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Describe cultural contexts that must be accounted for when caring for patients. 4. Discuss special legal/ethical...

Describe cultural contexts that must be accounted for when caring for patients. 4. Discuss special legal/ethical considerations relative to psychiatric nursing.

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Culture has been defined in a number of ways, but most simply, as the learned and shared behavior of a community of interacting human beings.
Cultural competency refers to an ability to interact effectively with people of different cultures.
The Significance of Cultural Competency
• Health care workers need to be aware of, and sensitive to, cultural diversity, life situations, and other various factors that shape a person’s identity.
• The first step is an open, non-judgmental attitude towards the Client .

Nurses' practice must incorporate cultural needs and beliefs into their nursing practice to provide care that is individualized for the client and appropriate to the client's needs. During the assessment phase of the nursing process, the nurse assesses the client's and family member's cultural background, preferences and needs, after which the nurse modifies the plan of care accordingly.

This cultural assessment and culturally oriented care enables the nurse to:

*Identify ways with which the client's culture and its features impact on their perceptions, beliefs, values, experiences with health, wellness, illness, suffering, and even death
*Remain accepting, respectful and welcoming of human diversity
*Facilitate more holistic assessments and plans of care as based on the client's culture
*Deep and strengthen their commitment to nursing and their insight into the nursing profession as based on culturally based nurse-patient relationships which emphasize the importance of the whole person rather than viewing the patient as simply a set of symptoms or an illness
*Integrate their full and in depth cultural knowledge into the treatment of patients
*Develop and integrate open mindedness into nursing care which can lead to some innovative, non-traditional, alternative nursing interventions such as spiritually based therapies like meditation and anointing.

In today's health care field, nurses and other health care providers have the professional responsibility to be sensitive to their clients' cultural backgrounds. This sensitivity is particular important and vital to the quality of care because culture is so integral and intrinsic to who the client is as a unique individual. Culture can greatly affect client health, as well as their reactions to treatments and care. Madeleine Leininger's Transcultural Nursing Theory facilitates the nurses' understanding of why and how the patient's cultural background is important to health.

Recognizing Cultural Issues That May Impact on the Client's Understanding of and Acceptance of a Psychiatric Diagnosis:
Cultural issues that may impact on the client's understanding and acceptance of a psychiatric mental health disorder and diagnosis are numerous and varied. For example, these cultural beliefs, values and practices can impact on the client's understanding and acceptance of a psychiatric mental health disorder and diagnosis among various cultures.
*The meaning of the mental disorder or illness to the client and their family members.
*The way with which the client relates their symptoms to the health care provider.
*Culture also impacts on the ways which some cultures cope with stress.

It must also be noted that psychiatric mental health professionals, including nurses, are affected and impacted by their own cultural beliefs, values and practices. It is, therefore, necessary that all health care providers eliminate their cultural biases towards clients with mental disorders and all other disorders and diseases; therefore, the nurse must recognize their own cultural biases and then overcome them with a full understanding, acceptance and respect for all clients regardless of their own integral cultural practices, values, beliefs and perceptions.

Incorporating the Client's Cultural Practices and Beliefs When Planning and Providing Care
culture also impacts on other areas of the client-nurse relationships. Some of these cultural influences include:-
*General Perceptions Relating to Illness and Health.
*Distance and Space Orientation.
*The size of the family unit, family member roles, internal family dynamics, power and decision maker powers, interpersonal interactions within the family, among members of the family, and with others outside of the family unit, and communication patterns within the family unit often vary according to one's culture.
*Communication Patterns: As fully discussed in the beginning of this review under the integrated process of "Communication and Documentation", verbal and nonverbal communication patterns and elements, such as terminology, silence, eye contact, choice of vocabulary, facial expressions, and touch, are impacted by different cultures.
Culture is integral to the person as a unique individual. It impacts greatly on the client's health, and their reactions to treatments and care. Cultural beliefs, perspectives, values and practices are determined and assessed by the nurse, after which they are then integrated into the planning, implementation and evaluation of client care. All aspects of the direct and indirect care of the client is modified and changed according to the client's culture and cultural background. Additionally, all these cultural modifications must be documented as all other aspects of nursing care.


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