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