Promoting Cultural Competence in Healthcare, Exams of Nursing

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cultural competence - answer ✅✅the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. is defined as "a dynamic, fluid, continuous process whereby an individual, system or health care agency find meaningful and useful care delivery strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behavior of those to whom they render care" culturally competent health care system - answer ✅✅can help improve health outcomes and quality of care and can contribute to the elimination of racial and ethnic health disparities. ex. of strategies to move the health care system towards these goals include providing relevant training on cultural competence and cross cultural issues to health professionals and creating policies that reduce administrative and linguistic barriers to patient care.

cultural awareness - answer ✅✅is their understanding of the differences between themselves and people from other countries or other backgrounds, especially differences in attitudes and values. Self-examination of one's own prejudices and biases toward other cultures. An in-depth exploration of one's own cultural/ethnic background. Norms - answer ✅✅rules and expectations by which a society guides the behavior of its members in any given situation. It varies widely across cultural groups. For ex. American maintain fairly direct eye contact when conversing with others. Asians, on the other hand, may avert their eyes as a sign of politeness ad respect. values - answer ✅✅the ideas, beliefs, and attitudes about what is important that help guide the way you live. It has major influences on a person's behavior and attitude and serve as broad guidelines in all situations. some common business ____ are fairness, innovation, and community involvement. The Kleinman explanatory model- consists of 3 sectors. - answer ✅✅the popular sector, the

professional sector and the folk sector. the model can be used to determine how individuals make decisions. socioeconomic status (SES) - answer ✅✅is an economic and sociological combined total measure of a person's work experience and of an individual's or family's economic and social position in relation to others, based on income, education, and occupation. disparities - answer ✅✅the term is often interpreted to mean racial or ethnic disparities, many dimensions of disparity exist in the U.S, particularly in health. If a health outcome is seen to a greater or lesser extent between populations, there disparity. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual's ability to achieve good health. It is important to recognize the impact that social determinants have on health outcomes of specific populations. healthy people strives to improve the health of all groups. Minorities - answer ✅✅a culturally, ethnically, or racially distinct group that coexists with but is subordinate to a more dominant group. as the term is used I the social sciences, this subordinacy is the chief defining characteristic of a minority group. As

such, minority status does not necessarily correlate population. food desert - answer ✅✅an urban area in which it is difficult to buy affordable or good-quality fresh food. determinant of health - answer ✅✅the range of personal, social, economic, and environmental factors that influence health status determinants of health fall under several broad categories - answer ✅✅policymaking, social factors, health services, individuals behavior, biology and genetics. It is the interrelationships among these factors that determine individual and population health. Because of this, interventions that target multiple determinants of health are most likely to be effective. Determinants of health reach beyond the boundaries of traditional health care and public health sectors; sectors such as education, housing, transportation, agriculture, and environment can be important allies in improving population health. Social determinants of health - answer ✅✅· Availability of resources to meet daily needs, such

as educational and job opportunities, living wages, or healthful foods · Social norms and attitudes, such as discrimination · Exposure to crime, violence, and social disorder, such as the presence of trash · Social support and social interactions · Exposure to mass media and emerging technologies, such as the Internet or cell phones · Socioeconomic conditions, such as concentrated poverty · Quality schools · Transportation options · Public safety · Residential segregation. They are important because they play a huge part on how a person is treated an how prone they are to have a certain condition. Social justice - answer ✅✅implies that there is a fair and equitable distribution of benefits and burdens in a society Data Sources used to assess determinants of health include: - answer ✅✅Chronic Disease Indicators, Interactive Atlas of Heart Disease and Stroke, National Center for HIV/AIDS, Viral

Hepatitis, STD, and TB Prevention Atlas, National Environmental Public Health Tracking Network, and The Social Vulnerability Index. Genetic testing - answer ✅✅analyzes your DNA to detect specific, inheritable, disease-related gene mutations that may increase the risk of certain cancers. It provides you with an in-depth cancer risk assessment. Genomics - answer ✅✅is an interdisciplinary field of biology focusing on the structure, function, evolution, mapping, and editing of genomes. A genome is an organism's complete set of DNA, including all of its genes. Pharmacogenomics - answer ✅✅is the study of how genes affect a person's response to drugs. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that will be tailored to a person's genetic makeup Genetic epidemiology - answer ✅✅The link of epidemiology and genetics. is the study of the role of genetic factors in determining health and disease in families and in

populations, and the interplay of such genetic factors with environmental factors. Genetic epidemiology seeks to derive a statistical and quantitative analysis of how genetics work in large groups. Genomics - answer ✅✅The study of all genes in the human genome as well as their interaction with other genes, the individual's environment, and the influence of cultural and psychosocial factors. plays a role in 9 of the 10 leading causes of death,5 including: Heart Disease, Cancer, Stroke, Diabetes, Alzheimer's disease. Women with a high risk of cancer should get genetic testing and those recently diagnosed with colorectal cancer. The Genetic Information Nondiscrimination Act of 2008 (GINA) - answer ✅✅is a federal law that protects individuals from genetic discrimination in health insurance and employment. Genetic discrimination is the misuse of genetic information. Essential components include - answer ✅✅the intake, cancer risk assessment, genetic testing for an inherited cancer syndrome, informed consent, disclosure of genetic test results, and psychosocial assessment

All traits depend both on genetic and environmental factors. - answer ✅✅Heredity and environment interact to produce their effects. This means that the way genes act depends on the environment in which they act. In the same way, the effects of environment depend on the genes with which they work. For example, people vary in height. Although height is highly heritable , environmental variables can have a large impact. For example, Japanese-Americans are on the average taller and heavier than their second cousins who grew up in Japan, reflecting the effect of environmental variables, especially dietary differences. Point Source Outbreaks - answer ✅✅Common source outbreaks where the source has infected cases at one particular geographical location, during a short period of time. In such situations the source is said to be located 'at a single point in time and place'. These outbreaks have a typical bell shaped epidemic curve, that increases sharply, peaks and then decline sharply, which reflects the normal distribution of the incubation period of the causative agent in humans. For this reason, the epidemic curve of a point source outbreak can help us identify the moment of transmission (i.e. when all cases have been exposed to the source).

Propagated outbreaks - answer ✅✅When an infectious disease is communicable (i.e. can be transmitted from person to person), then we can no longer consider that a single, common source is responsible for the outbreak. The causative agent is propagated within the population through human contact patterns. The shape of the epidemic curve in propagated outbreaks can vary and depends on the contact pattern and the proportion of susceptible individuals. Classically, when a pathogen is introduced into a fully naive (i.e. fully susceptible) population with relatively easy person to person transmission (e.g. airborne), the epidemic curve increases sharply with incremental 'jumps'. The jumps reflect the generations of cases in the population. Sporadic - answer ✅✅refers to a disease that occurs infrequently and irregularly. Endemic - answer ✅✅refers to the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area. Hyperendemic - answer ✅✅refers to persistent, high levels of disease occurrence. Occasionally, the amount of disease in a community rises above the expected level.

Epidemic - answer ✅✅refers to an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area. Outbreak - answer ✅✅carries the same definition of epidemic, but is often used for a more limited geographic area. Cluster - answer ✅✅refers to an aggregation of cases grouped in place and time that are suspected to be greater than the number expected, even though the expected number may not be known. Pandemic - answer ✅✅refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people. Disaster Epidemiology - answer ✅✅is defined as the use of epidemiology to assess the short- and long- term adverse health effects of disasters and to predict consequences of future disasters.

The current Director- General of The WHO - answer ✅✅is Tedros Adhanom, who started his five-year term on 1 July 2017. WHO - answer ✅✅began when our Constitution came into force on 7 April 1948 - a date we now celebrate every year as World Health Day. We are now more than 7000 people working in 150 country offices, in six regional offices and at our headquarters in Geneva, Switzerland. Our primary role is to direct and coordinate international health within the United Nations system. Our main areas of work are health systems; health through the life-course; noncommunicable and communicable diseases; preparedness, surveillance and response; and corporate services. We support countries as they coordinate the efforts of governments and partners - including bi- and multilaterals, funds and foundations, civil society organizations and the private sector. Working together, we attain health objectives by supporting national health policies and strategies. The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with international public health. It was established on 7 April 1948, and is headquartered in Geneva, Switzerland. The WHO is a member of the United Nations Development Group. Its predecessor, the Health Organization, was an agency of the League of Nations. The constitution of the World Health Organization had been signed by 61 countries on

22 July 1946, with the first meeting of the World Health Assembly finishing on 22 July 1946. It incorporated the Office International d'Hygiène Publique and the League of Nations Health Organization. Since its establishment, it has played a leading role in the eradication of smallpox. Its current priorities include communicable diseases, in particular HIV/AIDS, Ebola, malaria and tuberculosis; the mitigation of the effects of non- communicable diseases such as sexual and reproductive health, development, and aging; nutrition, food security and healthy eating; occupational The Sustainable Development Goals (SDGs) (or the Global Goals for Sustainable Development, the 17 Global Goals[1], the Global Goals[2] or simply the Goals[3]) - answer ✅✅are a collection of 17 global goals set by the United Nations General Assembly in 2015. The SDGs are part of Resolution 70/1 of the United Nations General Assembly[4]: "Transforming our World: the 2030 Agenda for Sustainable Development". That has been shortened to "2030 Agenda".[5] The goals are broad and interdependent, yet each has a separate list of targets to achieve. Achieving all 169 targets would signal accomplishing all 17 goals. The SDGs cover social and economic development issues including poverty, hunger, health, education, global warming, gender equality, water, sanitation,

energy, urbanization, environment and social justice.[6] If individuals do not have equal access to healthcare, food, and other health factors - answer ✅✅outbreaks could be more predominate do to poor health and lack of adequate medical services needed to treat the disease. Climate change can have increase effects on - answer ✅✅COPD, Asthma, and Respiratory infections. A Call to Action - answer ✅✅is meant to change planetary health through nursing. A Call to Action - answer ✅✅It falls to nurses and midwives, the most numerous and arguably most patient-centered component of the health workforce, to assume a leadership role in addressing planetary health. Leadership begins with educating ourselves, students, staff, patients, and communities. Engagement in political and policy processes are needed-and can take many forms. Even small measures may have impact. Local level sustainability and readiness is meaningful at one's university, hospital, and or health system levels.

a key productive action - answer ✅✅* Learning-and teaching-about planetary health. The collective changes possible with law and policy changes-in short, better governance-are necessary to limit further harm. Communication - answer ✅✅about planetary heal matters requires special care to keep emotions even keeled and avoid an apocalyptic focus. Just as gain-framed messages are demonstrably more effective in health prevention strategies for individuals, prevention in the planetary health domain can include emphasis on improved economies, jobs, population health, and social justice.

• answer ✅✅Finding common ground (leveraging beliefs, telling personal stories; see Figure S3) with an audience improves message receptivity. New research indicates "that it is possible to pre- emptively protect ('inoculate') public attitudes about climate change against real world misinformation" (van der Linden, Leiserowitz, Rosenthal, & Maibach, 2017, p. 1). Nurses in educational, community, and clinical leadership roles can provide listeners with information about the nature of disinformation campaigns and why certain parties seek to confuse their audiences.

This is the sort of health promotion ("inoculation") work in which nurses and midwives excel.

• answer ✅✅The formal and continuing education of nurses and midwives must keep pace with the changing conditions, evolving science, and higher levels of engagement from populations and patients in planetary health matters. Medical and public health curricula have made shifts to include climate change and health matters. Nursing curricula are arriving: the Global Consortium on Climate and Health Education (n.d.), a collaborative of nursing, public health, and medical schools formed in 2017, is developing interprofessional curricula on climate change and health. Green technology - answer ✅✅is an economic growth area. Economies based on wisely used, sustainable, and renewable sources of energy appear ready to thrive. Fossil fuel availability will peak then decline, creating potential market gaps for prepared leaders and nations to lead the green energy transition, enhancing the resiliency of cities, and making food and water systems sustainable. Embracing a planetary health mindset can challenge, renew, and unite us.

Pay attention to what narratives and stories we tell ourselves: - answer ✅✅"If we don't transition quickly to a sustainable way of life, humanity is doomed!" or rather, "We are transitioning to a more sustainable and resilient way of life that will offer tremendous benefits to humanity" (Frumkin, 2017; Hunter, Frumkin, & Jha, 2017). nurses role in resilient health system - answer ✅✅Nurses are essential to every solution that will improve the health of the planet, with implications for the development and use of the global healthcare workforce, for research, and for practice. Nurses help plan and build resilient health systems, but in order to develop health beyond health care, nurses must move into expanded roles, working with other sectors and individuals, to support the development of resilient communities. self same tools - answer ✅✅The science, techniques, and interventions useful in patient-level health promotion are uniquely understood by nurses and midwives. These self same tools can inspire and illuminate health promotion of the planet and the critical systems on which human existence depends. Safeguarding human health requires a healthy planet. The changes we make as individuals are useful, though as trusted clinicians, scholars, and leaders, those changes also can

inspire and educate others (Whitmee et al., 2015). The magnitude of our jewel of a planet's health crisis is enormous. But the timeliness, impact, and scale of the solutions that nurses and midwives will muster could evince the very best of our professional-and human-potential. by performing a community health assessment. - answer ✅✅You can assess an areas resources and its relationship to the health of the region continuing common source outbreak - answer ✅✅When all (or most) cases in an outbreak have been infected by the same source, however over a prolonged period of time, then this type of outbreak is called For example a recreational lake can be the source of leptospirosis to those who swim there. The shape of the epidemic curve of such outbreaks does not increase that sharply, it does not peak, yet reaches a plateau that is sustained over time, until the source is removed. EGAPP - answer ✅✅Evaluation of Genomic Applications in Practice and Prevention: assess validity and utility of genetic tests, guide interventions, and predict risk using population screening

-Use PICCO questions to answer if genetic tests for a specific disease have good analytical validity, clinical validity, and clinical utility.

• Then recommend who should be screened/tested GAPPNet - answer ✅✅Genomic Applications in Practice and Prevention Network (established in

2009. is a collaborative initiative involving partners from across the public health sector working together to realize the promise of genomics in health care and disease prevention. GEDDI - answer ✅✅Genetics Early Disease Detection Intervention project (established in 2009) developed a model strategy for using clinical, genetic, and family history information to reduce the risk of disease, death, and disability in affected individuals, family members, and populations. HuGENet - answer ✅✅Human Genome Epidemiology Network (established in 1998) helps translate genetic research findings into opportunities for preventive medicines and public health by advancing the synthesis, interpretation, and dissemination of population-based data on human genetic variation in health and disease. HuGENet reviews are systematic, peer-reviewed synopses of the epidemiologic aspects of human genes, including prevalence of allelic variants in different

populations, population-based information on disease risk, evidence for gene-environment interaction and quantitative data on genetic tests and services carried out according to specific guidelines. NHANES III - answer ✅✅CDC's Office of Public Health Genomics (established in 2002) formed a multidisciplinary working group with members from across CDC. It developed a proposal to measure the prevalence of selected genetic variants of public health significance in a representative sample of the U.S. population and to examine the association between the selected genetic variants and disease outcomes available in ______ data. genotics and health - answer ✅✅Understanding the relationships between genes, environment and health. family history - answer ✅✅is know to be a risk factor for many chronic diseases. Genomics translation - answer ✅✅Learn how genomic discoveries can be translated into practice.

Genetics - answer ✅✅The study of individual genes and their impact on relatively rare single gene disorders Culture humility - answer ✅✅A lifelong commitment to self-evaluation and self-critiques, redressing the power of imbalances in the patient- physician dynamic, developing mutually. Beneficial relationships. cultural knowledge - answer ✅✅Obtaining a sound educational foundation concerning the various worldviews of differences cultures. Obtaining knowledge regarding biological variations, disease and health conditions and variation in drug metabolism. Cultural skill - answer ✅✅Ability to collect culturally relevant data regarding the client's health history and presenting problem. Ability to conduct culturally based physician assessments. Conducting these assessments in a culturally sensitive manner. cultural desire - answer ✅✅Motivation of the healthcare provider to "want" to engage in the process of cultural competence, characteristics of compassion, authenticity, humility, openness,

availability, and flexibility, commi tment and passion to caring, regardless of conflict. Cultural competence in nursing consists of four principles. - answer ✅✅Care is designed for the specific client. Care is based on the uniqueness of the person's culture and includes cultural norms and values. Care includes self-employment strategies to facilitate client decision making to improve health behaviors. Care is provided with sensitivity and is based on the cultural uniqueness of clients. According to Giger and Davidhizer (2000), although cultures differ, they all have the same basic organizing factors that must be assessed in order to provide care for culturally diverse patients. These factors include - answer ✅✅communication (verbal and nonverbal); personal space; social organization; time perception; environmental control; and biological variations.

accommodation - answer ✅✅To create an environment that accommodates health practice and ritual from other cultures within a plan of care. Acculturation - answer ✅✅Degree two which an individual from one culture has given up the traits of that culture and adopted the traits of the dominant cultural in which they now reside Assimilation - answer ✅✅The social, economic, and political integration of a cultural group into a mainstream society to which it may have emigrated culture competence - answer ✅✅Respect for, and understanding of, diverse ethnic and cultural groups, their histories, traditions, beliefs, and value systems