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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.
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Health Disparities and Culturally Competent Care ZOYA MINASYAN RN-MSN EDU
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 • 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 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: Isosorbidedinitrate 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