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Communication within a health context
Cultural consideration in health care
Cultural consideration in health care
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Prostate cancer is a leading cause of mortality and medical expense in men age forty and above. However, it has only recently become a topic of conversation to men in America (Plowden, 2009). African-American men are affected by prostate cancer at a disproportionate level over all other men. They are diagnosed up to 65% more frequently and the mortality rate is twice that of their Caucasian counterparts (Emerson, 2009). So why is the African-American male less likely to take advantage of prostate cancer screenings even when it is free (Oliver, 2007)?
Current state of the science
Today, prostate cancer is usually detected through screening, and there are two methods for early detection. The prostate-specific antigen test (PSA) is used, but there are many factors that can influence the outcome of the PSA test. Medications such as antihistamines, physical exertion or recent ejaculation can raise a PSA level (Gray, 2009). The test itself was intended for staging the presence of known prostate cancer and is less reliable when used alone (Oliver, 2007).
Another test for early detection of prostate cancer has been the digital rectal exam (DRE). Although DRE is a better method for early detection, it is also a hindrance among men, particularly African-American men, to screening and early detection (Plowden, 2009). According to American Cancer Society (ACS) and American Urological Association (AUA), the PSA and DRE should be offered annually for all men beginning at age 50 (Gray, 2009). However, they also recommend that African-American men with a family history of prostate cancer should begin testing by age 45 (Plowden, 2009). However, due to the cultural barriers to prostate screening such as lack of understanding, traditions, mist...
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...efits of early detection versus late discovery; provide easy access to screening and the follow-up phase of the intervention; and maintain confidentiality. Peer group discussions with professionals have shown to aid in getting better compliance (Plowden, 2009).
Conclusion
The African-American males’ decision making process when considering prostate cancer screening is influenced greatly by cultural mores and beliefs. These cultural beliefs often lead to a lower rate of compliance to free screening versus all other races i.e. Caucasians, etc. Leisiniger’s cultural diversity theory can be used to effectively educate and increase compliance by teaching practitioners ways to overcome these cultural barriers. By following the concepts of care, caring, and understanding feelings of self, as well as the feelings of others, it is possible to overcome cultural barriers.
Cancer is one of the 9 National Health Priority Areas (NHPA), areas which account for a significant portion of the burden of disease, but have sizeable potential for improvement. In Australia, CRC is the second most common cancer, after prostate (in men) and breast cancer (in women) (AIHW, Cancer incidence projections). The incidence has gradually increased (by 13% in males from 1982-2007) (AIHW, Cancer in Australia an overview). This is compounded by the ageing population and population growth, with 14,860 new cases in 2010 (http://www.cancer.org.au/about-cancer/types-of-cancer/bowel-cancer). This graph demonstrates this upward trend ((AIHW, Cancer incidence projections):
The absence of cultural competency in some health care providers, lack of community perspective integration in health care facilities, and low quality health care received by women in developing countries.These are the three most pressing health care concerns that need to be addressed in our ever changing world. The first of the issues I’ll be discussing is the lack of cultural competency amongst health care providers, as well as the shortage of education and training in cultural competency. As we all know and see the United States is a racially and ethnically diverse nation which means our health care providers need to be equipped with the necessary education and training to be able to provide for diverse populations. As an East African
In conclusion, It it is very necessary that our health care officials try harder to gain trust with minorities so that medicine can be focused more on equality. We all know that for decades our country was very diverse and everyone was treated differently. Although things have changed and it is sometimes important to preserve our past, past actions should not still be carried out. Even today, racism still occurs and it hard for minorities to feel safe when visiting hospitals and doctor’s offices. Minorities should be given equal medical opportunities, be given the honest truth on their diagnosis and treatments and most importantly be given some sort of health care so they can be treated.
... cultural barriers to care. Journal of General Internal Medicine, 18(1), 44-52. Retrieved from http://proxy.samuelmerritt.edu:2106/pmc/articles/PMC1494812/
Colorectal cancer, or CRC, affects African American men and women more than Caucasians, at a rate 20% higher. This is concerning when faced with the mortality rates among African Americans, 28% higher for women and 14% higher for men than for Whites. African Americans are also more likely to be in later stages of the disease when diagnosed. There is a need to study and evaluate why these factors exist, as proper screening and early diagnosis can severely impact survival rates for CRC. One study attempts to find the solution through testing, however, this study slightly discredits itself along the way.
As the author highlighted in this book, the quickest way to be diagnosed for prostate cancer is to be screened for it; the same notion applies for many other diseases and illness. With the advent of the technological age, doctors are now able to see more than they did before, and therefore, are more quick to diagnose illnesses and cancers early. As Welch explains, the problem with that is that not all illness or cancers will kill you; some cancers will stick around, but never cause any harm. So, this leads to screening for cancers that were never going to kill a patient, that end up being detected early on and dealt with, thus giving credit to early screening as a success story. As Welch explains, most illnesses and injuries that undertake a natural course of events, without medical intervention, usually heal on their own. This is problematic because it creates this idea that medical intervention is helpful and necessary, when that is not always the case. In general, as a society, the benefits of medical care have been over-exaggerated, while the harms of medical care have been largely ignored. If Welchs’ instructions were followed, a closer examination of the effect of screenings and tests would be the new medical
Due to the persistent ethnic or racial healthcare disparities in the United States, the utilization and access to quality healthcare services are crucial to exploring distinctions in the perception of the patient’s healthcare quality across the ethnically diverse population. In this research, the role of race and acculturation in the perceptions of the patients of healthcare quality was critically analyzed to determine the role of race in the provision of quality health care (Pai & Chary,
The United States’ population is currently rising exponentially and with growth comes demographic shifts. Some of the demographics shifts include the population growth of Hispanics, increase in senior citizens especially minority elderly, increase in number of residents who do not speak English, increase in foreign-born residents, population trends of people from different sexual orientation, and trends of people with disabilities (Perez & Luquis, 2009). As a public health practitioner, the only way to effectively eliminate health disparities among Americans, one must explore and embrace the demographic shifts of the United States population because differences exist among ethnic groups (Perez, 2009). We must be cognizant of the adverse health conditions for each population and the types of socioeconomic factors that affect them. Culture helps shape an individual’s health related beliefs, values, and behaviors. It is more than ethnicity and race; culture involves economic, political, religious, psychological, and biological aspects (Kleinman & Benson, 2006). All of these conditions take on an emotional tone and moral meaning for participants (Kleinman & Benson, 2006). As a health professional, it is one’s duty to have adequate knowledge and awareness of various cultures to effectively promote health behavior change. Cultural and linguistic competencies through cultural humility are two important aspects of working in the field of public health. Cultural competency is having a sense of understanding and respect for different cultural groups, while linguistic competency is the complete awareness of the language barriers that impact the health of individuals. These concepts are used to then work effectively work with various pop...
Healthcare disparities are when there are inequalities or differences of the conditions of health and the quality of care that is received among specific groups of people such as African Americans, Caucasians, Asians, or Hispanics. Not only does it occur between racial and ethnic groups, health disparities can happen between males and females as well. Minorities have the worst healthcare outcomes, higher death rates, and are more prone to terminal diseases. For African American men and women, some of the most common health disparities are diabetes, cancer, hypertension, cardiovascular disease, and HIV infections. Some factors that can contribute to disparities are healthcare access, transportation, specialist referrals, and non-effective communication with patients. There is also much racism that still occurs today, which can be another reason African Americans may be mistreated with their healthcare. “Although both black and white patients tended not to endorse the existence of racism in the medical system, African Americans patients were more likely to perceive racism” (Laveist, Nickerson, Bowie, 2000). Over the years, the health care system has made improvements but some Americans, such as African Americans, are still being treating unequally when wanting the same care they desire as everyone else.
Planning and implementing a breast screening event in a predominantly African American community is one way the ARPNs are able to address disparities in preventative care. The event needs to be publicized at local social centers, parishes and other religious establishments. APRNs should collaborate with local health care providers in order to ensure follow up care is available to address any clinical findings.
The diversity among the U.S. population is very large and continue to grow, especially the Hispanic group. More so, health promotion can be defined or perceived in many ways depends on the minority group and their culture beliefs. As health care provider, recognizing and providing cultural competent is very important. In addition, assessing the health disparities among the minority group and teaching them how to promote good health will benefit along the way. Furthermore, health care providers have the role to promote good health but without proper education and acknowledge cultural awareness will be impossible to accomplish.
An individual’s culture and belief may significantly impact the type of services they require. In addition, it may affect the time, place, and method in the delivery of health care
Cultural competence like so many other social constructs has been defined in various ways. One particular definition as determined by the Office of Minority Health states cultural competence is a set of behaviors, attitudes, and policies that are systematically exercised by health care professionals which enables the ability to effectively work among and within cross-cultural situations (Harris, 2010). Betancourt (2005) implied cultural competence is starting to be seen as a real strategy to help with improving healthcare quality and eliminating the injustices pertaining to healthcare delivery and healthcare access. This appeal is gaining favor from healthcare policy makers, providers, insurers and
The program would target African American women because despite lower breast cancer incidence, they typically experience increased mortality as compared to Caucasian women. This can be attributed to African American women’s lower rates of mammography screening and tendency for later stage diagnosis. Breast cancer screening rates are also lower amongst women in rural areas, women of lower socioeconomic status, and women without health insurance coverage. The program would implement the utilization of lay health advisors (LHAs) to promote breast cancer screenings which is evidence-based and research tested. The LHAs will conduct culturally-appropriate small group educational sessions (10-15 women) and promote the program at intercept sites (i.e. grocery store, shopping center, etc.). A small media campaign will be simultaneously implemented, emphasizing the importance of screening and the availability of no-cost services for eligible women. The program will reduce access barriers by contracting with local partners (mobile detection unit) and evaluated by tracking and documenting the number of targeted women reached through education and outreach efforts, their change in knowledge (pre/post test) after exposure to the educational session, and the number of eligible women who take
As with breast cancer, regular self-examination is recommended for early detection of testicular cancer. The most common sign of testicular cancer is a lump or swelling. Additionally, there may be pain, and the sudden build-up of fluid in the scrotum. Health history must also be taken into account, as those who have had and undescended testicle or abnormal development of testicles will be at a higher risk for the disease. Any personal or family history, especially a father or brother who have had testicular cancer, will also increase your risk. Demographically, cancer can strike at any age, it is most