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**************APA Format********** Read chapter 24, 22 & 36 of the class textbook and review the attached PowerPoint presentations. Once done write an 800 words essay contracting the three study heritage. Mention in the essay if there is any similarity in their healthcare belief. Mention how do they see health and disease and their customs to deal with them, also, discuss how they view dead. How their health care belief affect or influence the delivery of evidence-based healthcare. Read content chapter 36 in Davis Plus Online Website.You must use at least 3 evidence-based references (excluding the class textbook). A minimum of 800 words (not counting the first and reference page are required). This time beside the content and references I will count the assignment base of the number of words.
cultural_nursing_ch24.ppt

cultural_nursing_ch22.ppt

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian American Culture
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Overview/Heritage
▪ This presentation focuses on Russians who are
immigrants to the United States.
▪ The Russian Federation, the largest country in
the world, is composed of 21 republics and
covers parts of two continents, Asia and Europe.
▪ Under communism all media were controlled,
disseminating only information that the
government wanted people to know.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Overview/Heritage
▪ Under Communism, everyone could attend
higher education institutions, resulting in a welleducated population.
▪ Many scientists, physicians, and other
professionals who have immigrated to the United
States find difficulty in continuing to practice their
profession, necessitating employment in
occupations that lower self-esteem.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Communication
▪ The official language of Russia is Russian.
▪ Most educated Russians in the United States
speak English to some extent because
professional literature in Russia was printed
in English.
▪ Many do not understand medical jargon and
have difficulty communicating abstract
concepts.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Communication
▪ Many older Russian Jewish immigrants speak
Yiddish.
▪ Younger Jewish immigrants usually do not
speak Yiddish because it was strongly
discouraged in Russia.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Communication
▪ Punctuality is the norm, and many arrive
early.
▪ Temporality is toward present and future
orientation.
▪ In Russia, many people concerned
themselves with having food and other
necessities, not just for that day, but also for
the following days and weeks ahead.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Communication
▪ Direct eye-to-eye contact is the norm among
family, friends, and others without distinction
between genders.
▪ Some may avoid eye contact when speaking
with government officials, a practice common
in Russia where making eye contact with
government officials and other people in
hierarchal positions could lead to questioning.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Communication
▪ Most individuals accept touch regardless of
age and gender.
▪ Vocal volume may be loud, extending to
those nearby who are not part of the
conversation.
▪ Russians do not appreciate when others
stand with their hands inserted into pockets,
cross arms over their chests, and slouch.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Communication
▪ Until trust is established, many Russians
stand at a distance and are aloof when
speaking with health-care providers.
▪ Many educated women keep their maiden
names when they marry.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Family Roles & Organization
▪ Family, children, and older adults are highly
valued. Russians, accustomed to extended
family living in their home country, continue the
practice when they emigrate.
▪ Decision-making among current immigrants is
usually egalitarian with decisions being made by
the parents or by the oldest child.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Family Roles and
Organization
▪ While parents work, grandparents care for
grandchildren.
▪ Older people live with their children when selfcare is a concern.
▪ Nursing homes are rare and are of poor quality in
Russia; thus, children may fear placing parents in
long-term care facilities.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Family Roles & Organization
▪ Children of all ages are expected to do well in
school, go on for higher education, help care for
older family members, and tend to household
chores, according to traditional gender roles.
▪ Teens are expected not to engage in sexual
activity.
▪ Sex and contraceptive education are not
traditionally provided.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Family Roles & Organization
▪ Single and divorced relationship statuses are
accepted without stigma.
▪ Gay and lesbian relationships are not
recognized or discussed and are still
stigmatized by a large part of the population.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Workforce Issues
▪ The concept of teamwork is new to Russian
nurses as is critical thinking and sensitive caregiving.
▪ When communicating in the workplace, Russians
promote the value of positive politeness, a
technique that employs rules of positive social
communication.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
The nurse is conducting an intake assessment on a 76 year
old Russian immigrant. She does not maintain eye
contact with the nurse. The lack of eye contact is most
likely due to
a. Respect for the nurse.
b. Lack of trust.
c. Does not want to tell the truth.
d. Most Russians do not maintain eye contact when
conversing.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: B
Many older Russian immigrants do not maintain
eye contact with governmental officials or people
in hierarchal positions because they could not be
trusted.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Workforce Issues
▪ The employee, using positive politeness, will
say nice things that show that the person is
accepted, while simultaneously providing
support, empathy, and avoiding negative
discourse with coworkers.
▪ When negotiating compromise, Russians
express emotion and invest considerable time
and effort into supporting decisions.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Workforce Issues
▪ With colleagues and friends, Russians
communicate directly, which is considered a
sign of sincerity.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Biocultural Ecology
▪ Russians in the US are predominately white
making them prone to skin cancer.
▪ Common health conditions of Russians include
alcoholism, depression, gastrointestinal
disorders, respiratory diseases, cardiovascular
diseases, cancer due to radiation, dental
disease, tuberculosis, diabetes mellitus, and
hyperlipedemia.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Biocultural Ecology
▪ Many who come from Eastern Europe were
exposed to the radiation effects of the
Chernobyl disaster in 1986, resulting in a high
incidence of cancer among this immigrant
group.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian High-Risk Behaviors
▪ Both men and women have high smoking rates.
▪ Domestic violence is common and is related
mostly to high rates of alcohol consumption.
▪ Domestic violence support services are not
available in Russia; thus, patients are reluctant
to report or seek help for domestic violence in
the United States.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Nutrition
▪ Common foods include cucumbers in sour
cream, pickles, hard-boiled eggs as well as eggs
served in a variety of other ways, marinated or
pickled vegetables, soup made from beets
(borscht), cabbage, buckwheat, potatoes, yogurt,
soups, stews, and hot milk with honey.
▪ Cold drinks are not favored.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Nutrition
▪ Meat choices include pickled herring, smoked
fish, anchovies, sardines, cold tongue, chicken,
ham, sausage, and salami.
▪ Bread is a staple with every meal.
▪ The diet overall is high in fat and salt.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Pregnancy and
Childbearing Practices
▪ Many new immigrants may not be aware of
different methods of fertility control.
▪ Abortion is very common in Russia, and some
may choose this option in the United States.
▪ Russian condoms are made of thick rubber,
discouraging their use by men.
▪ Pregnant women have regular prenatal checkups, which are mandatory in Russia.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Pregnancy and
Childbearing Practices
▪ During pregnancy, women are discouraged from heavy
lifting and from engaging in strenuous physical activities;
they are also protected from bad news that can be
harmful to the fetus.
▪ They are encouraged to eat foods that are high in iron,
calcium, and vitamins.
▪ Strawberries, citrus fruits, peanuts, and chocolate are
avoided to prevent allergies in the newborn.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Pregnancy and
Childbearing Practices
▪ As labor approaches, women take laxatives and enemas
to facilitate delivery.
▪ Traditionally in Russia, husbands and relatives could not
participate in the delivery or visit the hospital postpartum.
▪ There are no cultural restrictions for fathers or female
relatives not to participate in delivery.
▪ The delivery room should not have bright lights because
many individuals believe that bright lights will harm the
newborn’s eyes.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Pregnancy and
Childbearing Practices
▪ Many women breast-feed until the infant
reaches the toddler stage.
▪ Many women believe the breasts must be kept
warm during feeding lest the mother get breast
cancer later in life.
▪ Peri-care with warm water is important, and a
binder is worn to help the mother’s figure
return to its state prior to pregnancy.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Pregnancy and
Childbearing Practices
▪ In Russia, women were accustomed to 8 weeks
of maternity leave before delivery and up to 3
years leave following delivery.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Death Rituals
▪ Families want to be notified about impending
death first, before the patient is told.
▪ Most families prefer to have the dying family
member cared for at home.
Do-not-resuscitate orders are appropriate; many
families want their loved one to die in comfort.
▪ Few believe in cremation; most prefer interment.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Death Rituals
▪ Both men and women may wear black as a
sign of mourning.
▪ Black wreaths are hung on the door of the
deceased’s home.
▪ Expression of grief varies greatly.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Spirituality
▪ Most who practice a religion are Eastern Orthodox or
Jewish, with smaller numbers of Molokans, Tartar
Muslims, Seventh Day Adventists, Pentecostals, and
Baptists.
▪ Sixty percent of Russian people are nonreligious.
▪ The state-controlled Russian Orthodox Church was the
only accepted religion in Russia (other religions were
prohibited) until perestroika and glasnost.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Spirituality
▪ Russian Americans pray in their own way, which
may be different from that of the dominant
religion with which they identify.
▪ Because Judaism was forbidden in Russia, many
Jewish Russian in the US are unfamiliar with
many of the Jewish religious practices.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Health-care Practices
▪ Because health care is free at the point of entry
in Russia, newer immigrants might not be aware
of the need for insurance in the United States.
▪ Hospital stays in Russia average 3 weeks. Some
clients may expect this in the United States.
▪ Unmarried women are not accustomed to Pap
tests because in Russia only married women get
them. Mammography is uncommon in Russia.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Health-care Practices
▪ Many individuals are preoccupied with remaining
warm to prevent colds and other illnesses.
▪ Most do not want breezes from fans or drafts
from an open window to blow directly on them.
▪ They may also be reluctant to apply ice at the
recommendation of a health-care provider.
▪ Most Russians are stoical with pain and may not
ask for pain medicine.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Health-care Practices
▪ Some individuals may be reluctant to wash their
hair for fear of catching a cold if the room is not
warm or has a draft.
▪ Because of high radiation in parts of Russia,
many fear having an x-ray.
▪ Clients are not accustomed to being told about
cancer, terminal illnesses, or grave diagnoses;
many believe it makes the condition worse.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Health-care Practices
▪ A primary treatment for a variety of respiratory
illnesses is cupping.
▪ A small glass cup, a bonzuk or bonki, has
alcohol-saturated cotton or other materials in it.
▪ The material is lighted and then the cup is
turned upside down on the patient’s back. The
skin is drawn into the cup, leaving round
ecchymotic areas when it is removed.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Health-care Practices
▪ Common cultural practices include taking
vodka with sugar for a cough; soaking one’s
feet in warm water for a sore throat;
aromatherapy for a variety of respiratory
illnesses; mud and mineral baths to promote
healing; and herbs and teas for fever, colds,
and minor ailments.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Health-care Practices
▪ People are accustomed to not telling healthcare providers about depression or any other
emotional or mental health concerns because
mental illness carries a significant stigma and
mental health facilities are very poor in Russia.
▪ Inadequate screening of blood in Russia
creates fear of contracting HIV from blood
transfusions.
▪ Most do not believe in organ donation.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Russian Health-care Practitioners
▪ Health-care providers are respected.
▪ Because nurses function in higher roles in the
United States than in Russia, they may be
mistaken for physicians.
▪ Men and women are accustomed to living
together in very small physical quarters; thus,
most do not have a problem with privacy.
▪ Gender is not generally a concern in care.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
A 42 year old Russian immigrant has been ordered
a chest x-ray suspected pneumonia. He is very
reluctant to have the x-ray. A probably reason for
his reluctance is
a. High radiation in some parts of Russia.
b. He is unaware of the procedure.
c. He is modest and does not want to disrobe.
d. The physical environment is cold.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: A
Many Russians, especially recent immigrants, are
fearful of x-rays because of high radiation levels
in parts of Russia.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish American Culture
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ Over 9 million people in the United States and
800,000 people in Canada identify their ancestry
as Polish.
▪ Displaying fierce patriotism, courage, and
determination to resist another occupation,
Poland was the only country to combat Germany
from the first day of the Nazi invasion until the
end of the war in Europe.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ Between the 1939 Nazi invasion and the end of
World War II in 1945, nearly six million Poles,
comprising over 15 percent of Poland’s total
population, perished.
▪ Many Polish Jews were exterminated by the
Nazis in the Holocaust, prisoners killed in
concentration or forced labor camps, soldiers,
and civilians.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ After Stalin’s death, Polish communism vacillated
between repression and liberalization until about
1970.
▪ Poland’s resistance to Communist rule began in
1970 with the emergence of Lech Walesa, the
leader of a strike in the Gdansk shipyards.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ The 1980 emergence of Solidarity and the
election of a Polish Pope rekindled a religious
rebirth in the Poles, an increased sense of self,
social identity, and the realization of their
collective strength.
▪ Solidarity became a major social movement and
phenomenon unheard of within the Soviet bloc’s
political system.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ In July, 1989, the newly elected Parliament
changed the country’s name and constitution,
establishing the Third Republic of Poland and a
democratic system of government.
▪ Polish immigrants have maintained their ethnic
heritage by promoting their culture, attending
Catholic churches, attending parades/festivals,
maintaining ethnic food traditions, speaking the
Polish language.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ Newer immigrants are less concerned with
raising consciousness over Polish
American issues as they are with
financially helping families who remain in
Poland and raising concerns over the
political/economic climate in their
homeland.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ Like any other group that perceives themselves
as unaccepted, displaced, and different, Polish
immigrants established a geographically and
socially segregated area which was called a
“Polonia”.
▪ Polish immigration to America continues today;
many come to earn money then return to Poland.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ At the peak of Polish migration, Chicago
was considered the most well-developed
Polish community in the United States.
▪ Poles are a heterogeneous group. As such,
they were slow to assimilate into
multicultural America.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ Even after displaying a sense of duty, honor,
and patriotism during wartime, Polish Americans
often experienced discrimination during and
after the war.
▪ Poles were passed over for jobs because they
had difficulties speaking English and their
names were difficult to pronounce or spell.
▪ Name changes became common for Polish
Americans seeking upward mobility.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Polish Overview/Heritage
▪ Many Polish Americans still experience
discrimination and ridicule through
ethnic Polish jokes, which are similar in
scope to those about Irish, Italian, and
Mexican Americ …
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