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 influ-
enced 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). Other-
wise, 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.
ETHNIC CONSIDERATIONS
Besides cultural differences, there are also ethnic and racial differences in the
physiological response to drugs. As you’ll recall from Chapter 2, pharmaco-
genetics is the study of the influence genetics have on a drug response. For
example children with Reyes Syndrome, which is a liver disease, cannot metab-
olize aspirin because of a genetic defect.
Likewise, a genetic factor in African-Americans makes them less responsive
to beta-blocking agents used in cardiac and antihypertensive medications. Asians
have a genetic factor that causes undesirable side effects when given the typical
dose of benzodiazepines (diazepam [Valium]) alprazolam [Xanax], tricyclic anti-
depressants, atropine, and propranol [Inderal]. Therefore, a lower dose must be
given.
CHAPTER 3 Pharmacology and the Nursing Process^53