Influenceof Health and Illness Beliefs on Assessment
Influenceof Health and Illness Beliefs on Assessment
Thefirst and most critical phase of the nursing process is assessment,where the nurse collects the patient’s sociological, physiological,psychological and spiritual information. A patient’s beliefstructure directly influences their response to an assessmentinterview and the overall physical findings. Different cultures beardifferent health beliefs that tend to explain and understand thecauses and treatment of illnesses. Evidence Based Practice (EBP)advocates for quality care to all patients regardless of culturalbeliefs (Tzeng etal.,2002). Industrialized nations such as the United States considerillness as a scientific natural phenomenon, and embrace the use ofmedical technology to diagnose and treat the illness. However, somesocieties’ cultural beliefs relate the occurrence of an illness tosupernatural forces, and often seek spiritual interventions such asprayer to cure or treat the illness. Such cultural belief structuresmajorly contribute to a patient’s compliance in the assessmentphase. For a successful diagnosis and evaluation, nurses need tounderstand and acknowledge the diversity of cultural beliefs amongtheir patients.
Inthe United States, major organizations such as the AmericanCounselling Association and the American Psychological Association,have recognized the significance of reflecting on the influence ofcultural beliefs on the diagnosis and treatment process. Moreover,the United States Office of Minority Health developed guidingstandards for Cultural and Linguistic Appropriate Services (CLASStandards) in healthcare. The standards are a national guide forquality services towards diverse populaces that ensure thathealthcare systems are culturally competent (Handler etal.,2002).
Inthe treatment of culturally diverse individuals, nurses andclinicians need to consider culture in their interview sessions withtheir patients. Unlike nonminority patients, the assessment ofminority group of patients, especially ones bound to culturalethnicity, is a complex process. Therefore, it is up to the nurse todevelop cultural competent skill, attitude and knowledge, for qualityhealthcare outcomes. Nurses require special skills that are nottaught in class as the common interviewing method may not work onculturally diverse patients, hence, psychological findings may not beappropriate or valid (Handler etal.,2002). For best results, the nurse may need to relate with thepatient’s culture and use modified psychological tests.
‘Culture’refers to the integrated arrays of mankind including social, racialand ethnic institutions, beliefs, customs, actions, thoughts, andlanguage. Different cultures have their own perspectives andexplanations about health and illness. For instance some WestAfrican beliefs relate illness to ‘juju’, witchcraft or bad omennurses need to synch profession with such cultural beliefs during theassessment phase for better outcomes. For Asians, sick patients aresupposed to stay in bed, and are allowed to openly express anxietyand suffering they are not expected to be cheerful or active. Suchbehaviors could conflict with usual healthcare practices and mightalso bias findings since the patient’s symptoms are overshadowed bythe cultural practices associated with an illness. For Muslims,nudity and sexual interviews are offensive for both genders, womencover their bodies from men to toes, while men from waist to knee.For the Japanese, maintaining a direct eye contact during anassessment session is regarded adversarial and confrontational (Tzengetal.,2002).
Duringthe assessment process, before the discussion of any personalinformation, it Is essential for the nurse to understand the variousculturally related nonverbal cues portrayed by a patient during aninterview. Misinterpretation of such behaviors by the nurse may leadto miscommunication or misinterpretation of information. In somecultures, such as in Zimbabwe, maintaining direct eye contact isdisrespectful, while in others, they maintain eye contact whileconversing (Handler etal.,2002). Misinterpreting such behaviors may result to the nurserecording wrong data, or misunderstanding with the patient. In somecultures, beliefs on gender taboos are big issue and need to beaddressed with sensitivity. Gender beliefs regarding who the patientis allowed to share personal information with, directly affectsassessment, as some patients may hold back useful informationrequired for treatment of the illness. Therefore, it is of keyessence that a nurse acquires the necessary skills and knowledge ofcultural-based interview assessment with culturally diverse patients.
Culturalformulation strategies help solve the problem of cultural beliefsbarrier. At the beginning of the interview process, the nurse issupposed to convey empathy and try understand the patient’sperspective of the disease. Secondly, the patient nurse need tofurther understand the patients ethnical background by questioningthe context of the individual’s community, workplace, family and soon. By doing so, the nurse has established a trusting, supportive andpositive relationship with the patient, which is the first step toany successful assessment (Tzeng etal.,2002). Learning the patient’s cultural traditions is not enough,the nurse will need to keenly study the patient’s body languageduring the assessment process aspects to consider are such asanxiety relating certain topics, lack of response and so on.
Inconclusion, a patient’s beliefs on health and illness majorlyimpacts the success of any assessment in the nursing process.Cultural diversities influence a patient’s attitude and trusttowards health care and their understanding of how to cope and managethe discourse of an illness, consequences of a medical treatment oreven the diagnosis of the disease. Nurses need to understand thecultures of their patient’s before assessing their patients so asto accord them with the best kind of care.
Tzeng,H. M., Ketefian, S., & Redman, R. W. (2002). Nurses’ Assessmentof Patient’s Culture Patient Satisfaction with NursingCare. Internationaljournal of nursing studies, 39(1),79-84.
Handler,S. M., Castle, N. G., Studenski, S. A., Perera, S., Fridsma, D. B.,Nace, D. A., & Hanlon, J. T. (2006). Patient culture assessmentin the nursing home. Qualityand Safety in Health Care, 15(6),400-404.