N204 Diverse Populations and Health Care

1. N204Diverse Populations and Health Care

2. Agenda – 2/26/08 • Paper presentation • Virginia – 3 articles • Elisa – 2 articles • Indira - 3 articles • Gracie – ? • Next Week • Paper presentation • Rose - 2 articles • Gracie - ? • Transcultural Nursing Practice

4. Diversity • Divertere in Latin • Being different or having differences • Diversity in nursing practice • Providing competent care to clients from different cultures, conducting research in multi-cultural settings, and implementing educational programs to diverse population

5. Human migration • 175 million migrants • Pull & push factors– • no job opportunities, unsafe work environment, lack of political stability, high workloads, or lack of economic remuneration • Misnomer – need and demand • In US. 500,000 qualified nurses who are not active or employed • Misconception – • Migration does not take place only from developing countries to industrialized nations. Padilla, P. (April/May,2006). Nurse migration and the nursing shortage. Breakthrough to Nursing, IMPRINT, 18-22

6. International travel & tourist Resource: Bremner, B. (April 23, 2007). Guiding tourists to Asia. Businessweek, retrived October 20, 2007 from http:// www.businessweek.com/globalbiz/content/apr2007/gb20070423_942361.htm?chan=search

7. Medical tourism • Def: combination of travel to a foreign country to receive medical treatment while taking advantage of local tourism opportunities • 1.3 million tourists per year seeking low-cost medical care abroad • One of the world’s fastest growing industries – 30% a year (4 billion dollars industry within next few years)

8. Transcultural Nursing- Leininger, 1997 • Definition- A formal area of study and practice focused on comparative holistic culture care, health and illness patters of people with respect to differences and similarities in their cultural values, beliefs, and lifeways with the goal to provide culturally congruent, competent and compassionate care

9. Cultural needs • Equal access to treatment and care • Respect for cultural beliefs and practices • Leininger, (1995) & Narayanasamy, (2003) • Religious beliefs, taboos, customs • Dietary, personal care needs, daily routines • Dying needs • Communication needs • Cultural safety needs,

10. Cultural needs (Cont’d) • Pain • Health practice • Time orientation • Space • Family

11. Equal access to treatment and care • Ethnicity • racial discrimination, • racial harassment and • oppression • Secondary problems • stress • psychological trauma

12. Communication needs • Barrier • Impede early detection • delay prompt treatment and care • Forms • Language • Non-verbal communication • Translation services • Interpreters • Family interpreters • Health condition – acute illness & crisis

13. Cultural safety needs • Engage clients as partners • Respect & rapport -> self-esteem • Cultural negotiation & culture compromise

14. Transcultural Care Practice • Initiative • Enthusiasm • Commitment of individuals and groups • Strategic planning • Organization & coordination of services • Funding • Education • Recruitment & research

15. Giger-Davidhizar (2002) - Assessment Model Communication Culturally Unique Individual Space Biological Variations Social Organization Environmental Controls Time

16. ACCESS Model –Narayanasamy, 2002 • Assessment • Communication • Culture negotiation and compromise • Establishing respect and rapport • Sensitivity • Safety

17. Campinha-Bacote’s Cultural Competence Model • Cultural awareness • Cultural skill • Cultural knowledge • Cultural encounters • Cultural desire

18. Purnell’s Model • Macro level – global society, community, family, individual, health • Cultural domains – overview, communication, family roles, workforce issues, bioculturl ecology, high-risk behaviors, nutrition, pregnancy & childbearing practices, death rituals, spirituality,health care practice/practitioners • Cultural consciousness • Unknown phenomenon

19. Culturally Competent Organization • US Census Bureau, 2000 – total population = 281,421,906 • Latio 35.5 million = 12.1% • African American = 12.9% • Asians = 4.2% (60% is foreign born) • Multiracial = 2.4% • Ethnic minorities accounts for one fourth of the nation’s population • In 2020, it will be near to 40% • 10% of RNs in the US are from racial/ethnic minority background (2000)*

20. Organizational Diversity Competence Model(Frusti, Niesen, Campion, 2003) Drivers measurements Linkages Commitment Culture

21. Negotiation Process • Listen: to the client’s perspective • Teach: from your knowledge in language appropriate for client & family • Compare: similarities & differences, disagree but do not devalue client’s view • Compromise: • if client treatment not harmful, promote • If harmful, explain harm and suggest alternatives

22. Useful websites Internet: http://www. • apna.org – American psychiatric nurses’ association • sen.ca.gov – California State Senate • cdc.gov – Center of disease control • nami.org –National alliance for the mentally ill • health.gov/healthypeople/document/ - healthy people 2010 • library.sjsu.edu/staff/Peterson/Peterson.htm • For statistical data: • Census.gov/main/cen2000.html • google.com/unclesam • firstgov.gov • factfinder.census.gov