The cultural background of the patient and of the patient's family can impact the administration of medication. Cultural influences are learned values, beliefs, customs, and behavior. These influences include the patient's belief about health such as:
• What healthcare can do for the patient
• The patient's susceptibility to disease
• The benefits of taking steps to prevent disease
• What makes a patient seek healthcare
• What makes a patient follow healthcare guidelines
For example, a patient who is a coal miner may believe that all coal miners will eventually have lung cancer. In that case, the patient feels there is no benefit to stop smoking. Another patient may avoid taking pain medication for fear that they might become addicted.
Some cultures have their own beliefs about how to prevent and cure disease. For example, although garlic does lower blood pressure, taking garlic as an herbal cure might be dangerous if the patient is also taking antihypertensive medication because the patient's blood pressure could be lowered too much. Herbal remedies are preferred by some cultures over traditional Western medicine and some patients continue herbal treatment even when a mild illness progresses to a critical level.
Healthcare providers can have different beliefs than their patients. A patient may refuse any treatment because of the sole belief in the healing power of prayer. Healthcare providers must be nonjudgmental and tolerate alternative beliefs in healthcare even if those beliefs are harmful to the patient. When confronted with cultural differences that can result in an adverse effect to the patient, healthcare providers can educate the patient about the benefits of medications and treatment and the risk that the patient is exposed to by not following recommended treatment. This information is sometimes best given while the healthcare provider is assessing the patient. The nurse should be careful to remain nonjudgmental about the patient's decisions.
Cultural beliefs can also influence who makes healthcare decisions for the family. In most cultures, women are typically responsible for managing the fam ily's health. However, in some cultures, although the female is responsible for providing and obtaining care, the oldest male is seen as the head of the family and the authority figure for making overall decisions such as when to access healthcare.
The way the patient communicates with healthcare providers is greatly influenced by individual culture. Here are factors to consider when communicating with a patient:
• Eye contact might not be appropriate.
• Ask the patient how he or she should be addressed. Always address the patient formally until the patient gives permission to be addressed informally.
• Know how the patient perceives time (e.g., day/night, sunrise/sunset). Otherwise, the patient may be unable to comply with the appropriate medication schedule.
• Maintain the patient's personal space. Always ask permission to invade the personal space to perform a procedure. In some cultures, patients don't want anyone standing or sitting too close and they feel uncomfortable if someone touches them.
• Consider food beliefs and rituals as related to illnesses. Some patient's believe that the more you eat, the healthier you will become. Other people restrict certain foods for religious reasons.
• Evaluate the family's attitude toward the elderly. The elderly are revered in some cultures and the family goes to great lengths to care for them. In other cultures, the family leaves the elderly to die peacefully without interference.
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