Cultural Competency Assessment And Intervention In Healthcare

Impact of Cultural Diversity on Healthcare

Discuss about the Cultural Competency Assessment and Intervention.

Medical sociology can be described as the study, which defines how the human being accomplishes the disease, illnesses, and disorders (Juckett 2013). We cannot think our health as given. It is more of a model, which is socially constructed to make the person to interpret reality (Mareno and Hart 2014). Culture can be described as the shared concept of the specific social groups. This further influences the whole process of healthcare.

The biases of the patients and the healthcare professionals for their respective cultures gives rise to many health-related problems (Kirmayer 2012). When the healthcare authorities take the patient’s cultural viewpoint seriously and show respect to the background and beliefs of the patient, it promotes trust and a better outcome for the treatment (Long 2014). Hence, it is significant for the healthcare professionals to value the background and cultural beliefs of the patient to involve them in the effective healthcare management.

During my duty hours in the hospital, I have encountered a 52-year-old male American patient from Mexican descent who is living in Hong Kong for the last one year. The patient is working in an MNC there. The patient’s cultural view is purely Mexican-American and he feels completely out of place in Hong Kong (Mareno and Hart 2014). The patient is suffering from Diabetes type II and hypertension for 10 years. The patient came to the hospital with very high blood pressure (180/110) and stomachache. To assess the effect of socio-cultural factors in his health, I have asked him some questions. He answered the following-

The first question I asked the patient if he has experienced any discomfort during his stay here in the past months (McMillan 2012). He answered that the experience is still new for him and he is still trying to adjust to the system. When I asked him about his background, he said that he is an American of Mexican descent (Juckett 2013). He came to America when he was just five years old, and since then he was living there until last year he came to China for his job. He said that the assumed reason of the stomachache is the unfamiliar food. He also revealed that he does not know many people here and as a friendly person, he misses his friends. As he is of Mexican descent, he has a big family and he misses his whole family.  He assumes that his loneliness can be a reason for the high blood pressure (Kirmayer 2012).

Case Study of a Mexican-American Patient in Hong Kong

When I asked about his medical history, he showed me some report, which revealed that he is a patient of hypertension and Diabetes type II for 10 years. The conversation revealed that the patient is the believer of western medicine but also respects for the beliefs of his culture (Morton-Miller 2013).

Then I asked him, what his first response towards his problem was. He said that he tried the herbs the Curandero prescribed him at home apart from having the western medicine. He said he also believes some of the words the Curandero says, such as the imbalance in his life made his hypertension worse. He also said that the Chinese food here is also causing an imbalance to his body.

My next question was to him about his family. He said that he has a traditional big Mexican family who lives under the same roof. In his family, his 80-year-old father still considered to be the head of the family. The wife of the patient, who lives in the US with the rest of the family, has advised him to consult a local doctor from a hospital. The patient told me that generally, his mother and his wife give the home care, but in China, there is no one with him to provide him the needed care (Dudas 2012). He said, in traditional Mexican culture, the women of the house take care of the family members in sickness. The patient does not have many friends here in Hong Kong. He said that his Chinese colleagues have told him to consult some local healers who practice the Chinese traditional medicine (Giger 2016). He did not go there; instead, he came to the hospital to have the westernized treatment, though he considered consulting one.

My next question to the patient was, whether he had any specific actions to maintain his health in general (Dudas 2012). The patient replied that he had. For his diabetes, he takes insulin injection (14 ml daily) and for his hypertension, he takes one Nebivolol 5 mg tablet daily in the morning before breakfast. Apart from that, he also takes the traditional Mexican medicine to treat his condition. Then I asked the patient if the patient is taking his prescribed medicine daily, why he is also taking the folk medicine. He said that from his childhood, he went to the folk healers and sometimes he felt that their medicine also worked fine. However, he was brought up in a westernized social environment, which made him believe the westernized medicines also.

Significance of Culturally Competent Care

My next question to him was whether he had experienced any cultural diversity during his stay in Hong Kong (Powell Sears 2012). He answered that his colleagues believe in traditional Chinese medicines (TCM) and goes to the traditional healers for their health problems. He finds it quite similar to the Mexican culture as the Mexicans also visit the folk healers before consulting a doctor. He revealed that there is a TCM practitioner in his neighborhood. He met the healer for a few times. The healer had invited him to see the therapy (Purnell 2012). In his request, the healer discussed the main points of Chinese TCM. The patient found similarity in the inner philosophy of the Mexican folk medicine and Chinese Traditional Medicines as the TCM also discusses the imbalance of the five elements inside the body. The whole experience with the healer is quite different for him (Ma et al. 2014). He said that the healer has many patients coming to see him regularly. He has observed that the traditional medicine the Mexicans use is quite different from the Chinese folk medicines. He also observed that the older patients come to see the healer for their problem.

The next day, I met a British tourist of 48, who came with severe diarrhea and stomachache. When I asked him if he had encountered any problem during his stay here, he said he did not encounter any problem during his stay in Hong Kong. Rather, he found it intriguing and interesting. He said the cause of his illness is the spicy Chinese food. When I asked him his response to his illness, he told me that he came directly to the hospital. He also said that he went to the TCM practitioner who practices acupuncture for curing his arthritis. His wife responded that she brought him to the hospital in the first instance of the illness. When I asked about the previous case history and his general routine to maintain his health, he said that he has diabetes and takes insulin injection daily apart from running on a daily basis. When I asked him about the cultural diversity, he answered that exploring cultural diversity is the only reason he came here.

Hong Kong is one of the topmost international cities, which is populated with people of various cultures. However, more than 90% of the population of Hong Kong is Chinese, many people from different countries also live there. These people have different histories, different illnesses, and different socio-cultural backgrounds. China has its own tradition of folk medicine and it has gained popularity over the year. This can create conflict between the cultures. To prevent conflict between the different cultures and to provide the people with suitable and competent healthcare, the healthcare professionals have to be culturally competent. The culturally competent healthcare is needed, as the nurses have to consider patients of every culture as equal. To give the culturally competent care the nurses have to increase their understanding level to know every culture. With their increasing knowledge about different cultures, the caregiving process would also be effective. The culturally competent nurses gain the trust and respect of the patients, which makes the treatment more effective.

References:

Dudas, K. I. (2012). Cultural competence: An evolutionary concept analysis. Nursing Education Perspectives, 33(5), 317-321.

Giger, J. N. (2016). Transcultural Nursing-E-Book: Assessment and Intervention management. Elsevier Health Sciences.

Jeffreys, M. R. (2015). Teaching cultural competence in nursing and health care: Inquiry, action, and innovation. Springer Publishing Company.

Juckett, G. (2013). Caring for Latino patients. American Family Physician, 87(1).

Kirmayer, L. J. (2012). Rethinking cultural competence.

Long, T. (2014). Influence of international service-learning on nursing student self-efficacy toward cultural competence. Journal of Nursing Education, 53(8), 474-478.

Ma, F., Li, J., Liang, H., Bai, Y., & Song, J. (2014). Baccalaureate nursing Students’ perspectives on learning about caring in China: a qualitative descriptive study. BMC medical education, 14(1), 42.

Mareno, N., & Hart, P. L. (2014). Cultural competency among nurses with undergraduate and graduate degrees: Implications for nursing education. Nursing Education Perspectives, 35(2), 83-88.

McMillan, L. R. (2012). Exploring the world outside to increase cultural competence of the educator within. Journal of cultural diversity, 19(1), 23.

Morton-Miller, A. R. (2013). Cultural competence in nursing education: practicing what we preach. Teaching and Learning in Nursing, 8(3), 91-95.

Powell Sears, K. (2012). Improving cultural competence education: the utility of an intersectional framework. Medical Education, 46(6), 545-551.

Purnell, L. D. (2012). Transcultural health care: A culturally competent approach. FA Davis.