Chapter 1 A Every human society has a process for socialization of its members 1. Cultural groups establish rules and codes of conduct using a system of rewards and punishment to govern members, and these become norms, values, and mores of a group a. Reward leads to acceptance as a member of a group b. Punishment for antisocial behavior leads to rejection and separation from a group 2. Role of members includes specified rights, duties, attitudes, and actions 3. Social boundaries separate one group from another; nonmembers have limited social contacts with members; causes a segmentation of relationships and provides few rewarding experiences for nonmembers 4. Leader’s influence is limited to conditions placed on leader by total group B A society is a reflection of all functional relationships that occur among its individual members; participation in society is a major influence on an individual’s intellect, creativity, memory, thinking, and feeling C Society or a group can change because of conflict among members 1. Conflict is greatest when there is absence of certain members, introduction of new members, or change in leadership 2. Ensuing reorganization goes through three stages 3. Resolution of conflict and restoration of equilibrium 1. Culture defines for its people what is important and what is true and real 2. Age, ethnicity, gender, education, income, and belief system (e.g., worldview, religion, or spirituality) make up sociocultural profile of clients 3. Clients’ perceptions of health and illness, their help-seeking behavior, and adherence to treatment depend on beliefs, social norms, and cultural values 4. When clients face increased stressors, suffering, or pain, belief systems play a greater role in their lives 5. Ethnocentrism: belief that one’s own culture is generally right or best 6. Assimilation: integration of common values, beliefs, attitudes, and behaviors of dominant culture 7. Common sociocultural stressors: stereotyping, intolerance, stigma, prejudice, discrimination, and racism 1. Nurses should be in touch with their own personal and cultural experiences 2. Culturally competent nurses have an understanding of cultural diversity to provide care within a context that is appropriate for clients 3. Nurses must have a holistic perspective to assess sociocultural context of clients from different cultures Nurses must appreciate that clients bring their own cultures, attitudes, and belief systems to a situation 4. Together, nurse and client should agree on the nature of a client’s coping responses and set goals and behavioral outcomes within client’s sociocultural context 5. Degree of compatibility between client’s and nurse’s belief systems often determines greater satisfaction with treatment, adherence to therapeutic regimens, and treatment outcomes 1. Societies traditionally are responsible for caring for their ill 2. Society’s role in health maintenance and prevention of disease has intensified 3. Society’s provision for health maintenance includes a. Establishment of public health care agencies for supervision, prevention, and control of disease and illness; protection of food, water, and drug supplies; development of public education programs b. Awarding scholarships/grants for health education and research c. Development of unemployment insurance programs and Workers’ Compensation insurance; laws to ensure universal health insurance d. Establishment of Social Security and Medicare programs; establishment of social welfare services and Medicaid programs B Health care agencies function as a subculture of society 1. Employees develop both written and unwritten agency policies that a. Set standards of acceptable behavior for both clients and staff b. Provide formal delivery of nursing care (e.g., primary nursing, team nursing) c. Avoid rewarding unacceptable behaviors by any members of a group, including the client 2. Health care agencies have several functions C Delivery of health services is the responsibility of the community 1. Health maintenance and treatment are no longer considered a privilege, but a right of all members of society 2. Members of society become active participants in prevention of illness 3. Services provided by health care agencies are influenced by community needs (e.g., based on shorter length of hospitalization; clients’ need for transitional care provided by home care agencies, extended care, or assisted living facilities) A Group membership helps individuals achieve goals that are not attainable through individual effort 1. Types of groups include social, self-awareness, task-oriented, and therapy 2. Group functional roles include task roles, group-building or maintenance roles, individual or self-serving roles 3. Group content refers to subject matter or task being addressed 4. Group process refers to what is happening among and to group members while working; it addresses morale, feeling tones, influence, competition, conflict 5. Types of roles assumed by members of group a. Harmonizer: brings other group members into accord while reconciling opposing positions b. Questioner: asks questions, seeks information, and gives constructive criticism to group members c. Deserter: talks about irrelevant material; usually disruptive in some manner d. Tension reducer: introduces levity when needed and appropriate e. Encourager: contributes to ego of others and is a responsive member f. Monopolizer: attempts to control group; does not allow others to talk g. Clarifier: restates issues for clarification and then summarizes for group h. Opinion giver: uses own experience to back up opinion or belief i. Initiator: proposes ideas or topics for discussion and suggests possible solutions for group discussion j. Listener: shows interest in group by expressions on face or by body language while making little or no comment k. Negativist: pessimistic, argumentative, and uncooperative l. Energizer: pushes group into action m. Aggressor: hostile and aggressive, verbally attacks other group members 1. Helps society to establish and maintain its code of behavior 2. Provides individual family members with nontangible support a. Strong emotional ties that occur when members (1) Experience sensory stimuli through close contacts (2) Learn to care about emotional and physical well-being of one another (3) Are responsive to one another’s feelings, acts, and opinions (4) Learn empathy by vicariously living experiences of others b. Feeling of security by meeting dependent needs c. System of communication: overt (e.g., words) or covert (e.g., body language) d. Role identification and intimacy that help internalize acceptable behavioral patterns of family e. Spirit of cooperation and competition through sibling interaction 3. Changes that have influenced family’s ability to indoctrinate children with norms of society a. Society has progressed from an agrarian culture through Industrial Revolution to Age of Technology (1) Families have undergone change from extended to nuclear units, with increased numbers of blended, single-parent, and same-gender parent households (2) New social groups are established to replace the extended family (3) Electronic influences (e.g., Internet, cell phones) have weakened family structure (4) Increased mobility of individuals has reduced contact with extended or separated family members (5) Participation in individual activities has grown, reducing time for involvement in family activities
Factors Influencing Client Needs and Nursing Care
Concepts from Sociology
Basic Concepts
Culture and Health
Society and Health
Groups
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