Biological Variations in ethnic populations NURS 3700 Tamara Mohr, BSN, RN

Before we begin… Any questions from last week? Chapter 7 Giger & Davidhizar, outline printed out, characteristics

Objectives List biological variations in different populations By the end of today, you should be able to: List biological variations in different populations Describe implications for nursing practice when caring for patients of different ethnicities and cultures Illustrate how access to healthcare impacts overall health Compare and contrast how genetic and biological differences may affect overall health

Let’s begin Cultural differences can be easier to spot than biological variations – what are some examples that come to mind? Examples: communication, spatial relationships, social organization (family, kinship, tribes), time orientation Just as no two people are alike, no two cultural or racial groups are alike Giger & Davidhizar (2007)

Biological variations Examples of ethnic variations Body structure Bone density Facial features Skin color ECG variations Disease susceptibility Nutritional preferences/deficiencies Giger & Davidhizar (2009) Adams-Homoda, Caldwell, Stotts & Drew (2003)

Nursing implications What are some things that nurses should be aware of when caring for diverse patients? Clinical standards and norms based on “white normed” standards(ex: Portland Fetal Growth Curves) (Geissler,1991) Need to know different disease processes seen in different ethnicities and races Sickle-cell Tay-Sachs Cystic Fibrosis(CF) Osteoporosis Phenylketonuria (PKU)

Nursing implications Disease susceptibility Biological factors affecting different ethnicities Disease susceptibility TB Blood type Diabetes Hypertension Drug interaction and metabolism Different ethnicities do not always respond to meds in the same way Skin color May affect assessment Check volar surface of arm, palms, soles of feet, mouth, conjunctiva, nail beds

Healthcare inequity Equal access to healthcare? There is growing concern that equal access does not guarantee equal quality of care Many racial and ethnic minorities continue to experience lower quality of health services Examples: less likely to receive dialysis, kidney transplants, analgesics to suppress pain with long-bone fractures Giger & Davidhizar (2007)

Healthcare inequity Diabetes Minorities undermanaged Equal access to healthcare? Diabetes Minorities undermanaged Disparities arise from multiple causes Access to high quality healthcare Unhealthy food choices Lack of opportunities for safe recreation Cultural beliefs about food Distrust of medical care providers Nurses need to improve patient knowledge and increase motivation to make healthy lifestyle changes Multifaceted approach needed Giger & Davidhizar (2007)

Healthcare inequity Hypertension Access to healthcare and it’s impact Hypertension Extremely prevalent in lower socioeconomic groups Geography affects prevalence Barriers to control of hypertension Lack of awareness of disease consequences Lack of access to patient education Delayed diagnosis Disadvantaged communities Distrust of medical community

And the categories are… Biological Variations Name that disease

Biological variations $100 Dependent upon the amount of melanin one has What is skin tone?

Biological variations $200 Differences can be seen in newborns; affects height, obesity; some ethnicities missing certain muscles What is body structure?

Biological variations $300 Epicanthic folds, tooth size, small/large noses, attached or unattached earlobes What are facial features?

Biological variations $400 Highest in Polynesians and African Americans, lowest in Asians and Caucasians What is bone density?

Biological variations $500 Precordial voltages, elevated ST segments What are ECG variations?

Name that disease $100 What is obesity?

Name that disease $200 What is diabetes?

Name that disease $300 What is hypertension?

Name that disease $400 What is sickle cell?

What is cystic fibrosis? Name that disease $500 What is cystic fibrosis?

Please turn in your 1 minute papers before you leave Thanks for your participation everyone and have a great day!

references Adams-Homoda, M. G., Caldwell, M. A., Stotts, N. A., Drew, B. J. (2003). Factors to consider when analyzing 12-lead electrocardiograms for evidence of acute myocardial ischemia. American Journal of Critical Care, 12(1), 9-16. Retrieved from http://ajcc.aacnjournals.org/content/12/1/9.full Geissler, E. M. (1991). Transcultural nursing and nursing diagnosis. Nursing and Healthcare, 12(4), 190-203. Retrieved from http://www.culturediversity.org/bio.htm Giger & Davidhizar (2008). Transcultural Nursing: Assessment and Intervention (5th ed.). St. Louis, MO: Mosby Elsevier