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Spirituality, economics, politics, and kinship are among the cultural factors considered in this guide to transcultural nursing, an area of healthcare that incorporates the values, beliefs, and lifestyle choices of a patient in order to provide culturally congruent, competent, and compassionate care.
Cultural competence in Health Care provides a balance between a theoretical foundation and clinical application. Because of the focus on basic principles, this book will be useful not only in the United States, but throughout the world as Cultural Competence is intending to fill the cultural competence gap for students and practitioners of medicine and related health sciences, by providing knowledge and describing the skills needed for culturally relevant medical care of patients of diverse ethnic and cultural backgrounds.
Healthcare in the U.S. faces two interpenetrating certainties. First, with over 66 racial and ethnic groupings, our "American Mosaic" of worldviews and values unavoidably generates clashes in hospitals and clinics. Second, our public increasingly mistrusts our healthcare system and delivery. One certainty fuels the other. Conflicts in the clinical encounter, particularly with patients from other cultures, often challenge dominant assumptions of morally appropriate principles and behavior. In turn, lack of understanding, misinterpretation, stereotyping, and outright discrimination result in poor health outcomes, compounding further mistrust. To address these cultural fault lines, healthcare institutions have initiated efforts to ensure "cultural competence." Yet, these efforts become institutional window-dressing without tackling deeper issues, issues having to do with attitudes, understanding, and, most importantly, ways we communicate with patients. These deeper issues reflect a fundamental, original fault line: the ever-widening gap between serving our own interests while disregarding the concerns of more vulnerable patients, those on the margins, those Others who remain disenfranchised because they are Other. This book examines this and how we must become the voice for these Others whose vulnerability and suffering are palpable. The author argues that, as a vital and necessary condition for cultural competency, we must learn to cultivate the virtue of Presence - of genuinely being there with our patients. Cultural competency is less a matter of acquiring knowledge of other cultures. Cultural competency demands as a prerequisite for all patients, not just for those who seem different, genuine embodied Presence. Genuine, interpersonal, embodied presence is especially crucial in our screen-centric and Facebook world where interaction is mediated through technologies rather than through authentic face-to-face engagement. This is sadly apparent in healthcare, where we have replaced interpersonal care with technological intervention. Indeed, we are all potential patients. When we become ill, we too will most likely assume roles of vulnerability. We too may feel as invisible as those on the margins. These are not armchair reflections. Brannigan's incisive analysis comes from his scholarship in healthcare and intercultural ethics, along with his longstanding clinical experience in numerous healthcare settings with patients, their families, and healthcare professionals.
The cultural groups discussed in this guide include African American, Anglo-American, Asian, Hispanic/Latino, Jewish, Middle Eastern, Native American, Russian, South Asian, and Southeast Asian. The book also discusses cultural patterns, including values, worldview and communication, time orientation, pain, family/gender issues, pregnancy and birth, children, end of life, and health beliefs and practices. The sections on health beliefs and practices are especially informative. This is a very handy pocket resource that broadly describes selected cultural groups. It includes a mnemonic (the 4 C's of Culture) to help healthcare professionals remember the questions to ask each patient: CALL (what do you call the problem?), CAUSE (what do you think caused the problem?), COPE (how do you cope with the problem?), and CONCERNS (what are your concerns?). This book should be required for all health professionals and students.
The second edition of this popular introductory text explores the many sensitive issues of culture, race and ethnicity as they affect patient care, including: -health and illness beliefs, and their relationship to religious beliefs -mental health and culture -women's health in a multicultural society -caring for older people death and bereavement All chapters have been updated to present the latest theory and practice and new chapters on men's health and cultural care, and migration and asylum seekers have been added, along with updated case studies and reflective exercises to help the reader link theory to practice. This book is essential reading for all nursing students, as well as midwifery, allied health and health and social care students. It is also a useful reference for qualified nurses, midwives, health care assistants, assistant healthcare practitioners and allied health professionals.
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
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Culturally safe healthcare is rapidly challenging previous notions of cultural competency or cultural sensitivity in healthcare provision. The increasing number of vulnerable populations means healthcare must be given by a healthcare provider who has developed a social consciousness in relation to his or her own socio-cultural positioning versus that of the patient. A culturally safe practitioner has engaged in an active examination of the power differences existing in this patient-provider relationship. In this book, Lucy Mkandawire-Valhmu critically analyzes the complex issues affecting the health of vulnerable populations. Written from a critical theoretical perspective she seeks to enhance the ability of the healthcare student to develop a social consciousness about the realities faced by many populations living on the margins of society, and thereafter make an active and conscious decision to engage in culturally safe healthcare and contribute to the elimination of health disparities. Through the application of postcolonial feminist theory this book conceptualizes health as being historically situated in social relations of power and emphasizes health interventions that are potentially empowering, and enhance emancipatory change. Through discussions of health provision for ethnic minorities, immigrant populations, and refugees, the book seeks to provide pragmatic guidance for culturally safe care for a variety of marginalized populations and invites students and professionals to think deeply about the implications of power, culture and health.
As the United States population becomes increasingly diverse, the need for guidelines to assure competent healthcare among minorities becomes ever more urgent. Cross-Cultural Medicine provides important background information on various racial, ethnic, and cultural groups, their general health problems and risks, and spiritual and religious issues. Individual chapters are devoted to the special concerns of several groups: blacks and African Americans, Latinos, American Indians and Native Alaskans, Asian Americans, and Arab Americans and American Muslims. These chapters lay the foundation for exploring an individual's health beliefs and concerns in the context of his or her sociocultural experiences.