Transcript Health Disparities and Culturally Competent Care

Health Disparities and Culturally
Competent Care
ZOYA MINASYAN
RN-MSN EDU
Determinants of Health
Health Disparities
• They refer to differences in measures of health
status between different groups of people
living in a community, a state, or entire nation.
• They occur when one group of people has a
– higher incidence or mortality rate than another
– when survival rates are less for one group than
another.
Health Disparities
 Factors and Conditions Leading to Health
Disparities
– Race, ethnicity, and culture
– Geographic location
– Income, education, and occupation
– Gender
– Age
– Health care provider attitude
Health Disparities
 Impact of Health Disparities on Health
Cancer-African Americans have higher rates
than whites.
Diabetes mellitus- more in minority groups
with higher risk of complications.
Obesity- affects African American , Mexican
American and white women.
Nursing Interventions to eliminate
Health Disparities
• Treat all pts equally.
• Monitor for their response to therapy.
• Be a pt advocate regardless of cultural
differences.
• Be aware of one’s own biases.
• Give the same standards of care to all pts.
• Participate in research.
Culture
• Culture encompasses the knowledge, values,
beliefs, art, morals, law, customs, and habits
of the members of the society.
• Culture includes the systems of technology,
education, social structures and political
practices.
• Cultural patterns of behavior develop over
time, shared by members of the same cultural
group and transmitted to the next generation.
Culture
Culture
• Values are the set of rules by which individuals,
families, groups and communities live.
• Acculturation- an individual or group learns how to
take on many, but not all values, beliefs of another
culture.
• Assimilation-and individual or group from one culture
adopts certain features of other culture; it may be
voluntary or forced on a group.
• Subcultures-smaller and may not hold all of the values
of the dominant culture:
Religious subcultures- Catholics, Jews, Muslims
Ethnic subcultures- African Americans, Hispanics and
Native Americans.
Culture
• Ethnicity-groups whose members share a common
social and cultural heritage.
• Race- share a common ancestry and physical
characteristics such as skin color, bone structure,
or blood group.
• Stereotyping- viewing members of a specific culture,
race or ethnic group as being alike and sharing the
same values and beliefs.
• Ethnocentrism-belief of once own ways are superior to
those of others from different culture, ethnic, or
racial background.
• Trans-cultural nursing-study and analysis of cultures
and subcultures.
Cultural Competence
• Cultural awareness-Identify one’s own cultural
background, values, biases.
• Cultural Knowledge- learn, assess, read, view
documentations and do not make assumptions.
• Cultural skills- become aware of cultural differences,
be alert for unexpected responses.
• Cultural encounter-interact with different cultural
groups, attend cultural events, visit markets and
restaurants , learn about their beliefs and practices.
Cultural Diversity in the Health Care
Workplace
Cultural Diversity in the Health Care
Workplace
Cultural Factors Affecting Health and
Health Care
 Personal Space
Intimate distance 0-18 inches.
Personal distance 18 inches to 4 feet.
Social distance 4-12 feet or more.
 Touch
Nurse must ask permission before touching anyone.
 Nutrition
Food and rituals associated with food. Immigrants
may face with many unfamiliar foods.
Cultural Factors Affecting Health and
Health Care
 Medications
National Medical Association (NMA) and National
Pharmaceutical Council (NPC) titled “Racial and Ethnic
Differences in Response to Medicines: Towards
Individualized Pharmaceutical Treatment.”
Ex: Isosorbide dinitrate and Hydralazine-for
African American pts.
 Psychologic Factors
Culture-bound syndrome that is within a cultural group
Ex: Susto- Latin America-soul loss, fright sickness
which can cause loss of appetite, anxiety, social
withdrawal.
Nursing Management:
Reducing Health Disparities and Increasing Cultural
Competency
 Nursing Implementation
-Communication- Voice tone, gestures,
spoken words, small talk, silence.
-Choosing an interpreter-should be trained,
able to translate, act as pts advocate, be
culturally sensitive.
Activates and characteristics of the
nurse
• Nurse as
– Caregiver
– Educator
– Advocate
– Leader
– Manger
– Researcher