The Client in the Context: Culture, Spirituality and Family

Objectives
After the discussion about the concept, the students will be able to:
1. 2.

3.

Identify the relevance of Culture, Spirituality and family as part of health assessment Utilize related concepts in the care of the client with varied cultural orientation Value the importance of culture, spirituality and family as major components in health assessment

Culture, family and community are systems. But it is very difficult to separate the three systems to examine each because the systems constantly interact and change based on the interaction. A cultural group that is entirely isolated would not be known by outsiders. So, the introduction of outsiders into the group begins to influence the isolated culture, and the outsiders begin to effect small to large changes of the culture.

Within the isolated culture, there are norms for the family pattern ( who belongs to the family, what the purpose of the family is, how family members relate to nonfamily members of the cultural group and so forth).

What is culture?

It is an anthropologic term that is widely used in many fields of study. It is difficult to define ( Purnell and Paulanka)It provides a useful definition capturing the sense of many others by defining culture as the totality of socially transmitted behavioral pattern, arts, beliefs, values, customs, lifeways, and all other products of human work and thought characteristic of a population or people that guide their worldview and decision making.based on this definition, culture is composed of all verbal and behavioral systems that transmit meaning

Cultural Variation in Health Assessment

To be successful in completing a health assessment, the nurse must develop skill in the many areas of cultural competence. The variations in communication style and content, the different beliefs and behaviors that result from different world views, the effects of environment and genetics all affect behavioral, physical and pharmacologic variation. Recognizing the possible influence of culture on assessment skill and findings is essential for the nurse assessing any client, not just the client who comes from a culture obviously different from the nurses own

What is a family?
Family is a basic unit of society. It consist of those individuals, male or female, youth or adult, legally or not legally related, genetically or not genetically related or are considered by the others to represent their significant persons

Family Assessment

The purpose of family assessment is to determine the level of family functioning, clarify family interaction patterns, identify family strengths and weakness, and describe the health status of the family and its individual members This gives an overview of the family process and helps the nurse identify areas that need further investigation. Nurses carry out a detailed assessment in specific target areas as they become more acquainted with the family and begin to understand family needs and strengths more fully

The assessment begins with a complete health history. The nurse focus first on the family unit and then on individuals in that family. Understand the health beliefs of individuals and families because this may reflect a lack of information or misinformation about health or disease

Religion

May be considered a system of beliefs, practices, and ethical values about divine or superhuman power worshipped as the creator and ruler of the universe.

Spirituality

This may be defined as the inherent quality of humans to believe in something greater than the self and in a faith that affirms life It involves interconnectedness between the self, nature and others. It is larger than religion, although religion is a forum for expressing or spiritual nature It is characterized by meaning, hope, purpose, love, trust, forgiveness and creativity

Spiritual Assessment

Its goal is to detect strength, potential problems, or dysfunction It is unique because the only tools needed are you and time, your ability to listen actively A persons spirituality cannot be measured so you must rely on other evidence to make nursing diagnoses in the spiritual dimension

To assess your patients spiritual health, focus your attention in 4 areas ( behavior, verbal, relationship and environment)

Behavior

Is the patient praying, meditating Shutting others out Having sleep difficulties Constantly complaining

Verbal Communication

Is the patient talking about God, church, temple, mosque, prayer, hope, faith, or meaning of life

Relationships

Have many visitors, who are her visitors

Environment

Does the patient have Bible, Koran, other religious reading, religious jewelry, symbols such as cross, star, shawl, religious greeting cards