N204 Diverse Populations and Health Care

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N204Diverse Populations and Health Care
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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

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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

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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

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International travel tourist
Resource Bremner, B. (April 23, 2007). Guiding
tourists to Asia. Businessweek, retrived October
20, 2007 from http// www.businessweek.com/globalb
iz/content/apr2007/gb20070423_942361.htm?chansear
ch
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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 worlds fastest growing industries
  30 a year (4 billion dollars industry within
  next few years)

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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

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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,

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Cultural needs (Contd)

• Pain
• Health practice
• Time orientation
• Space
• Family

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Equal access to treatment and care

• Ethnicity
• racial discrimination,
• racial harassment and
• oppression
• Secondary problems
• stress
• psychological trauma

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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

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Cultural safety needs

• Engage clients as partners
• Respect rapport -gt self-esteem
• Cultural negotiation culture compromise

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Transcultural Care Practice

• Initiative
• Enthusiasm
• Commitment of individuals and groups
• Strategic planning
• Organization coordination of services
• Funding
• Education
• Recruitment research

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

• Assessment
• Communication
• Culture negotiation and compromise
• Establishing respect and rapport
• Sensitivity
• Safety

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Campinha-Bacotes Cultural Competence Model

• Cultural awareness
• Cultural skill
• Cultural knowledge
• Cultural encounters
• Cultural desire

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Purnells 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

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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
  nations population
• In 2020, it will be near to 40
• 10 of RNs in the US are from racial/ethnic
  minority background (2000)

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

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

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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

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