Culturally competent care is the newest trend in modern nursing. Medicine, as a holistic science, recognizes the individual cultural uniqueness of every patient in order to deliver a better quality of care. According to Jeffreys (2015), paying attention towards a patient’s culture, race, and background, as well as choosing the method of communication best suited to address their needs helps establish rapport and trust between the patient and the medical personnel, thus leading to better health outcomes. American nursing, as it stands, is largely concerned with its major population groups, such as European-Americans, African-Americans, and Latino-Americans.
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The needs of smaller populations, such as Asian-Americans, are often neglected, however (Holland, 2018). Asian culture and traditions, though similar to western perceptions in some regards, also have significant differences revolving around the concept of saving face, respect, and not wanting to waste a physician’s time (Ring, Nyquist, & Mitchell, 2016). The language also plays a very important role, especially for citizens yet to be naturalized into American culture. This brings about a unique set of challenges for the existing healthcare system. The purpose of this paper is to analyze an article dedicated to a culturally tailored intervention for Asian-American breast cancer survivors, written by Chee et al. and published in the Journal of Telemedicine and Telecare in 2017.
The abstract section of the paper provides an overview of the study, enabling quick understanding of key information present in it. It covers the introduction, methods, results, and discussion sections of the article. Important statistical information is cited in this section as well. The author also provides a set of keywords which could be used by search engines in order to locate the article during searching operations. The chosen keywords are as follows: Web-based intervention, online intervention, issues, nursing.
Chee et al. (2017) state that Asian-American cancer survivors enjoy a significantly lower standard of quality of support and medical care when compared to the titular white population. According to the author, internet cancer support groups (ICSG) play a significant role in helping cancer survivors through the recovery process by sharing experiences, techniques, and providing social and moral support. Asian-Americans are reported to be less receptive to these kinds of interventions due to the fact the majority of the existing ICSGs are geared towards Whites and not Asians, Hispanics, Blacks, or any other minorities. As a result, Asian-American patients rarely complain about pain, do not seek out social support, and delay requesting medical help, which serves as a detriment to their health (Chee et al. 2017).
Aims and Purposes of the Study
The article seeks to enrich the available body of knowledge by providing the information about how Asian-American breast cancer survivors perceive dedicated and culturally competent ICSG. It has two main purposes, which are as follows:
- Evaluate the quality of an Asian-American-focused ICSG through various quantitative and qualitative means. These include usability tests, expert reviews, interviews, and checklists.
- Determine the efficacy of a dedicated ICSG A-A at improving patient outcomes, decreasing morbidity, and reducing the number of preventable deaths among Asian-American breast cancer survivors.
The design of the study was based on the comprehensive program theory, which stresses out the importance of racial and ethnic-specific healthcare factors, language barriers, and integration of existing evidence-based practices into the process (Chee et al., 2017). The study was performed in two stages, with the first stage covering the usability tests and the expert reviews of the newly created ICSG site, and the second stage involving a randomized controlled trial. The research continued from January 2014 to November 2015.
Review of Literature
The article provides literature support for the chosen intervention and the components included in it. Namely, the ICSG A-A targeted the patients based on three factors, those being language, sub-ethnicity, and the country of birth. It provided support in several categories, such as emotional support, informational assistance, and educational help. These are the three core aspects of influencing the effectiveness of a support group. The site’s interface was optimized for four languages: English, Chinese Mandarin, Korean, and Japanese. These languages are used by the vast majority of Asian minorities in the USA, thus effectively covering the needs of most, if not all, breast cancer survivor patients. A group of 5-10 dedicated users provided color preferences, functionality and usability of the site, and overall impressions.
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The sample for the randomized controlled trial included 65 Asian-American breast cancer survivors aged 21 or older, who had been diagnosed with breast cancer in the past 5 years, and who could read and write in English, Japanese, Korean, or Chinese Mandarin. All relevant data were collected using the Personal Resource questionnaire, the Supportive Care Needs survey, and several other forms. The patients were asked to pass the tests before and after the intervention. The efficacy of the ICSG A-A was measured based on these results.
According to Chee et al. (2017), all participants approved of the program and the tools it offered to breast cancer survivor patients. The overall positive outlook was compatible with previous literature findings. The researchers expected a negative change in healthcare and support needs. However, it was discovered that the test group’s needs did not change throughout the course of the intervention. At the same time, the control group’s healthcare needs gradually increased over time.
Implications for Nursing Practice
While the information about the effectiveness of culturally competent internet support groups in the literature was rather inconsistent, the intervention managed to either reduce healthcare and support needs of breast cancer survivors or keep them at marginally the same level (Chee et al., 2017). At the same time, patients with conventional support groups to rely upon often feel alienated, which exacerbates the problem and forces a gradual increase in physical and psychological help over time. It is implied that ethnically dedicated ICSG sites can be used as means of facilitating long-term physical and emotional stability and aid with the ongoing recovery efforts.
The article supports the use of cultural competence in the creation and maintenance of ICSG A-A platforms for breast cancer survivors. The existence of such initiatives helps promote participation in personal and community healthcare from Asian-Americans. The perceived level of anonymity plays well into the Asian traditions of saving face and maintaining a respectful visage. The effectiveness of the proposed intervention is evidenced by quantitative data and subsequent literature research. ICSG groups either reduce the need for additional healthcare interventions or keep the patients at a manageable level, preventing the existing issues from getting worse. The variability of results is likely associated with individual perceptions and characteristics of different patients. Thus, culturally competent care is associated with better results for Asian-American breast cancer survivor patients.
Chee, W., Lee, Y., Im, E. O., Chee, E., Tsai, H. M., Nishigaki, … Mao, J. J. (2017). A culturally tailored Internet cancer support group for Asian American breast cancer survivors: A randomized controlled pilot intervention study. Journal of Telemedicine and Telecare, 23(6), 618-626.
Holland, C. (2018). Cultural awareness in nursing and healthcare: An introductory text (3rd ed.). New York, NY: Taylor & Francis.
Jeffreys, M. R. (2015). Teaching cultural competence in nursing and healthcare: Inquiry, action, and innovation. New York, NY: Springer.
Ring, J., Nyquist, J., & Mitchell, S. (2016). Curriculum for culturally responsive health care: The step-by-step guide for cultural competence training. New York, NY: CRC Press.