| Does Cultural Competence Make a Difference? More
articles have been written about the impact of culture on the
physician-patient relationship than the nurse-patient relationship,
but the findings are useful for nurses. Patients may perceive
a lack of cultural awareness on the part of health
care providers as insensitivity. Culturally insensitive
care can lead to discriminatory and unequal care (Tucker et al., 2003). Unequal care can lead to health disparities. The
US Department of Health and Human Services identified six focus
areas
in which racial and ethnic minorities experience
serious health disparities:
Health Disparity Focus Areas |
- Infant Mortality (Target: African-American,
American Indian, and Puerto Rican infants)
- Cancer Screening and Management (Target:
African-American women)
- Cardiovascular Disease (CVD) (Target:
African-American adults)
- Diabetes (Target: American
Indians and Alaska Natives, African Americans,
and Hispanics)
- HIV Infection/AIDS (Target: African
Americans and Hispanics)
- Immunizations (Target: older Hispanics
and African Americans)
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| Adapted from National Healthcare Disparities Report, 2003 |
Although the nursing
profession has been racially integrated for the past 50 years
(Gooden, et al, 2001), it is still primarily white (86.6%)
with a small minority population: 4.9% Black, 3.9% Asian, and
2.0%
Hispanic (Spratley, et al, 2000). The significant under representation
of minorities in nursing and other health professions is one
reason behind the disparity
in the health status of whites and minority groups (Gonzalez,
et al, 2000). Gooden, et al (2001) assert it is imperative
for nursing to embrace diversity If the profession is going
to be
instrumental in closing the health-disparity gap and improving
the health of Americans.
The literature regarding cultural competence focuses primarily
on creating culturally competent organizations. Institutions,
organizations, and private practices have invested time and resources
toward developing culturally competent staff. The primary impetus
for organizational competence is patient satisfaction and regulatory
compliance (Frusti, Niesen, & Campion, 2003; Hall, 2001).
Studies have shown that staff training changes behaviors, improves
patient satisfaction, and decreases health disparities (Majumdar,
Roberts, Browne & Carpio, 2004; Suh, 2004).
Luna (2002) asserts that identifying the influences of culture
in health care helps us fully understand others. Culturally
competent nursing care involves sensitivity to culture, race,
gender, sexual orientation, social class, and economics (Robinson,
2000). It means really listening to the patient's beliefs about
health and illness and understanding how culture influences
health choices and actions (Robinson, 2000; Transcultural Nursing,
2004).
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