People of French Canadian Heritage.

People of French Canadian Heritage.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition French Canadian Culture Larry Purnell, PhD,

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RN, FAAN Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ More than 2.2 million people of French Canadian descent reside in the United States. ▪ Nowadays, French speaking Canadians, unlike those of the 19th century living in the USA, may have been raised within the French culture but descended from a variety of ethnicities. ▪ The Multiculturalism Canada Act of 1988 provides guidelines for implementing policies regarding multicultural diversity. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ Before the latter half of the 18th century, most French immigrating to Canada were Catholics. ▪ French Protestants tended to come directly to the United States. ▪ After the French Revolution, more Catholics sought shelter in the US, most coming via Canada settled in the New England states and later dispersed throughout the United States. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ The Métis, descendants of Native Americans and Europeans, are mainly, though not entirely, Frenchspeaking. ▪ Another major portion of Canada’s French-speaking population are the Acadians who are the descendants of the early French colonists. ▪ Canadians whose first language is French are called Francophones. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ Canada has become an increasingly diverse society composed of various ethnocultural groups with more than 100 different languages as mother tongue. ▪ Much like that of the US, interethnic marriage patterns have dramatically changed from a multiethnic society to multiethnic individuals. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Canada has two official languages, French and English. ▪ In many homes in the US and in Canada English and French may be used equally. ▪ The French-speaking population may lack sufficient knowledge of the English language to access the workforce and other material. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Among French Canadians, a conversation may be conducted with high voice crescendos, which do not necessarily mean anger or violence. ▪ Volume can increase with the importance and the emotional charge invested in the content of the message. ▪ French Canadians encourage sharing thoughts and feelings. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Using hand gestures for emphasis when speaking is common. ▪ Facial expressions for men and women of all ages are a part of communication, often replacing words. ▪ Spatial distancing for differs among family members, close friends, and the public. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ When in the intimacy zone, people may touch frequently and converse in close physical space; however, they tend to avoid physical contact in public. ▪ When greeting another person, men usually shake hands. ▪ Close female friends and family members may greet each other with an embrace. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Maintaining eye contact is an important French Canadian value. ▪ Most French-speaking Canadians have a past, present, and future orientation in their worldview. ▪ More traditional people, and many from rural backgrounds, attach primary importance to living in the present. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Until the late 1970s, women and children took the father’s surname. ▪ Today, under Quebec law, a woman keeps her maiden name throughout her lifetime, although in other parts of Canada this practice is decided between the spouses. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Québécois family of two spouses and two children may well include four different surname combinations: one child may have the father’s surname or the mother’s surname alone or a hyphenated or non-hyphenated surname composed of those of the father and mother. For a second child, the surnames are the same, but in reverse order. ▪ The decision for using surnames rests entirely with the parents. Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck The Métis in Canada are a. Mostly English Speaking. b. Mostly speak an indigenous dialect. c. Descendants of Native Americans and Europeans. d. Descendents of French and Arabic. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: C a. Descendants of Native Americans and Europeans. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ Many older people with a strong religious background maintain a future worldview regarding life after death. ▪ Many of the younger generation reject past traditions and attempt to maintain a balance by enjoying the present, working, and planning for their future. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ Traditionally, in French-speaking Canadian families, the man was seen as the moral authority and responsible for material wellbeing, such as economic provider and purveyor of affection and security. ▪ The woman served as the family mediator and social director as well as being responsible for household activities, child care, and health care. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ With more women working, family roles are becoming more egalitarian. ▪ French Canadians have always attributed great value to family relationships and obligations. ▪ Research reports that Francophones are less committed than Anglophones to with respect to marriage, sexual activity, and non-married parenthood. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ The greatest source of pride for French Canadian families is to see their children well established with a good education. ▪ The French Canadian family is more nuclear and autonomous than its counterpart in France. ▪ French-speaking Canadian family is known for its closeness, and some families are a “closed” family system. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ Traditionally, the Catholic Church dictated the parameters of sexual behavior for French Canadians. ▪ There is a growing trend for couples to live together without marrying. ▪ Many young couples answer that they cannot financially afford to get married. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ In 1996, the Canadian government extended health, relocation, and other job benefits to same-sex partners of federal employees. ▪ The Ontario Court of Appeals ruled that samesex couples must be treated as common-law couples under the Family Leave Act. ▪ Canada is one of the few countries in the world where same-sex marriage is legalized. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Workforce Issues ▪ Opportunities for Francophone nurses to function successfully outside Quebec and in the US are limited if they have not mastered the English language. ▪ Because Francophone culture is more collevistic than individualistic, some may initially have difficulty adapting to an environment where autonomous decision-making is required. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ Canadians of French descent are white or Caucasian; however, Francophones, as a linguistic group, represent a mosaic of ethnocultural characteristics, including racial differences prompted by acculturation, adoption, and the children of mixed marriages. ▪ Assess individuals for biological risks according to their racial and cultural heritage. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ Higher incidences of prostate and breast and ovarian cancers have been seen among Francophones. ▪ A high rate of suicide and suicidal ideation, particularly among Francophone adolescents and young adult males, is seen in Canada. It is unknown if this extends in the US. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ Genetic and hereditary diseases include spastic ataxia Charlevoix-Saguenay type, cystic fibrosis, tyrosinaemia, cytochrome lipase deficiency, familial chylomicronemia resulting from the lipoprotein lipase (LPL) deficiency, hyperlipoproteinemia type I which has been traced to migrants from the Perche region of France. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ An increased incidence of cystic fibrosis and muscular dystrophy occurs among Frenchspeaking Canadians. ▪ Sickle cell anemia is also higher among Francophones than the general population. Transcultural Health Care: A Culturally Competent Approach, 4th Edition High-Risk Health Behaviors ▪ Misuse of alcohol, tobacco, marijuana, and psychotropic drugs are major health problems. ▪ Tobacco and alcohol use is highest among French-speaking males and is associated with masculine sex roles, higher self-esteem, and an external locus of control. ▪ The rate of individuals who do not exercise on a regular basis has increased over the last decade. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition ▪ For French Canadians, food is associated with hospitality and warmth. Food is part of all meetings and celebrations. ▪ Common vegetables enjoyed by French Canadians include potatoes, turnips, carrots, asparagus, cabbage, lettuce, cucumbers, and tomatoes. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition ▪ Meat choices are mainly beef, pork, and poultry. Lately, however, lamb has gained popularity. ▪ In Acadia, due to the proximity of the coastal areas, fresh fish and seafood are part of the diet. ▪ Common foods include fricot (stew made with a special spice called summer savory). ▪ French Canadians do not escape the overall trend toward being overweight. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ Until the middle of the 20th century, French Canadians maintained high fertility rates, which is uncommon for a population living in an industrialized country. ▪ This phenomenon, called the “revenge of the cradles,” has never been explained. ▪ The number of children per family has been declining since the mid-1960s. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ Effective contraception and family planning methods such as the pill, intrauterine devices, and tubal ligation have become available to all women. ▪ The pill remains the primary reversible method for birth control. ▪ On the basis of relative frequency, tubal ligation and vasectomy follow the pill as nonreversible methods of fertility control. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ Diaphragms, foams, and creams are not commonly used for birth control, partially because perceptions imply that women are not supposed to, or do not like to, touch their genitals. ▪ The beliefs that condoms reduce the level of sexual feeling during intercourse, or that contraception is not a man’s responsibility, are inversely proportionate to the age of men. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ Few French Canadians practice natural childbirth. ▪ Men are welcomed and encouraged to be in the delivery room with their wives. ▪ Breastfeeding has regained importance after years of bottle feeding. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ In Canada, maternity and paternity leaves are available with pay for a period ranging from 6 to 20 weeks. ▪ Although the movement used in washing a floor resembles that of an exercise aimed at strengthening the perineal muscles, this activity in the past was associated with the onset of labor and early or preterm deliveries. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ French Canadians do not differ from Canadians and others of European origins on issues related to death and death rituals. Expectations are closely related to Christian religious practices, in particular, those of the Roman Catholic Church. ▪ Whether one is an active church-goer or not, religious funerals are the norm. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals ▪ Cremation is an acceptable practice. ▪ Supports for those who have lost a family member include openly acknowledging the family’s right to express grief, being physically present, making referrals to appropriate religious leaders, and encouraging interpersonal relationships. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality ▪ While most French Canadians identify themselves as Roman Catholic and are baptized at birth, they may or may not remain active church members. ▪ Older adults are more inclined to use prayers for finding strength and adapting to difficult physical, psychological, and social health problems. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality ▪ In times of illness and tragedy, French-speaking Canadians use prayer to help recovery. ▪ Many of the younger generation are not strongly influenced by religious values, beliefs, and faith practices. ▪ The younger generations turn towards spirituality rather than religion. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-care Practices ▪ Canada’s ensures free, universal health coverage at any point of entry into the system. ▪ Many people in the upper socioeconomic classes call on their family physicians instead of the local community service centers. ▪ Many lower socioeconomic individuals many do not seek health care until their health becomes a crisis situation. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-care Practices ▪ French-speaking Canadians have joined the current trend toward over-the-counter drug use. ▪ Language differences may be a barrier to accessing health care. ▪ French-speaking subjects rate acute pain as more intense than chronic pain, and more affectively laden than the English-speaking subjects. Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck ▪ On issues of death and dying, which religion most influences French Canadian’s decision making? ▪ Baptist ▪ Methodist ▪ Catholic ▪ Islamic Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: C The Catholic religion has the most influence on decision making for death and dying issues for French Canadians. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-care Practices ▪ As a cultural group, French Canadians have no official proscriptions against receiving blood or blood products. ▪ The decision to donate or receive an organ is an individual decision without cultural influence for French Canadians. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-care Practitioners ▪ Health-care providers hold a favorable status in the eyes of French Canadians, especially among older people. ▪ The universal health insurance system in Canada makes the folk practitioners less appealing. ▪ Professionals throughout Canada are vigilant in trying to avoid exploitation by traditional and folk healers, who are viewed as practicing outside the law. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German American Culture Larry Purnell, PhD, RN, FAAN Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German American Overview/Heritage ▪ Over 50 million Americans are of Germans heritage. ▪ The first wave of German immigrants came to the USA for religious freedom. ▪ The second wave arrived between 1840 and 1860 and was fleeing political persecution, poverty, and starvation. ▪ Many worked as indentured servants. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German American Overview/Heritage ▪ The 1930s and 1940s saw a third wave because of the rise of fascism in Germany. ▪ Germans receive a stronger education than Americans. ▪ The German undergraduate degree is equal to the American master’s degree, except for nursing which is at a lower level than that of the USA. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ German is the official language of Germany. ▪ German is a low-contextual language, with a greater emphasis on verbal than nonverbal communication. ▪ A high degree of social approval is shown to people whose verbal skill in expressing ideas and feelings is precise, explicit, and straightforward. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ For traditional Germans, sharing one’s feelings with others often creates a sense of vulnerability or is looked on as evidence of weakness. ▪ Expressing fear, concern, happiness, or sorrow allows others a view of the personal and private self, creating a sense of discomfort and uneasiness. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ “Being in control” includes harnessing one’s emotions and not revealing them to others. ▪ Newer generations are more demonstrative in sharing their thoughts, ideas, and feelings with others. ▪ In families where the father plays a dominant role, little touching occurs between the father and children. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ Affection between a mother and her children is more evident. ▪ Germans generally are careful not to touch people who are not family or close friends. ▪ Most individuals place a high value on privacy. People may live side by side in a neighborhood and never develop a close friendship. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ Germans would never consider dropping in on another German neighbor because this behavior is incongruent with their sense of order. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ Even looking into a room from the outside is considered a visual intrusion. ▪ Eye contact is maintained during conversations, but staring at strangers is considered rude. ▪ A closed door requires a knock and an invitation to enter, regardless of whether the door is encountered in the home, business, or in-patient facility. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ To focus on the present is to ensure the future. ▪ The past, however, is equally important, and Germans often begin their discussions with background information. ▪ There are rarely good excuses for tardiness, delays, or incompetence that disturbs the “schedule” of events. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ Those in authority, older people, and subordinates are always addressed formally. ▪ Younger generations or the more acculturated may be less formal in their interactions. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Traditional families view the father as head of the household. ▪ In the USA, the husband and wife are more likely to make decisions mutually and share household duties. ▪ Older people are sought for their advice and counsel, although the advice may not always be followed. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Helping parents or grandparents to remain in their own home is important to families. ▪ Prescriptive behaviors for children include using good table manners, being polite, doing what they are told, respecting their elders, sharing, paying attention in school, and doing their chores. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Prescriptive behaviors for adolescents include staying away from bad influences, obeying the rules of the home, sitting like a lady, and wearing a robe over pajamas. ▪ Restrictive and taboo behaviors for children include talking back to adults, talking to strangers, touching another person’s possessions, and getting into trouble. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Restrictive and taboo behaviors for adolescents include smoking, using drugs, chewing gum in public, having guests when parents are not at home, going without a slip (girls), and having run-ins with the law. ▪ One’s family reputation is considered part of a person’s identity and serves to preserve one’s social position. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Because families are concerned about their reputations in the community, an unwed mother taints their reputation and may result in the family being ostracized by others. If marriage follows the pregnancy, less sanctioning occurs. ▪ The fact that pregnancy existed before marriage creates a stigma for the woman, and sometimes for the child, that may last the rest of their lives. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Many older gays and lesbians may fear exposure because of the extreme discrimination homosexuals experienced in Nazi Germany. ▪ Younger generations of gays and lesbians are less likely to fear exposure of their sexuality. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Workforce Issues ▪ For Germans being on time is important. ▪ Business communication should remain formal: shaking hands daily, using the person’s title with the last name, and keeping niceties to a minimum. ▪ Employees are not addressed by their first names. Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck Common German cultural individualist is values include a. Timeliness and sharing emotions. b. Timeliness and direct communication. c. Smooth inexact communication and readily sharing emotions. d. Readily sharing emotions and present orientation. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: B German and German Americans value direct communication and timeliness in work and in social engagements. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Biocultural Ecology ▪ Germans range from tall, blond, and blue-eyed to short, stocky, dark-haired, and brown-eyed. ▪ Common health conditions for German Americans include cardiovascular disease, stomach cancer, muscular dystrophy, hereditary hemochromatosis, sarcoidosis, Dupuytren’s disease, peyronie’s disease, cystic fibrosis, hemophilia, and cholelithiasis. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German High-Risk Health Behaviors ▪ Smoking and excessive alcohol consumption remain high-risk behaviors for most Germans. ▪ Most individuals enjoy the outdoors, fresh air, and exercise. ▪ Sports are played for exercise and the pleasure of participating in group activities. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Nutrition ▪ Food is a symbol of celebration for Germans and is often equated with love. ▪ Children are rewarded for good behavior with food. ▪ Real cream and butter are used. ▪ Gravies, sauces, fried foods, rich pastries, and sausages are only a few of the culinary favorites that are high in fat content. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Nutrition ▪ Foods are also fried in butter, bacon fat, lard, or margarine. ▪ Traditional food preparation methods use highfat ingredients that add to nutritional risks. ▪ Garlic and onions are eaten daily to prevent heart disease. ▪ Those who are ill receive egg custards, ginger ale, or tomato soup (without cream) to settle their stomach. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Nutrition ▪ Ginger ale or 7-Up relieves indigestion and settles an upset stomach. ▪ After gastrointestinal illnesses, a recuperative diet is administered to the sick family member beginning with sips of ginger ale over ice. ▪ Coddled eggs, a variation of scrambled eggs prepared with margarine and a little milk, is used for recuperation. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Pregnancy and Childbearing Practices ▪ Heterologous artificial insemination, use of contraceptive pills, and unnatural contraception are forbidden among strict Catholic Germans. ▪ Therapeutic or direct abortion is forbidden as the unjust taking of innocent life. ▪ Prescriptive practices during pregnancy include getting plenty of exercise and increasing the quantity of food to provide for the fetus. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Pregnancy and Childbearing Practices ▪ Restrictive practices during pregnancy include not stretching and not raising the arms above the head to minimize the risk of the cord wrapping around the baby’s neck. ▪ Prescriptive practices for the postpartum period include getting plenty of exercise and fresh air for the baby. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Death Rituals ▪ Death is a transition to life with God. ▪ Because illness is sometimes perceived as a punishment, the duration and intensity of the dying process may be seen as a result of the quality of the life led by the person. ▪ Careful selection of the clothes to be worn by the deceased and the flowers that represent the immediate family is important. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Death Rituals ▪ The body of the deceased is prepared and “laid out” in the home where support from family and friends is readily available ▪ A short service is held in the home before the body is taken to the church, where family and friends can attend a funeral service. After the church services, the body is taken to the cemetery for burial. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Death Rituals ▪ After a short graveside service, the minister invites everyone at the graveside service to go to the home of the deceased for food. ▪ The viewing provides an opportunity for family, friends, and acquaintances to view the body. ▪ Crying in public is permissible among some families, but in others the display of grief is private. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Death Rituals ▪ A tradition of wearing black or dark clothing when attending a viewing or a funeral may be expected of both family and friends. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Spirituality ▪ Major religions among Germans include Roman Catholicism, Methodism, and Lutheranism. ▪ Other religions, such as Judaism, Islam, and Buddhism, have substantial membership. ▪ Prayers are often recited at the bedside with all who are present joining hands, bowing their heads, and receiving the blessing from the clergy. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Spirituality ▪ Family and other loved ones are also sources of support in difficult times. ▪ Home, family, friends, work, church, and education provide meaning in life for individuals of German heritage. ▪ Family loyalty, duty, and honor to the family are strong values. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-care Practices ▪ In traditional families, the mother usually ensures that children receive check-ups, get immunizations, and take vitamins. ▪ Women in the family often administer folk/home remedies and treatments. ▪ German Americans use a variety of over-thecounter drugs, believing that individuals are responsible for their own health. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-care Practices ▪ Common, natural folk medicines include roots, herbs, soups, poultices, and medicinal agents such as camphor, peppermint, and spirits of ammonia. ▪ Folk medicine includes “powwowing,” use of special words, and wearing charms. ▪ Many value being stoic when experiencing pain. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-care Practices ▪ Mental illness may be viewed as a flaw, resulting in this group being slow to seek help because of the lack of acceptance and the stigma attached to needing help. ▪ Physical disabilities caused by injury are more acceptable than those caused by genetic problems. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-Care Practices ▪ Blood transfusions, organ donation, and organ trans-plants are acceptable medical interventions unless a religious choice contradicts them. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-care Practitioners ▪ Health-care providers hold a relatively high status among Germans. ▪ This admiration stems from the love of education and respect for authority. ▪ Most individuals accept care from either gender. Some younger and older, more traditional women prefer intimate care from a same-sex health-care provider.
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MN 520 Unit 4 Topic 1 discussion

MN 520 Unit 4 Topic 1 discussion

Topic 1: Feasibility and Permission

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Building on work done in the clinical practicum setting this week, and looking toward work with the EBP, address the following questions:

Topic: Reduce CVC Rate in Hemodialysis Patients

What are the benefits, risks, and feasibility of your proposed change?
Must the governing entities grant permission to make your proposed changes
Please include subtitles to each paragraph, Use references less than 5 years old

MN 520 Unit 5 Assignment

MN 520 Unit 5 Assignment

In this unit, submit the draft for Chapter III: Implementation. Select the icon at the bottom of the page to access the Final Project Template.

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You may not have all of your results but you should be able to submit a draft of your procedures/methods, artifacts, and initial findings.

Review the following Final Project Template.

Chapter III: Implementation Topic Reduce CVC Rate

Write a brief introduction to the chapter stating what it will include. Do not use a heading called “Introduction” as APA does not use that type of heading. Some suggestions for this chapter include reiterating the statement of the problem and briefly discussing what this chapter will include.

Procedures/Methods

Provide a summary of the steps taken to implement the change.

Results

Summarize the results.

Artifacts

Record and explain any policies, procedures, or programs that come as a result of your project.

Conclusion

Write the chapter summary here.

Response to below to DQ 150 word 1 Citiation and refernce apa format

Response to below to DQ 150 word 1 Citiation and refernce apa format

Iosif Padurets posted Jun 14, 2018 11:48 PM

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The Interview

What does it means to document accurately and appropriately?
It means that provider’s documentation has to reflect all necessary details of the interview that are within scope of provider’s practice and meet clinical and legal requirements.

What are the documenting guidelines? When is it appropriate to use abbreviations?
Documenting guidelines are usually specified by organizational standard of practice. All documentation must be dated and completed at the time of service. At the same time, least common abbreviations are discouraged of use because it creates a potential for errors, miscommunication and possible safety concerns (Kaiser Permanente, 2018).

What is the difference between subjective and objective data?
Subjective data are variables that described by patient vs objective data is data that is collected by provider during examination/assessment.

What does it mean to demonstrate clinical reasoning skills?
Demonstration of clinical reasoning is application of learned material by the provider in the clinical settings.

How can you use clinical reasoning to plan the organization of a comprehensive exam?
Clinical reasoning may be a factor in focused assessment and organization of comprehensive exam. For example, patient comes with chief complain: headache. In this case provider can structure his/her exam and interview around the topic, causes, history, and other relevant information that will help in obtaining the data related to the chief complain.

How will you document variations of normal and abnormal assessment findings?
Documentation of normal and abnormal assessment findings are documented according to acceptable limits that define the ranges. At the same time, each normal or abnormal finding is documented in very descriptive manner with details or example of findings.

What factors influence appropriate tools and tests necessary for a comprehensive assessment?
It depends on focus of assessment. Furthermore, application of evidence-based practice may influence use of appropriate tools in obtaining accurate data that is required for deriving diagnosis or tailoring treatment plan (Budd et al., 2018).

Reflect on personal strengths, limitations, beliefs, prejudices, and values.
As any other individual I have my strengths or limitations. However, generally I am open-minded when it comes to any topics. I am willing to listen others point of view and try to obtain data that I could use to derive my stance on a topic.

How will these impact your ability to collect a comprehensive health history?
Any information that is obtained during comprehensive health history may contribute to patient plan of care. In order to improve ability to collect data and to improve comprehensive health history I was always attempted to be present during patient assessment by the provider. It was interesting to observe how each provider assessed patient and performed their exam. It showed different variations and approach in diagnosing chief complain.

How can you develop strong communication skills?

Any skills are mastered with practice and repetition and constructive criticism.

What interviewing techniques will you use to interview the patient to elicit subjective health information about their health history?
Focused interview with open-ended questions may help patient to be open to discuss more information about their health.

What relevant follow-up questions will you use to evaluate patient condition?
It is application of closed loop communication. I mean, to follow up on the care plan and obtain patients feedback.

How will you demonstrate empathy for patient perspectives, feelings, and sociocultural background?
It requires for provider to be culturally competent in order to be on a same page as patient and to demonstrate understanding/empathy in patient care (McElfish et al., 2017)..

What opportunities will you take to educate the patient?
Education opportunities come very often in a clinical settings. For example, these opportunities come up during comprehensive assessment, when creating care plan and so on.

Reference

Budd, E. L., deRuyter, A. J., Zhaoxin, W., Sung-Chan, P., Xiangji, Y., Furtado, K. S., & … Mui,

T. (2018). A qualitative exploration of contextual factors that influence dissemination and implementation of evidence-based chronic disease prevention across four countries. BMC Health Services Research, 18(1), 1-13.

Kaiser Permanente (2018). Medical Records and Documentation

Standards. Retrieved fromhttps://provider.ghc.org/open/render.jhtml?item=/o…

McElfish, P. A., Long, C. R., Rowland, B., Moore, S., Wilmoth, R., & Ayers, B. (2017).

Improving Culturally Appropriate Care Using a Community-Based Participatory Research Approach: Evaluation of a Multicomponent Cultural Competency Training Program, Arkansas, 2015-2016. Preventing Chronic Disease, 14E62.

Master’s Prepared Nurse Interview Guide

Master’s Prepared Nurse Interview Guide

Refer to the “Master’s Prepared Nurse Interview Guide_student” as you prepare this assignment.

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Interview a nurse who is master’s-prepared in nursing and is using this education in a present position. Preferably, select someone who is in a position similar to your chosen specialty track. The purpose of the interview is for you to gain insight into the interplay among education, career path, and opportunities. Be certain to identify specific competencies that the MSN-prepared nurse gained, and is presently using, that reflect advanced education. Organize your interview around the topics below:

Overview of the master’s-prepared nurse’s career
Reason for seeking graduate education
Description of present position and role
Usefulness of graduate education for present role
Pearls of wisdom he/she is willing to share
In 750-1,000 words, write the interview in a narrative format. Use the following guidelines:

Within the paper’s introduction, explain your interview selection.
Do not identify the individual by name.
Use centered headings to separate parts of the interview.
In the conclusion, identify one or more competencies from the interview that are consistent with GCU program competencies and/or AACN education essentials. In addition, provide a statement that reflects what you gained from the interview.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center.

 

Master’s-Prepared Nurse Interview

1
Unsatisfactory
0.00%

2
Less Than Satisfactory
80.00%

3
Satisfactory
88.00%

4
Good
92.00%

5
Excellent
100.00%

70.0 %Content

5.0 %Introduction

Introduction lacks any discernible overall purpose or organizing claim.

Introduction is insufficiently developed and/or vague. Purpose is not clear.

Introduction is clear, forecasting development of the paper.

Introduction is comprehensive; purpose of the paper is present.

Introduction is comprehensive and makes the purpose of the paper clear by restating the thesis.

15.0 %Career Overview

Omits major elements and is disorganized.

Describes but fails to paint a clear picture of the nurse’s career and/or progression in a logical order.

Addresses most of the primary elements of the individual’s career in a logical fashion.

Addresses the primary elements. Reader can easily see purpose.

Thoroughly presents all of the information to portray a clear chronology as well as richness of detail.

15.0 %Graduate Education

Omits major elements; is disorganized; and has no depth or detail.

Describes but fails to address some of the elements; lacks depth and detail.

Addresses the same elements but lacks depth and detail.

Necessary elements are present and clearly presented. Decision-making process is evident to the reader.

Thoroughly presents the process that led to the decision to seek graduate education as well as the program itself with clarity, order, and depth.

20.0 %Present Position (includes pearls of wisdom)

Omits major elements; information is tangential and disorganized.

Describes but fails to address most of the primary elements in any depth.

Addresses most of the primary elements of the present position with recognition of competencies but lacks detail.

All key elements are presented with clarity.

Thoroughly presents all of the key elements of the present position with emphasis on competencies required. Describes in rich detail, and includes advice given and original insights.

15.0 %Conclusion

Conclusion lacks any discernible purpose.

Conclusion is insufficiently developed and/or vague.

Conclusion is clear and identifies key points of interview but fails to draw inferences.

Conclusion is clearly evident to the reader. Career opportunities are present.

Conclusion is comprehensive; paints a clear picture of the potential outcomes and career opportunities of graduate education; identifies key points of the interview; and demonstrates insight and interpretation.

20.0 %Organization and Effectiveness

7.0 %Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.

Thesis and/or main claim are apparent and appropriate to purpose.

Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear.

8.0 %Argument Logic and Construction

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

10.0 %Format

5.0 %Paper Format (Use of appropriate style for the major and assignment)

Template is not used appropriately or documentation format is rarely followed correctly.

Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

Appropriate template is used. Formatting is correct, although some minor errors may be present.

Appropriate template is fully used. There are virtually no errors in formatting style.

All format elements are correct.

5.0 %Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment and style)

No reference page is included. No citations are used.

Reference page is present. Citations are inconsistently used.

Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.

Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct.

In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error.

100 %Total Weightage

Information Systems in Nursing

Information Systems in Nursing

Write 3–5 pages in which you discuss how a current information system used in the delivery of patient care contributes to improved patient outcomes.

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In using information system technology, nurses are able to track and measure data to improve patient outcomes.

Competency 1: Describe the importance of effective scholarship and evidence-based information to advance the profession of nursing.By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Describe how an information system used in nursing contributes to evidence-based nursing practices.
Competency 2: Identify strategies and best practices for using informatics in nursing and health care.
Describe how a nurse researcher uses information technology to define patient safety within the context of outcomes.
Competency 3: Explain the use of information management tools and technologies to monitor and improve health care delivery and patient outcomes.
Describe how nurse leaders and nurse informaticists use technology and evidence-based practice to contribute to improved patient outcomes.
Competency 4: Communicate in a manner that is consistent with the expectations of a nursing professional.
Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics.
Continued rapid changes in information technology reflect significant progress in health care delivery and the practice of nursing. The use of patient monitoring devices, robotics, electronic medical records, data management resources, and ready access to current science are a few examples of how technology is used in providing care to patients across multiple settings.

How technology will continue to interface with nursing care, research, and future practice is significant to advancing the profession and maintaining high quality of care standards and delivery.The following search terms relate to nursing informatics and evidence-based practice. Keeping an eye on them will help the nurse informatics practitioner stay up to date about current trends and applications of technology:
Electronic Health Records (EHR) Incentive Programs.
The Health Insurance Portability and Accountability Act (HIPAA).
Office for Civil Rights – A Healthcare Provider’s Guide to the HIPAA Privacy Rule.
Patient Safety and Quality Improvement Act (PSQIA).
Agency for Healthcare Research and Quality (AHRQ).To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of the business community.

Consider the following questions from the point of view of a specific organization:

Technologies used for direct care:
How are data used to improve patient outcomes?
How does technology contribute to safety and quality of care in this setting?
Technologies used for data management:
How are data tracked, monitored, stored, or trended in your data management system?
How is technology used for data archiving and retrieval?
Reliability and safeguards:
How do you know your data are reliable?
What types of safeguards are in place to protect patient data?
Research:
How are data extracted and used for research endeavors in your organization?
What are examples of how nurses at the bedside are involved in technology design and testing in your organization? In other organizations? How might you do it differently?
Technology and professional development:
What are the challenges for successful implementation of new technologies in health care environment and nursing practices—in general? Specific to your organization?
If you had the power to improve the way technology is used in your organization, what you would like to see changed or enhanced?
Write an essay in which you analyze an information system for its effectiveness in improving patient care.
PREPARATION
Select an example of a current information system used in the delivery of patient care. Note: Ideally, select a system from your workplace to examine. If you are not currently working, select a system from an organization close to where you live. This technology should be used for data management designed to improve patient care.Familiarize yourself with the technology. Do some personal research to gain a deeper understanding about the technology. Visit the Web site of the company who markets the technology to familiarize with how the company positions the technology in the market. Read articles online and in the library related to your chosen system. Remember to take notes to keep track of what you discover. Examine the following aspects of the technology:
How is the information system designed to contribute to safety and quality in the care of patients?
What types of data are tracked, monitored, stored, and trended in the system?
How well does it accomplish what it is designed to do in your chosen real-world setting?
How is this information system used to support research? If it is not currently being used to support research, how could it be used in the future?
What types of opportunities are available for nurses, in any scope of practice, that gives them the chance to participate in the design and testing of this system?
How might the technology be enhanced so it better meets the needs of the professionals currently using the system?
Compare what you learn with how your chosen technology is being used in the workplace. Think about your own workplace and consider speaking with other professionals who currently use the system.
DIRECTIONS
Write an essay in which you discuss what you have learned about how your chosen information system is used in the delivery of patient care and how it contributes (or does not contribute) to improved patient care. Include the following categories:
Describe your chosen information system and its intended role in improving patient care.
Explain why you chose to examine this particular system.
Capture in 1 or 2 sentences the main point of what you learned and your personal opinion of this system based on what you learned.
Support your main point with subpoints that include examples and supporting evidence that address each of the six points listed above under the Preparation heading. Be sure to cite expert opinions and evidence where appropriate.
Include a concluding statement. Offer ideas, concepts, or activities that nurses, in any scope of practice, might want to consider that could improve how they could use this system to improve patient care.
ADDITIONAL REQUIREMENTS
Written communication: Ensure written communication is free of errors that detract from the overall message.
APA formatting: Format resources and citations according to current APA style and formatting guidelines. Include the following:
Title page.
Running head (a short title that appears on every page).
Title on the first page of text.
Level 1 headings for paper sections.
In-text parenthetical citations and a reference list.
Number of resources: Cite a minimum of four peer-reviewed resources.
Length: Submit 3–5 typed, double-spaced pages.
Font and font size: Use Times New Roman, 12 point.

what is my opinion about OUTBREAK MOVIE

what is my opinion about OUTBREAK MOVIE

I need only one page in APA format with my opinion about OUTBREAK movie.

I need a standard cover page in APA format .

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Case Study

Case Study

A 34 year old Hispanic American woman who is in her first pregnancy is seen for prenatal care at 28 weeks gestation

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. Her weight is 220lb, and her blood pressure is 130/80 mmHg. Uterine size is appropriate for gestational age. Her type and screen shows that she is Ab negative. Her family history reveals that her mother has type 2 diabetes mellitus, A urine dipstick shows 3+ glycosuria and negative ketones.

1. Based on the information provided, is this mother and/or her fetus at risk at delivery? If so explain why?

2. What treatment may be needed for this mother prior to delivery of her baby? How would this treatment be provided to the patient in your role as professional nurse? Please explain.

3. Explain a potential complication that this mother may experience at delivery?

4. What are medical conditions that might require immunization for subsequent pregnancies.

5. APA format with Journal Refrences no more than 5 years old.

what is practice of nursing ?

what is practice of nursing ?

As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an

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important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.
Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.
In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.
A minimum of three scholarly references are required for this assignment.
While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Discussion Question 300 words 3 Scholary Sources ( less than 5yr old) APA format

Discussion Question 300 words 3 Scholary Sources ( less than 5yr old) APA format

Click [Start a New Thread] to post to the Discussion, then click [Post] once complete. Be sure to post a response to

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all Discussion topics. Please review the Discussion Board Participation grading rubric under Course Resources. This is important information that will ensure that you earn maximum points. Your postings should be qualitative and provide substantive depth that advances the discussion. Please see the Writing Center for assistance with writing, APA, and online communication.

Applying “Evidence-Based Practice”

Population groups with differences determined by culture, religion or ethnicity also show differences in terms of illness behavior and beliefs.

Discuss a patient population that are at risk and apply evidence-based practice guidelines in management of their illnesses across the age continuum.