This assignment discusses the importance of cultural competency in healthcare and explores case studies of patients from different cultural backgrounds. It highlights the need for nurses to be respectful and responsive to the cultural beliefs and practices of patients in order to provide culturally competent care.
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Running head: CULTURAL CONSIDERATIONS CULTURAL CONSIDERATIONS Name of the student: Name of the university: Author note:
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1 CULTURAL CONSIDERATIONS Introduction: Cultural competence is now considered to be one of the most important attribute that every healthcare professionals need to develop in the present generation. Studies have found positive co-relationship between cultural competency of the nurse and higher patient satisfaction and greater treatment adherence. This can be defined as the capability of the healthcare providers as well as the organizations in effectively delivering healthcare services that meet the cultural, social as well as the linguistic needs of the patients. Healthcare professionals need to be respectful as well as responsive to the healthcare beliefs and practices of the people coming from different cultural backgrounds. When nurses are able to provide care that aligns with the cultural traditions and customs of patients, it results in improved patient outcomes as well as increased respect and mutual understanding from the patients and enhances participation from the local community(McGough et al., 2018, pg 213). The nurses can develop the attribute of cultural competence through a lifelong procedure by increasing their self-awareness, developing social skills as well as behaviors around diversity and gaining the capability to advocate for others. Along with that they also need to develop cultural awareness and cultural knowledge. Cultural awareness can be described as the understanding of the differences between themselves and the patientsofothercultures,backgroundswithdifferentvaluesandattitudesandcultural knowledge is the development of ideas and collecting information about the patients’ culture, ethnicity,values,traditions,inhibitions,andothers. Firstly, this assignment would be considering a 45 year old Aboriginal and Torres Islander people, which would then be followed by discussion on another old male patient who is 60 years old suffering from hypertension and is the resident of Iraq, and is Muslim in origin. The assignment would then talk about a 70-year-old Asthma patient from Greece who cannot speak
2 CULTURAL CONSIDERATIONS English and then this section would be followed by a discussion on a 25-year-old man from Sudan and suffering from abdominal pain.This assignment will show the ways by which nurses can enhance cultural competency through exhibiting appropriate cultural awareness and cultural knowledge among each of these patients. The cultural considerations that the nurses should keep in mind should be discussed in details. Health is considered to be a holistic concept by the people of the Aboriginal community. This concept encompasses the entire physical, emotional as well as social and spiritual well being of the individuals as well as that of the entire community. Studies are of the opinion that communication difficulties occur because of differences in the languages. It comprises of both verbal and non-verbal modes of communication as well as lower health literacy among the aboriginal communities and the cultural differences often become barriers when healthcare professionals try to improve the health outcomes for the Aboriginal and Torres Islander people (Gibson et al., 2015, pg 71). The nurse who would be treating the 45 year old patient of the aboriginal origin should be culturally aware of the traditions, customs and preferences of the aboriginal people before they proceed with the treatment and consultation procedures. The nurse would be first needing to know about any risk factors that are resulting in unbalanced level of glucose in the blood in the patient. For that the nurse would be requiring to investigate the lifestyle choices and health behavior of the patient to understand the root cause of occurrence of diabetes in the patient. However, aboriginal people are not comfortable discussing their personal lives with strangers and often feel uncomfortable to do so. Therefore, the nurse would first initiate informal conversations with the patient at first in order to make him comfortable and when the nurse had already developed a rapport with the patient through culturally competent communication method, and then only she can initiate asking personal questions about the
3 CULTURAL CONSIDERATIONS lifestyle behaviors that are contributing to diabetes(Hunt et al., 2015, pg 462). However, number of communication methods both verbal and non-verbal - needs to be taken in order to ensure culturally competent care. The nurse should never have direct eye contact with the people while communicating. Studies suggest that Aboriginals consider direct eye contact as rude and disrespecting which might make them feel humiliated unlike the direct eye contact preferred by the organization. Another important aspect is that aboriginals prefer long period of silence while communication, which is not preferred by western communicators as they always, try to fill in the space. This might make the aboriginals feel that the professionals do not respect their culture and that they are culturally insensitive(Isaacs et al., 2016, pg 94). Moreover, the nurse should also be careful about using touch and gestures while communication as most of the Aboriginals are also cont comfortable of touch and gesture from unknown people. The communities believe on kinship where they provide huge importance to family members and elders of their houses in decision-making(Holland, 2017, pg 245).Therefore, if the patient is trying to involve her family members in his diabetes treatment, the patient’s decision should be supported and respected. This would help the nurse in providing culturally competent care to the patient that aligns with the cultural traditions and customs with the patient. The Muslims are not a monolithic group and that they are seen to vary widely in the different religious adherence as well as cultural background and even in acculturation. Nursing professionals need to ensure culturally safety of the environment where the patient is present by ensuring that the nurse is not judgmental about the procedures by which Muslims are seen to align religion with their everyday activities of life. Studies are of the opinion that the Muslim worldview had been derived from the religion of Islam which means total submission as well as obedience to the will of Allah is the best way to achieve health and success in life (Hunt et al.,
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4 CULTURAL CONSIDERATIONS 2015, pg 462). They are the believer of Tawhid which means ‘oneness to Allah” and this requires the Muslims to live in a way that reflect the unity of mind and body with Allah(Rassool, 2015, pg14).Developmentofthisculturalknowledgeisextremelyimportantforthenursing professional who would be treating the 60 year old patient of Muslim origin suffering from hypertension. Hence, they should be respectful for the beliefs of the patients and should not try to judge or reason such behaviors as this might affect their dignity and autonomy(Pacquiao, 2018, pg 22).Another important aspect is that family structure is given central importance in the lives of the people where they can even sacrifice separateness and individuality for maintaining cohesiveness. They also derive self-image, esteem, identity and security from that of family. Hence, if the patient wants to include family members in his decision-making and treatment procedures, it should be respected by the nurses. There is a concept of “jinn and the evil eye” which is often believed to be the cause of disorders in many cultures and even it has place in their holy book of “Quran”(Cruz et al., 2017, pg 220). Such beliefs should not be judged and should be patiently listened to handled with expertise so that the patient feels that their cultural is not disrespected. Traditional medicine as well as folk remedies is also preferred by Muslims alongside western medication. Hence, the nurse should respect such cultural beliefs and should try to accommodate such treatment procedures along with their own course of treatment for hypertension that she should initiate. One very important aspect that the nurse should respect is the protection of modesty and dignity which is extremely important for the people of Muslim background. They identify the importance of covering their bodies for maintaining modesty during procedures and also examinations and hence, this should be respected by the nurse while she collects objective cues and data to diagnose his issues if hypertension(Holland, 2017, pg 247). Moreover, they also maintain modesty by feeling the need to avoid touch between the male
5 CULTURAL CONSIDERATIONS patients and female professionals or vice versa and hence, it should be also respected. The patient with hypertension is male and hence, arrangements can be made so that he is treated by other male professionals only to ensure preserving his cultural preferences and traditions. While treating the 70 year old patient, the nursing professionals need to be well aware of a number of cultural aspects in order to provide culturally competent care. It has been found that many of the Greek values are based on the individual in relation to that of the family, the local community as well as the wider society. However, the nurse should be knowing that the western notions of that of the privacy, personal conscience, individuality as well as independent decision- making are very different from that of the Greek sense of theindividual (Foronda et al., 2018, pg 43).It has been found that expectations of the immediate as well as the extended family and even the members of the patient’s broader community determine the responsibility as well as behavior of the person. Hence, the nurse while treating the 70 year old patient for asthma must take into consideration of the influence of the immediate ad extended families while determining the care plan for the patient. Studies have found that families play an important role in decision-making regarding the care of elderly people and hence, nurses should respect the participation of the patients(Karatay et al., 2018, pg 547). Theymainly are seen to prefer healthcare professionals who can speak their own language and are aware of their culture but they are seen not to entirely reject care by other professionals. In considering towards the cultural aspects of communication, it is seen that elderly people usually prefers calling their names after being followed by the terms of “Mr. and Mrs.” As they do not feel comfortable to be called by their first names initially. After the development of rapport and comforts, professionals can take the chance of calling their first names. They indeed prefer greeting as well as physical contact for showing sympathy and emphasize a subject. Therefore, touching, while conversing with men and women, can be
6 CULTURAL CONSIDERATIONS accepted in their culture and can be followed by nurse when interacting with the old Greek patient (Papadopoulos et al., 2017, pg 480). However, the nurse should never point at the patient as it is considered impolite to pint at someone with the index finger. The nurse should keep one important aspect of communication in mind. Unlike the western communicators, Greeks do not nod or shake their head for communicating. They tilt their head backward to say no and nod their head slightly forward to state yes(Rassool, 2015, pg 15).This would help the nurse to avoid confusion. If the nurse is not aware of the Greek language, summoning an interpreter for support would be helpful. Sudan is one of the largest countries in Africa which had its own set of cultures and traditions.Inordertoestablisheffectivecommunicationthatalignswiththeircultural preferences would help the nurse establish good rapport and trust from the patient. shaking hands are only preferred with individuals of same gender and hence nurse should be careful while interacting with the femalepatient (Malliarou et al., 2017, pg 10).Direct eye contact is considered to be rude and slightly averting the eye is a sign of respect and hence nurses need to ensure that this is followed while communicating with the 25 year patient.Calling by “MR or Mrs” is preferred in the culture. Studies have found that exhibiting interest in the culture as well as practices can enable nurses to enhance the relationship with the patients and hence, this aspect should be taken into consideration so that the nurse can develop supportive relationship with the patient and enhance her alignment to the treatment. The nurses caring for the lady should be also aware about the family values that are shared by the Sudanese. Families are extended and they are seen to be living together with all children and everyone is treated equally and males are the heads of the households and are seen to dominate the social as well as economic domains (Deems et al., 2018, pg 223).The lady might include the males of her family in her treatment and
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7 CULTURAL CONSIDERATIONS the nurse should be supporting and respecting those decisions of the patient. Western biomedical concept of the causations of disorders is now practiced in the different urban areas and hence, the nurse can approach with the western approach of treatment with the patient. However, some important cultural beliefs need to be known by her. They are believers of spiritual and supernatural attributes where concepts of witches, spirit possession, jinn, evil eye are some of the beliefs harbored by Sudanese behind the occurrence of the disorders. Sorcery, witchcraft, effects of ancestors, and punishment from god – all are believed by Sudanese people to cause suffering. Hence, the nursing professional who would be treating the young lady might be disclosed about such beliefs by the patient(Abdalla et al., 2018, pg 78).The nurse should be very careful about nottojudgethemordisrespectsuchbeliefs.Inplacetheyshouldshowrespectwhile encouraging the patient to adopt the interventions prescribed by the nurse for her abdominal pain. The lady might also want to take the help of the traditional and complimentary practices like the use of herbal remedies. The nurse should try to find out the evidences of its effects on the patient’s health and accordingly try to help the patient pick up the proper interventions that have positive health outcomes(Woods et al., 2017 56). Conclusion: From the above discussion, it can be seen that the cultural competency is an important attribute of healthcare profession. Every professional should take extra initiative to develop skills of cultural safety maintenance in the workplace to ensure that all people are cared for as per their cultural traditions, preferences and inhibitions. The nurses need to ensure that they develop proper cultural knowledge, cultural awareness and cultural sensitivity while managing care of patientsfromvariousbackgrounds.Thisassignmenthadclearlyexhibitedhowcultural preferences, communication styles, health beliefs and others are seen to differ from one patient to
8 CULTURAL CONSIDERATIONS another. When nurses would be able to follow such cultural expectations of the patient properly, the adherence of the patient would increase. The patients would be able to feel emotionally connected with the professionals and as a result they would be able to trust the professionals. This would encourage them to develop their self-coping abilities and live better quality care. References: Abdalla,S.M.,Mahgoub,E.A.,Abdelgadir,J.,Elhassan,N.,&Omer,Z.(2018). Operationalization of patients’ rights in Sudan: Quantifying nurses’ knowledge.Nursing ethics, 78-89 .Cruz, J. P., Alquwez, N., Cruz, C. P., Felicilda‐Reynaldo, R. F. D., Vitorino, L. M., & Islam, S. M. S. (2017). Cultural competence among nursing students in Saudi Arabia: a cross‐ sectional study.International nursing review,64(2), 215-223. Deem, M. J., & Stokes, F. (2018). Culture and Consent in Clinical Care: A Critical Review of Nursing and Nursing Ethics Literature.Annual review of nursing research,37(1), 223- 259. Foronda, C. L., Baptiste, D. L., Pfaff, T., Velez, R., Reinholdt, M., Sanchez, M., & Hudson, K. W. (2018). Cultural competency and cultural humility in simulation-based education: an integrative review.Clinical Simulation in Nursing,15, 42-60. Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., ... & Brown, A. (2015). Enablers and barriers to the implementation of primary health care interventions for Indigenouspeoplewithchronicdiseases:asystematicreview.Implementation Science,10(1), 71.
9 CULTURAL CONSIDERATIONS Holland, K. (2017).Cultural awareness in nursing and health care: an introductory text. Routledge.pg 245-256 Hunt, L., Ramjan, L., McDonald, G., Koch, J., Baird, D., & Salamonson, Y. (2015). Nursing students' perspectives of the health and healthcare issues of Australian Indigenous people.Nurse education today,35(3), 461-467. Isaacs, A. N., Raymond, A., Jacob, E., Jones, J., McGrail, M., & Drysdale, M. (2016). Cultural desire need not improve with cultural knowledge: a cross-sectional study of student nurses.Nurse education in practice,19, 91-96. Karatay, G., Bowers, B., Karadağ, E. B., & Demir, M. C. (2016). Cultural perceptions and clinicalexperiencesofnursingstudentsinEasternTurkey.Internationalnursing review,63(4), 547-554. Malliarou, M., Oikonomou, A., Nika, S., & Sarafis, P. (2017). Greek military nurses readiness to provide transcultural care to immigrants.Journal of Advances in Medicine and Medical Research, 1-11. McGough, S., Wynaden, D., & Wright, M. (2018). Experience of providing cultural safety in mental health to Aboriginal patients: A grounded theory study.International journal of mental health nursing,27(1), 204-213. Pacquiao,D.(2018).ConceptualFrameworkforCulturallyCompetentCare.InGlobal Applications of Culturally Competent Health Care: Guidelines for Practice(pp. 1-27). Springer, Cham.
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10 CULTURAL CONSIDERATIONS Papadopoulos, I., Kouta, C., Malliarou, M., Shea, S., Apostolara, P., & Vasiliou, M. (2016). Exploring the cultural aspects of compassion in nursing care: a comparative study of Greece and Cyprus.International Journal of Caring Sciences,9(2), 471-480. Papadopoulos, I., Taylor, G., Ali, S., Aagard, M., Akman, O., Alpers, L. M., ... & González-Gil, T. (2017). Exploring nurses’ meaning and experiences of compassion: An international online survey involving 15 countries.Journal of Transcultural Nursing,28(3), 286-295. Rassool, G. H. (2015). Cultural competence in nursing Muslim patients.Nursing Times,111(14), 12-15. Suhonen, R., Charalambous, A., Berg, A., Katajisto, J., Lemonidou, C., Patiraki, E., ... & Radwin, L. E. (2018). Hospitalised cancer patients’ perceptions of individualised nursing care in four European countries.European journal of cancer care,27(1), e12525. Woods, D. L., Mentes, J. C., Cadogan, M., & Phillips, L. R. (2017). Aging, Genetic Variations, and Ethnopharmacology: Building Cultural Competence Through Awareness of Drug Responses in Ethnic Minority Elders.Journal of Transcultural Nursing,28(1), 56-62.