African American's tend to in general use some form of alternative health care, whether it is spiritual or herbal in nature. As a nurse trying to incorporate the alternative cultural care with Western health care is a must. Ultimately the nurse's job is to bring about trust and healing from a people group who may still feel oppressed. Nursing care also focuses on education for prevention. Obesity is a big problem among this group; early education may help reduce future problems. The nurse's job is to be a patient advocate for every client; this is especially true in a culture that seeks to build trust.
I found three good articles that are a starting place for research, each has piqued my curiosity.
Campinha-Bacote, J. (2009). A culturally competent model of care for African Americans. Urologic Nursing, 29(1), 49-54. Retrieved from Consumer Health Complete - EBSCOhost database.
This article is all about how nurse's can give competent care to those of the African American culture. It's interesting to think that one healthcare workers bias can lead to unfair treatment of a patient which may lead to misdiagnosis, under-medication, or overmedication. The patient then goes home, voices his concern, and his entire family is turned off to Western medicine. Therefore before going into any clinical situation one must ask themselves if they are aware of their own personal beliefs, and potential biases. It is also imperative for anyone working in a clinical situation to know that a specific culture is more at risk for. For instance the African American people are at a high risk for hypertension. Preventing this early could help reduce consequences like a heart attack. Becoming more culturally competent will ultimately lead to better patient care.
Positives
The article makes a good point in describing what jaundice and pallor may look like in an African American. Teaching for this is usually revolved around what is normal for a Caucasian person. The article gives five great ways to assess. Things to try are asking a family member what is a usual color for the client, using direct sunlight, observing areas with as little pigmentation as possible, palpating the surface, and comparing skin in parallel areas. The article also makes some pretty conclusive points, but with those points come a fact to back up each one. One example would be that African American's in general feel like health care professionals are not trustworthy. 12% of African American's would agree with that statement, while only 1% of Caucasians would. The statistics in this article are alarming and require action on the part of the health care system.
Negatives
The article talks about cultural humility as something you need to have before interacting with a client of a different race. I think a more suitable word would be respect. Having a respect for all cultures but still allowing your own uniqueness shine through in a way that doesn't bring others down. The beauty of nursing to me is that people of different walks of life are coming together to care for each other.
Early on in the article the author states that a person does not need to be culturally competent, but instead working towards that. Later in the article the author makes a point of saying there are just some things that a person needs educationally to build that base before expanding it. This is a well written article, but it does contradict itself some, some clarity would be helpful.
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Sadler, C., & Huff, M. (2007). African-American women: health beliefs, lifestyle, and osteoporosis. Orthopaedic Nursing, 26(2), 96-103. Retrieved from CINAHL Plus with Full Text database.
African American women in general have higher bone density then that of Caucasians. Because of this and other factors little effort has been put into intentionally preventing osteoporosis. Times are beginning to change though, and statistics are starting to say that they are at more risk then we think they are. As healthcare professionals we need to aim at prevention from a culturally relevant angle. Throughout the article the author continually addresses the need for this people group to develop a therapeutic relationship with their healthcare provider. African American's want to know that they can trust their health care provider, and there are numerous tips contained in this article to ascertain this.
Positives:
Recognition is occurring that the role of African American's is changing in America from a very active lifestyle to a more sedentary life, this has a potential to create more health related problems in the future. Knowing this the health care provider knows where to aim teaching at especially in the area of lifestyle changes.
Many African American's simply view illness as a way of life; it is unchangeable and ever present. It is important to break this line of thinking, and instill more primary, secondary, and tertiary interventions.
Negatives:
This article states that what is responsible for delay in seeking care is using folk medicine and religion first. I would disagree and say that it is primarily a lack of knowledge and because of that lack of knowledge this group first turns to the only things they know.
The article offered a lot of great statistics and facts, but no real basis for change. Like nutrition, African American's tend to be less conscious of their body size then Caucasians. That's great to know, but what can I do to change that statistic. As a healthcare professional I would like to know effective strategies for change primarily, and then the facts to back them up secondarily.
Moyad, M., Lusk, W., & Schwartz, L. (2007). Alternative medicine utilization by African Americans and improving life expectancy: Is there a correlation?. Urologic Nursing, 27(5), 449-459. Retrieved from Consumer Health Complete - EBSCOhost database.
As long as life expectancy number has been kept it seems that African American's in general live shorter lives then Caucasians. Currently there is about a five year difference, this could potentially be contributed to a couple things that should be explored. Primarily this maybe because deaths related to diabetes and coronary artery disease are higher among these groups. A lot of the discrepancies are knowledge based. A lack of even basic teaching has been absent among this culture. As future health-care providers our job is to once again instill trust and remove skepticism from thinking.
Positives:
It is interesting that in general African American's do not take more supplements then the average people group. Instead the alternative therapy of choice is that of a spiritual nature like prayer. This is good because it shows that recognition is happening, and that research is being done. With this research then change can start happening and patient teaching can be changed to reflect.
There is a large gap in lifespan, the article provided steps that are being taken to reduce the divide, and increase life expectancy through effective teaching. African American's also tend to be good listeners; it is to the healthcare provider's advantage to use this.
Negatives:
There are some unanswered questions for me in this article. The researchers have several pertinent questions to ask, they are very basic general why questions. There is never really a resolution, which troubles me because I would like to know the best way to fix the problems. The author also brings up that the number of uninsured African American's is high, but there is also never any resolution. I want to know why they are uninsured, and how this translates in to the care that I deliver to patients.
Campinha-Bacote, J. (2009). A culturally competent model of care for African Americans. Urologic Nursing, 29(1), 49-54. Retrieved from Consumer Health Complete - EBSCOhost database.
Giger, J.N. & Davidhizer, R.E. (2008). Transcultural nursing: assessment and intervention. St. Louis, MO: Mosby Elsevier.
Moyad, M., Lusk, W., & Schwartz, L. (2007). Alternative medicine utilization by African Americans and improving life expectancy: Is there a correlation?. Urologic Nursing, 27(5), 449-459. Retrieved from Consumer Health Complete - EBSCOhost database.
Sadler, C., & Huff, M. (2007). African-American women: health beliefs, lifestyle, and osteoporosis. Orthopaedic Nursing, 26(2), 96-103. Retrieved from CINAHL Plus with Full Text database.
Appendix D - Annotated Bibliography
This paper will be submitted electronically. This rubric will be copied and pasted onto a separate page at the end of the Annotated Bibliography.
NAME: Kristen Kalvig DATE: 4/2/10
***WHO Proofed your paper?>>> My mother
Content Item
Excellent
Satisfactory
Unsatisfactory
Points Earned
Directions
10-8.9 Pts -
a. All directions are followed completely.
b. Paper flows well.
c. Critical thinking evident
8.8-7.8 Pts -
a. Some errors or confusing.
b. Little or no Critical Thinking evident.
7.7-0 Pts - Work is incomplete and/or incorrect.
Summary
10-8.9 Pts -
a. Clear description of the people group.
b. Addresses the focus of the articles related to the people group.
8.8-7.8 Pts -
a. Description of the people group is vague, lacks depth.
b. Focus of the annotated bibliography is unclear.
7.7-0 Pts - Work is incomplete and/or incorrect.
5 Articles Reviewed
20-17 Pts -
a. Clear description of the article.
b. 2+2 is thoughtful and clear.
c. Articles are connected to the stated purpose in the summary.
16.9-15.5 Pts -
a. Description of the article is vague, lacks depth.
b. Connection of the article to the annotated bibliography is unclear.
c. Article does not meet criteria
15.4-0 Pts - Work is incomplete and/or incorrect.
Grammar and APA
10-8.9 Pts Includes:
a. 1-3 grammar errors - or -
b. 1-3 spelling errors - or -
c. 1-3 APA errors
d. Professional deliverable
e. Proofed per name listed above.
8.8-7.8 Pts Includes:
a. >3 grammar errors - or -
b. >3 spelling errors - or -
c. >3 APA errors
d. Marginally professional deliverable
7.7-0 Pts Multiple errors.
Total
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