culture in health care response to colleague

ekaette akpabio

main question post

COLLAPSE

Health and human service organizations are recognizing the need to enhance services for culturally and linguistically diverse populations (CDC, 2020). The dynamic nature and cultural diversity in the healthcare sector require nursing acculturation to promote quality and patient-centered care. Nurse practitioners cannot effectively play an advocate role to patients without being culturally aware of their own cultural beliefs and biases, must be culturally sensitive, culturally flexible, and respect each patient as an individual. Cultural competence is designed for practitioners to treat and care for the patient in a manner that promotes quality of care. Implementing cultural competency strategies while dealing with diverse patients can be an accessory to the quality improvement process. The cultural competence framework requires that the practitioner comprehend, respect, and acquire knowledge and skills needed to treat patients from diverse cultures (Ball, 2019). In the case scenario provided, JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”. In caring for this patient, the nurse practitioner would consider the communication techniques, family dynamics, health beliefs, and the use of herbal medicines. Asians are known for their strong family values, traditional, cultural, and religious beliefs. In caring for this patient, I would rule out any communication barrier that may impact this encounter. If the patient speaks fluent English, then no translator or interpreter would be needed. While maintaining eye contact is positively evaluated by Western Europeans, it is not the case with people of East Asian cultural backgrounds (Uono & Hietanen, 2015). The sensitive issue, in this case, would be to avoid eye contact during my interaction with the patient. Maintaining eye contact with this population while communicating is a sign of rudeness or disrespect (Ball et al., 2019).Low socioeconomic status is one major barrier to preventing Asian Americans from accessing health insurance. The way Asians deal with the disease process is different from the general population. Older Asians living in America often experiencesocial isolation, inadequate community outreach, and limited English proficiency play a large role in low socioeconomic status(Zhang,2021). Considering the socioeconomic factor, the patient lives with the daughter who is responsible for his upkeeps. Asian American seniors, especially foreign-born seniors, are likely to receive much less Social Security benefits because they tend to earn less and over fewer years during their working years in the United States (Zhang, 2021). As a result of the financial status, this patient depends on the daughter for the majority of his financial needs. Another factor to consider is the patient’s spirituality and how it impacts his health. I have elderly Asian patients whose family brings traditional medicine from time to time based on their belief system. In this case, the nurse has to inform the primary physician who would authorize the herbal medicine to be added to the patient’s list of medications. The physician would have the pharmacy review patient’s medications to ensure no adverse effect would result from adding herbal medicine to the current list of medications. Many Asians are known to use herbal or traditional medicine to treat one ailment and the practitioners should be conversant with the basic remedies in this population and incorporate them into the treatment plan as appropriate

Questions to ask my assigned patient

To conduct a comprehensive health history on my patient, I would start with an open-ended question to enable my patient to speak freely and voice his concerns. By so doing, the patient would reveal as much information as possible. My first question would be, what health concerns do you have? This would enable the patient to share pertinent information. I would also use this opportunity to discuss his current health condition and the medication to ensure he understands how to manage his medications and his medical conditions. Secondly, what are your food choices? this question is important since the patient has B12 deficiency and may need education on food choices to supplement for B12 deficiency. Thirdly, I would ask the patient about his physical activity. This is important because of his age and other comorbid conditions. Physical inactivity in Asian American adults has been recognized as a high-risk factor for disease (Zhy & Sun, 2016). Fourthly, I would ask the patient, do you feel depressed? This is important since the patient is dependent on his daughter. Also, living with chronic health conditions can be depressing. Lastly, I would ask the patient about who makes health care decisions and if he does have health insurance. This question is important since he is depending on the daughter financially and he had stated that he did not want to be a burden to the daughter.

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.

Uono, S & Hietanen (2015). Eye contact perception in the West & East: A cross-cultural study.Plos One,10(2). Doi: 10.1371/journal.pone.0118094

Zhang, N. (2021). Why income inequality is growing at the fastest rate among Asian Americans. Retrieved from https://www.cnbc.com/2021/05/26/why-income-inequality-is-growing-at-fastest-rate-among-asian-americans.html

 Center for Disease Control and Prevention(2020, October 21). Cultural competence in health and human services. Retrieved from https://npin.cdc.gov/pages/cultural-compe-tence

Zhu, W., Chi, A., & Sun

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culture in health care response to colleague

Culture reflects at the whole human behavior, is the sum of beliefs, ideas, attitudes, way of speaking and thinking, ways of relating to each other, the manner one looks at material and spiritual belongings, imagination, and ingenuity. One individual may belong to one or more cultures, may identify with different cultures through religion, sexual orientation, profession, or gender. To be a culturally competent provider means to be able to be sensitive to a person’s beliefs, sexual orientation, ethnicity, socio-economic situation, and cultural background. It is achieved by acquiring knowledge, respect of others and their cultures, and developing the communication skills to extract the necessary information regarding the belief of “well-being and health” (Ball et al., 2019).

Scenario

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has ahx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”

Cultural Factors

The patient is a male of Asian descent, 86 yo with significant history of heart disease, GI conditions, prone to anemias and genitourinary conditions, taking medications necessary to maintain health, and financially dependent on the daughter’s income. Research shows that in Asian culture the health decisions depend on socio-economic status and often people don’t visit the doctors unless medical emergencies arise due to the fear of financial burden (Somsak & Gunda, 2019). With this in mind, the medical provider must explain the patient his options and an interdisciplinary team formed of the medical provider and social worker is more beneficial to help the patient maintain optimal health. The social worker may intervene by finding resources to obtain cheaper or even free. The provider needs to understand that some cultures may use traditional healing techniques such as herbal supplements in forms of ointments, teas, root extracts that may interact with prescribed medications and develop the communication techniques and create a safe space where the patients feels comfortable expressing and provides the necessary information (Young & Guo, 2020).

Targeted Questions

Evidence Best Practice is used to guide patient care and help achieve the best possible outcomes for the patient (Coleman, 2019). The provider’s responsibility is to ask pertinent questions to help gather the necessary amount of information to help guide the right decisions for patient’s health. The questions are aimed towards health beliefs and practices, faith, language skills, sources of support beyond family, or dietary practices:

“Who makes the health decisions such where to go, whom to see, or what advice to follow in your family?

“What are the faith-based practices or beliefs that may affect health care when the patient is ill or dying?”

“How well does the patient understand spoken and written English? Is there a need for an interpreter?”

“Are there ethnic or cultural organizations that may have an influence on the patient’s approach to health care? Are there organizations that may provide support (financial and mental)?”

“Who is responsible for food procurement and preparation? Are there specific beliefs or preferences concerning food, such as those believed to cause or cure an illness? (Ball et al., 2019).

 

 

 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

David E. Coleman (2019) Evidence Based Nursing Practice: The Challenges of Health Care and Cultural Diversity, Journal of Hospital Librarianship, 19:4, 330-338, DOI: 10.1080/15323269.2019.1661734

Somsak Thojampa, & Kenje Gunda. (2019). Patient and Family Centered Care from a South East Asian Cultural Perspective: A Discussion. International Journal of Caring Sciences, 12(2), 1286–1289.

Young, S. & Guo, K.  (2020).  Cultural Diversity Training.  The Health Care Manager, 39 (2), 100-108.  doi: 10.1097/HCM.0000000000000294

 

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Frequently Asked Questions

A Page will cost you $12, however, this varies with your deadline. 

When you pay us, you are paying for a near perfect paper and the time convenience. 

Upon completion, we will send the paper to via email and in the format you prefer (word, pdf or ppt). 

Yes, we have an unlimited revision policy. If you need a comma removed, we will do that for you in less than 6 hours. 

As you Share your instructions with us, there’s a section that allows you to attach as any files. 

Yes, through email and messages, we will keep you updated on the progress of your paper. 

Start by filling this short order form thestudycorp.com/order 

And then follow the progressive flow. 

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Regards,

James from thestudycorp.com