Culture counts

Journal of Cultural Diversity, Fall, 2004 by Barbara A. Broome

The Surgeon General Executive Summary report U.S. Department of Health and Human Services Center for Mental Health Services concludes the "culture counts" in the care of individuals that are experiencing mental health (DHHS, 2003) or any other physiological problems. This report further underlines the need for an appreciation for the intrinsic diversity within each of the recognized racial or ethnic groups and the implications of that diversity. Race and culture have Been identified as barriers to health care. Other barriers include lack of or limited health insurance, lack of financial resources to cover services, lack of a primary health care provider, cultural and spiritual differences, language barriers and issues of discrimination (HP2010). Another barrier is the lack of cultural similar practitioners.

Dr. James Caillier and colleagues investigated the potential of racial discrimination in the delivery of invasive cardiac treatments. Their findings strongly support additional research in the area of medical treatment and minority populations and, further, is an encouragement for further research on potential gender differences in medical care.

Communication discord and insight into cross-racial primary care relationships in a nurse-managed center is offered by Dr. Ramona Benkert, Dr. Joanne Pohl, and Dr. Patricia Coleman-Burns as they explore communication patterns between patients and practitioners.

Maren Coffman, RN, MSN further examines the phenomena of culture with a meta-analysis of qualitative research as it relates to cultural caring in practice. These findings offer strong support for cultural sensitivity and competence in practice. Dr. Merle Kataoka-Yahiro, et al, extend this need for cultural understanding by the health care team in the exploration of the grandparenting caregiving role in Filipino American families. The authors provide sup port for education in nursing schools that includes the diverse and complex needs of extended families.

A willingness to decrease ethnocentristic behaviors and to become educated about others is the catalyst to cultural knowledge and is a part of nursing curricula. However, the development of cultural competence in schools and colleges of nursing is a struggle because the profession is very homogenous, with approximately 90% white females (National Advisory Council on Nurse Education and Practice [NACNEP], 2000). There is clear evidence to support the work that needs to be done with the current population of practitioners; NACNEP proposes that great energy should be placed on preparing the next generation of nurses (p18). The faculty that prepare this next generation must be knowledgeable of the importance of cultural competency and have an appreciation of the need for and a vision to promote cultural competence. Dr. Ndiwane and his fellow authors address this issue from the curriculum level. Another important way to assure this type of quality cultural education is through the accreditation process of schools and colleges of nursing. Dr. Mary Wawrzynski and Dr. Ruth Davidhizar offer clear suggestions for making the site visit a positive experience for the visitors and the institution.

Our authors in this edition of The Journal of Cultural Diversity lend their expertise as they offer insight into to the need to be willing understand and accept other world views, actively listening to patients and families, and in the important role of site visitor at Schools and Colleges of nursing.

REFERENCES:

Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General (U.S. Department of Health and Human Services). /surgeongeneral.gov/library/mentalhealth/cre/ resources.asp

Healthy People 2010. http://www.health.gov/ healthypeople/

NACNEP--National Advisory Council on Nurse Education and Practice (2000). A report to the Secretary of Health and Human Services and Congress: The National Agenda for Nursing Workforce Racial/Ethnic Diversity. HRSA: Washington, DC.

Barbara A. Broome, PhD, RN is Chair of Community Health Nursing and Assistant Dean of the College of Nursing at the University of South Alabama in Mobile, AL.