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Nursing as a
Profession
Prepared by:
Ronivin Garcia Pagtakh
an, RN,MAN (c)
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PROFESSION
a calling that requires specialknowledge, skill and preparation
NURSING AS A PROFESSION
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FOUR CRITERIA TODETERMINE
PROFESSION
SPECIALIZED EDUCATION ETHICS
BODY OF KNOWLEDGE
AUTONOMY
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BENNERS LEVELS OF
NURSING PROFICIENCY (1984)STAGE 1. NOVICE
STAGE 2. ADVANCED BEGINNER
STAGE 3. COMPETENTSTAGE 4. PROFICIENT
STAGE 5. EXPERT
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ROLES OF THE
PROFESSIONAL NURSE
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CARE PROVIDER
Mothering actions
- chief goal in human relations is to convey
understanding about what is importantand to provide support
Caring is central to effective nursingpractice (Benner and Wrubel, 1989)
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COMMUNICATOR/HELPER
shapes relationships between nursesand clients, nurses and support
persons, and nurses and colleagues
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COUNSELOR
Counseling is the process of helping a
client to recognize and cope with stressful
psychologic or social problems, to
develop improved interpersonalrelationships, and to promote personal
growth.
It involves providing emotional,intellectual, and psychological support
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CLIENT ADVOCATE
pleads the cause of another or argues orpleads for a cause or proposal
involves concern for and defined actions in
behalf of another person or organization tobring about change.
involves promoting what is best for theclient
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CHANGE AGENT
a person or group who initiates changes
or who assists others in making
modifications in themselves or in thesystem
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LEADER Nursing Leadership is defined as a mutual
process of interpersonal influence through which
the nurse helps a client make decisions in
establishing and achieving goals to improve the
clients well-being
Purposes of Leadership
improve health status and potential of individuals
and families
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MANAGER
Management is defined as planning,giving direction, developing staff,
monitoring operations, giving rewardsfairly, and representing both staffmembers and administration asneeded.
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RESEARCHER
Research for new ways more than
the old fashioned nursing
interventions to promote health for
the patient.
Eg. Studies of complementary therapy
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EXPANDED NURSING ROLES
Nurse Generalist
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Nurse Practitioner
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Nurse Specialist
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History of Nursing :Foreign
Prepared by:
Ronivin Garcia Pagtakhan,RN
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From
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To
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Nursing Defined
As a Science and Art
It is blending of 3 factors
1. Art2. Science
3. Spirit
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Definition
Nurse = latin word nutricius = that
nourishes, foster, protects
is a service to the individual which
helps him to regain, or to keep a normal
state of body and mind.
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Intuitive
Apprentice
Dark
Educated
Contemporary
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Intuitive nursing was practiced since
prehistoric times among primitive tribes
and lasted through the early Christian
era.
PERIOD OF INTUITIVE
NURSING
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PERIOD OF APPRENTICE
NURSING
11th Century to 1836
Started from the founding of
religious orders in the crusaders totraining of Deaconesses.
Called period of on-the-job-training
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Saint Elizabeth of Hungary
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Saint Camillus de Lellis
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THE DARK PERIOD of NURSING
Extends form 17th Century to 19th Century
Period of reformation until the U.S. Civil war
Martin Luther destroyed the unity of Christian Faith.
Wrath of Protestantism swept away everything connectedwith Roman Catholicism in schools, orphanage, and
hospitals Properties of Hospitals and School were confiscated
Nurses fled to their lives
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Began on June 15, 1860
Opened Florence Nightingale School of
Nursing at St, Thomas Hospital inLondon.
Arousal of Social consciousness
PERIOD OF EDUCATED
NURSING
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Mother of Modern Nursing
Lady with a Lamp
Born May 12, 1820 in Florence, Italy
Education was rounded out by a
continental tour
Victorian Lady, developed her self-
appointed goal: to change the
profile of nursing
Facts about Florence Nightingale:
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PERIOD OF CONTEMPORARY
NURSING
After world war II present
Scientific and technological
development and social changes
marks this period.
Events and trends
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Nursing Informatics
Nursing Informatics is a specialty of
Health care informatics which deals
with the support of nursing by
information systems in delivery,
documentation, administration and
evaluation of patient care and
prevention of diseases.
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American Nurses Association's Scope and
Standards for Nursing Informatics Practice(2006): Nursing Informatics is a specialty that
integrates nursing science, computer science,
and information science to manage and
communicate data, information, andknowledge in nursing practice.
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"Nursing informatics is the multidisciplinary scientific
endeavor of analyzing, formalizing and modeling how
nurses collect and manage data, process data into
information and knowledge, make knowledge-baseddecisions and inferences for patient care, and use this
empirical and experiential knowledge in order to
broaden the scope and enhance the quality of their
professional practice.
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NURSING PROCESS
Prepared by:
Ronivin Garcia Pagtakhan, RN,MAN (c)
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Nursing Process
A systematic method that directs the
nurse and client as, together, the
determine the need for nursing care, and
then plan, implement, and evaluate care. The steps in this client centered, goal-
oriented process are interrelated
Each of the five steps depends on the
accuracy of the step preceding it
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It is a framework for providing nursing
care to clients, families, and communities. It is goal-oriented.
It provides a systematic and organized
approach. It is based on individualized problem
identification and problem solving.
It can be utilized throughout the life of the
patient.
It can be used in all settings.
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History of the Nursing Process
1955 Lydia Hall ORIGINATED the termNURSING PROCESS
1959 Johnson, 1961 Orlando,
1963 Weidenbach 1963 Henderson, utilized scientific method,
McCain termed assessment 1971 Orem proposed: needs assessment,
nursing action, control of action 1973 ANA utilized nursing process using
the 5 phases: Assessment, Diagnosis,Planning, Intervention, Evaluation
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1975 Gebbie and Lavin introducedthe term Nursing Diagnosis
1976 introduced the six steps of thenursing process: Assessment,Problem identification, Goal setting,approaches, Evaluation. Sheadvocated the term NursingDiagnosis
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Phases of theNursing Process
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Assessment
DECRIPTION Collection Validation Communication of client data
PURPOSE Make critical and sound judgement about
clients:
Health status Ability to manage his own health care and need
for nursing Plan individualzed holistic care that draws on
client strength and is responsive to the changes
in the clients condition
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Assessment
ACTIVITIES1. Establish the data base:
* Nursing health history
* Physical Assessment
* Review of client record and nursingliterature
* consultation with clients support
perople and health care professionals2. continuously update the data base
3. validate data
4. communicate data
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Types of Assessment
Initial Assessment
Focus or ongoing assessment
Emergency assessment
Time lapsed assessment
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Types of Data
Subjective Symptoms or covert data
Objective- Signs or overt data
Data should be: Accurate
Complete
Factual Relevant
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Nursing Diagnosis
DECRIPTION
Analysis of client data to identify client
strengths and health problems that
independent nursing intervention can
prevent or resolve
PURPOSE
Develop a prioritized list of nursing
diagnoses
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Nursing Diagnosis
ACTIVITIES
1. Interpret and analyze client data
2. Identify client strengths and healthproblems
3. Formulate and validate nursing
diagnoses
4. Develop prioritized list of nursing
diagnoses
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Types of Nursing Diagnosis
Actual Health problem is present during assessment
Risk More vulnerable than others
Potential Needs more data for confirmation
Collaborative Together with other members of health team
Syndrome Under risk, after trauma
Wellness At a higher level of wellness
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Components of the Nursing Diagnosis
Problem
Diagnostic label
Etiology Related and risk factors
Defining characteristics
Clustered signs and symptoms toconfirm the diagnosis
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Format:
P + E
P + E + S
P + E + 2
P + E + 2 + S
S as manifested by, as seen in
2 - MDx
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Criteria in prioritization of
Nursing Problems
Type of nursing diagnosis
ABC (Airway, breathing, circulation) Maslows Hierarchy of Needs
Threat to patients integrity
Patients salience
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Types of Nursing Diagnosis
Actual
Risk
Potential Collaborative
Syndrome
Wellness
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A airway
B breathingC circulation
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Maslows Hierarchy of Needs
Physiologic Needs
Safety
Love and Belongingness
Self Esteem
Self Actualization
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Planning
DECRIPTION
Specification of:
1. Client goals and objective to prevent,reduce, or resolve the problems identifiedin the nursing diagnoses
2. Related nursing interventions
PURPOSE
Develop an individualized plan of nursing care
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Measurement Criteria for Expected
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Measurement Criteria for Expected
Outcomes
Derived from the diagnosis
Mutually formulated with the client
and health care provider
Specific
Measurable
Attainable
Realistic
Time bounded
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Implementation
DECRIPTION
Carrying out the plan of care
PURPOSE
Assist clients to achieve desired goals
promote wellness, prevent disease andillness, and restore health
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Implementation
ACTIVITIES
1. Carry out the plan of care
2. Continue data collection and modify
the plan of care as needed
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Types of Nursing Interventions
Independent Interventions
Nurse initiated
Dependent Interventions
Physician initiated
Collaborative Interventions
Carried out with other health team
members
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Evaluation
DECRIPTION
Measure degree which goal, objectives or
outcome measures were achieved and the
factors affecting the resulting upshot
PURPOSE
Determine whether goal and objectives were
met, whether to continue with the plan ofcare or modify
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Evaluation
ACTIVITIES
1. Collaborte with patient related to
outcome
2. Judge if goals and objectives were
met
3. Relate nursing actions to outcome
4. Review, re-assess, re-diagnose, re-
plan, and modify.
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Thank you & good day!
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Review Outline for
Fundamentals of Nursing
Nursing Theories, Transcultural
Nursing, CommunicationTechniques
http://www.printfection.com/busybodies/Nurse/_s_16360 -
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NURSING THEORIES
Nursing Theories
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Theory building
Concepts
Statements
Theories
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Levels
Meta theory
Grand
Middle range practice
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Criteria
Nursing
Health
Person Environment
1 FLORENCE
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1. FLORENCE
NIGHTINGALE, 1850s
Mother of Modern Nursing
THEORY: Environmental Theory
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2. VIRGINIA HENDERSON, 1997-1996
THEORY: Definition of Nursing
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PERSON: A whole complete and independent being
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PERSON: A whole, complete and independent being
who has 14 fundamental needs.
1. to breathe
2. eat and drink
3. eliminate
4. move and maintain posture5. sleep and rest
6. dress and undress
7. maintain body temperature
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8. keep clean
9. avoid danger
10.communicate
11.worship12.work
13.play
14.learn
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3. MARTHA ROGERS,1914-1994
THEORY: Unitary Human Beings as an
Energy Field
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4. DOROTHEA OREM, 1980 - 2007
THEORY: SELF-CARE DEFICIT THEORY
Self-care TheorySelf-care Deficit Theory
Nursing System Theory
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5. Sister Callista Roy, 1976
THEORY: Adaptation Model
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7. Betty Neuman, 1972
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y ,
THEORY: Health Care Systems Model
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8. Dorothy Johnson
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y
THEORY: BEHAVIORAL SYSTEM
MODEL
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9. Hildegard Peplau, 1952
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g p ,
THEORY: Psychodynamic Nursing
Theory and Interpersonal Relations
Theory
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10. Madeleine Leininger, 1978
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THEORY: Transcultural Care Theory or
Culture Care Diversity and Universality
Theory
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11. Jean Watson, 1979
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THEORY: Philosophy and Science of
Nursing
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12 Faye Abdellah
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12. Faye Abdellah
THEORY: TYPOLOGY OF NURSING
PROBLEMS
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13. Ernestine Wiedenbach (1900-1996)
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( )
THEORY: HELPING ART OF CLINICAL
NURSING
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14. Joyce Travelbee
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THEORY: HUMAN TO HUMAN
RELATIONSHIP MODEL
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15. Lydia Hall, 1960s
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THEORY: Theory of Care, Core and Cure
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16. Ida Orlando, 1961
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THEORY: Dynamic Nurse-Patient
Relationship or Deliberative Process ofNursing
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18. Margaret Newman
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THEORY: HEALTH AS EXPANDING
CONSCIOUSNESS
19. Rosemary Rizzo Parse
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THEORY: THEORY OF HUMAN
BECOMING
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COMMUNICATION
TECHNIQUES
Communication Techniques
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TRANSCULTURAL NURSING
Transcultural Nursing
Transcultural Nursing
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Transcultural Nursing
Cross-cultural nursing
Intercultural nursing
Multicultural nursing
Transcultural Nursing
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Transcultural Nursing
Definition of Terms
Ethnicity
Belonging to a specific ethnic group (individuals
who share a common social and cultural heritage
that is passed on to successive generations)
Race
Classification of people according to shared
biologic characteristics and physical features
Transcultural Nursing
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Transcultural Nursing
Culture Knowledge, belief, art, morals, laws,
customs, or any other capabilities
and habits acquired by humans as
member of society
Characteristics
It is learned from birth through
language and socialization
It is shared by members
It is influenced by specific conditions
It is dynamic and ever-changing
Cultural Assessment Parameters
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1. COMMUNICATION
Continuous process by which one
person may affect another through
written or oral language, gestures,facial expressions, body language,
space and other symbols
Verbal Communication
Nonverbal communication
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Silence Native Americans, Chinese, Japanese
value silence, essential inunderstanding a persons needs
English, Arabic to preserve privacy
Asian sign of respect
Russia, France, Spain may indicate
agreement
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Cultural Assessment Parameters
Touch American firm handshake is a
recognized form of greeting thatconveys character and strength
European kiss in one or both cheeksalong with handshake
Orthodox Jewish husband cannot touch
his wife during labor and delivery Arabic kiss with same sex
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Facial Expression
Italian, Jewish, African-American, Latino
use facial expression to communicate
feelings Irish, English, northern Europe less
facial expression and less open in their
response
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Eye Movement
Western culture direct eye contact is
important and shows attentive listening
Native American, Filipino American,Asians impolite or invasion of privacy
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Cultural Assessment Parameters
2. SPACE
Relative concept that includes the individual,
the body, the surrounding environment
American, Canadians, British requires more
personal space
Latin Americans, Japanese, Arabic need the
least amount of personal space
Cultural Assessment Parameters
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3. SOCIAL ORGANIZATION Includes the family and other groups within a
society that dictate culturally accepted rolebehaviors of different members of the society
and rules of behavior Latino husband usually provider anddecision-maker
Native-Americans, African-Americans matriarchal
Asian, Native-Americans elders arerespected
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Cultural Assessment Parameters
Middle-east or Nigerian male patientcannot accept instructions from female
nurse/physician
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Cultural Assessment Parameters
4. TIME Individuals focus on the past, present,
future
American directed to the future Some African Americans, Puerto
Ricans, Mexican Americans, Chinese
Americans avoid fixed schedule
Cultural Assessment Parameters
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Cultural Assessment Parameters
5. ENVIRONMENTAL CONTROL Magico-religious health belief view
Scientific or Biomedical health belief
view Holistic health belief view
6. BIOLOGIC VARIATIONS
Common Biologic Variations and IncreasedSusceptibility to Disease in Ethinic/Racial
G
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Groups
AfricanAfricanAmericanAmerican Keloid formation, hypertension,Keloid formation, hypertension,sickle-cell disease, lactosesickle-cell disease, lactoseintolerance, DMintolerance, DM
EuropeanEuropean
AmericansAmericans
Breast cancer, skin cancerBreast cancer, skin cancer
MexicanMexicanAmericansAmericans
DM, HPN, Pernicious Anemia,DM, HPN, Pernicious Anemia,TBTB
NativeNative
AmericansAmericans
DM, altered alcohol metabolism,DM, altered alcohol metabolism,
arthritis, TBarthritis, TB
AmericanAmericanEskimosEskimos
GlaucomaGlaucoma
Common Biologic Variations and IncreasedSusceptibility to Disease in Ethinic/Racial
G
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Groups
AsiansAsians Altered alcohol metabolism,Altered alcohol metabolism,lactose intolerance, Cancer,lactose intolerance, Cancer,thalassemia, DM (Filipino),thalassemia, DM (Filipino),Thyroid cancer (Filipino)Thyroid cancer (Filipino)
East IndiansEast Indians Lactose intolerance,Lactose intolerance,ThalassemiaThalassemia
HaitianHaitianAmericansAmericans
TB, sickle-cell diseaseTB, sickle-cell disease
JewishJewishAmericansAmericans
Tay-Sachs disease, StomachTay-Sachs disease, Stomachcancer, high serum cholesterol,cancer, high serum cholesterol,Polycythemia vera, DM, ChronsPolycythemia vera, DM, Chronsdisease, Ulcerative colitisdisease, Ulcerative colitis
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Thank you!
Ronivin Garcia Pagtakhan, RN, MAN
(c)