Introduction
Globalization has become one of the factors that contributed to the emergence of the necessity for culturally sensitive practices in healthcare. The U.S. population has always been diverse, and culture has always played a major part in the process of care delivery. There are about 40 million African-Americans in the United States, who constitute about 12% of the total country’s population, which makes it the most populous ethnic minority in the U.S (Tucker, Moradi, Wall, and Nghiem, 2014). In addition, the African-American population is revealed to have more health issues and health outcomes related to diabetes, and other diseases (Tucker et al., 2014). In light of this, it is paramount to review an article containing valuable insights on cultural sensitivity in nursing professional communication and discuss the practical implications of the identified tactics and strategies as related to the black population.
Article Review
The article under analysis is developed by Tucker et al. (2014). The article reviews the role of care providers’ cultural sensitivity as perceived by African-American patients. The authors’ main goal was to test the refined model of culturally sensitive care developed on the basis of patient-centered care. Care justice was selected as a core aspect of such a model that served the purpose of providing patients with fair treatment. Earlier studies in this area showed excellent adherence of culturally-sensitive practices and models to patients coming from ethnic minorities. After the application of such care delivery methods, health outcomes and patient satisfaction among African-Americans, Latinos, and other groups rose by various degrees. The need for development and updating the existing mechanisms of communication and culture-sensitive care arose from new challenges and needs of the targeted population, such as the perceived low levels of justice and trust to care agents. The new model was aimed to address those concerns through three dimensions, “competence/confidence, sensitivity/impartiality, and respect/communication” (Tucker et al., 2014, p. 283).
The sample consisted of 298 African-American patients from primary care hospitals (Tucker, Marsiske, Rice, Nielson, & Herman, 2011). The participants were selected as a sample based on their successful completion of the Health Care Justice Inventory (HJI), Patient Satisfaction Questionnaire, and Health Care Provider Inventory, also providing their demographics. The dataset for HJI was retrieved from an earlier study that involved a variety of patients in 67 care facilities across the U.S. The analysis of the data through the use of descriptive statistics showed that all three domains revealed positive correlations with trust towards health care providers. All of the measured variables also had a positive correlation with patient satisfaction levels. The researchers conclude that health care providers could benefit significantly from assessing patients from ethnic minorities’ opinions on health care. Such an approach could provide insights on tailoring care in accordance with the trust and impartial needs of the certain patient.
The cultural differences that should be taken into consideration when providing medical assistance include the understanding of trust and impartiality in African-American culture. The trust in health care providers who represent the white majority is a sensitive aspect, as the history of slavery and adverse healthcare experiences of that period are still vividly remembered. According to Murray (2015), the primary attributes of trust were dependence, openness to cooperation, and met expectations. The initial level of trust in a white care provider will be rather significantly dependent on previous experiences. Once trust is gained, however, an increased and constant level of loyalty can be expected. Impartiality is also a factor of significance as the same history of slavery undermines the capacity of certain representatives of the white population to perceive black people as equals, which occasionally forms a negative experience with healthcare providers. Due to that fact, impartiality is often questioned and before demonstrated can be perceived as absent. According to Hansen, Hodgson, and Gitlin, (2016) these topics are highly recurrent in African-American older adults.
Practical Application
As it was suggested by Tucker et al. (2014), assessment of the health care experiences of the patient can be vital for developing trusting relationships for the whole period of admission and beyond. Positive verbal communication can set the patient in a more relaxed mood and prepare him or her for further conversations. It is of utmost significance to fulfill the given promises. For instance, telling a patient that a procedure would take several minutes, make sure that it is so. Otherwise, it could be perceived as a violation of trust and would lead to lower levels of compliance and cooperation. Certain neutrality or negativity in verbal practice from a patient could indicate his or her irritability with previous experience of care reception. In such cases, it could be advisable to politely inquire about such experience in order to identify key issues of significance to a patient that are to be addressed in the first place. Such an intervention should raise the perceived level of trust and compliance.
Cultural sensitivity is also developed in the domain of knowledge of the problems of cultural minorities in relation to their experiences with the health care system. As such, African-Americans often feel underserved or mistreated in hospitals (Hansen et al., 2016). It is in the power of nurses to gain such trust by providing a high quality of assistance. The health care provider should also possess a set of beliefs that allow him or her to embrace cultural differences and exercise respectful and non-neglectful speech practices in relation to all people of all races. If certain aspects of culture or differences stay vague, it is thought best to politely insure the nature of the difference in order to devise an appropriate culturally-sensitive response.
Patient education is also a sensitive area, where maximal caution must be exercised (Attridge, Creamer, Ramsden, Cannings-John, & Hawthorne, 2014). However, maintaining the generally respectful and friendly tone of voice and choice of words should be able to achieve good levels of compliance, provided previous encounters were also successfully managed. The key here is to make sure that the given piece of advice or instruction is non-conflicting with religious, cultural, or other practices to which the patient adheres. If a conflicting situation arises, a polite conversation with a description of benefits and negative consequences of non-compliance needs to be held with the patient (Horvat, Horey, Romios, & Kis-Rigo, 2014). A patient’s family also needs to be notified in either case.
Conclusion
All things considered, cultural sensitivity is a powerful tool that is able to increase patient outcomes, satisfaction, and compliance. The article provided factual data on the significance of trust, impartiality, and respect that African-Americans demonstrate in their health care reception experiences. It seems to motivate nurses on using culturally sensitive conversation practices in order to provide the best care possible and eliminate the possible bias of ethnic minorities towards medical personnel.
References
Attridge, M., Creamer, J., Ramsden, M., Cannings-John, R., & Hawthorne, K. (2014). Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, 4(9), CD006424.
Hansen, B., Hodgson, N., & Gitlin, L. (2016). It is a Matter of Trust. Journal of Applied Gerontology, 35(10), 1058-1076.
Horvat, L., Horey, D., Romios, P., & Kis-Rigo, J. (2014). Cultural competence education for health professionals. Cochrane Database of Systematic Reviews, 5(5), CD009405.
Murray, T. (2015). Trust in African Americans’ healthcare experiences. Nursing Forum, 50(4), 285-292.
Tucker, C., Marsiske, M., Rice, K., Nielson, J., & Herman, K. (2011). Patient-centered culturally sensitive health care: Model testing and refinement. Health Psychology, 30(3), 342-350.
Tucker, C., Moradi, B., Wall, W., & Nghiem, K. (2014). Roles of perceived provider cultural sensitivity and health care justice in African American/black patients’ satisfaction with provider. Journal of Clinical Psychology in Medical Settings, 21(3), 282-290.