Heritage Assessment Tool
This is a benchmark assessment.
The RN to BSN program meets the requirements for clinical competencies as defined by CCNE and AACN using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, their specific care discipline, and their local communities.
The learning activity and corresponding assignment in this topic requires students to perform a heritage assessment with families selected by the student from their local community.Heritage Assessment Tool.
Note: The greater the number of positive responses, the greater the person's identification with a traditional heritage. The one exception to positive answers is the question about family name change. This question may be answered negatively.
1. Where was your mother born?
2. Where was your father born?
3. Where were your grandparents born?
(1) Your mother's mother?
(2) Your mother's father?
(3) Your father's mother?
(4) Your father's father?
4. How many brothers and sisters do you have?
5. What setting did you grow up in? Urban Rural Suburban
6. What country did your parents grow up in?
Father
Mother
7. How old were you when you came to the United States?
8. How old were your parents when they came to the United States?
Mother
Father
9. When you were growing up, who lived with you?
10. Have you maintained contact with
a. Aunts, uncles, cousins? (1) Yes (2) No
b. Brothers and sisters? (1) Yes (2) No
c. Parents? (1) Yes (2) No
d. Your own children? (1) Yes (2) No
11. Did most of your aunts, uncles, cousins live near your home?
(1) Yes
(2) No
12. Approximately how often did you visit your family members who lived outside your home?
(1) Daily
(2) Weekly
(3) Monthly
(4) Once a year or less
(5) Never
13. Was your original family name changed?
(1) Yes
(2) No
14. What is your religious preference?
(1) Catholic
(2) Jewish
(3) Protestant
(4) Denomination
(5) Other
(6) None
15. Is your spouse the same religion as you?
(1) Yes
(2) No
16. Is your spouse the same ethnic background as you?
(1) Yes
(2) No
17. What kind of school did you go to?
(1) Public
(2) Private
(3) Parochial
18. As an adult, do you live in a neighborhood where the neighbors are the same religion and ethnic background as yourself?
(1) Yes
(2) No
19. Do you belong to a religious institution?
(1) Yes
(2) No
20. Would you describe yourself as an active member?
(1) Yes
(2) No
21. How often do you attend your religious institution?
(1) More than once a week
(2) Weekly
(3) Monthly
(4) Special holidays only
(5) Never
22. Do you practice your religion at home?
(1) Yes
(2) No (If yes, please specify)
(3) Praying
(4) Bible reading
(5) Diet
(6) Celebrating religious holidays
23. Do you prepare foods of your ethnic background?
(1) Yes
(2) No
24. Do you participate in ethnic activities?
(1) Yes
(2) No (If yes, please verify)
(3) Singing
(4) Holiday celebrations
(5) Dancing
(6) Festivals
(7) Costumes
(8) Other
25. Are your friends from the same religious background as you?
(1) Yes
(2) No
26. Are your friends from the same ethnic background as you?
(1) Yes
(2) No
27. What is your native language?
28. Do you speak this language?
(1) Prefer
(2) Occasionally
(3) Rarely
29. Do you read your native language?
(1) Yes
(2) No