Mental disorders and syndromes found among Asians residing in the United States

The Asian population in the United States is the fastest growing minority; consequently it behooves psychiatric nurses and other mental health professionals to be aware of symptom presentation of emotional problems that may differ from those of other population groups. Specific syndromes, psychiatric disorders, and symptoms that commonly present as physical disorders are discussed. Recommended adaptations of psychiatric interventions, including medications and other therapies, are offered to enable mental health professionals to provide culturally sensitive care. Mental health care that is culturally competent may improve access to care for Asians residing in the United States.     

Developing local public health capacity in cultural competency: a case study with Haitians in a rural community

With the increase in cultural diversity in all regions of the United States, public health employees and other health care providers are more challenged than ever before to provide culturally sensitive care to citizens from an increasing range of cultures. Building on their existing experience and skill, health care staff must expand their competencies to address this changing diversity in their communities. This project serves as a case study of how 1 small rural health department in Delaware created a Web site using Purnell's model for cultural competence (Purnell & Paulanka, 2003) as the organizational framework and rose to the challenge of assisting public health staff to provide culturally sensitive health services to a rapidly increasing population of Haitian immigrants.     

A growing challenge: patient education in a diverse America.

Patient education is a vital part of nursing practice, but the inability to provide consistent culturally sensitive patient care to minority populations has most certainly contributed to disparities in health and healthcare. This article explores minority populations in the United States and their characteristics in relation to health and healthcare, popular cultural competence theories, and nursing school curricula, and discusses teaching strategies for developing more culturally competent nursing professionals.     

Barriers to Mental Health Care Access in an African American Population

Emphasis has been placed on understanding the mental health disparities that exist within minority populations in the United States. Disparities are of particular importance when examining access to services. This paper reports findings from a NINR-funded qualitative study that examined the barriers to mental health care service use in an African American low-income population. Barriers were identified at three levels--Individual, Environmental, and Institutional. Fourteen barrier categories were identified within those levels with three categories common to the majority of participants. The identified categories provide insight into the process of seeking services within this population and provide direction for future investigation.     

Barriers to mental health care access in an African American population

Emphasis has been placed on understanding the mental health disparities that exist within minority populations in the United States. Disparities are of particular importance when examining access to services. This paper reports findings from a NINR-funded qualitative study that examined the barriers to mental health care service use in an African American low-income population. Barriers were identified at three levels--Individual, Environmental, and Institutional. Fourteen barrier categories were identified within those levels with three categories common to the majority of participants. The identified categories provide insight into the process of seeking services within this population and provide direction for future investigation.     

Health beliefs, practice, and priorities for health care of Arab Muslims in the United States.

The Arab Muslim population is one of the dramatically increasing minorities in the United States. In addition to other factors, religion and cultural background influence individuals' beliefs, behaviors, and attitudes toward health and illness. The author describes health beliefs and practices of the Arab Muslim population in the United States. That population is at an increased risk for several diseases and faces many barriers to accessing the American health care system. Some barriers, such as modesty, gender preference in healthcare providers, and illness causation misconceptions, arise out of their cultural beliefs and practices. Other barriers are related to the complexity of the health care system and the lack of culturally competent services within it. Nurses need to be aware of these religious and cultural factors to provide culturally competent health promotion services for this population. Nurses also need to integrate Islamic teachings into their interventions to provide appropriate care and to motivate healthy behaviors.     

End-of-life care for ethnic minority groups

Death and dying are profound events that bring into focus important ethical and medical questions for all patients, whatever their cultural background. For ethnic minority groups and their families, specific issues or barriers may arise related to culturally appropriate health care practices, cultural or religious differences, diverse health beliefs, and access to services for care and support during end-of-life conditions. National policy and local initiatives in both the United States and the United Kingdom support the development of services that address the care of ethnic minorities. This article examines end-of-life care for ethnic minority groups.     

Factors influencing the access to prenatal care by Hispanic pregnant women

PURPOSE: To explore factors influencing the access to prenatal care among Hispanic pregnant women living in the United States. DATA SOURCES: A convenience sample of 46 Hispanic migrant pregnant women was interviewed over a 12-month period using a set of five open-ended questions. CONCLUSIONS: The ability of the health care providers to communicate in Spanish, as well as the availability of culturally sensitive prenatal care were the main factors influencing the willingness of Hispanic women to access to prenatal care. IMPLICATIONS FOR PRACTICE: With the Hispanic population increasing in the United States, there is a need to provide culturally appropriate health care for that population; prenatal care is one of the areas of health care in demand. This study supports the findings in the literature and provides nurse practitioners a deeper understanding of the needs of Hispanic women needing prenatal care.     

Teaching Culturally Appropriate Care: A Review of Educational Models and Methods

The disparities in health care and health outcomes between the majority population and cultural and racial minorities in the United States are a problem that likely is influenced by the lack of culturally competent care. Emergency medicine and other primary-care specialties remain on the front lines of this struggle because of the nature of their open-door practice. To provide culturally appropriate care, health care providers must recognize the factors impeding cultural awareness, seek to understand the biases and traditions in medical education potentially fueling this phenomenon, and create a health care community that is open to individuals' otherness, thus leading to better communication of ideas and information between patients and their health care providers. This article highlights the rationale for and current problems in teaching cultural competency and examines several different models implemented to teach and promote cultural competency along the continuum of emergency medicine learners. However, the literature addressing the true efficacy of such programs in leading to long-lasting change and improvement in minority patients' clinical outcomes remains insufficient.     

African American consumers: What should we know to meet their mental health needs?

National health care organizations have placed greater emphasis on meeting the mental care needs of minority clients in the United States. Disparities in mental health care use among various populations have been clearly demonstrated. This article discusses what is known about mental health care use among African Americans and the need for new knowledge to address current and future needs. Strategies for examining and addressing mental health disparities in this population are addressed, and implications for nurse clinicians and researchers are presented. (J Am Psychiatr Nurses Assoc [2002], 8, 188-93.)     

Cultural perspectives on nursing in the 21st century.

By the year 2000, more than one fourth of the US population will consist of individuals from culturally diverse groups. Increasing numbers of international visitors and exchange students will use the US health care delivery system, and US nurses will engage in international interchanges with increasing frequency. To keep pace with these population and health care trends, US nurses will need to base their nursing care on a theoretically sound foundation that draws on knowledge from the physical, natural, and behavioral sciences, as well as on research-based theories from transcultural, cross-cultural, and international nursing. The purposes of this article are to (1) trace past, present, and future population trends among minority groups in the United States; (2) examine the ways in which transcultural nursing has provided a framework for meeting the health care needs of culturally diverse people; (3) identify current issues and trends in transcultural nursing; and (4) suggest ways in which nurses can prepare for the increasing numbers of culturally diverse individuals who are projected to need nursing care in the future.     

Service gaps related to culturally appropriate mental health care for African immigrants

The population of overseas‐born Australians continues to grow including the recent increase of immigrants and refugees from African countries. Due to this increase, healthcare services need to assess if current available services are culturally appropriate for African immigrant inpatients . This qualitative study, with a quality improvement focus, examined current services to identify key service gaps and consider recommendation to improve care of African immigrant mental health inpatients in the hospital from the point of view of staff working within the organisation. What was revealed is that services currently offered to African mental health inpatients were culturally inappropriate. Emerging themes included inadequate interpreter services, lack of cultural awareness staff training, lack of organisation link with other services, unmet spiritual needs, use of staff/families as interpreters, culturally inappropriate information, and lack of or inadequate culturally appropriate policies and framework. Changes to current practices are recommended to provide culturally appropriate mental health care to African inpatients.     

Israeli families immigration and intercultural issues: challenges to mental health counselors

Israeli families who immigrate to the United States present certain sociocultural issues that need to be recognized in order to provide culturally relevant, respectful and empowering mental health counseling. Israeli families are further situated within the complex social, cultural, economic and political context of Jews in the United States, who are themselves rarely recognized as a minority group. The purpose of this article is to present some major themes observed in working with Israeli families. A brief case example and analysis are presented, along with some general guidelines for counselors working with Israeli families.     

Cultural sensitivity and day care workers. Examination of a worksite based cardiovascular disease prevention project.

Reaching workers in small worksites presents economic and access barriers for occupational health nurses. Some barriers can be overcome through strategies based on cultural sensitivity. Day care centers employ young, low income, mostly minority women in settings with few workers onsite at any one center. These settings were used to develop a culturally sensitive approach tested through onsite cardiovascular screening, informal interviews, and discussion of behavior change for better health. The study examined both the impact of the Healthier People Health Risk Appraisal (HPHRA) as a culturally appropriate recruitment strategy to involve a group of child day care workers in a cardiovascular disease (CVD) screening and risk reduction program and the effect of that program on observable CVD measures. Faculty and students from an institution of higher education forged a trust relationship with day care providers at nine day care centers in a large metropolitan area. Cardiovascular health was the impetus for the project because minority populations in the southeastern United States have high heart attack and stroke mortality and morbidity rates. Participation rates in the project increased from 26% of the day care workers in the first year of the project to 73% when long term relationships were built on culturally appropriate strategies. The project's culturally sensitive educational intervention focused on individual risks and lifestyle. Statistical analysis of outcomes of the intervention and personal interviews demonstrated the improvement of cardiovascular status in the day care workers. This psychosocial approach can provide the foundation for culturally sensitive care in larger occupational and community settings.     

Occupational health nursing with Navajo workers. Providing culturally competent care.

1. Native Americans in the southwestern United States are considered a "vulnerable population." Native Americans have economic difficulties, poor health, and little access to health care. The Navajo nation is the largest Native American reservation in the United States. 2. Occupational health nurses who provide culturally competent care increase the likelihood for Navajo workers to obtain optimal benefits from workplace health services. 3. The nurse uses cultural assessment skills and critical thinking abilities to maximize therapeutic interactions and minimize barriers in communications with workers of other cultural backgrounds. 4. The nurse who is knowledgeable about the Navajo way can help achieve a balance between the traditional ways and Western ways of addressing serious health care issues facing the Navajo worker. This knowledge and cultural awareness also increases the effectiveness of health promotion and health education programs offered to workers, their families, and their communities.     

A review of the literature about depression in late life among Hispanics in the United States

Depression is a common psychiatric disorder with devastating effects on the older Hispanic population. This review synthesizes the research on depression among older Hispanics in the United States to educate and provide direction for further research and practice. A literature search of PubMed, CINAHL, and PsycINFO databases was conducted. Article titles, abstracts, and texts of articles were scanned for those that met the inclusion criteria for this review. Inclusion criteria included the following: research studies published between 2000 and 2012; studies published in the English language; studies about depression that included older Hispanics (50 years old and older) who resided in the United States; and studies about depression, acculturation, and other associated stressors that may contribute to depression in this population. The results of this review indicate that acculturation, associated stressors, health-related factors, and psychosocial factors may have a negative impact on older Hispanics' mental health. More research is needed to further explore Hispanics' perceptions and experiences of depression as well as the cultural dimensions of Hispanic depression. The cultural formulation can be a useful framework for assessment, prevention, and treatment of older Hispanics with depression. Knowledge regarding depression and what causes it can lead to better assessment practices, early detection, and culturally sensitive interventions, care and services.     

An innovative approach for affirming cultural diversity among baccalaureate nursing students and faculty

"Cultural Diversity" has become the buzz word of the nineties. The United States has become the most culturally diverse nation in the world. Since there is no arena where cultural diversity is more critical than health care, it is imperative that nursing students and faculty become comfortable with the issues surrounding the delivery of culturally competent care. The University of Southern Mississippi has developed an innovative program with a dual purpose: (a) to provide an environment of mutual understanding and respect for people of different cultures; and (b) to provide a comfortable environment where minority students can be valued and nurtured.     

Health issues of children in foster care

Community health nurses provide care to children in foster care. Nurses who understand the health needs of the foster care population are better prepared to assess health status, provide appropriate services and evaluate the care. The health needs of these children are related to the reason for their placement in foster care, the lack of continuity of caregivers, and the health care systems available. The health issues are especially acute in the United States where the number of children in foster care has reached over 500,000. (Leslie et al., 2000) The health issues include chronic physical problems, developmental delays, and especially, mental health issues.     

Use of Community Health Workers in Research With Ethnic Minority Women

PURPOSE: To explore roles and effectiveness of community health workers in research with ethnic minority women in the United States (US). METHODS: Medline (1966-2002) and CINAHL (Cumulative Index to Nursing and Allied Health Literature; 1982-2002) databases were used to locate published research studies on the use of community health workers with ethnic minority women in the US. Key words for searches were community health workers, community health aides, health promoters, and community workers. RESULTS: An integrative analysis of 24 studies showed that, despite varying roles and functions, evidence indicates that community health workers are effective in increasing access to health services, increasing knowledge, and promoting behavior change among ethnic minority women. Other advantages of using community health workers are to provide social support and culturally competent, cost-effective care. Recommendations for future directions of research with community health workers and ethnic minority women include improved conceptualization of the community health worker role, theoretical frameworks for research designs, enhanced methods for evaluating effectiveness, and increased community involvement.     

Reducing health disparities by improving quality of care: lessons learned from culturally diverse women

Disparities in health care for culturally diverse populations in the United States lead to poorer health outcomes. This article focuses on decreasing health disparities by improving the quality of care for culturally diverse women. Findings from 3 pilot studies are organized using Fongwa's Quality of Care Model, which demonstrate specific modifications suggested by culturally diverse women that can potentially improve health care services for these women.