CULTURAL COMPETENCE IN HEALTH CARE Diversity in Health Care July, 2011 The United States is a country consisting of many cultures, races, and religions. It is becoming increasingly diverse and global, with many minority cultures and races developing into majority cultures and races. Newer religions take their place alongside traditional faiths. Both cultural and spiritual differences in people are potential causes for misunderstanding, confusion, and conflict arising from intolerance and ignorance of these differences. It therefore becomes apparent why it is imperative for professionals of all types to have an awareness, knowledge, and appreciation for others whose beliefs, practices, and values are different.
The earliest Africans were seen in the same light as indentured servants from Europe. According to Hine D., Hine W., & Harrold S. (2014), they (Africans) interacted culturally and physically with the white indentured servants and with American Indians. This cordiality, however, did not last. By the latter half of the 17th century, obvious differences existed in the treatment of black and white servants. Slave codes were soon approved – in Massachusetts in 1641 and Virginia in 1661 –and any minor liberties that might have existed for African American were taken away (Feature Indentured Servants In The U.S , n.p.).
The number of foreign-born residents in America has steeply increased, leading to a demand of nursing development in the area of cultural competency. This paper carries a purpose of addressing the importance of becoming a culturally competent nursing professional as well as the importance of developing an ethnically diverse workforce. Nurses must be aware of their own values and beliefs, which is the first step to becoming culturally competent. People develop their set of values, beliefs, and social norms from childhood. Years of cultural conditioning can create barriers for a nurse wanting to achieve an unconscious level of cultural competency.
Care of patients in acute and local community settings has become quite complex, requiring advanced skills and knowledge, while higher levels of nursing competency and specialization in a variety of fields has become necessary for modern practice (IOM, 2010). With an aging population and the prevalence of multiple chronic diseases, patients are sicker and technologies used for treating them have become more sophisticated, while the need for and shortage of primary care providers is growing. To respond to the demands of a changing, technologies based health care system and meet the complex needs of patients, nurses must pursue higher levels of education and training, while continuing to
The United States is known as the “Melting Pot” for cultural immigration. Therefore, this brings every culture and its considerations to the forefront. Americans view illness as a result of naturally occurring development, and advocates for active medical interventions to fight against infection or utilization of highly advanced technical knowledge to name and care for a disease ("Euromed Info," n.d.). Cultural influences will contribute to a large percentage in patient compliance with a formulated plan of care. Opposing opinions often alter patients’ perception about health care and their ability to comprehend, govern, and handle the course of a sickness, diagnosis, and risk versus benefit of medical treatment.
In a culturally diverse country and world, the need to be aware of and understand the various different cultures that exist is essential in providing effective healthcare (Beheri, 2007, p. 14). To provide culturally appropriate nursing care, it is essential to understand the meanings and importance of culture and cultural diversity. This however has always been a challenge, due to its multifaceted nature and complexity (Beheri, 2007, p. 14). It is important to understand culture and diversity as nurses interact with a variety of patients from different cultures and to administer effective nursing care. WHAT IS CULTURE?
Healthcare: Plato’s View Versus Modern Western Society People in today’s society have an immense number of expectations in regards to their quality of life. Perhaps the most prevalent is the expectation to the healthcare they choose. On the surface, it seems pretty clear cut. After all, why shouldn’t the individual patient be allowed to make choices that directly, or even indirectly, effect their general health? The waters become murky, however, when one takes into account the amount of resources allocated to providing some services or procedures to certain patients.
“Patient-Family” Centered Care versus “Disease-Based” Approach to Health Care Medicine faces several critical and conflicting challenges. The tremendous and changing cultural diversity of our population requires physicians to develop new skills in communication and negotiation with their patients. But managed care constraints, litigation, and growing regulatory pressures have compromised communication and trust between physicians and patients. This, along with the surge in technologic development, has driven the medical system even further toward a “disease-based” approach to health care that views individuals as “cases” and undervalues the sociocultural and humanistic aspects of patient care. The results are a diminishing faith in the medical establishment and the rise of alternative medical philosophies and practices.
In order to improve the nation’s health and end the disproportion in health care to vulnerable populations, the social determinants of health must be addressed foremost in order to achieve an understanding of the issues that are affecting so many Americans and what must be done in the fight toward equality in the U.S. health care delivery system. All of the social factors are a part of a cycle, one affecting the other. Elements of each social factor influence the others in a specific way. These social factors mainly affect the underserved populations of racial and ethnic minorities, women and children, rural residents, the uninsured, homeless peoples, mental health patients, patients with chronic illness or disabilities, and HIV/AIDs patients. In the U.S., social factors are associated with lower overall health care usage and access (Shi & Singh, 2010).
Position Statement Cultural Cultural Competency Defining Cultural Competence Health care providers may experience challenges stemming from cultural differences when treating patients of various ethnicities, and these challenges may lead to suboptimal patient care. Current data shows that despite substantial advances in the overall health of Americans, health disparities persist among US racial and ethnic groups. A recent editorial in the Journal of the American Medical Association suggests that miscommunications due to language barriers with Spanish, the most common non-English language spoken in the US, lead to substandard health care. For many individuals with limited English proficiency, inability to communicate in English is the primary barrier to accessing health information and services. Elimination of health disparities must be placed at the forefront of the country’s health priorities.