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Results for “Cultural Competency”

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PubMedDate not supplied

Teaching cultural competence. The value of experiential learning and community resources.

Nurse educators are responsible for developing graduates who are culturally competent care givers and marketable as culturally sensitive coworkers. An undergraduate course in transcultural nursing is described that relies heavily on experiential learning activities and local community resources. Student evaluations reveal both immediate and long-term effects of this course on graduates' clinical practice.

Adolescent↗

PubMedDate not supplied

A culturally competent approach to cancer news and education in an inner city community: focus group findings.

Ethnic minorities who live in socioeconomically disenfranchised communities suffer disproportionately from many health problems including cancer. In an effort to reduce these disparities, many health-care practitioners and scholars have promoted "culturally competent" health education efforts. One component of culturally competent education is a grounded knowledge base. To obtain knowledge about the cancer-related ideas of members of one African American community, researchers conducted focus groups with public housing residents and used the findings to develop a five-part television news series about breast, prostate, and cervix cancers. We found that participants gathered information from the folk, popular, and professional health sectors and constructed their cancer-related ideas from this information. Furthermore, experiences of racism, sexism, and classism colored their beliefs and behaviors regarding the prevention, detection, and treatment of common cancers. For this community "cancer" represents a giant screen upon which individual fears and societal ethnic, political, and economic tensions are projected.

Adult↗

PubMed2006

Community transformation through culturally competent nursing leadership: application of theory of culture care diversity and universality and tri-dimensional leader effectiveness model.

Transcultural knowledge and competency have become a critical need for nurses to accommodate the global trends in cultural diversity and health care disparities. Today, nurses are increasingly taking on leadership roles in community settings. This article addresses the application of Leininger's culture care theory with the sunrise model and Hersey and Blanchard's tri-dimensional leader effectiveness model as potential collaborating theories for capacity building and community transformation from a global, transcultural nursing perspective. The two theories, used in collaboration, view the provision of competent leadership as the delivery of effective, culturally congruent nursing care in promoting health and health equity at the community level.

Community Participation↗

PubMed2004

Using standardized patients to teach and evaluate nurse practitioner students on cultural competency.

With the increasing diversity in the American population, it is imperative that nurse practitioners learn to manage patients with varying healthcare beliefs and needs. In order to develop culturally competent nurse practitioners, a number of methods have been developed. Many of the current methods focus on improving the awareness and knowledge of nurse practitioners regarding diverse populations. However, very few of the current programs focus on improving the skills and increasing the encounters the students have with diverse populations. This paper focuses on providing nurse practitioner students with diverse encounters using culturally enhanced standardized patient scenarios. The standardized patient programs provide nurse practitioner students with the opportunity to develop knowledge and skills related to cultural competency in a safe environment where the students can practice communication and physical assessment skills as they receive feedback from the patients they are seeing.

Cultural Diversity↗

PubMed2006

Medical education for a changing world: moving beyond cultural competence into transnational competence.

Given rapidly changing global demographic dynamics and the unimpressive evidence regarding health outcomes attributable to cultural competence (CC) education, it is time to consider a fresh and unencumbered approach to preparing physicians to reduce health disparities and care for ethnoculturally and socially diverse patients, including migrants. Transnational competence (TC) education offers a comprehensive set of core skills derived from international relations, cross-cultural psychology, and intercultural communication that are also applicable for medical education. The authors discuss five limitations (conceptual, vision, action, alliance, and pedagogical) of current CC approaches and explain how an educational model based on TC would address each problem area.The authors then identify and discuss the skill domains, core principles, and reinforcing pedagogy of TC education. The five skill domains of TC are analytic, emotional, creative, communicative, and functional; core principles include a comprehensive and consistent framework, patient-centered learning, and competency assessment. A central component of TC pedagogy is having students prepare a "miniethnography" for each patient that addresses not only issues related to physical and mental health, but also experiences related to dislocation and adaptation to unfamiliar settings. The TC approach promotes advances in preparing medical students to reduce health disparities among patients with multiple and diverse backgrounds, health conditions, and health care beliefs and practices. Perhaps most important, TC consistently directs attention to the policy and social factors, as well as the individual considerations, that can alleviate suffering and enhance health and well-being in a globalizing world.

Clinical Competence↗

PubMed2002

Developing culturally competent marriage and family therapists: treatment guidelines for non-African-American therapists working with African-American families.

To serve African-American families effectively, marriage and family therapists need to develop a level of cultural competence. This content analysis of the relevant treatment literature was conducted to examine the most common expert recommendations for family therapy with African Americans. Fifteen specific guidelines were generated, including orient the family to therapy, do not assume familiarity, address issue of racism, intervene multi-systemically, do home visits, use problem-solving focus, involve religious leader, incorporate the father, and acknowledge strengths. Conceptual and empirical support for each guideline is discussed, and conclusions are made regarding culturally competent therapy with African-American families.

Black or African American↗

PubMed2007

Community-based approaches to strengthen cultural competency in nursing education and practice.

This article explores existing informal as well as formal approaches that address health disparities in the communities where they occur, enhancing the opportunity to strengthen the cultural competency of providers, students, and faculty. A particular focus centers on the community-based participatory research approaches that involve community members, providing opportunities to develop mutually respectful, trusting relationships through co-teaching and co-learning experiences. With community-based participatory research approaches to community involvement in place, the stage is set for partnerships between communities and schools of nursing to collaboratively design, implement, and integrate informal and formal cultural competence components in nursing curricula.

Attitude of Health Personnel↗

PubMed2000

Cultural competence in patient education.

As a community health nurse, have you tested your cultural consideration quotient in patient education recently? Can you define the difference between ethnocentrism and multiculturalism? Do you find that you and your colleagues work with more or less transcultural nursing in your daily practice? Find out why cultural competence is vital to nurses' success in the 21st century.

Community Health Nursing↗

PubMed1999

Patients' rights and professional responsibilities: the moral case for cultural competence.

A right to health care can be derived from basic ethical principles. The empirical evidence revealing significant racial inequities in health status, access to health services, quality of care received and outcomes of health services is reviewed. The need for health care providers to acquire cultural competence in order to fulfill their professional responsibilities is discussed; the insight, knowledge and discipline required to function effectively in the context of cultural differences are described. The broader implications of cultural competence for institutional and public policy, research and professional education are outlined.

Culture↗

PubMed2006

An elective course in cultural competence for healthcare professionals.

OBJECTIVES: To develop and assess a cultural competence elective course used to increase students' levels of awareness, acceptance, and understanding of the role of culture on healthcare perceptions. DESIGN: Classroom and at-home assignments were designed, small group discussions were conducted, and guest speakers were recruited to allow students to explore different viewpoints about other cultures. ASSESSMENT: Student performance was assessed based on assignments and participation in class discussions. Student satisfaction with the course was assessed using a standard course evaluation form. CONCLUSION: Participation in the course resulted in greater student understanding of cultural issues facing healthcare providers and in students feeling more capable of integrating cultural factors into patient care.

Cultural Diversity↗

PubMed2003

Promoting culturally competent care for gay youth.

Gay youth and those questioning their sexual identity have been referred to as "hidden," "invisible," "stigmatized," and "marginalized." As a result, the unique safety and health needs of this subculture have been overlooked, or worse, ignored, placing these youth at risk. Because school nurses have been identifying at-risk populations of students and developing programs to promote youth and family health for years, they should be prepared to provide health care for the subculture of gay youth. However, nurses are saying they do not have the knowledge or skills needed to identify and address the needs of this group. Providing school nursing care for gay youth requires the school nurse to be culturally competent. School nurses need to be aware of, sensitive to, and knowledgeable about the subculture. They must also possess communication skills required to relate appropriately to this group. This article presents information and nursing strategies that will promote the safety and health of gay youth while enhancing the school nurse's cultural competence.

Adolescent↗

PubMed2006

Treating the world without leaving your ED: opportunities to deliver culturally competent care.

When asked about cultural sensitivity, well-meaning, highly educated, and competent physicians admit that while they desire to be culturally sensitive, it is not usually a conscious element of their professional interactions. When it is conscious, they sometimes feel at a disadvantage in their knowledge base or experience. Often physicians are familiar with certain cultural practices but do not know what those practices represent in the lives of their patients; how they produce, exacerbate, or ameliorate illness; and how to function in the patient's best interest within this milieu. In acute clinical encounters, language discordance is by far the most obvious cultural obstacle to providing care. However, increasing exposure to cultural minority populations demonstrates that beyond language, a host of other factors contribute in both obvious and subtle ways to suboptimal care. This report explores some of the challenges faced by immigrant patients and their treating physicians during clinical encounters. It examines the roots of miscommunication and dissatisfaction stemming from cultural differences and expectations and suggests ways to minimize their negative effects.

Clinical Competence↗

PubMed2002

Linking cultural competency and community service: a partnership between students, faculty, and the community.

OBJECTIVE: The purpose of the migrant health initiative is to give medical students the opportunity to provide clinical services, at appropriate levels of training, to a population that reflects a different ethnic and economic background than medical students typically see in the clinical setting. This initiative integrates concepts of cultural competency with experiential learning. DESCRIPTION: The migrant health initiative provides an infrastructure for a cultural competency educational program in the first two years of medical school within an essentials of clinical medicine course (ECM). The ECM course emphasizes the impacts of family, society, and community on the delivery of patient health care. Experience in the provision of clinical care to migrant workers provides an exceptional opportunity to expose students to a medically underserved, diverse group of people and to provide care to persons with a different language. The program was developed from grass-roots initiatives of students and the region's Area Health Education Center (AHEC). Historically, migrant workers provide the majority of the labor for harvesting onions in southeast Georgia. In April 2000, the regional AHEC organized a one-day clinic for migrant workers, staffed by one local physician and allied health students. Care was provided to over 400 laborers. As a result of the response by the migrant workforce, the AHEC developed a partnership with the local community to expand the health care services to this underserved group. Five medical students, working with the school's associate dean for curriculum and local AHEC, had observed a migrant health clinic organized by the AHEC and were seeking ongoing community service opportunities. Based on the interest and enthusiasm of the students, a faculty-supervised migrant health elective was developed for first- and second-year students. The number of students who wanted to take the elective exceeded the available opportunities. The ECM course will be enhanced with an integrated and longitudinal curriculum that focuses on migrant health care; the revised ECM course will provide students with the knowledge, skills, attitudes, and behaviors to care for individuals from different cultures. First-year students will be able to volunteer to work in the program. Second-year students will participate in at least one migrant health clinic, traveling only three hours but providing a different world with medical care. In addition, the opportunities for medical students to participate in a community health initiative and to work with nursing and allied health students will enhance their public health knowledge and their team and leadership skills. DISCUSSION: The partnership between students, faculty, and the community provides the mechanism to thoughtfully develop and integrate cultural issues and experiences into the curriculum. Students have recently received a Caring for Community five-year grant from the Association of American Medical Colleges. Program expansions will continue into the third-year medicine clerkship and include a senior elective. The program expansions will result in a migrant health initiative that will be coordinated; comprehensive; and expand student knowledge, skills, and experiences in cultural health care.

Community Health Services↗

PubMedDate not supplied

Using focus groups to develop a culturally competent diabetes self-management program for Mexican Americans.

PURPOSE: The purpose of this study was to describe factors that facilitate or hinder diabetes self-management and elicit participants' preferences and recommendations about the essential components of a culturally competent diabetes self-management program. METHODS: Latino patients with type 2 diabetes and their family caregivers were interviewed in focus groups. Four focus groups consisted of patients, and 2 groups consisted of family caregivers for a total of 40 participants. Participants were assigned to groups based on break characteristics of gender and preferred language. RESULTS: "Being in the dark" emerged as an important concern, and patient respondents wanted timely access to information that they deemed understandable about how to manage their diabetes. Family members' support and understanding were crucial in maintaining lifestyle changes. Patient and family caregiver participants wanted a self-management program to incorporate information on how to modify traditional foods, home remedies, and stress management. Preferences for information delivery included group didactic and interactive sessions, written information, and videotapes. Higher technology strategies using computers were not seen as useful. CONCLUSIONS: Culturally competent diabetes self-management for Latinos should incorporate the family and include techniques for stress management as well as diet modification. Information delivery should include a variety of techniques.

Diabetes Mellitus, Type 2↗

PubMed2001

Developing culturally competent marriage and family therapists: guidelines for working with Hispanic families.

As the Hispanic population of the United States continues to grow, so will the need for therapists who have been trained to work with Hispanic families. This content analysis of the available treatment literature generated several specific guidelines that can be used in training and evaluating culturally competent therapists. Guidelines included: Use family therapy, act as advocate for the family, assess immigration experience, assess acculturation, respect father, interview family subsystems separately, do not force changes, provide concrete suggestions, and warmly engage the family. Empirical and conceptual support for each guideline is discussed and several conclusions are made regarding culturally competent therapy with Hispanic families.

Cultural Characteristics↗

PubMedDate not supplied

Providing culturally competent primary care for immigrant and refugee women. A Cambodian case study.

Currently, one of every 13 U.S. residents is foreign born. A 1991 survey of certified nurse-midwives (CNMs) indicated that 51% of the respondents serve immigrant women. Using a case study approach, this article illustrates barriers to health care experienced by foreign-born women and demonstrates how cultural competence increases provider effectiveness in meeting the unique needs of this population. Effective primary care requires understanding the context of the refugee experience and its physical and emotional sequelae; addressing geographic, linguistic, economic, and cultural barriers; and providing high-quality care through the efficient use of resources without unduly controlling women's choices. Providing care within the context of the traditional family structure, gender roles, family support systems, and community services and resources further enhances health care services. Equally important is the establishment of a sustained partnership with clients, based on the support of protective traditional health practices and the recognition that a woman is expert in her own health. By respecting the complex cultural, political, economic, and personal backgrounds that contribute to immigrant women's perceptions of health, illness, and health care needs, culturally competent primary care providers serve diverse populations more effectively and help to enrich the communities in which they live and work.

Adult↗

PubMed2006

Using prayer in psychotherapy: applying Sue's differential to enhance culturally competent care.

In this article, the authors discuss the application of Sue's cultural competence differential of hypothesis testing, dynamic sizing, and cultural specific expertise as a model for considering cultural factors in the treatment of an African American family. Three cultural dimensions are highlighted: spirituality, womanism, and community exposure to trauma. Given the centrality of spirituality for this African American family, prayer is used to facilitate the therapeutic process. Discussion from a womanist perspective highlights the spiritual, communal, and personal dimensions that the aunt faces as an African American woman. Consideration of the community context and potential exposure to trauma and loss allows for a fuller appreciation of the psychosocial context of the nephew. Sue's differential guides the case discussion.

Adolescent↗

PubMed1998

Contesting competency: cultural safety in advanced nursing practice.

A central tenet of the competency approach to nursing education and regulation is that it ensures the safe care of clients and communities with whom nurses work. However, the competency approach is problematic in its conception and application to nursing. Incorporation of this framework into advanced practice requires that its limitations are acknowledged so that current interpretations and applications can be challenged and resisted. Through exploring the concept of cultural competence some of the problems associated with the application of the competency approach to professional nursing practice will be exposed. The issues revealed in this exploration prompt the question whether the competency framework is the best way to ensure competent professional practice.

Clinical Competence↗