Feb 23, 2024 Diversity And Health Assessments NURS 6512
Diversity And Health Assessments NURS 6512
Diversity And Health Assessments NURS 6512
The population in the united states is composed of people from diverse cultural backgrounds and this aspect is also duplicated in the healthcare system. To ensure the provision of quality and effective healthcare services to the diverse population, the healthcare providers must be competent, sensitive, and also be aware of the diversity of the patient cultures and other essential beliefs as well as avoid stigmatizing patients based on their cultural differences.
When a healthcare provider is culturally competent, he or she accepts the diverse needs of their patients even though the diverse needs may be different from those of theirs. To ensure culturally competent healthcare services, the healthcare providers must be sensitive to the patient’s socioeconomic status, heritage and ethnicity. Distinct from cultural awareness and cultural sensitivity, cultural competence is the ability of healthcare providers to modify their practices such that they effectively meet the needs of the different cultural groups (Sharifi, Adib-Hajbaghery, & Najafi, 2019). On the contrary, cultural awareness and sensitivity highlight the ability to recognize the differences without necessarily modifying practices to meet the various needs of different patients.
Case scenario
The case study presents Mono Nu, who is a 44- year old Filipino patient who started blood thinner medications a period of two weeks ago. The patient is from a low-income household and hence does not afford the prescribed medication. Besides, he has no adequate understanding on the working mechanism of the medications or why they are necessary. In addition, the patient lacks a social support network so that he can maintain his medications. His main diet is fish and tofu, which may lack in some essential nutritional components hence affecting the mode of action of the blood thinner medications.
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Cultural Factors
Mono Nu is from the Philippines which makes him have a different understanding of health and wellness contrary to people from the western culture. The culture in the Philippines is such that they rely on family, friends, and faith in God for healing (Cacho & del Castillo, 2022). This culture of health and wellness prevents the Philippines from access to healthcare. The culture of the patient, therefore, has an impact on his health because it can dictate his willingness to adhere to the prescribed medications (Collado, 2019).
In addition, the patient does not understand why his medications are producing
Diversity And Health Assessments NURS 6512
the anticipated results meaning that the patient might be frustrated or, might be in a state where he feels helpless. His choice of diet however indicates that he appreciates specific diet which is essential to healthy eating. As a health practitioner, some of the most sensitive issues to take into account while interacting with this particular patient include their age, cultural differences in terms of health beliefs, the likelihood of frustrations with the medications, and some potential side effects of medications.
Targeted Questions
What is your level of income? Do you have financial challenges in obtaining your prescribed medications?
Do you understand the mode of action of your blood thinner medications and why they are necessary for your current state?
Are there some cultural beliefs that may negatively influence your willingness to take the prescribed medications?
Do you have any social program that can assist you in obtaining your medications as prescribed?
Are there any other health concerns that you feel that I should be aware of?
References
Cacho, R., & del Castillo, F. (2022). God’s Benevolent Love in the Time of COVID-19 Pandemic: Articulations and Experiences of Select Filipino Youth. Religions, 13(2), 162.
Collado, Z. C. (2019). Challenges in public health facilities and services: evidence from a geographically isolated and disadvantaged area in the Philippines. Journal of Global Health Reports, 3.
Sharifi, N., Adib-Hajbaghery, M., & Najafi, M. (2019). Cultural competence in nursing: A concept analysis. International journal of nursing studies, 99, 103386.
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I enjoyed reading your post. It is important that providers know and understand different modes of communication, when, and how to use them with their various patients. In addition to communication, they should also know how health beliefs may vary from one culture to another, also how diet and nutritional practices may be different (Ball, et., 2019). Anticoagulants or blood thinners are a serious and important class of medication that prevent or reduce the risk of a blood clot.
Patients should be educated on why they are on this medication, its use, and when and how to take the medication. They should be aware of labs and how often the lab should be monitoring and foods they needed to avoid while on this medication. As you mentioned in your discussion that the culture of the patient, therefore has an impact on his health because it dictates his willingness to adhere to the treatment (Collado, 2019).
Some cultures or countries believe that they do not need medications for some illnesses because of not being aware of illness, resources, or how to treat them. Providers should educate, provide resources and allow patients to demonstrate what they learned or skills in order to make sure that they understand what was discussed.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Collado, Z. C. (2019). Challenges in public health facilities and services: evidence from a geographically isolated and disadvantaged area in the Philippines. Journal of Global Health Reports, 3.
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I agree with you, the emphasis should be more on the patient cultural background. Generally, when interacting with this patient, the patient’s condition, race, culture, life experiences, and beliefs; should be put into consideration (Ball, Dains, Flynn, Solomon, & Stewart, 2019). Cultural beliefs played a key role in patient health. In this case study, Mono Nu is from the Philippines and has a culture that has been known for the traditional use of plant medicines.
There are several factors that the healthcare professional should consider when assessing patients with different cultural backgrounds. First, this professional should consider the patient’s socioeconomic status since they are likely to affect the patient’s health literacy, perception of healthcare, health-seeking behavior, ability to afford medical services, and the risk factors that patients face (Arpey et al., 2017; McMaughan et al., 2020).
with this, in mind, the health care professional will assess the patient’s drug history and make sure to ask about herbal supplements. Many herbal plant decreased the effectiveness of the medicine and block the action of blood thinners. Warfarin for instance role is to prevent clot formation, a diet rich in VitK decreased the effectiveness of the medication and may lead to severe health consequences (Rosenthal and Burchum, 2018). Also, it’s important that the healthcare professional educate patient Mono Nu about the importance of blood thinners and emphasize more the diet low with vitk.
References
Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017). How socioeconomic status affects patient perceptions of health care: A qualitative study. Journal of Primary Care & Community Health, 8(3), 169–175. https://doi.org/10.1177/2150131917697439
Ball, J.W., Dains, J.E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination. (9th ed.). St. Louis, MO: Elsevie Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice nurse and physicians assistant. St. Louis, MO: Elsevier.
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Lenora Wade Walden Instructor Manager
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Maryam,
Thanks for sharing your discussion and explaining the difference between cultural awareness, sensitivity and competence.
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Week 2 Initial post NURS-6512N
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Cultural Competence Case Study group B
Culture generally is about entire human behaviors, attitudes and ideas, speech patterns, imaginations, language, beliefs, and etiquette; basically, it is features that distinguish one group entity from other groups of human entities (Ball, Dains, Flynn, Solomon, & Stewart, 2019).
Healthcare professionals should demonstrate competence when dealing with diverse patients. According to Nair and Adetayo (2019), cultural competence is beneficial for both patients and healthcare providers since it encourages patient engagement/participation, promotes respect, enhances understanding between persons, and promotes better health outcomes.
This competence is particularly vital when dealing with patients in multicultural societies like the US that are characterized by cultural diversity. In the assigned case study, for instance, the language barrier inhibits communication between a healthcare professional and Paloma Hernandez and may have led to poor health outcomes for the patient.
There are several factors that the healthcare professional should consider when working with the patient. First, this professional should consider the patient’s socioeconomic status since they are likely to affect the patient’s health literacy, perception of healthcare, health-seeking behavior, ability to afford medical services, and the risk factors that patients face (Arpey et al., 2017; McMaughan et al., 2020).
Socioeconomic factors are of great significance when serving patients like Paloma whose communities have higher rates of poverty. Other factors like spirituality may also affect health-seeking behavior, perception towards treatment, medication adherence, and medication refusal. For instance, some patients could refuse medication on a religious basis or their belief that healing comes from God. Precisely, Latinos have tight religious ties and view the church as a major spiritual, social, and educational resource for the people and a significant determinant of medication compliance (Caplan, 2020; Gast et al., 2020).
Although healthcare professionals should help patients to overcome their health problems, they must always respect the patients’ views and interests. Lifestyle factors should also be considered when dealing with patients like Paloma due to their impact on risk factors, treatment, and health outcomes. For instance, lifestyles like smoking, alcohol consumption, and the diet (foods that the patient consumes) could affect their likelihood of developing gastrointestinal complications (Capurso & Lahner, 2017; Livovsky et al., 2020).
Other important cultural factors include language, beliefs, and values. For instance, close family and social ties among Latinos could be a good facilitator for accessing health support, although the language barrier could interfere with communication and involvement in clinical decisions. For instance, miscommunication due to a language barrier between the healthcare professional and the patient created confusion, poor medication adherence, or the consumption of dosage, which could in turn have led to the re-hospitalization of the patient.
There are many reasons why healthcare professionals should be sensitive when dealing with patients like Paloma. Cultural competence, awareness, and sensitivity reduce the risk of misunderstanding/misjudging patients from other cultures, reduces the risk of bias, guide healthcare professionals to select the right words, promote respect between patients and healthcare professionals, and help healthcare professionals to involve patients in clinical decision-making.
In other words, cultural competence is critical to care coordination and patient-centered care as it encourages patient engagement and ensures that their health needs are met. Cultural insensitivity could lead to communication barriers, conflicts, lack of respect, and lack of collaboration.
Creating a health history for Paloma can significantly help in assessing the patient, tracking her progress, and making informed clinical decisions. Below are some important questions that are relevant to Paloma.
When did your pain start?
Where is the location of your pain?
How would you rate your pain on a scale of 1-10?
Do you smoke or drink?
Do you always take Omeprazole as instructed, and how does this medication affect your pain?
Are there any foods on your diet that you believe could be worsening your abdominal pain?
Do you eat a lot of spicy food?
References
Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017). How socioeconomic status affects patient perceptions of health care: A qualitative study. Journal of Primary Care & Community Health, 8(3), 169–175. https://doi.org/10.1177/2150131917697439
Ball, J.W., Dains, J.E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination. (8th ed.). St. Louis, MO: Elsevier
Caplan, S. (2019). Intersection of cultural and religious beliefs about mental health: Latinos in the faith-based setting. Hispanic Health Care International, 17(1), 4–10. https://doi.org/10.1177/1540415319828265
Capurso, G., & Lahner, E. (2017). The interaction between smoking, alcohol and the gut microbiome. Best Practice & Research Clinical Gastroenterology, 31(5), 579–588. https://doi.org/10.1016/j.bpg.2017.10.006
Gast, J., Peak, T., & Hunt, A. (2017). Latino health behavior: An exploratory analysis of health risk and health-protective factors in a community sample. American Journal of Lifestyle Medicine, 14(1), 97–106. https://doi.org/10.1177/1559827617716613
Livovsky, D. M., Pribic, T., & Azpiroz, F. (2020). Food, eating, and the gastrointestinal tract. Nutrients, 12(4), 986. https://doi.org/10.3390/nu12040986
McMaughan, D. J., Oloruntoba, O., & Smith, M. L. (2020). Socioeconomic status and access to healthcare: Interrelated drivers for healthy aging. Frontiers in Public Health, 8(231), 231. https://doi.org/10.3389/fpubh.2020.00231
Nair, L., & Adetayo, O. A. (2019). Cultural competence and ethnic diversity in healthcare. Plastic and Reconstructive Surgery – Global Open, 7(5), e2219. https://doi.org/10.1097/gox.0000000000002219
Patient Associated Factors
Cultural competence is described by the Centers for Disease Control and Prevention (n.d.) as a collection of compatible attitudes, practices, and rules that exist inside a system, organization, or group of experts and allow for productive cross-cultural work. As nurses and future providers, having cultural competence is essential to the health outcomes of the patients as it increases the quality of services. Our services are provided to many diverse cultures.
Therefore, it is important to be knowledgeable of the patient’s culture and avoid stereotypes. This week’s case study follows the case of Shawn Billings. He is a 28-year-old African American patient who comes into the clinic today with a migraine. The staff has deemed him a “frequent flyer” due to his numerous office visits. He is worried that he will not receive his medication. The purpose of this discussion is to explain the factors associated with this patient and sensitive issues when interacting with the patient.
Given the patient’s case, it seems as though this patient has been affected by healthcare disparities in his community. Thus, his socioeconomic status, including income, community safety, education, social support, and employment, may be poor. The patient may have limited access to healthcare, or they may have received poor-quality care. This may be why he is worried that he will not receive his medication. African Americans tend to use spirituality and church as coping mechanisms. Churches were cited as dependable locations for finding health resources as well as spiritual and social support (Siler et al., 2021).
With the patient being young, his lifestyle could include risky activities and lack of sleep, which could be two possible reasons for the patient’s migraines. In addition to these variables, the patient’s potential is limited due to the lack of culturally appropriate health information and services available to the patient.
Sensitive Issues
Because the patient is African American, he is at an increased risk of being stereotyped and discriminated against in the healthcare system. While seeking treatment for themselves or a member of their family, black people are more likely to encounter barriers to care and discrimination (KFF, 2022). Therefore, it is important to create a non-judgmental environment.
Deeming the patient as a “frequent flyer” could be a sensitive issue as the patient’s concerns could be disregarded and a potential health problem could be missed. Family history and level of education are also sensitive issues for African American patients.
Patients tend to exclude extended family from health history, and some may not know their family history due to lack of conversation regarding the topic or the patient may not know their biological family. Knowing your patient’s level of education assesses how well the patient will understand their diagnoses, treatment plan, and medications.
It can also indicate how the provider will conduct education regarding their health. This includes if the provider needs to use pictures, audio, diagrams, etc. when providing education. Being sensitive to the patient’s socioeconomic and cultural factors ensures a non-biased approach and creates an environment that provides optimal quality care and greater efficiency regarding health outcomes for patients.
Targeted Questions
The five targeted questions I would ask the 28-year-old African American with complaints of a migraine include:
What is your occupation? (This question assesses if the patient has a job that is strenuous, thus, leading to the exacerbation of a migraine).
How are you sleeping? (This question assesses how much and well the patient is sleeping as a lack of sleep can exacerbate a migraine).
Do you use any illicit or recreational drugs? (Because the patient is young, he may engage in risky behaviors including illicit or recreational drug use, which can have side effects that include headaches).
What is your diet like? (The patient could be consuming foods that could trigger a migraine).
Is there a family history of migraines? (Genetics could play a factor in the patient’s development of migraines).
References
Centers for Disease Control and Prevention. (n.d.). Cultural competence in health and human services | NPIN. https://npin.cdc.gov/pages/cultural-competence
Links to an external site.
KFF. (2022, March 22). Disparities in health and health care among black people. https://www.kff.org/infographic/disparities-in-health-and-health-care-among-black-people/
Links to an external site.
Siler, S., Arora, K., Doyon, K., & Fischer, S. (2021). Spirituality and the illness experience: perspectives of african american older adults. American Journal of Hospice and Palliative Medicine, 38(6), 618–625. https://doi.org/10.1177/1049909120988280
This is a detailed post about the case study. Indeed, I agree with you that nurses should demonstrate cultural competence is essential to the health outcomes of the patients as it increases the quality of services. Cultural competence assists healthcare providers in communicating, understanding, and associating with patients effectively (Young & Guo, 2020). It also centers on appreciating the relationship between nurses and patients. Cultural competence is crucial in promoting communication, which sustains the safety of patients.
Effective communication enables healthcare professionals to gather precise medical data. It also fosters active dialogue where patients and providers can freely ask questions, develop trust, and correct misunderstandings. Failure by healthcare professionals to identify the distinctions between them and their patients may unintentionally give poor-quality care (Botelho & Lima, 2020). As such, cultivating skills that enhance cross-cultural communication is instrumental in providing equitable care.
In this case, I concur that the patient is most likely at an increased risk of being stereotyped and discriminated against in the healthcare system due to his African American origin. Indeed, the best way to assess this patient is to create a non-judgmental environment during the interview (Van Humbeeck et al., 2020). This can be achieved by adopting an attitude of empathy, acceptance, and genuineness.
The nurse practitioner must also be ready to identify cultural differences, demonstrate active listening skills, and reflect on the state of mind. Respecting the patient’s beliefs and listening to his concerns are essential. Nurse practitioners should be able to understand the patient without being distracted by their experiences and thoughts. If the patient feels safe during the interview, he will likely feel comfortable and speak openly. The patient’s needs are met, providing the best possible nursing care.
References
Botelho, M. J., & Lima, C. A. (2020). From cultural competence to cultural respect: A critical review of six
models. Journal of Nursing Education, 59(6), 311-318. https://doi.org/10.3928/01484834-20200520-03
Van Humbeeck, L., Malfait, S., Holvoet, E., Vogelaers, D., De Pauw, M., Van Den Noortgate, N., & Van Biesen,
(2020). Value discrepancies between nurses and patients: A survey study. Nursing ethics, 27(4), 1044-
https://doi.org/10.1177/0969733020906595
Young, S., & Guo, K. L. (2020). Cultural diversity training: the necessity of cultural competence for health care
providers and in nursing practice. The health care manager, 39(2), 100-108. DOI:
10.1097/HCM.0000000000000294
Cross-cultural interactions are one of the hardest experiences healthcare providers encounter. Cultural encounters and lack of understanding between the patient and the caregiver could jeopardize the treatment outcomes. Therefore, the healthcare givers must develop cultural competencies and handle patients based on their age, cultural identity, and social background (Mills, et al., 2017). In this case, the patient is a 23-year-old Native American who consumes alcohol and marijuana.
The fact that the client consumes alcohol and marijuana could expose him to serious mental conditions which must be established during the interview. Therefore, I agree with you that starting with a targeted question such as, ”how long have you been experiencing anxiety?” is appropriate. The question is appropriate because the caregiver already has some history of the patient’s lifestyle (Saunders & Vehviläinen‐Julkunen, 2017). Otherwise, it would be inappropriate if the client was new and had not revealed any history of anxiety and substance abuse.
On the other hand, I feel some of the questions presented in your post are sensitive and I would not ask my client such. It could be appropriate to ask the client whether he feels some of his behaviors are risky, but getting directly into promiscuity could appear offensive. Instead, I would recommend the use of open-ended q
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