Cultural Competent Health Care - PowerPoint PPT Presentation

1 / 29
About This Presentation
Title:

Cultural Competent Health Care

Description:

Patients may not adhere to medical advice because they do not understand or do ... Greater adherence to medical advice. Expanded choices and access to high ... – PowerPoint PPT presentation

Number of Views:144
Avg rating:3.0/5.0
Slides: 30
Provided by: chiali
Category:

less

Transcript and Presenter's Notes

Title: Cultural Competent Health Care


1
Cultural Competent Health Care
2
Agenda
  • Questions concerns
  • Discussion on culture, race, ethnicity, value
  • Needs for cultural competent care
  • Negotiation for dates for individual
    presentations

3
Shrink the Earths Population to 100
  • 57 Asians
  • 21 Europeans
  • 14 North, Central and South Americans
  • 8 Africans
  • 70 would be non-white, 30 white
  • 70 would be non-Christian, 30 Christian

4
Population in the U.S.
  • Year 2000
  • Whites 69.4
  • Black 12.7
  • Hispanic 12.6
  • Asian 3.8
  • Year 2050
  • Whites 50
  • Black 14.6
  • Hispanic 24.4
  • Asian 8

US Census Bureau, 2004
5
Registered Nurses in the U.S.(2000)
  • 86.6 - non-Hispanic white

(US dept of Health Human Service, 2003)
6
Population in San Jose (2000)
  • Whites - 47.5
  • Hispanic - 30.2
  • Asian - 26.9
  • Black - 3.5
  • U.S. Census Bureau (2006)

7
Globalization Q How to define
globalization? A Princes Dianas death Q How
come? A An English princess with an Egyptian
boy- friend crashes in a French tunnel, in a
German car with a Dutch engine, driven by a
Belgian who was pissed on Scottish whiskey,
followed closely by an Italian paparazzi, on
Japanese motorcycles, treated by an American
doctor, using Brazilian medicines. And this is
sent to you by a Israeli, using Bill
Gates Technology which he stole from the
Taiwanese.
8
Minorities Receive Lower Quality Health Care Than
Whites
  • Institute of Medicine, 100 studies reviewed over
    past 10 yrs.
  • Full report www.nap.edu/books/030908265X/html
  • Minorities less likely to receive sophisticated
    Txs for AIDS
  • More likely to have leg amputations for diabetes
  • Poorer relationships with MDs

9
Other Cultural Domains
  • Folk beliefs/religion - can be confused with
    religiosity
  • Stereotyping labels - avoid generalizations
  • Ethnopharmacology - genetic influence, effect,
    metabolism
  • Herbal therapies - interactions with meds
  • Folk healers treatment approaches, e.g..,
    hysteria, psychosis

10
Cultural competence impact on clinical outcomes
  • Patients fear of being misunderstood or
    disrespected
  • Providers are not familiar with the prevalence of
    conditions among certain minority groups
  • Providers may fail to take into account differing
    responses to medication
  • Providers may lack knowledge about traditional
    remedies, leading to harmful drug interactions
  • Patients may not adhere to medical advice because
    they do not understand or do not trust the
    provider
  • Providers may order more or fewer diagnostic
    tests for patients of different cultural
    backgrounds

11
ethnic disparities in health care
  • African American women are more likely than
    European American women to die from breast
    cancer, despite having a lower incidence of the
    disease.
  • Infant mortality rates are 2.5 times greater for
    African Americans and 1.5times greater for Native
    Americans than for European Americans.
  • Influenza death rates are higher for African
    Americans and American Indian/Alaska
    Natives/Native Alaskans than they are for
    European Americans.
  • Mortality for colorectal cancer is highest for
    African Americans, followed by Native Alaskans,
    and then Hawaiians.

12
Needs for cultural competence
  • American nurses experienced a lack of cultural
    confidence in caring for culturally diverse
    populations - Coffman, Shellman, Bernal (2004)
    and Hagman (2006)
  • There were gaps in healthcare providers
    knowledge of other cultures and how to care for
    them in culturally sensitive ways - Jones, Cason,
    and Bond (2004)

13
Other evidences
  • Negative racial stereotypes - rate black patients
    as more likely to abuse drugs and alcohol, less
    likely to comply with medical advice, and less
    likely to participate in cardiac rehab than white
    patients - Van Ryn and Burke (2000)
  • Less Dx test - physicians were less likely to
    recommend catheterization procedures for black
    female patients than white or black male patients
    if they experienced the same kind of symptoms.
    Schulman et al. (1999)

14
cultural competence is a process
  • American Nurses Association published its first
    guidelines on cultural diversity in nursing
    curricula in 1986 - understanding the concept of
    human diversity including cultural and racial
    variations
  • The Board of Registered Nursing of California
    (2006) has required all nursing schools in
    California to include cultural diversity and
    competence into their curricula

15
Language barriers and disparity
  • Utilization of health care services
  • Fewer doctor visit and less preventive services
  • More diagnostic test to compensate communication
    problems
  • Satisfaction
  • Less satisfied unless with interpreter
  • Adherence
  • Miss the appointment or drop out
  • Outcomes
  • Patient education

16
Health Disparities
  • President Clinton (1998) set the goal reduce
    health disparities by the year 2010.
  • Target areas (NIH, 2003)
  • Infant mortality,
  • Cancer screening and management,
  • Cardiovascular disease,
  • Diabetes,
  • HIV/AIDS,
  • Immunization

17
Problems with Health Disparities- with cultural
factors
  • Flaskerud, J. et al (2002) a review of 79
    articles in the past 5 decades
  • Ignorance of certain groups (indigenous peoples)
  • Inappropriate lump together ie. Hispanic members
    of disparate groups with their own cultural
    identity eg., Puerto Ricans, Mexicans, Cubans,
    Dominicans

18
Adays 2010 Priorities Showcase Needs within
vulnerable population
  • High-risk mothers infants-of-concern
  • Chronically ill disabled
  • Persons living with HIV/AIDS
  • Mentally ill disabled
  • Alcohol other substance abuses
  • Suicide- or homicide-prone behavior
  • Abusive families
  • Homeless persons,
  • Immigrants/refugees

19
Impact of Cultural Competency
  • More successful patient education
  • Increases in pts health care seeking behavior
  • More appropriate testing and screening
  • Fewer diagnostic errors.
  • Avoidance of drug complications
  • Greater adherence to medical advice
  • Expanded choices and access to high-quality
    clinicians.

20
Culture - Bound Syndromes
  • A person living within a certain reality
  • Learned way to interpret the world based on
    enculturation
  • Recurrent, locality- specific patterns of
    aberrant behavior and troubling experiences that
    may not be linked to a DSM-IV diagnosis

21
Culture Bound Syndromes
22
Culture Bound Syndromes Cont.
23
Culture Bound Syndromes Cont.
24
Culture Bound Syndromes Cont.
25
Temporal Relations
  • Time Orientation
  • Past, present or future-oriented
  • Punctuality

26
Negotiation Process
  • Listen to the clients perspective
  • Teach from your knowledge in language
    appropriate for client family
  • Compare similarities differences, disagree but
    do not devalue clients view
  • Compromise
  • if client treatment not harmful, promote
  • If harmful, explain harm and suggest alternatives

27
The Health Promotion Matrix
Gorin, S. Arnold, J. (1998). Health Promotion
Handbook. St Louis Mosby. P 92
28
Before Next Class
  • Take extra care of yourself and your family
  • Prepare by reading for class get copies of
    articles
  • Decide on group presentation medium for
    presentation bring IBM compatible disk one week
    before if you want to use Power Point for your
    presentation limit slides to 30
  • Continue work on your group for presentation
  • Have a great week

29
The End
Write a Comment
User Comments (0)
About PowerShow.com