that helps depict his or her cultural stand. In essence, with the cultural values and moral issues solved, there is the ease of trouble in providing the right interventions without objectives. A nurse may ask: As you are unwell, any views on what may have caused your condition? Or Are there any reasons why your sickness started? Or ask: What medication or treatment do you prefer for your state? Or lastly, ask; Any aspects of your disease that scares you the most? The responses to the questions asked by a nurse will thus help determine if the patient has any cultural backing and ideologies that may affect the care plan. From the answers and data collected, the nurse, therefore, shifts to more specific types of questions aligned to the cultural positioning of the patient (Hardy, 2016 and Registered Nurisng.Org, 2017). After the interview with the male or female patient, collected data from the cultural assessment thus helps the patient as well as the attending RN in the formulation of a mutually satisfactory, culturally receptive
INFLUENCE OF HEALTH AND ILLNESS BELIEFS ON ASSESSMENT PROCESS 4 treatment and care plan (Napier et al., 2014).Assessment Health And Illness Beliefs Essay  Although the beliefs in health and illness may seem like an overstated idea in healthcare cultural assessment, it is a vital aspect as depicting the right to the cultural values, ethics, beliefs and practice of the patients. In essence, as a nurse aiming to deliver stress-free and tussle free patient care, understanding the cultural factors is essential during the health assessment procedures. From the assessments, the culture is thus noted to influence the physical nature and activities of the patient with some preferring certain types of care like therapy, spirituality or meditation, and yoga as opposed to drugs or seeing a doctor. It is critical to identify as well as respect the beliefs of patients in the provision of a culturally competent care for useful services (Napier et al., 2014). Similarly, where information on the cultural values of the patient differs with those of a nurse, it is crucial to remain nonjudgmental and focus on the patient. Assessment Health And Illness Beliefs Essay

​​​​​​​Many variables such as culture, socioeconomic factors, generational practices, and current trends affect patients’ and families’ health beliefs and practices. Routine and accepted US health care system processes, structures, and norms may be unfamiliar to patients and families from other countries or cultures. Following are some of the areas in which pediatricians are most likely to encounter differing (or a range of) perspectives.

Clinic and Emergency ​​Department Use
Pediatricians understandably expect patients to comply with a predictable and scheduled appointment format. However, patients from other countries or cultures may be accustomed to different processes. In certain countries in Latin America, for example, patients are expected to walk in to a clinic or practice, take a number, and wait for the provider, instead of being scheduled for a specific time. Likewise, patients may favor using emergency services for non-emergent complaints rather than accessing a primary care provider. Some patients may use the emergency department as a medical home because of perceived advantages in accessibility, availability of ancillary laboratory and radiology services, and even availability of interpretive services. Pediatricians should clarify the scheduling process in their practices. Assessment Health And Illness Beliefs Essay

​Pain and An​algesia
The expression of pain and the health-seeking behavior centered on the relief of pain varies from culture to culture. For example, in some cultures it is considered honorable and desirable to stoically tolerate pain, while these same behavior expectations are not shared by other cultures. While there are culturally associated variations in patients’ expression of pain, physicians’ analgesic prescribing responses to patients of different cultures also may vary. Although some research studies have demonstrated that physicians may prescribe less analgesia to ethnic and racial minority populations, there is evidence to suggest that the disparity has lessened over time.1​

Traditional Practices, A​​lternat​ive Medicine, and Indigenous Healers
It is increasingly recognized that some patients from the United States or other countries use alternative or traditional practices, medicines, or healers. Families may use these options prior to, in combination with, or after seeking medical care from the pediatrician. In some cultures, the concept of a “folk illness” is embraced and there is a strong belief in a definite constellation of symptoms and treatments associated with the folk illness. Pediatricians should respect patients’ health beliefs that may not be consistent with a biomedical model of disease etiology. For example, some Latino/Hispanic families believe in folk illnesses such as empacho (gastrointestinal discomfort), susto (a form of panic attack), or mal de ojo (evil eye). Many traditional practices used to treat these and other folk illnesses may be entirely benign, while others have been associated with adverse health outcomes. Folk medicines such as greta and azarcon, often used by Mexican Americans, may contain elevated lead levels and have been associated with lead poisoning in children.​ Assessment Health And Illness Beliefs Essay

Bed Sharing and Sudden Infant Death Syndrome
Since the American Academy of Pediatrics (AAP) Back to Sleep campaign to decrease the incidence of sudden infant death syndrome (SIDS), there has been a substantial increase in the percentage of mothers that place their babies to sleep on their back or sides. However, in some minority populations, this public health campaign has not been as effective. African American mothers, for example, are more likely to share beds with their infants and place them in a prone position to sleep, both risk factors for SIDS. Co-sleeping is considered a culturally acceptable, if not desirable practice, in some communities. Additionally, in large families with few resources, co-sleeping can be viewed as a necessity rather than an option.​

Birth and Early Inf​ancy
At birth and immediately after birth, different cultural groups may have specific norms regarding the amount of postpartum time mothers are to remain indoors, the care of the umbilicus, early feedings, co-sleeping, circumcision, and others. In some cultures, for examples, mothers and newborns stay secluded indoors for a defined period. In other cultures, because of limited resources or cultural practices, newborns sleep in the same bed with their mother. Another example of a culturally bound practice involving newborns and babies centers on covering their heads, even if in tropical climates.​ Assessment Health And Illness Beliefs Essay

Death and D​ying
Death rituals are often shaped by culture. In dying or severely ill patients, the amount of information that physicians and families share with the patient about his or her prognosis, the patient and family members’ expression of grief, the use and acceptance of hospice care, the termination of life support systems, the integrity of the body and burial, and other end-of-life issues pose significant cross-cultural and bioethical challenges for pediatricians. Koenig and Gates-Williams2 offer the following helpful guidelines in dealing with these complex situations:

Determine who controls access to the body and how the body should be approached after death.
Consider the relevance of religious beliefs, particularly about the meaning of death, the existence of an afterlife, and belief in miracles.
Assess how hope for a recovery is negotiated within the family and with health care professionals.
Assess the degree of fatalism versus an active desire for the control of events into the future.​ Assessment Health And Illness Beliefs Essay
Role of W​omen
The culture-specific roles of women and men have the potential to affect the care of pediatric and adolescent patients. In some cultures, for example, women are expected to defer important decisions to and, in some instances, to communicate through the male figure. The concept of machismo in Hispanic cultures often portrays the masculine figure as a protector, provider, and decision-maker. Whereas the cultural connotation may be one of masculine honor and respect, it can be viewed as disempowering toward women. Men in some cultures, for example, may exert power and control over women. If men are viewed as final decision-makers on health matters, this may affect pediatricians’ ability to empower female adolescent patients. This culturally bound and potentially disempowering role of women can adversely affect their ability to successfully negotiate condom use with a male sexual partner.

Role of Family
Given the cultural variability of the role of the patient’s family in medical decision-making as well as healing processes, the pediatrician should respectfully ask questions with the goal of fully understanding these important issues. In some cultures, the family (nuclear and extended) is the main social unit and family members are actively engaged in all aspects of the care of the patient. In dealing with hospitalized patients, for example, pediatricians should anticipate the possibility of a large number of family members during visiting hours and the possibility of exceeding the hospital’s allowable visitors’ quota. Immigrant families may be divided between the United States and the country of origin, posing an added stressor in family-centered cultures.​ Assessment Health And Illness Beliefs Essay

Culture is one of the most important determining factors in healthcare preferences and practices. Thus, the need for transcultural nursing is undeniable. “Transcultural nursing requires sophisticated assessment and analytic skills and the ability to plan, design, implement, and evaluate nursing care for individuals, families, groups, and communities representing various cultures” (Andrews and Boyle, 2008, p.4). In order to effectively practice transcultural nursing, one must first understand the need for cultural competence. It is vital for nurses to have a desire to become culturally aware, culturally knowledgeable, culturally skillful, and to seek cultural encounters. Cultural desire is the stimulator in the eruption of the process of cultural competence and the nurse must seek and be open to learn and accept others, understand the process is lifelong, and set aside personal feelings to effectively treat unique patients (Campinha-Bacote, J, 2003). The Giger and Davidhizar (2002) Transcultural Model is a helpful tool that addresses and effectively treats patients who have different cultures. The model takes into consideration 6 important phenomena. Assessment Health And Illness Beliefs Essay

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Communication keeps culture alive by verbal and nonverbal means; it is one of the biggest obstacles in healthcare. Nurses ask questions to determine patient’s views on illness, causes, and possible treatments. They listen and interpret their patient’s level of understanding and ability to follow through with treatment. Also, nurses interact with the patient’s family. Communication varies from culture to culture. Americans are expected to speak Standard English; however, it varies based on region, ethnicity, and social class (United States, 2001). Americans use a variety of nonverbal communication. Eye contact, which is viewed as a sign of trust and honesty, between patients and healthcare professionals is the norm. Expression of emotion varies in American culture. Americans use a combination of verbal language, body language, and gestures. Americans are often straightforward and rather demanding. Unlike Americans, Asians rarely complain. Silence and withdrawal may be the only indication of a problem. Asians tend to not ask for anything, accept pain, and remain stoic (Fernandez V. & K., 2008, Asian Community). Many Asians don’t engage in eye contact with powerful persons; the avoidance of eye contact shows respect and reverence (Non-Verbal Communication, p.4). Asians speak more than 100 languages; they vary based on the geographic regions they descend from (Asian Americans, p. 2). Arab Muslims usually cooperate by answering questions, listening, and following directions until they see improvement. They believe their expression, such as pain, should be quickly met with response (Fernandez V. & K., 2008, The Middle Eastern Community). The Arabic language uses devices that outmatch reality and is not very direct or explicit (Ayish, 2003). Hispanics are very emotionally expressive. Effective communication with Hispanics is not based on just speaking their language; cultural rules allow for certain discussions with certain people (Fernandez V. & K., 2008, The Hispanic American Community). Eye contact is expected on the nurse’s part but will not necessarily be reciprocated (Andrews & Boyle, p.25). Nurses, if available, should undergo cultural competency training. Berln and Fowkes’ LEARN Model can assist; LEARN, represents the process of listening to the patient, explaining your view, acknowledging differences and similarities, recommending and negotiating a plan (Campinha-Bacote, J.,2003). Nurses should enlist the help of trained interpreters, preferably of the same gender, mature, and of no relation to patient; if there is no interpreter, the following but not limited to, is necessary: politeness, slow and concise speaking, simplicity, pantomime, validation of understanding, and instructions in the proper sequence (Andrews & Boyle, p.29). Assessment Health And Illness Beliefs Essay

Space is also important when dealing with various cultures. Nurses are required to interact with patients, often invading personal space. Giger and Davidhizar (2002) state:

Territoriality refers to feelings or an attitude toward one’s personal area. Each person has their own territorial behavior. Feelings of territoriality or violation of the client’s personal and intimate space can cause discomfort and may result in a client’s refusing treatment or not returning for further care. (p. 185)

Americans tend to require a need for personal space. When family and friends are near, Americans tend to be relaxed; however, when a stranger or mere acquaintance invades space, it can become uncomfortable. Asians prefer a great amount of social distance. Many prefer minimum physical contact with acquaintances; excessive contact is viewed as inappropriate. Unlike Americans, who believe touch is a sign of friendliness, Asians view the head as a personal area that contains the seat of the soul and it should not be touched. Arab Muslims seem to require the least amount of space. It is not uncommon for people from the Middle East to stand closely when conversing. However, gender can play a role; Muslim woman may become distraught when a male, even a healthcare professional, stands or sits near her; Arab Muslims expect females to tend to females and males will care for males. Hispanics, unlike Americans, are use to standing or sitting near people they are not well acquainted with (Non-Verbal Communication, p.3). Hispanics and Arab Muslims may unintentionally invade nurse’s space as a means of getting closer and more comfortable (Andrews & Boyle, p.26). Nurses should take the patient’s lead; if the patient seems to gravitate towards you or initiates touch, then it is acceptable to do the same. At all times respect the patient and boundaries. Assessment Health And Illness Beliefs Essay

When dealing with patients, there must be consideration of social organizations or what role the patient’s culture plays in his or her life. Family members are often the providers of a patient’s eating habits, sick role behaviors, and medications used. Americans view family as a vital part of their healthcare plans. It is common for Americans to be visited and supported by family; they often discuss and make important decisions. Asians are concerned with family interdependence over independence; family usually likes to assist with patient care. In some Asian cultures, some members, such as men and elders, dominate and consider women and children inferior (Galanti, 2005). Arab Muslims regard family as the foundation of their society. The husband answers questions, makes all major decisions, and gives consent. Often times, Arab Muslims don’t believe in divulging family history. The family cares for the ill. (The Middle Eastern Community). Hispanics have large families who visit for long hours as a way to demonstrate their love and genuine concern. Often times, decisions are made by the entire family or designated members (Galanti, 2003). Religious and spiritual beliefs are important factors during illness, recovery, and death. In the United States, most people consider themselves Christians; Catholics singly dominate, but the Protestant groups combined outnumber them. Americans include religious practitioners such as priest, ministers, and rabbis as well as nontraditional leaders during health related situations. Americans include religious objects, such as the Bible, and also rituals, such as communion. Death and end of life choices are also influenced by religion and practices; typically, Americans consider death a sad and somber time. Asians are host to numerous religions; Christian, Muslim, Buddhism, and Hindu are just a few. Many Asians believe in bad spirits; infants attract them and induce death. If the illness is thought to be caused by spirits, healers are sought (Asian Community). Arab Muslims are usually of the Islamic faith and pray 5 times a day to the Holy Land, Mecca. Muslims recharge their spiritual battery during the month of Ramadan; fasting from dawn to sunset accompanies. Arab Muslims often read from the Al Quran (The Middle Eastern Community). Hispanics are usually Catholics with the recent emergence of Pentecostals. Shrines and religious objects are common in practice. Health is viewed as God’s gift and should be revered (The Hispanic Community). Nurses must be accommodating to patient’s families and the value placed on family within cultures. Nurses must be sensitive to religious beliefs or practices and must not impose personal beliefs. Seeking knowledge is essential. However, exposure to diverse cultures is one the best learning mechanisms. Assessment Health And Illness Beliefs Essay

Understanding a cultures notion of time elapsing, specific periods, and clock time are

necessary for effective healthcare. Cultures may be past, present, or future oriented. Americans use time to provide order. Americans expect care at designated times; appointments are a prime example. Americans are future oriented; they believe they can manipulate the future by taking certain actions. Americans tend to be proactive; the focus is optimism, coping strategies, and preventive measures. Americans often demonstrate this orientation through self examinations, check-ups, and staying informed about healthcare advances. Asians tend to have a past orientation. They prefer to adhere to traditional methods and treatments; they are apprehensive about new innovations. Recently however, Asians are shifting towards future orientation (Galanti, 2004). Arab Muslims are present oriented and are neglectful of preventive measures. They may be late or not attend appointments at all (The Middle Eastern Community). Hispanics also focus on the present. They believe the future arrives in its own time and thus the notion that one cannot be late exist (Galanti, 2004). Nurses must explain the importance of time regarding life processes while being respectful and mindful of cultural views. Nurses should try to refrain from making time oriented promises that can’t be kept. Assessment Health And Illness Beliefs Essay

Environmental control or the attempt to control nature affects patient’s health practices, values, and the definitions of health and illness (Giger, & Davidhizar, 2002). Americans believe nature can be controlled. Americans equate the body to a machine; if it’s broken, allow healthcare professionals to fix it (Galanti, 2004). Americans conform to the Western biomedical model which defines health as the absence of disease or the signs and symptoms of disease. The holistic paradigm exists in Asian cultures; it deals with the concept of yin and yang, in which forces of nature must be balanced to produce harmony (Andrew & Boyles, 69). Asians tend to view people as part of nature. The land is a resource used to treat disease; herbal remedies are common (Galanti, 2004). Arabs believe the key to good health is personal hygiene and a healthy diet. “They place a high value in modern Western medicine and have confidence in the medical profession” (The Middle Eastern Community). Hispanics believe natural forces are not in their control and preventative measures are not often taken. (Galanti, 2004). Their system, the Curanderismo, combines spiritualistic, homeopathic, and scientific elements; curandero or holistic healers are utilized (The Hispanic Community). Nurses should become familiar with factors. Nurses should not dismiss patient’s view of their power and accountability or lack thereof. Assessment Health And Illness Beliefs Essay

Biological variations exist between races; some groups are sensitive to certain medications, have metabolic differences, and are prone to certain diseases or factors that can affect healthcare. African Americans are three times more likely to get tuberculosis than whites; they also have higher rates of hypertension. Sensitivity to cardiovascular effects from Propranolol occurs more in Asians than Whites. Ethnic minorities, such as Hispanics, have higher HIV rates (Giger and Davidhizar, 2002). Middle Easterners or Arab Muslims have a lower percentage of sweat chlorides (Andrews & Boyle, 54). The list of variations is broad and extensive. “Accurate assessment and evaluation of clients require knowledge of normal biocultural variations among healthy members of selected populations” (Andrews & Boyles, 49). Nurses must acquire skills that will allow the recognition of variations.

A nurse must always remember that the focus should remain on the patient’s well being and recovery. It is necessary to understand that individuals will never be the same. A patient’s health status and treatment is directly influenced by their culture and it is this reasoning, which has been proven through testing and the development of theories that has led to the conclusion that culture cannot and will not be ignored. “Human diversity makes tolerance more than a virtue; it makes it a requirement for survival” (Dubos). Healthcare will not suffice without negotiation, adjustment, and respect of differences. Transcutlural concepts in nursing care have made cultural competency an expected standard and it is the duty of every nurse to help maintain this standard. Assessment Health And Illness Beliefs Essay

Why are Culture Beliefs so Important in a Health Care Setting?
There are many cultures out in the world today that practice beliefs different than those in the United States. America is based off Western Culture and traditional medicine practices which focus on preventative and curative medicine. Most cultures around the world practice folk medicine, which focus more on the person as a whole with remedies and ceremonies rather than medicine and treatment. Even though each one believes in a different practice, all medical professionals should have the knowledge and awareness of each culture’s health beliefs to properly treat their patients in a respectful and kind …show more content…
They also may believe in witchcraft and voodoo practices which help with getting the evil out of the body. Mullner and Giachello (2011) write that “brujos” or male witches help alleviate illnesses and may ward off dangers on a person by using oils, ointments, religious objects, or herbal treatments. Assessment Health And Illness Beliefs Essay
They also use “curanderos” or folk healers who practice folk medicine. They use rituals and practices to cleanse the body, get rid of negative energy, bad illnesses, and evil spirits. (Mullner and Giachello, 2011) My father once believed that he had skin cancer as a little boy because of a mole he had, so his mother called upon the curandero who lived in their community. He used holy water and different types of oils that were placed on my father and what he remembers is that the healer used a charm that got positioned above his head. Then the curandero started a chant that he repeated over and over again to get rid of the negative disease in the body. My father swears that it worked and the skin cancer went away and he never saw it again (B.Montoya, personal communication, April 19, 2011). If a certain culture believes in a healer then it is important to incorporate it into the healing process in the healthcare setting if a patient is sick or terminally ill. Although religion plays a key aspect in the healing process so does the family. Assessment Health And Illness Beliefs Essay

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