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Exploring Cultural Barriers in Healthcare: A Focus on Hispanic Patients, Assignments of Health sciences

The challenges of obtaining a health history from hispanic patients due to language barriers and cultural differences. It highlights the importance of proper medical interpreting services and the impact of acculturation on contraceptive use and cancer screening rates. The document emphasizes the significance of the patient-provider relationship and the need to assess and address barriers to committing to plans of care.

What you will learn

  • How does acculturation affect contraceptive use and cancer screening rates among young Hispanic women?
  • What are the language barriers that Hispanic patients face when trying to receive healthcare?

Typology: Assignments

2021/2022

Uploaded on 10/12/2022

nrc4823
nrc4823 🇺🇸

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DISCUSSION POST #1.1—EXPLORE ANOTHER CULTURE:
Discussion Introduction
After you have completed readingLesson 1.2: Cultural Assessmentand your
textbook reading, you should complete this discussion on exploring another
culture.
Initial Post
For this discussion, you should explore a culture (other than your own).
Listthreeconcerns that can affect your practice of obtaining a health
history as it relates to the culture you have researched and explored. In your
discussion post, clearly articulate what those concerns are to your peers.
Ideas of Cultures To Explore:
Here are some possible cultures you can consider, but you are highly
encouraged to think of additional cultures to explore beyond these cultures
presented.
Muslim
Lesbian, Gay, Bisexual, Transsexual, Queer, etc. (LGBTQ+)
Hispanic
Jehovah's Witnesses
Korean
So many more....
Hispanic patients run into many barriers when trying to receive care from
providers, and often the biggest blockade that they face umbrellas around
language barriers that are often present. Language barriers pose challenges in
terms of achieving high levels of satisfaction among medical professionals and
patients, providing high-quality healthcare, and maintaining patient safety” (Al
Shamsi et al., 2020, pp. 1). Patients with limited English language proficiency (LEP)
must rely on interpreters to communicate with health care providers who do not
speak their language or be subjected to impaired communication (Morales et al.,
2006). Although federal guidelines issued by the Department of Health and Human
Services Office for Civil Rights encourage federally funded entities to develop and
implement plans for improving language access to health care, professional
medical interpreters can often times be unavailable for health care encounters,
leaving clinicians and LEP patients to communicate with little or no common
language, making the provider feel the need to rely on untrained family members,
bilingual medical staff, or other ad hoc interpreters (Morales et al., 2006). With this
being said, it is vital for nurse practitioners and other healthcare providers to
become aware of not only their entities interpreting services available at their
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DISCUSSION POST #1.1—EXPLORE ANOTHER CULTURE:

Discussion Introduction

After you have completed reading Lesson 1.2: Cultural Assessment and your

textbook reading, you should complete this discussion on exploring another

culture.

Initial Post

For this discussion, you should explore a culture (other than your own).

List three concerns that can affect your practice of obtaining a health

history as it relates to the culture you have researched and explored. In your

discussion post, clearly articulate what those concerns are to your peers.

Ideas of Cultures To Explore:

Here are some possible cultures you can consider, but you are highly

encouraged to think of additional cultures to explore beyond these cultures

presented.

 Muslim

 Lesbian, Gay, Bisexual, Transsexual, Queer, etc. (LGBTQ+)

 Hispanic

 Jehovah's Witnesses

 Korean

 So many more....

Hispanic patients run into many barriers when trying to receive care from providers, and often the biggest blockade that they face umbrellas around language barriers that are often present. Language barriers pose challenges in terms of achieving high levels of satisfaction among medical professionals and patients, providing high-quality healthcare, and maintaining patient safety” (Al Shamsi et al., 2020, pp. 1). Patients with limited English language proficiency (LEP) must rely on interpreters to communicate with health care providers who do not speak their language or be subjected to impaired communication (Morales et al., 2006). Although federal guidelines issued by the Department of Health and Human Services Office for Civil Rights encourage federally funded entities to develop and implement plans for improving language access to health care, professional medical interpreters can often times be unavailable for health care encounters, leaving clinicians and LEP patients to communicate with little or no common language, making the provider feel the need to rely on untrained family members, bilingual medical staff, or other ad hoc interpreters (Morales et al., 2006). With this being said, it is vital for nurse practitioners and other healthcare providers to become aware of not only their entities interpreting services available at their

institution, but to also become knowledgeable about the reproable medical interpreting services that are in their area that they practice in order to ensure proper medical care for both Hispanic patients, as well as, other limited LEP patients that they are treating. Another concern or barrier that a provider might face when trying to obtain a health history from a less accultured Hispanic female. Some barriers that have been noted in previous studies include these female patients in statistically have lower percentages of obtaining needed routine screenings as well as being more likely to use no contraception or cyclic hormonal contraception at last sexual intercourse, as compared to Hispanic women classified as high in acculturation (Ronancio, Ward, & Berenson, 2012). Young Hispanic women are only half as likely to use contraception to non- Hispanic white women of the same age (Ronancio et al., 2012). Given this, it is not surprising that 76% of pregnancies among this group are unplanned. In order to reduce the alarming rate of unplanned pregnancies among this population, more information about their contraceptive use is needed (Ronancio et al., 2012). Acculturation is one characteristic that may help explain differences in contraceptive use among young Hispanic women. In a survey study done by Unger (2000), she identified that “moderately accultured women expressed lower intentions to use contraceptives, were less certain that they would be able to use contraceptives consistently for the next 6 months, and reported lower social support for contraceptive use, than did unaccultured women.” Therefore, social norms and low self-efficacy may place moderately accultured Hispanic females at risk for unintended pregnancy and STDs. Lastly, when more moderately accultured Hispanic females are due for a routine cancer screening (more specifically a colorectal exam/screening or a mammogram), research has shown that this group of women fall lower than national averages in obtaining these vital cancer screenings. Research has found that the relationship between past and future mammography thoughts, plans and behavior is mediated by a complex combination of sociodemographic, intrapersonal, and interpersonal factors. However, healthcare factors, operationalized as access and experience, may also influence the relationship between past and future mammography behavior as well (Scheel et al., 2017). For example, women reporting adherence to screening mammography guidelines are more likely to also report greater healthcare access, including having health insurance and a regular provider, and experiences with their providers, including having had a clinical breast examination (CBE) and a provider recommendation (Scheel et al., 2007). These findings emphasize the importance of the patient-provider relationship during a clinic visit and the relevant questions that need to be obtained when conducting a health history on Hispanic female patients. It is important to assess and discuss with the patient any reluctance that they have to the providers recommendations or plans of care. Additionally, assessing barriers that the patient might have in committing to plans of care as it relates to education needs, health insurance access or cultural-related barriers such as unfamiliarity with navigating the U.S. medical system etc., is another vital concern that health care providers need to consider with every patient that comes into their care. References:

rarely called me to inform me that they were in pain (even though most other patients with the

same injuries would be screaming bloody murder). Although they voiced no pain when asked,

their vital signs dictated to me and my care team otherwise as well as non-verbal cues that they

elicited when attempting to move or reposition etc.

I found it very interesting that Chinese culture bows their head/avoids eye contact to show

respect to the individual talking, whereas this is very opposite of the gesture of respect in

western culture. Although I have noticed my patients of Chinese descent to do this at times, I

never fully understood as to why this was a commonality that I would encounter with these

patients. I agree that it is helpful for providers to understand and be aware of as to ensure that

they are showing their Chinese patients respect as well as ensuring that they are being

culturally sensitive as well. Thank you for the very informative post and for sharing what you

have learned!

Hey Kathleen,

Very informative post as usual! I was interested while reading your discussion post due to my

previous experience with caring for gender-reassignment surgical patients. Although my

hospital did provide a course for all healthcare workers who would be taking care of this patient

population post-operatively, I was still nervous when the time came for me to care for my first

patient. With that being said, one of the first things I learned whilst caring for these patients is

that being open is very important, as well as keeping an open dialogue and ensuring that you

will follow up with them if you are uncertain of the appropriate answer(s). Additionally, I was

very nervous about mis-addressing patients (or using the wrong pronoun). However, as you

stated, being open with LGBTQ patients on your first assessment/interaction is important, and

this often is a great time to ask the patient how they would like to be addressed, and to also

inform the patient of your preferred pronouns/what they can refer to you by. I have found that

by opening up your conversation and clarifying in an open-type format, that this not only shows

respect to that individual, but additionally prevents miscommunication or hiccups in your

communication later on. Thanks for sharing!

you not only show the patient respect, but additionally, that yo