Culture and population health: Nursing

Culture is an evolving and complex phenomenon that encompasses the beliefs, assumptions and values that are widely shared by groups of people over time.

As the community health nurse or C HN, you'll provide culturally competent care to promote positive population health outcomes for individuals, groups and communities.

OK. So there are some important concepts to keep in mind when caring for people from different backgrounds to help you be better equipped to practice cultural competence.

First race describes a person's biological variations that have origins in genetic ancestry, like skin color or hair texture.

On the other hand, ethnicity refers to belonging to a group that shares cultural patterns such as beliefs, values and traditions and is often influenced by factors like geographic location, heritage and education.

Keep in mind that people of the same race can have different ethnic and cultural backgrounds. For instance, black individuals are often wrongly viewed as sharing the same ethnicity and culture, even though they're a culturally diverse group with ancestry and heritage that can be traced back through North America, Africa and the Caribbean.

Speaking of cultural diversity, this term encompasses the variations among populations based on factors like race and ethnicity.

As well as sexual orientation, social class and physical and mental abilities. Now, in order to provide effective and equitable care and promote positive population health outcomes for people of diverse cultural groups, you'll work toward developing cultural competence.

Although the process of developing cultural competence looks different for each person. It generally includes five key elements.

First, cultural awareness involves examining one's own cultural background to discover how attitudes biases and prejudices can impact the provision of care.

Next, cultural knowledge is the process of gathering information about the worldviews and practices of different cultural groups.

This information can come from patients themselves or through formal training or resources. Then cultural skill is where cultural awareness and knowledge are integrated and put into action to meet the needs of diverse groups of people.

Another key element involves seeking out cultural encounters like engaging in discussions and other interactions with people from diverse cultural groups.

These encounters can help decrease stereotypical beliefs and promote empathy. Lastly, cultural desire is when a genuine interest and motivation to understand and respect cultural differences is developed.

Although it's impossible to understand everything about every culture being open to learning, enables nurses to collaborate with patients to make choices that align with and honor their values, ultimately enhancing health outcomes.

As the community health nurse, your goal is to provide culturally competent care to diverse groups of people to promote positive population health outcomes for individuals, groups and communities begin by performing a cultural self assessment to consider how your own social and cultural heritage impacts your beliefs about health and illness and how you relate to your patients.

Next. Gather information about your patient's culture using communication techniques that support a respectful approach.

Remember to be cognizant of cultural variations in verbal communication such as cadence, dialect, and word pronunciation, as well as non verbal factors like hand gestures, eye contact and the preferred physical distance between you and your patient.

During the initial assessment work on building trust by asking questions in a non judgmental way. For example, when gathering information about your patients presenting health concerns, you might ask, what do you think might be causing you to feel this way?

When appropriate, you can also elicit the support of a licensed medical interpreter to support effective communication. You can also ask your patient about their beliefs, values and practices including information on religion or spirituality, support systems, diet and education as well as treatment modalities.

They're open to trying during the conversation, pay close attention to how social determinants of health or the social and economic circumstances impact their health like whether they have access to transportation, safe housing and childcare or if they're able to afford medications or assistive devices as needed.

Keep in mind that you may need to gather information over several encounters to allow for adequate report and trust development.

Once trust is established, your patient will likely be more forthcoming with sensitive information as you plan care. Be sure to consider nursing interventions that support cultural competence.

You can practice cultural preservation by facilitating the use of scientifically backed cultural practices. Alongside Western healthcare methods like acupuncture paired with prescribed analgesics, you'll also practice cultural accommodation by supporting cultural practices that are not harmful to your patient.

This may involve allowing a postpartum patient to take their placenta home, to bury it, honoring their belief in spiritual protection from ancestors.

On the other hand, you may need to practice cultural re patterning by helping patients modify potentially harmful cultural practices.

So you might encourage patients to choose baked foods over fried ones, even if fried foods are a traditional part of their culture.

Lastly, you'll engage in cultural brokering by advocating, negotiating and intervening between your patient's culture and traditional Western health care.

For example, you might advocate for your patient to have a spiritual healer at their bedside while at the same time ensuring that the healer understands and respects the patient's medication treatment plan.

Other interventions can include teaching patients about health promotion while considering their values, health beliefs and practices.

For instance, while planning a public health workshop, you'll avoid scheduling it during certain holy days observed by the prominent local religious group or consider shared dietary restrictions when making nutritional recommendations for a cultural subgroup.

Finally be mindful of political or legal issues affecting culturally diverse groups and work with community leaders to influence legislation and funding to support population health of diverse groups of people.

All right. It's a quick recap.

Culture is an evolving and complex phenomenon that encompasses the beliefs, assumptions and values developed over time and shared by groups of people.

As the community health nurse, you'll provide culturally competent care to promote positive population health outcomes for individuals, groups and communities.