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Difficulty: MediumCultural Awareness and Influences on Health

A community health practical nurse (PN) is conducting an initial interview with an older adult client of Navajo (Diné) descent. Throughout the interaction, the client stares toward the floor and entirely avoids direct eye contact with the PN. What is the most appropriate action for the PN to take?

  1. Continue the data collection while recognizing the client's averted gaze as a cultural demonstration of respect.Answer
  2. B
    Question the client by asking, "Why are you looking down instead of making eye contact with me?"
  3. C
    Stop the interview immediately to screen the client for acute delirium based on the unusual behavior.
  4. D
    Step into the public waiting area to openly discuss the client's withdrawn behavior with other clinic staff.

Answer

Continue the data collection while recognizing the client's averted gaze as a cultural demonstration of respect.
In Navajo (Diné) culture, making direct eye contact with an authority figure, elder, or healthcare provider is often considered disrespectful, aggressive, or intrusive. Averting the eyes is a demonstration of attentiveness and deep respect. The culturally competent action is to recognize this as a normal cultural variation and continue the interview without attempting to force eye contact.

Step-by-Step Solution

1
Analyze the client's demographic background and presenting nonverbal behavior.
The client is of Navajo descent and is deliberately avoiding direct eye contact.
Identifying cultural context is essential for accurately interpreting a client's nonverbal communication.
2
Evaluate the behavior against known cultural norms and practices.
In Navajo culture, as well as several other Native American and Asian cultures, avoiding direct eye contact is traditionally a sign of respect, not a sign of evasion or pathology.
Cultural awareness prevents the misinterpretation of normal cultural behaviors as medical, psychological, or behavioral issues.
3
Determine the most appropriate and culturally congruent nursing intervention.
The PN should respect the client's cultural practice and proceed with the interview without demanding eye contact.
Culturally competent care requires adapting nursing interactions to align with the client's values and traditions.

Key Concept

Cultural Awareness and Influences on Health
Estimated Time:1m 0s
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Cultural Awareness and Influences on Health

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