Assigned reading correction : Craven & Hirnle: Ch 46
Nurse Caring Concepts 1A
Cultural Awareness
Self Concept
Week 15
November 24, 2003
Cultural Characteristics
• Learned
• Habituated
• Shared unequally
• Relative
• Dynamic
• Pervasive
• Diversified
• Ethnocentric
• Reasonable
• Ritualistic
• Implicit
• Recognizable
Transcultural Nursing
• Viewing patients from their culture
• Transcends cultural boundaries
• For all cultures, not just ethnic or minority
groups
• Why do we need to be transcultural nurses?
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Cultural Patterns
• Transcultural nurse will look for patterns in
behavior to explain unusual behaviors,
especially if displayed by person from
another culture
• Opportunity for insightful nursing
assessment to make significant difference
Cultural Effects on Older Adults
• Care of older adult important to nursing as
population increases
• Culture shapes way individuals view aging
& helps explains adjustment to aging
• Cultural awareness facilitates individualized
care
Skilled Nursing Facility Living
• Adults > age 65
– White American : 6%
– Hispanic American : 3%
– Asian American: 3%
• Adults > 85 years
– White American : 23%
– Hispanic & Asian American: 10%
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Functions of Self-Concept
• The mental image a person has of oneself
• One with healthy self-concept:
– Has clear sense of self
– Distinguishes self as a separate individual
– Views others realistically
– Relates to others in satisfying ways
– Acknowledges own emotions
– Handles realities & solve problems
Patterns of Self-Concept
• Positive body image: feelings about physical
self
• Self-esteem: feelings about oneself
• Strong personal identity: sense of individuality
awareness as separate from others
• Role performance: how one performs expected
behaviors of specific role
Self-Concept Development
• Newborn: undifferentiated from mother
• Toddler/Preschooler: rudimentary body image
• School Age: influenced by others
• Adolescent: rapidly changing view of self
• Adult: stabilization of role, body image
• Older Adult: may question role identity &
body image
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Factors Affecting Self-Concept
• Biologic make-up
• Stressful life events
• Culture
• Incomplete psycho-
• Coping ability
social development
• Previous experience
• Role transition
• Locus of control
• Illness, trauma, surgery
Disturbed Body Image
• Definition: disruption in perceptions, beliefs, &
knowledge about body structure, function, etc
• Defining characteristics: verbal or behavioral
response to change in body structure or function;
avoid looking at or acknowledging body
• R/t: amputation, colostomy, obesity, illness, etc
• Goals: Client will:
– Short term: look at affected body part today
– Long term: verbalize acceptance of appearance
Disturbed Body Image Implementation
• Provide privacy; spend time with client; assist
to express feelings
• Provide reliable info re altered appearance &
effect on physical functioning;
• Provide info re supportive devices/prostheses
• Clarify misunderstandings re appearance
• Support efforts to view/touch changes in body
• Support efforts to adapt to functional changes
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Siutational Low Self-Esteem
• Definition: one who previously had positive
self-esteem experiences negative feelings
about self in response to event
• Defining characteristics: episodic occurrence
of negative self-appraisal in response to events
• R/t: disfigurement, feelings of failure,
menopause, marital or scholastic problems, etc
• Goals: Client will:
– Short term: Make eye contact with RN today
– Long term: Express positive outlook for future
Situational Low Self-Esteem
Implementation:
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Encourage to identify personal strengths
Recognize past accomplishments & knowledge
Discourage from focusing on past weaknesses
Provide info about & encourage participation in
self-esteem promoting activities & support
groups
• Help determine factors that interfere with
positive interpersonal relationships
Ineffective Role Performance
• Definition: state in which one experiences
disruption in way role performance is perceived
• Defining characteristics: Conflict related to role
perception or performance
• R/t: illness, disability, poverty (any factor that
creates difficulty fulfilling role responsibilities)
• Goals: Client will:
– Short term: express positive feelings about
capabilities
– Long term: Perform capably
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Ineffective Role Performance
Implementation
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Assist to express feelings about role changes
Help accurately assess role loss or change
Help differentiate perceived role from actual role
Provide resources for role-modeling or
instructions regarding role change
• Demonstrate needed role behaviors
• Praise when demonstrates success in new role
performance
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