For first year B.Sc(N) student

1. Presented by:
Mr. Anslin., M.Sc(N)
HOD Mental health nursing
Sacon

2.  Knowledge an culture diversity is
vital at all levels of nursing
practice. Ethnocentric approaches
to nursing practice are ineffective
in meeting health and nursing
needs of diverse cultural group of
clients.

3.  Knowledge about culture and
their impact on interaction with
health care is essential for nurses,
whether they are practicing in a
clinical setting education,
research and administration.

4.  Knowledge and skills related to
cultural diversity can strengthen
health care delivery systems
concept of illness, wellness and
treatment modalities evolve from
a cultural perspective.

5. Cultural diversity in nursing
practice derives its conceptual
base from nursing, other cross
cultural health discipline and the
social science such as
anthropology, sociology and
psychology.

6. “Cultural diversity” refers to the
difference between people
based on a shared ideology and
valued set of beliefs, norms,
customs and meanings
evidenced in a way of life.

7. Define:
Stress is the “Non- specific response
of the body to any kind of demand
made up on it”.
- Selye (1956)
Stress is the arousal of mind and
body in response to demands made
upon them.
- Schafer (2000)

8. Stress is a condition in which the
human system response to
change in its normal balanced
state. Stress result from a change
in the environment that is
perceived as a challenge a threat
or a danger.
- Pender, Murdaugh & Parsons (2006)

9.  Major life changes
 Stress can also be self generated
 Work
 Relationship difficulties
 Being too busy
 Financial problem
 Children and family

10.  Inability to accept uncertainty
 Pessimism
 Negative self talk
 Unrealistic expectation
 Lack of assertiveness
 Perfectionism

11. Cognitive
symptom
memory concentration Judgment

12. Physical
symptom
Diarrhea
Chest
pain
Nausea &
Dizziness

13. Emotional
symptom
moodiness
Agitation &
Irritability
Loneliness

14. Behavioral
symptom
Eating
more/ less
Using
alcohol/
cigarette
Sleeping
too much

15. Coping:
Coping is the ability of person
to adjust with situation. Adaptive
coping mechanisms are those that
promote health while helping the
person successfully reduces
stress.

16. It is a natural or learned way of
responding to a changing
environment or specific problem
or situation. There are two type of
coping strategies:.
1. Problem focused coping
2. Emotional focused coping

17. Problem focus coping improve a
situation by making changes or
taking some action.
Emotional focused coping thoughts
and actions that relieve emotional
distress. It does not improve
situation but the person often
feels better.
Which is divided in to two:

18. Coping
Long term coping
Change life style
pattern such as
eating health diet,
exercise regularly,
problem solving &
decision making
Short term coping
Using alcohol
beverages or
drug, day
dreaming.

19. a) Nursing history:
Nurse should assess for client perceived
stressors, manifestations of stress and
past & present coping strategies.
b) Physical examination:
 Indicators of stress (Nail biting,
nervousness, weight change)
 Stress related health problem
(Hypertension, Dyspnea).

20. Diagnosis:
Anxiety
Family
coping
Fear
Impaired
adjustment

21. Resolve or
Decrease
Anxiety
Increase
ability to
manage
Planning
Improve
role
performance

22. Teach health activities of daily living
Eg: Exercise, Rest & sleep, Nutrition
Encourage use of support system
Encourage use of management technique
 Massage and progressive relaxation.
 Anticipatory guidance (psychologically
preparing herself for an unfamiliar painful
event)
 Guided imagery and Bio feed back
 Therapeutic touch (Music, Humor, Laugh)

23. Nurse collect data in accordance
to outcome criteria established.
 Evaluation activities.

24.  It is one’s mental image of one-self
 A positive self concept is essential to a
person’s mental and physical health
 Individuals with a positive self concept
are better able to develop and
maintain interpersonal relationships
and resist psychological and physical
illness.

25.  Individual who have a poor self-
concept may express feelings of
worthlessness, self-dislike or even
self-hatred
 They may feel and sad or hopeless
and may state they lack energy to
perform task.

26. How one thinks, talks & acts
Choice one make
Ability to take action to change things
How one see and treats another person
Ability to give and receive love

27. 1) Self knowledge – once ability, nature,
limitation, insight.
2) Self expectation – Realistic/
unrealistic
3) Social self – how a person is
perceived by others/ society.
4) Social evaluation – the appraisal of
oneself in relationship to others.

28. Components
of self
concept
Personal
identity
Body
image
Role
performance
Self
esteem

29.  Personal identity is conscious sense of
individuality and uniqueness that is
continually evolving throughout life.
 People often view their identity in term
of nature, sex, age, race, ethnic origin
or culture, occupation or roles, talents
and other situation characteristics
(eg: marital status and education).

30.  The image of physical self in
how a person perceive the size,
appearance and function of the
body and its part.
 Body image is the sum of person’s
conscious and unconscious attitude
about his or her body.
 This does not necessarily have to reflect
reality (Thin – fat).

31.  Throughout life people undergo
numerous role changes. A role is a set
of expectations about how the person
occupying once position behaves.

32.  It is one’s judgment of one’s own
worth, that is how that persons
standards and performance compare
to others and to one’s ideal self.

33.  When thinking about the six topics
sometimes we make judgments about
how much we approve or disapprove
of ourselves. Those judgments will
affect how we behave and how much
we think we can secured.

34.  If there is a mismatch between how
you see yourself (eg: your self image)
and what you’d like to be (eg: your
ideal self) then this is likely to affect
how much you value yourself.
therefore there is an intimate
relationship between self image, ego-
ideal and self esteem.

35.  A person ideal self may not be
consistent with what actually happens
in life and experience of the person.
Hence a difference may exist between
a person’s ideal self and actual
experience. This is called
incongruence.

36. Incongruent Congruent
Self
image
Ideal
self
Self
image
Ideal
self
The self image is
different to the ideal
self. There is only a
little overlap. Here self
actualization will be
difficult.
The self image is
similar to the ideal
self. There is a
more overlap. This
person can self-
actualize.

37. Self
awareness
(Infancy)
Self
recoganitation
(18 months)
Self
definition
(3 years)
Self
concept
(6 – 7 yrs)

38.  To promote a positive self- concept include
helping a client to identify areas of strength
for ex: writing, painting, music, sports.
The following nursing technique may
enhance self esteem…
1. Encourage client to express their feelings
2. Provide accurate information
3. Avoid criticism
4. Explore clients positive qualities
and strength.

39.  Many disease, accidents, illness and their
treatments create sexual dysfunctions
and role changes. Rehabilitation nurses
are in an excellent position to address
these issues with their client. To
accomplish this, nurses need to
overcome barriers, such as cultural and
professional stereotyping, and lack of
education.

40.  Nurses must also develop an awareness of
belief, attitudes and values related to
sexuality, and awareness of how these
beliefs, attitudes and values affect their
practice.
 Rehabilitation nurses have an important role
in assuring that experiencing a disability,
having a chronic illness or aging does not
need to translate into permanent sexual loss
or eliminate the ability to give and receive
affection.

41.  Spirituality generally involves a belief
in a relationship with some high
power, creative force, drive being or
infinite source of energy.
Ex: person may believe in god.

42.  Spirituality is unique to each individual
 Your “spirit” usually refers to the deepest
part of you, the part that lets you make
meaning of your world.
 Your spirit provides you with the
revealing sense of who you are, where
you are here of what your purpose for
living is.
 It is that inter most part of you that
allows you to gain strength and hope.

43.  The basis of spirituality is discovering
a sense of meaning fullness in your
life and coming to know that you have
purpose to fulfill.

44.  Spiritual distress refer to a challenge
to the spiritual well being or to the
belief system that provides strength,
hope and meaning to life.

45. Treatment
related
factors
Situation
factors
Physical
problem
Ex: Pain, experiencing
loss of body parts or
function, terminal
illness.
Blood transfusion,
surgery, abortion,
amputation of a body.
Death, illness

46.  No one really knows for sure how spirituality
is related to health. However it seems the
body, mind and spirit are connected.
 Some research shows that things such as
positive beliefs, comfort and strength gained
from religion, meditation and prayer can
contribute to healing and a sense of well
being.
 Improving your spiritual health may help you
feel better, prevent some health problem &
help you cope with illness, stress/ death.

47.  For many people, religion and
spirituality are a significant part of
who they are, many patient turn to
religion & faith as they try to find
meaning in their illness and cope with
their altered life situation.
 Religious faith and spiritual coping
has been observed in patient with
some disease.

48.  If these needs are not addressed,
internal struggles may result in
existential crisis leading to dejection
and perception of being abandoned.
(ex: god does not care for me)
 The components of a spirituality
based indicator would include a vision
of a peaceful and united future: The
selected principles.

49. Unity in diversity
Equity and justice
Equality of the sexes
Trustworthiness and moral leadership
Independent investigation of truth

50.  The loss of a loved one is life’s most stressful
event and can cause a major emotional crisis.
After the death of someone you love, you
experience bereavement, which literally
means “to be deprived by death”.
 When a death take place, you may
experienced a wide range of emotion.
 When a death is expected, then there is no
real order to the giving process.

51. Denial
Shock
Despair Anger
Guilt
Disbelief
ConfusionSadness Emotions

52.  It is not easy to cope after a loved one
die, you will mourn and grieve.
 Mourning is a natural process you go
through to accept a major loss.
 Mourning may include religious
traditional honoring the death or
gathering with friends and
family to share your loss.

53.  Mourning is personal and may lost
months or years.
 Profound emotional reaction may
occur. (Ex: anxiety, chronic fatigue,
depression and thoughts of suicide).

54.  It is very important to allow yourself to
express these feelings. Many people
report physical symptom that
accompany grief. (stomach pain, loss
of appetite, intestinal upset, sleep
disturbance and loss of energy.
Mourning can seriously discussed by
your relationship with the person who
died.

55.  Child death arouses an overwhelming sense
of injustice – unfulfilled dreams and senseless
suffering. Parents may feel responsible for
the child’s death. Parents may also feel that
they have lost a vital part of their own
identity.

56.  A spouse death is very traumatic. The
death may cause a potential financial
crisis if the spouse was the family’s
main income source.

57.  Elderly people death may be especially
vulnerable when they lose a spouse
because it means losing a life time of
shared experiences. At this time,
feeling of loneliness may be
compound by the death of close
friends.

58. Define:
 Grief is a reaction to a major loss. It is
most often an unhappy and painful
emotion.
 Painful psychological and
physiological response to loss.

59. Death of loved
one
Illness
Chronic condition
affect quality of life
Diverse

60. Denial, Disability, Numbness
Anger, Blaming others
Bargaining
Depressed mood, sadness & crying
Acceptance

61. 1. Seek out caring people (find relatives and
friends who understand).
2. Express your feelings (tell others).
3. Take care of your health (meet physician).
4. Accept that life is for the living .
5. Postpone major life change (moving,
remarrying, changing job).
6. Be patient
7. Seek outside help when necessary.

62. Helping
others
grieves
Share the
sorrow
Don’t
offer false
comfort
Offer
practical
help
Be patient
Encourage
profession
al help
when
necessary

63.  Examples of therapeutic health care
modalities are:
Life style
modification
Recreational &
divisional
therapy

65. 1. Music therapy
2. Activities according to the hobbies
3. Play activities
4. Reading
5. Painting
6. Yoga
7. Exercise
8. Group activities/ occupational therapy
9. Other activities (watching tv, etc).

66. Thank you