The US is among countries whose population is extremely diverse in terms of culture. As a result, addressing healthcare needs of the culturally diverse population has been increasingly becoming a challenge. As such, healthcare professionals are required to understand clearly the healthcare needs of the specific culture they are dealing with in order to provide care that takes into consideration various cultures. Hispanics face various healthcare needs, including a low rate of underweight births and a relatively low level of infant mortality as compared with the national average, as well as cancer, mental health problems, diabetes, and occupational injuries. Thus, providing effective care to Hispanics requires culturally competent care. This study assesses ways to improve culturally competent care. Effective methods for delivering culturally competent care require incorporating theoretical frameworks such as the Purnell model and the transcultural nursing care theory. In addition, the transcultural assessment models and culturally competent programs can improve delivery of culturally competent care.
Delivery of Culturally Competent Care
The United States has one of the most culturally diverse populations worldwide. For instance, studies show that 17% of the US population are Hispanics (Velasco-Mondragon, Jimenez, Palladino-Davis, Davis, & Escamilla-Cejudo, 2016). Different cultures experience culture-specific healthcare needs. As a result, addressing healthcare needs of the culturally diverse population is increasingly becoming a challenge. As such, healthcare professionals are required to understand clearly healthcare needs of the specific culture they are dealing with in order to provide a culturally competent care. There are theories and models that have been developed to help nurses improve their understanding of cultures and how cultures play a key role in delivering care. In this study, healthcare needs of the Hispanics are researched in an attempt to address application of nursing processes in order to be able to provide care that accounts for cultural diversity.
Hispanics’ Healthcare Needs
Hispanics are among the biggest minority groups in the US. Hispanics, just like any other cultural group, are affected by social determinants of health such as economic status, education, and cultural values. Several literature reviews have been conducted on assessing health needs of the Hispanics. Velasco-Mondragon et al. (2016) have assessed the status of health of the Hispanics within the US and their health-related needs. The findings reveal that the Hispanics face various healthcare needs. While the Hispanics have the highest birth rate in the US, they are leading in the number of underweight births (Velasco-Mondragon et al., 2016). According to Velasco-Mondragon et al. (2016), the high rate of birth is explained with a strong cultural support from members of the community. However, underweight births occur simply because the Hispanics have inadequate healthcare, including cultural factors such as nutrition.
Diabetes incidences are common among the Hispanics. According to Velasco-Mondragon et al. (2016), the Hispanic minority group is the third in terms of a high prevalence of diabetes. Studies have shown that the Hispanics are at a high risk of developing type 2 diabetes (Caballero, 2014). According to Caballero (2014), cultural beliefs of the Hispanics that are rooted in strong religious beliefs contribute to a high risk of developing type 2 diabetes. Still, studies indicate that incidence of diabetes among the Hispanics is likely to rise due to the lifestyle factor (Velasco-Mondragon et al., 2016). According to Caballero (2014), the Hispanics are more likely to die from diabetes in comparison to non-Hispanic Whites. Cancer is another disease that affects the Hispanic population. According to Velasco-Mondragon et al. (2016), cancer is the leading cause of the high mortality rate among the Hispanics. Colon and prostate cancers are the commonest types of cancer affecting men, while breast cancer is the leading type of cancer that affects women, being followed by thyroid cancer. High blood pressure and occupational injuries have also been found to be common among the Hispanics.
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Cultural Factors that Contribute to the Hispanics’ Health Needs
The cultural beliefs of the Hispanics contribute immensely to their health needs. Firstly, language barrier is the most significant cultural factor that leads to low access to the healthcare among the Hispanics. Research conducted by Medina (2017) has identified language barrier as one of the chief reasons why the Hispanics do not seek healthcare services. While English is the most commonly used language among health professionals, most Hispanics speak Spanish. Velasco-Mondragon et al. (2016) have revealed that Hispanics’ health care professionals are underrepresented in all sectors of healthcare. Language barrier means communication breakdown between nurses and health care providers and clients. Most Hispanics with the low social background are likely to shun seeking professional healthcare services and instead prefer traditional care offered by fellow Hispanics with whom they can communicate effectively.
Secondly, women are primary caretakers in the Hispanic culture. Women are the ones considered to be experts in health matters. As a result, men and children often seek advice from women first before seeking any health care services. In this regard, women’s perception of health care affects the community’s perception. Thirdly, Hispanics have a strong cultural belief on loyalty to extended family (Caballero, 2017). As such, Hispanics seek advice from a number of people, mainly from extended family, before making any decision on health matters. As opposed to the individualistic culture among non-Hispanic Whites, collectivism requires that addressing healthcare needs incorporates communal elements.
Cultural taboos constitute another cultural factor that affects the Hispanics’ healthcare needs. The Hispanics believe that certain health topics such as mental problems and sexual health are taboos and cannot be discussed openly. For this reason, most Hispanics are afraid to seek professional health services for health problems such as mental disorders and sexual problems. Religious belief also plays a critical role in addressing the Hispanics’ healthcare needs (Finkelman & Kenner, 2013). Most Hispanics believe that diseases are God’s will and, therefore, are less likely to seek professional medical advice. Instead, the Hispanics are likely to seek religious counselling and traditional treatment that incorporates religious rituals. Most importantly, perhaps, cultural values such as respect, trust, friendliness, and loyalty have a significant influence on the Hispanics seeking treatment. In the United States, most nurses are not keen on having strong interpersonal relationships with their clients. Research shows that the Hispanics are reluctant to visit healthcare professionals who do not exhibit the sense of trust, respect, and friendliness (Medina, 2017). Other cultural factors are beliefs relating to home remedies and nutrition. Thus, cultural factors contribute to healthcare needs of the Hispanics.
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Theoretical Models and Application to Nursing Care
Thus, the challenge of delivering care in a culturally diverse environment is addressed by cultural competence. Purnell saw the need for students and nurses to have a framework for learning culturally competent care (Finkelman & Kenner, 2013). As a result, Purnell developed a theoretical model known as Purnell model. Purnell model helps nurses and other healthcare professionals learn about their cultural beliefs, as well as cultures of their clients. Purnell tackles the issue of cultural competency by relating global cultural issues with community, family, and individual. According to Purnell model, individuals first learn about culture from the immediate family, which is then followed by the community and finally the global setting (Karabudak, Tas, Basbakkal, 2015). The model presents 12 cultural domains, namely, pregnancy, nutrition, high risk behavior, biocultural ecology, workforce issues, family roles and organization, communication, heritage, healthcare professionals, healthcare practices, and spirituality (Daniel & Betancourt, 2015). The purpose of Purnell model is to enable nurses to have a holistic approach to the cultural competent care. Thus, by applying Purnell model nurses are able to understand cultural beliefs of their clients, including their own cultural biasness, in such a way that they can develop nursing care that addresses challenges arising in a multicultural environment.
Transcultural assessment model is a tool that nurses can use for delivering culturally competent care. Developed by Giger and Davidhizar, transcultural assessment model is a tool that specifically helps nurses understand how to address cultural values of patients in order to deliver care that does not conflict with the patients’ cultural beliefs (Karabudak et al., 2015). Transcultural assessment model is based on the transcultural nursing care theory formulated by Leninger. In particular, transcultural assessment model allows nurses to evaluate patient’s culture in six dimensions. First, nurses are able develop a clear communication strategy according to the individual’s cultural beliefs. Second, interpersonal space affects how nurses relate with their clients. By understanding how every client perceives interpersonal space is important in delivering culturally competent care. For instance, most Hispanics do not prefer private space. Third, social organization is another important cultural dimension. Understanding how the Hispanics organize themselves socially is important. For instance, Medan (2017) has noted that the Hispanics organize themselves around family with women taking a central role in family relationships. Understanding how the Hispanics relate among themselves will improve culturally competent care. Other dimensions such time, illogical variations, and environmental control also play an important role in delivering culturally competent care.
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Applying transcultural nursing care theory improves delivery of culturally competent care. Transcultural nursing care theory is a comparative study of specific cultures and universal cultures across different societies used to acquire cultural competency (Daniel & Betancourt, 2015). Application of transcultural nursing care theory helps nurses with understanding and respecting cultural diversity of patients. Moreover, transcultural nursing care theory encourages nurses and healthcare providers to develop culturally inclusive care programs (Karabudak et al., 2015). In addition, nurses and caregivers are able to deliver culturally relevant diagnoses. Still, understanding of cultural diversity is helpful in evaluating how cultural beliefs influence patients’ decision-making. Nurses can utilize various resources that provide relevant information on cultural practices of different people (Daniel & Betancourt, 2015). For example, dreams from endangered culture provides wealth of information about cultural diversity. From the novel, danger of a single story, nurses can learn the importance of listening objectively to patients from other cultures without biasness. Finally, taking part in cultural competency project helps improve their cultural awareness. Various state departments have developed culture competency programs to improve cultural competency of their citizens. Programs that encourage cultural diversity can be incorporated in the framework of delivering nursing care.
In conclusion, culturally competent care is a critical component of delivering care in a multidimensional cultural setting. Undoubtedly, every culture has unique healthcare needs. Hispanics’ healthcare needs are a subject of cultural uniqueness of the Hispanics. Nurses offering healthcare to Hispanics are, thus, required to have a proper understanding of their culture. Improving delivery of care requires cultural competency among nurses. Hence, nurses are required to incorporate cultural skills and knowledge into care delivery. There are a number of theoretical frameworks applicable to the delivery of care that take into consideration various cultures. Purnell model and transcultural assessment model can be effectively applied by nurses to help them deliver culturally competent care. In addition, taking part in cultural competency projects will improve cultural competency of nurses. Overall, efforts to improve delivery of culturally competent care for the Hispanics depends on improvement of cultural competency among nurses.
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