HEALTH ASSESSMENT

Cultural, Nutritional & Spiritual

CULTURAL ASSESSMENT

- Systematic, comprehensive examination of individuals, families, groups,

communities.
- It is about health-related cultural beliefs, values, and practices.

 ETHNIC GROUP
- People who self-identify membership to a certain group.
- It starts with ethnicity.

 RACE
- Social construct
- Dividing people into groups based on certain physical characteristics, usually
genetic ancestry
- Biologically speaking, race has nothing to do with our genetics.

 CULTURE
- A system of shared beliefs, ideas, rules.
- Influences how the world is viewed or “lens”
- One culture may view the world differently from a person with or coming from
a different culture. So, this will change the perspective.
- Broader than ethnicity.
- It is not limited to ethnic or minority groups. It can be any group
e.g., LGBT groups, cults, squad, etc.

CULTURALLY AND LINGUISTICALLY APPROPRIATE

- It is important for nurses to be culturally and linguistically appropriate in
serving in health and healthcare.

 Culture as a process, not a state. Thus, nurse is becoming competent, not

being competent. (Capinha-Bacote)

 Cultural Sensibility – deliberate pro-active behavior by health care providers.

(Fletcher)

 Cultural Humility – needed for reflection.

 SELF REFLECTION
- Cultural humility is needed to create a self-reflection.
 - It is done because it is necessary to analyze own biases
3 DIMENSIONS OF CULTURAL HUMILITY

1. Self-Awareness – first one that we need because it is the most important.

2. Respectful Communication
3. Collaborative Partnership

- We can use this with patients from any culture.

 ASPECTS OF CULTURE RELEVANT TO HEALTH ASSESSMENT

 Communication and Language

- There are certain cultures that they do not want eye contacts or etc. that’s
why we need to know the preferences of our patients.
 - Language, just because they understand you it doesn’t mean that that’s the
language that you will use.
 Family Structure
- There are patients that wants their family to be there and we need to
understand their dynamics.
 Family Roles & Organization
 Social Networks
 Educational Background and Learning Style
 Nutrition
 Childbearing and child-rearing practices
 High-risk behavior
 Health care beliefs and practices
 Health care practitioners
 Spirituality and Religion

SPIRITUAL ASSESSMENT

 SPIRITUALITY
- No specific definition
o Different authors have different definition of spirituality.
- As aspect of culture
- Viewed differently per culture
- It doesn’t have to be based on religion.
- Most human experiences that seek to transcend self and find meaning and
purpose through connection with others. (Buck)

 All human behaviors that give meaning to life and provide strength (Purnell)

 SPIRITUAL DISTRESS
- A state where one is suffering due to inability to realize one’s meaning in life
by connecting with self, others, the world, or a superior being.

 SPIRITUALITY ASSESSMENT
- It is not easy.
- Can be done in 2 or more parts, the first is usually brief assessment.
- Trusting relationship is necessary before you can go to intimate questions.
- Listening is important for nurses’ presence to be felt by the patient.
- Observe non-verbal cues.
 NUTRITION

 NUTRITIONAL ASSESSMENT
- Nurses perform general nutrition assessment and nutrition screening pero
‘yung mababaw lang.
- Individuals with complications, illnesses, or admitted in long term facilities
may require more in-depth assessment.
- Nurses also supplement nutrition education.
o When you give your patient a nutrition education it has to be in line with
the plan of other healthcare professionals.
- Referrals are also done by nurses.

 SCREENING TOOLS
- Consider nutrition screening and mini nutritional assessment
Philspen – Philippine society of parenteral and enteral nutrition.

 MALNUTRITION
- Either over or under nourished (obese)
- There is also macro and micro malnutrition
 HYDRATION STATUS
- Nurses closely monitor hydration status
- Over or under hydration can be fatal if not assessed early
o Daily weight taking
o Intake and Output
o Physical Examination

 NUTRITION HISTORY
- Food pattern
- Personal food preference
- Food preparation
- Finances
- Accessibility
- Patient Health
- Exercise Pattern
- Body Image
- Family Health
  PHYSICAL EXAMINATION

Height
Weight
Body Frame
Body Mass Index = kg / (m x m)