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Abstract
Culturally competent care is a new approach in the context of delivering healthcare services to members of minority groups. At its core, this concept espouses the need to acquire a certain level of cultural sensitivity that stems from the realization that there are certain factors and historical precedents that may render conventional treatment and intervention strategies ineffective or produce less than ideal results.
By focusing the study on the plight of Native Americans suffering from Type 2 diabetes and those battling the consequences of substance abuse, it was discovered that prevention is better than administering Western-based medical cures. The support given to culturally competent care comes in large part to the acknowledgement of the inherent weakness of conventional treatment protocols in addressing other aspects of social life that may have a significant impact in the patients ability to receive and enjoy long-term and sustainable medical benefits.
Introduction
Culturally competent healthcare is the right mind-set to have in order to deliver cost-efficient service to members of the Native American population. Ignorance of the principles of cultural competence in healthcare leads to a waste of time and resources.
Needless to say, the failure to understand the difficulties and challenges faced by minority groups like Native American leads to inefficiency due to poor communication, assumptions about the effectiveness of certain treatment or intervention strategies. It is easy to validate these assertions after examining the delivery of healthcare services to Native Americans in the context of treating diabetes and the medical consequences of substance abuse.
Understanding Culturally Competent Healthcare
Culturally competent care focuses on the nuances that form part of a people groups social outlook and internally shared values. Larry Purnell in his book entitled Guide to Culturally Competent Healthcare warned healthcare providers of the folly of ignoring the need to customize the process of delivering certain healthcare-related services in accordance to the specific cultural framework that one can find within minority groups.
These unique attributes that help distinguish between African American or Native American culture also affect the way the recipient of healthcare services are going to enjoy the full benefits of the treatment or medical intervention strategies that were applied earlier to deal with a medical emergency or physical infirmity (Purnell, 2014). Priscilla Sagars book entitled Transcultural Nursing Theory and Models expounded Purnells model and provides a definition of the said concept when dealing with minority groups. He defined cultural competence as the capability of nurses and doctors to interact effectively on the basis of the patients culture or social perspective.
The author also pointed out that this conceptual framework is comprised of four major components:
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the need to have an awareness of the healthcare providers own cultural worldview;
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awareness of the healthcare providers attitude towards cultural differences;
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the need to have a certain degree of knowledge regarding the different cultural practices and worldviews of each group;
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the need to acquire cross-cultural skills and worldviews (Sagar, 2012).
In other words, healthcare workers that are familiar with this concept demonstrate signs of cultural sensitivity when helping patients receive appropriate medical care.
There are also underlying layers of knowledge that needs to be studied in order to gain more understanding about this concept. The skill required in order to gain a certain level of competence in this area of expertise calls for the discovery of insights related to language, food, traditions, values, sacred rites and the things that are considered taboo in certain cultures.
It is detrimental to the health of the patient and the effectiveness of the medical team when workers ignore important aspects of culture, such as, language, diet, and core values that minority groups consider as critical building blocks when discerning their respective cultural identity. Failure to consider the impact of a language barrier causes a major breakdown in communication that may lead to misdiagnosis or to less than ideal delivery of medical assistance.
Cultural sensitivity translates to different forms, however, one way to apply this principle is manifested in terms of giving due consideration to the patients educational background. It has to be made clear that for a large number of patients belonging to the specially categorized ethnic groups, they lacked the educational attainment necessary to understand complex medical procedures. Poverty and other social barriers prevented them from rising to the top and ensuring access to certain resources.
It does not require a social scientist to understand the mediocre levels of educational achievements and language proficiency among the impoverished members of the population especially those identified with minority groups like the Native Americans, African Americans, Mexican Americans, and Puerto Ricans. This assertion was discussed in greater detail in Joseph Healeys book entitled Diversity and Society: Race, Ethnicity, and Gender.
In the said reference material, the author highlighted the level of disparity when compared to the accomplishments of the members of the dominant group, especially those controlling public offices and business establishments. In the case of Puerto Ricans and Mexican Americans, poverty is the outcome of the economic disadvantages that are inherent in the world of immigrant families.
On the other hand, African Americans and Native Americans struggle to break free from poverty and ignorance after oppressive institutions made it impossible for them to secure better opportunities for their children (Healey, 2014). Doctors and nurses must take a hard look at social injustice in order to give them the impetus to learn the skills linked to cultural sensitivity.
Culturally Competent Care: Native Americans
In order to have a deeper understanding of the said subject matter, it is best to focus on one minority group. In an article that was published under the Journal of Cultural Diversity, authors Karethy Edwards and Beverly Patchell discovered a better approach in developing effective intervention strategies in the context of Native Americans suffering from Type 2 diabetes. They came to the realization that in order to prevent the onset of diabetes, it is imperative to study the history and culture of Native Americans.
In their quest, the authors discovered that Native Americans were healthier in the past because they had access to healthy food systems made available by cultivating and consuming different variety of crops (Edwards & Patchell, 2009). They also found out that a significant decline in the quality of the people groups health was observed when Native Americans were forced out of their homelands under the fosterage of the Federal government (Edwards & Patchell, 2009). The health conditions of the Native Americans worsened when they were compelled to live in designated areas called Indian reservations.
The disruption of the indigenous peoples way of life was made possible to a great extent by the ill-advised policies of the national government. As a result, they lacked the ability to earn a living in the best way they know how, and the once proud members of Indian tribal groups were persuaded to embrace government assistance that came in the form of relief goods, food packages, and welfare checks (Healey, 2014).
It did not take long before the families living the so-called Indian reservations became acutely dependent on external help in order to survive. As a result, they accepted the kind of assistance that was given to them. Aside from the low quality of the food aid given to them, Native Americans were never given the opportunity to go back to their traditional ways of growing their own food. The lack of access to nutritious meals was exacerbated by the geographical isolation of some of the Indian reservations (Edwards & Patchell, 2009). Using this information it is possible to develop a more effective intervention strategy enhancing the need for the immediate application of drugs to treat Type 2 diabetes.
It was mentioned earlier that in order to develop competency using this new approach, it is important to underscore the healthcare providers awareness of his or her own worldview. If the nurse or doctor graduated from a medical school using Western practices, it is not easy to incorporate certain cultural beliefs and tradition into a particular treatment protocol. Consider for instance the American Indians conception of substance abuse treatment requiring not only the need to eradicate a specific addictive behavior but also the need to heal the mind, body, and emotions.
This was the challenge faced by healthcare workers as described in an article entitled Cultural Interventions to Treat Addictions in Indigenous Populations (Rowan, et al., 2014). In addition, alcoholics are expected to heal their relationships with the members of the community.
One can argue that the concept of healing a person from the consequences of substance abuse is an idea that was never discussed in medical schools or nursing schools in the United States and Europe. However, the same study that probed into the use of indigenous treatment methods reported a high success rate, especially the elimination of substance use problems (Rowan et al., 2014). The success rate was higher in program that integrated Western-based medicines and culture-based treatment services.
In order to embrace this new approach, it is of critical importance to acknowledge the inherent limitations of Western-based medicines and the enhancing effect of using information and insights that are culturally relevant in helping the patient experience long-term and sustainable health benefits.
Conclusion
Culturally competent healthcare is not just an option when it comes to poor and marginalized members of society. The importance of this new approach was seen in its ability to see the root cause of the problem and its capacity to develop appropriate intervention programs or strategies. In addition, culturally competent care utilizes socially acceptable practices that have been part of the social development of people belonging to specific ethnic groups.
Finally, the use of culturally competent healthcare approaches also stem from the realization that Western-based medicine has certain limitations, especially when it comes to other aspects of human existence that arguably has a direct impact on his or her recovery process. For example, the need to mend relationships with members of the community can form part of an effective prevention strategy that can also become an accountability system making it harder for the patient to retrogress to his or her old ways.
References
Edwards, K., & Patchell, B. (2009). State of the science: A cultural view of Native Americans and diabetes prevention. Journal of Cultural Diversity, 16(1), 32-35.
Healey, J. (2014). Diversity and society: Race, ethnicity, and gender. Thousand Oaks, CA: Sage Publications.
Purnell, L. (2014). Guide to culturally competent health care. Philadelphia, PA: F.A. Davis Company.
Rowan, M., Poole, N., Shea, B., Gone, J., Mykota, D., Farag, M.,& Dell, C. (2014) Cultural interventions to treat addictions in indigenous populations: Findings from a scoping study. Substance Abuse Treatment, Prevention and Policy, 9(1), 34.
Sagar, P. (2012). Transcultural nursing theory and models: Application in nursing education, practice, and administration. New York, NY: Springer.
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