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Learning Outcomes

Cultural Considerations in Healthcare: The African American Client Jenny Holloway Liberty University NUR 503 April 14, 2013. Learning Outcomes. After reading this presentation the participant should be able to: Define culture competencies as it applies to nursing

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Learning Outcomes

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  1. Cultural Considerations in Healthcare:The African American ClientJenny HollowayLiberty University NUR 503April 14, 2013

  2. Learning Outcomes • After reading this presentation the participant should be able to: • Define culture competencies as it applies to nursing • Identify cultural characteristics specific to the African American population • Discuss how cultural and spiritual practices can impact the African American client’s health care choices (North Carolina Concept Based Learning Editorial Board, 2011).

  3. Cultural Competency • The Joint Commission (2010) defined cultural competency as the health care providers ability to both understand and incorporate an individuals cultural and language needs during the health care process. • In order to demonstrate cultural competency, the Joint Commission (2010) requires that health care providers: • value diversity • assess themselves • manage the dynamics of difference • acquire and institutionalize cultural knowledge • adapt to diversity and the cultural contexts of individuals and communities served (p.1)

  4. Culture • Culture is defined as the values, beliefs, and practices of a particular group of individuals (Giger&Savidhizar, 2008). • Wicher and Meeker (2012)state that culture is comprised of “beliefs, values, and lifestyle” (p.30).

  5. National Standards on Culturally and Linguistically Appropriate Services (CLAS) • How do health care workers know if they are culturally competent: • CLAS standards– “the collective set of culturally and linguistically appropriate services (CLAS) mandates, guidelines, and recommendations issued by the United States Department of Health and Human Services Office of Minority Health intended to inform, guide, and facilitate required and recommended practices related to culturally and linguistically appropriate health services” (National Standards for Culturally and Linguistically Appropriate Services in Health Care Final Report, OMH, 2001 as cited on the Office of Minority Health website).

  6. African American Population in Vance County, North Carolina • The State Center for Health Statistics and Office of Minority Health and Health Disparities reported in July 2010 that North Carolina has the seventh largest population of African Americans in the United States. • Vance County is a relatively small rural county seated on the Virginia border. The total population of the county is 45,000 (US Census Report, 2010). • Over 50 percent of Vance county residents are African Americans, more than double the states percentage of African Americans and quadruple that of the total population of the United States (US Census Report, 2010) .

  7. African American Population in Vance County, North Carolina • Research demonstrates that low socioeconomic status has a direct impact on a client’s overall health (Hazen and Giles, 2011) • 27 percent of families in Vance County live at or below the poverty level (US Census Report, 2010). • This is nearly double the state’s overall percentage of residents living below the poverty level which was 15 percent (US Census Report, 2010). • Even for those that live above the poverty line the average income for Vance County is 34,000 dollars a year compared to the state average of 45,000 dollars a year (US Census Report, 2010).

  8. Cultural Awareness Concerning African American Clients • The African American Family: • Mazanec et al, 2010 wrote that the African American household has a deep sense of family that is often headed by single women. • The female head of household sees providing care for a love one as an important responsibility and will expect to be included in health care planning (Mazanec et al., 2010). • For the Western culture this can be very difficult to understand as patient autonomy is viewed as the correct way for decision making (Mazanec et al, 2010). • Healthcare providers must not equate lack of a patriarchal figure with a lack of family values. (CLAS Standard 1)

  9. Cultural Awareness Concerning African American Clients • Unique Health Practices of the African American: • Campinha-Bacote (2009) reported that many of the African American clients in the United States use home remedies to both maintain and treat their health. • Many African Americans resort to home remedies as a result of lack of trust in the current health care system.

  10. Cultural Awareness Concerning African American Clients • Mistrust of the current health care system: • While the history of slavery in the US is well known, not many outside of the African American culture are aware of the mistreatment that many African Americans have endured. • Washington, Bickel-Swenson and Stephens (2008) reference the infamous Tuskegee Study that allowed African American men with diagnosed syphilis to go untreated for the sake of research.

  11. Cultural Awareness Concerning African American Clients • Further compounding the mistrust of the health care system is the disparities that continue to occur when it comes to access and treatment among the African American population. • According to Pullis (2011) minority patients are less likely to receive medications to treat common diagnosis such as diabetes, yet they are more likely to develop and suffer long term effects from treatable conditions.

  12. Cultural Awareness Concerning African American Clients • Spiritual Beliefs and Practices: • Mazanec, Daly and Townsend (2010) stated that many African Americans believe that the church is the center of their extended family. The church itself provides a source of “empowerment, social change and emotional and tangible support” (p. 563). • Hazin and Giles (2011) report that some studies have discovered that there is a perception among African Americans that accepting death without fighting is nothing more than lack of faith in God’s ability to heal.

  13. Cultural Awareness Concerning African American Clients • Spiritual Beliefs and Practices continued: • The influence of their religion and support from their extended church family should be considered when approaching the African American about health care decisions, especially decisions that involve life and death. (CLAS Standard 1) • Clients should be informed that they will have access to their church family as well as their preacher.

  14. Cultural Awareness Concerning African American Clients • Spiritual Beliefs and Practices continued: • Having rituals such as gospel singing, bible reading and visits from the pastor are all mentioned as important during the end-of-life for the African American client (Pullis, 2011). • Health care providers need to recognize and allow this important aspect of the client’s life regardless of setting.

  15. Cultural Competency • Are you culturally competent? • Campinha-Bacote utilized the mnemonic ASKED in 2002 to self assess whether or not you are culturally competent (as cited in Campinha-Bacote, 2009): • Awareness • Are you aware of the bias and prejudices against cultures in healthcare. Do you share any of the same feelings? • Skill • Do you have the skills to perform a cultural assessment? • Knowledge • Are you knowledgeable about a culture’s practices and beliefs? • Encounters • Do you actively seek out encounters with client’s from different cultures? • Desire • Do you really care about being culturally competent?

  16. Cultural Competency • Hebrews 13:2 instructs us to care for strangers as though they were angels. Cultural competency provides Christian Nurses with the opportunity to provide Christ like compassion and understanding to clients in need.

  17. References Campinha-Bacote, J. (2009). A culturally competent model of care for African Americans. Urologic Nursing, 29 (1), 49-54. Hazin, R. & Giles, C. (2011). Is there a color line in death? An examination of end-of-life care in the African American community. Journal of the National Medical Association, 103(7), 609-613. Giger, J.N., &Davidhizar, R.E. (2008).Transcultural nursing: Assessment and intervention (5thed.). St. Louis, MO: Elsevier. Mazanec, P.M., Daly, B.J., & Townsend, A. (2010). Hospice utilization and end-of-life care Decision making of African Americans.American Journal of Hospice and Palliative Medicine 27(8), 560-566.

  18. References North Carolina State Center for Health Statistics and Office of Minority Health and Health Disparities (2009). Retrieved from http://www.schs.state.nc.us/schs/data/minority.cfm. The Joint Commission (2010). Advancing affective communication, cultural competence, and patient- and family center care. Retrieved from: http://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinalversion727.pdf Pullis, B. (2011). Perceptions of hospice care among African Americans. Journal of Hospice & Palliative Nursing, 13(5), 281-287. US Census Report. (2010). Retrieved from http://2010.census.gov/2010census/. Washington, K.T., Bickel-Swenson, D., & Stephens, N. (2008). Barriers to hospice use among African Americans: A systematic review. Health and Social Work, 33(4), 267-274. Wicher, C.P. and Meeker, M.A. (2012). What influences African American end of life preferences. Journal of Health Care for the Poor and Underserved, 23(1), 28-58.

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