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Health Disparities and Culturally Competent Care
ZOYA MINASYANRN-MSN EDU
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Determinants of Health
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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.
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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
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Health Disparities
Impact of Health Disparities on HealthCancer-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.
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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.
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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.
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Culture
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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, MuslimsEthnic subcultures- African Americans, Hispanics and
Native Americans.
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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.
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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.
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Cultural Diversity in the Health Care Workplace
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Cultural Diversity in the Health Care Workplace
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Cultural Factors Affecting Health and Health Care
Personal SpaceIntimate 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.
NutritionFood and rituals associated with food. Immigrants may face with many unfamiliar foods.
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Cultural Factors Affecting Health and Health Care
MedicationsNational Medical Association (NMA) and National Pharmaceutical Council (NPC) titled “Racial and Ethnic Differences in Response to Medicines: Towards Individualized Pharmaceutical Treatment.”Ex: Isosorbide dinitrate and Hydralazine-for African American pts.
Psychologic FactorsCulture-bound syndrome that is within a cultural groupEx: Susto- Latin America-soul loss, fright sickness which can cause loss of appetite, anxiety, social withdrawal.
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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.
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Activates and characteristics of the nurse
• Nurse as – Caregiver– Educator– Advocate– Leader– Manger– Researcher