Cultural Care, Health Disparities & Health Equity, Person-Centered Care, Caring in Nursing Practice

Culture

Learned and shared beliefs, values, norms, and traditions of a particular group, which guide our thinking, decisions, and actions

Unconscious bias

Bias we are unaware of and that happens outside our control, which is influenced by our personal background, cultural environment, and personal experiences

Culturally congruent care

Emphasizes the need to provide care based on an individual’s cultural beliefs, practices, and values

Cultural competence

Professional health care must be culturally sensitive, culturally appropriate, and culturally competent to meet the multifaceted health care needs of each person, family, and community

Racial/Ethnic identity 

based on one’s self-identification with one or more social groups in which a common heritage with a particular racial group is shared

Acculturation

occurs when an individual or group transitions from one culture and develops traits of another culture

Assimilation

the process in which the individual adapts to the host’s cultural values and no longer prefers the components of the origin culture

Cultural respect

similar to cultural competence, cultural respect is critical to reducing health disparities and improving access to high-quality health care that is respectful and responsive to the needs of the diverse patient

Campinha-Bacote Cultural Competence Model (5 Aspects) *probably select all question

1. Cultural awareness-self examination of one’s own biases

2. Cultural knowledge

3. Cultural skill

4. Cultural encounters

5. Cultural desire

Etic

outsider perspective

Emic

insider perspective

Cultural skills

• Storytelling

• Collecting a patient history

• Assessing health literacy

• Culturally based physical assessment

• Teach-back and plain language

Working with interpreters

Never use a family member or visitor as an interpreter

Always look at the patient when speaking (NOT the interpreter)

Avoid using medical jargon as much as possible

Health Disparity

A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

Social determinants of health

The conditions in which people are born, grow, live, work, and age 

Examples of social determinants of health?

• household income

• safe housing

• access to nutritious food

• quality education

• reliable public transit

• community safety

Marginalized groups

Are more likely to have poor health outcomes and die earlier

Examples of marginalized groups

• LGBTQ+

• people of color

• people who are physically or mentally challenged

• people who are not college educated.

Leininger’s Transcultural Caring 

• Even though human caring is a universal phenomenon, the expressions, processes, and patterns of caring vary among people of different cultures

• For caring to be effective, nurses need to learn culturally specific behaviors and words that reflect human caring in different cultures to identify and meet the needs of all patients.

Watson’s Transpersonal Caring

• transpersonal care: a nurse who focuses on transpersonal caring looks for deeper sources of inner healing to protect, enhance, and preserve a person’s dignity, humanity, wholeness, and inner harmony.

• carative factors

• connectedness with the patient

Swanson’s Theory of Caring

• Knowing: Striving to understand an event as it has meaning in the life of the other

• Being with: Being emotionally present to the other

• Doing for: doing for the other as one would do for oneself if it were at all possible

• Enabling: Facilitating the other’s passage through life transitions (e.g., birth, death) and unfamiliar events

• Maintaining Belief: sustaining faith in the other’s capacity to get through an event or transition and face a future with meaning

Ethics of Care 

• Caring is an interaction of mutual respect and trust. 

• The term “ethic” refers to the ideals of right and wrong behavior. 

• An ethic of care is concerned with relationships between people and with a nurse's character and attitude toward others.

Person-centered care main concept

Putting individual preferences and needs at the center of health care delivery

Patient-centered care

• Clearly establishes and clarifies the roles involved

• Primary focus on what they need as a patient

Person-centered care

• Emphasizes holistic care

• Broader focus (more than just the disease)