Edukasi dan

Informasi Obat
References

Patient Education: Addressing Cultural Diversity and Hea

lth Literacy Issues.Margaret Chang, MN, RN; Ann E. Kell
y, MSN, APRN, BC.Urol Nurs. 2007;27(5):411-417. http:/
/www.medscape.com/viewarticle/564667_1
Study case 2

Mr. T, a 78 y.o Asian male, was admitted to the hospital for a

cute urinary retention and congestive heart failure. A Foley c
atheter was inserted to relieve the urinary retention, and th
e patient was placed on bed rest. Later during staff rounds
, Mr. T's nurse was shocked and distressed to find Mr. T in hi
s room squatting on the toilet seat trying to move his bowels
. The nurse scolded Mr. T for getting out of bed without assis
tance and for squatting on the toilet seat instead of sitting. M
r. T remained in the hospital overnight and was discharge
d home about 5:00 p.m. the next day with his Foley cathet
er still indwelling. He was sent home with new prescription fo
r furosemide twice daily, digoxin once daily, and potassium o
nce daily.
Goals
Assessment should include evaluation of the patient and family's kno
wledge, beliefs, attitudes, and skills for selfcare. When time and ener
gy are limited, the nurse needs to know what learning must be achie
ved for survival and how best to achieve this (Rankin, Stallings, & Lo
ndon, 2005). Examples of survival behaviors for Mr. T and his famil
y include:
1. Being able to demonstrate appropriate catheter care (including e
mptying the urinary drainage bag)
2. Being able to care for the catheter and genital area.
3. When to take his medications and the potential side effects of ea
ch medication
4. How and when to contact medical assistance if adverse side effe
cts occur.
Urinary catheter care

https://www.youtube.com/watch?v=L7lIIYArTX4
Assessments:

1. Low health literacy: a thorough discussion and written handout (i

n simple terms with universal signs to facilitate understanding in an
y language) as to when his medication should be taken. It cannot b
e assumed that someone understands what is being said becaus
e they nod and sign a sheet of paper.
2. Language issues. When English is the second language, individua
ls may have more difficulty speaking and understanding English du
ring times of stress and illness. During a health crisis, family memb
ers frequently are asked to act as interpreters. In some cultures, it i
s inappropriate to discuss personal, healthrelated information wit
h someone younger and/or of the opposite gender. This could hav
e been the situation for Mr. T. when his daughterinlaw was used a
s the interpreter for his discharge instructions..
3. Cultural behavior. It is noteworthy that Mr. T did not want his daug
hterinlaw to empty the urinary drainage bag. This is a cultural issu
e related to gender, family relationships, and the sick role. In this si
tuation the home health carer could assess the wife's ability to ma
nage the task. She could probably teach the wife to empty the urin
ary drainage bag. Continued home health care could be provided
and should include contacting the physician facilitating the remova
l of the urethral catheter.
Toileting: less straining and energy were required for him to squat th
an to sit on the western toilet. In the aforementioned situation, th
e nursing staff could have checked on him and provided privacy fo
r him, as long as they deemed that he was in a safe situation. Ther
e are no cleanliness issues in using the squatting position providin
g the seat is in the upright position.