What has the literature taught us about culturally competent care of women and children

This article describes what is currently in the literature about culturally competent care for women and children. With the population of the United States growing increasingly diverse, there is a developing need for cultural competency among nurses and throughout healthcare organizations. Cultural competence includes both culture-specific and culture-generic knowledge, attitudes, and skills. While databased literature on cultural competency still requires further development, we do have evidence of positive outcomes of culturally competent care. The end result of the provision of culturally competent care by culturally competent nurses and healthcare organizations can be significant improvements in the health and well-being of women and children.     

A Glance at the Future of Cultural Competency in Healthcare

Cultural competency was first articulated in the 1980s to address the issues of discrimination and disparities in the provision of healthcare services. Since then, countless efforts have been made to educate and train a culturally competent healthcare task force. As the current US government unveils its healthcare reform, one might wonder what will be the future of the cultural competency in health care. The question is even more pertinent if the upcoming demographic shift of the US population is added to the picture. The most recent data from the Census Bureau stated that Asians and Hispanics are the fastest-growing ethnic groups in the US population.¹ Therefore the majority of the patients receiving primary and preventive care under the changes with the Affordable Care Act will be among today’s minority groups. So more than ever before, time needs to be spent on analysis and discussion of how these important changes will shape the quality of care that ought to be culturally sensitive as an aspect of delivery of excellent care.     

Cultural Competency in Baccalaureate US Nursing Education: Hybrid Course

The ability to appropriately care for diverse populations is an expected competency of the graduated Bachelor of Science in Nursing (BSN). To provide effective materials to ensure this competency is met, the American Association of Colleges of Nursing developed the Toolkit of Resources for Cultural Competent Education for Baccalaureate Nurses. The toolkit provides information on cultural competency models and teaching strategies nurse educators can use to facilitate student learning in cultural sensitivity and competency. This article demonstrates how one model in particular, Campinha-Bacote's Model of Cultural Competence, was utilized for 15 weeks in an undergraduate BSN nursing course for a student population in an urban school of nursing to effectively provide students with the skill set needed to give culturally competent care. This article will provide the methods and strategies used to teach cultural competency as based on Campinha-Bactote's Model in an undergraduate nursing course.     

Cultural competence: assessment and education resources for home care and hospice clinicians

Home healthcare and hospice clinicians face many challenges in the complex healthcare system caring for patients and their families in the home environment. One of those challenges is providing culturally competent care for an increasingly diverse population. This article will highlight free, easily accessible, online resources to assist clinicians and organizations to assess organizational and individual cultural competence and provide many resources for cultural competency education programs.     

Culture diversity/a mobile workforce command creative leadership, new partnerships, and innovative approaches to integration

Today's healthcare environment requires that nursing leaders meet the needs of a growing multicultural workforce and patient population. Cultural factors may be overlooked as healthcare delivery becomes increasingly dominated by technological, economic, and social changes. Through creative leadership, the chief nurse executive (CNE) can encourage staff to pay closer attention to cultural factors that will impact on patient, staff, and hospital outcomes. The CNE can begin by enhancing his/her own multicultural competency, building these competencies in his/her staff, and then empowering staff to respect and accommodate cultural differences. An understanding to transcultural nursing theory can enhance the development and maintenance of a multicultural perspective. The use of Madeline Leininger's Culture Care modalities can assist staff in making culturally competent decisions and in implementing actions. This article will provide an overview of one community hospital's experiences in integrating a multicultural perspective to better meet the needs of specific patient populations.     

Cultural awareness: bridging the gap between caregivers and Hispanic patients

The healthcare environment is undergoing rapid change. Healthcare settings have shifted from acute care to encompass a variety of other locations. The healthcare work force is changing from a common ethnic origin to include a multitude of ethnic and racial groups. The patient population also embraces a plethora of different cultural backgrounds. By the year 2080, an estimated 51.1% of the population will be composed mostly of Hispanics, followed by African Americans and Asians. This dynamic transformation has created a critical need for nurses to become more knowledgeable and culturally aware to care for and work with people of other cultures. This article attempts to sensitize nurses to the important roles culture and ethnicity play in the delivery of optimal nursing care. The domain of intercultural communication and its importance in providing culturally competent, patient-relevant care is discussed.     

Continuing the cultural competency journey through exploration of knowledge, attitudes, and skills with advanced practice psychiatric nursing students: an exemplar

Numerous training and education programs have evolved to address culturally competent health care delivery. This article describes an exemplar educational approach used to teach cultural competency to beginning graduate psychiatric mental health nursing students. Using interactive strategies delivered within the 4 phases of the curriculum, the approach has been shown to facilitate students' ongoing journey to cultural competence. Building on baccalaureate nursing competencies, the course addresses attitudes, knowledge, skills, and cultural humility to strengthen cultural self-assessment, cross-cultural clinical practice expertise, and the use of culturally appropriate research for graduate students.     

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.     

Nurse practitioners' contributions to cultural competence in primary care settings

PURPOSE: To document unique ways Nurse Practitioners (NPs) contribute to the delivery of culturally competent healthcare to diverse and underserved patient populations in urban primary care practices. DaTA SOURCES: Data are from a multi-year, multi-site study and includes 50 intensive interviews with healthcare professionals and repeated observations at three urban primary health clinics in a Northeastern U.S. city. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Different healthcare professionals reported common perspectives on cultural competence dealing with distinctive patient communities, including altruistic motivations, advocacy, and addressing root causes while treating diverse patients. What made NPs distinct among healthcare workers in this study was the comprehensiveness of their cultural competence approaches, both in patient interactions and within healthcare teams. NPs established culturally sensitive partnerships with patients, encouraged self-advocacy, addressed contextual considerations, and adjusted practices to meet the patient needs. They also developed niches in multidisciplinary teams that emphasized holistic approaches to establish trust and to cross cultural boundaries, both with other health professionals and their diverse patients.     

Adolescent Homosexuality and Culturally Competent Nursing

Nursing is striving for cultural competency. Cultural competency includes the ability to deliver care to disenfranchised and marginalized people. The adolescent gay, lesbian, or bisexual person is at risk for violence, disease, harassment, and problems with identity development. Ethnic/minority youth who are also gay, lesbian, and bisexual suffer from prejudice and disenfranchisement within their ethnic community as well as in the dominant white culture. Healthcare workers exhibit homophobia and heterosexism in the delivery of care to patients. Nursing needs to evaluate its own values and prejudices and incorporate sexual orientation into culturally valid tools of assessment to provide competent care.     

Community transformation through culturally competent nursing leadership: application of theory of culture care diversity and universality and tri-dimensional leader effectiveness model.

Transcultural knowledge and competency have become a critical need for nurses to accommodate the global trends in cultural diversity and health care disparities. Today, nurses are increasingly taking on leadership roles in community settings. This article addresses the application of Leininger's culture care theory with the sunrise model and Hersey and Blanchard's tri-dimensional leader effectiveness model as potential collaborating theories for capacity building and community transformation from a global, transcultural nursing perspective. The two theories, used in collaboration, view the provision of competent leadership as the delivery of effective, culturally congruent nursing care in promoting health and health equity at the community level.     

Immersion in another culture: one strategy for increasing cultural competency

Educating nursing students in the United States to be culturally competent is a challenge. Undergraduate and graduate nursing students, including nurse-midwifery students were paired with faculty on a short-term transcultural nursing experience in Choluteca, Honduras. Students provided health screenings, prenatal assessments, and birth attendance. Learning objectives were designed to improve cultural competency in the healthcare setting for nursing students. A case study exemplar in the labor and delivery setting is presented. As a result of the cultural immersion experience, the student demonstrates versatility and flexibility in clinical practice, reflecting the skills necessary to adapt interventions to populations and circumstances.     

Cultural competency of graduating US Bachelor of Science nursing students

Cultural competence in the delivery of nursing care is an expectation of accreditation and approval boards for nursing in the United States. This study evaluated the effectiveness of four different nursing program curricula in developing culturally competent new graduates. Four methodologically and geographically diverse groups of graduating BSN students in the United States were given the Inventory for Assessing the Process of Cultural Competency Among Healthcare Professionals-Revised (IAPCC-R prior to graduation and after completion of course work. A variety of curricular methods for achieving cultural competency were included. Two programs utilise a theory or a model developed by recognised transcultural expert nurses, Madeline Leininger and Josepha Campinha-Bacote. One program utilised an integrated approach employing no specific model. One program utilised a free-standing two credit culture course within the curriculum, taught by nursing faculty with strong cultural preparation. Results indicate that these 212 graduating nursing students scored only in the culturally aware range, as measured by the IAPCC-R, regardless of what program model they attended.     

Distance Learning Teaching Strategies in Registered Nurse to Baccalaureate Nurse Programs: Advancing Cultural Competence of Registered Nurses in Providing End-of-Life Care

In order to prepare nurses to effectively provide holistic nursing care to an increasingly diverse patient population, nurse educators must incorporate cultural care practices into the nursing curricula. Specifically, teaching culturally competent end-of-life care is essential but can pose challenges for distance education programs. The purpose of this article is to identify multiple learning strategies utilized in an online nursing program to teach students how to provide culturally competent end-of-life care.     

Enhancing undergraduate nursing curricula to cultivate person-centred care for culturally and linguistically diverse older people

With an ageing global community and widening socio-cultural diversity, nurse educators are increasingly challenged to align responsive undergraduate nursing curricula to rapidly changing healthcare environments. In future-proofing nurse education, educators need to collectively examine ways of interconnecting and developing gerontological and cultural competence within undergraduate curricula. However, there is limited guidance as to how this can be achieved in already compacted curricula. We suggest that this could be achieved by critically examining undergraduate curricula to make explicit how they can be adapted to educate nurses in the provision of culturally competent person-centred care. This approach could help nurse educators adapt student nurse preparation to meet the needs of culturally diverse older people and their families.     

Discovering cultural aspects of nurse-patient relationships

The purpose of this article is to illuminate modes of inquiry that unconceal cultural aspects of the meaningful life-world of individuals. To present strategies for acquiring cultural awareness, sensitivity, and competence based on insights gained from these modes of inquiry. Nurses can acquire and implement culturally competent patient care by inquiring into individual's personal interpretations of their life's world experiences rather than relying on catalogs of cultural attributes or by adhering to popularly held opinions. By following the procedures for augmenting culturally competent nursing outlined in this article nurses reported being able to provide a more culturally competent, higher quality of patient care.     

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.