Examine how might nurses and nursing organizations improve policies to encourage the judicious use of antibiotics in humans? Identify the correlation between global disease surveillance and domestic disease surveillance, and the significant role the family nurse practitioner plays.  apa format, turniting , 250 words 

With each passing year, the United States is becoming more racially, ethnically, and culturally diverse. This growth of diversity is not occurring in our population of healthcare professionals and this lack of parallel growth results in the provision of discordant patient care. Nurses must be educated to be able to negotiate across cultural divides that may occur during our interactions with patients whose cultural background is different from our own. Nurses must become culturally competent to provide safe, high-quality care for diverse patient populations for improved patient outcomes. 

Part 1. Discuss the following questions:

How does culture shape nurses’ concepts of health and their nursing practice?

What does it mean to be culturally competent and culturally sensitive? Why are these important in nursing? 

Part 2. Discuss the meaning of healthcare disparities.

Choose one of the following cultural groups. Discuss the healthcare disparities they encounter and culture-specific nursing considerations.

1. Asian/Pacific Islander Americans

2. Black Americans

3. Latino/Hispanic Americans

4. Native Americans/Alaska Natives/American Indians

5. White Americans

Part 3: Discuss what learned in the OMH Cultural Competency Assignment.

Support your discussion with information from one or more of the ANA textbooks

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Case study:

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”

Discussion: Diversity and Health Assessments

Introduction

            Health care providers should exhibit knowledge of population diversity and treat all patients with respect regardless of their culture and belief system. This is essential in understanding patient’s lifestyle, and behavior which may affect their health care. Accepting patient’s culture in a nonjudgmental manner creates a unique relationship between the patient and the healthcare provider. Therefore, APRN’s should be cognizant of patient’s culture, beliefs, lifestyle, and socioeconomic status as it relates to healthcare. A culturally competent healthcare provider accustoms his/herself to the exclusive needs of patients with cultures that are different from his or her own. Being accustomed to the belief’s and values of a patient lays the foundation for a trusting patient-provider relationship (Ball et al., 2019).

Socioeconomic, Spiritual, Lifestyle, and Cultural Factors Associated with the Patient

            The case study presents an 86-year-old Asian male that is physically and financially dependent on his daughter who is a single mother with little money to care for the patient’s healthcare needs.  Understanding the Asian culture is relevant to providing care to this elderly patient.  I will verify patient’s preferred language, ask about patient’s preference with a healthcare provider regarding race or ethnicity, gender, and age. Ensuring respect for this patient despite his financial and physical dependency will encourage a trusting relationship between the patient and the health care provider. Asian culture is known to teach respect for parents and family is a priority over self. Additionally, in Asian culture adult children are required to make financial, physical, and social sacrifices for their parents that are aging (Miyawaki, 2015). As a healthcare provider, I will welcome this patient, show respect by avoiding eye contact as some Asian countries consider making eye contact as rude. Maintaining eye contact is not done with individuals of East Asian cultural backgrounds. Also, the Japanese culture, teaches against maintaining   eye contact with others as it is believed to disrespectful (Uono & Hietanen, 2015).

            I will make the patient understand that I am familiar with culture of adult children caring for their aged parents. I will explain to the patient that he should not consider himself a burden to his daughter as the daughter is maintaining the requirement of their culture. This will encourage a relaxing environment that will enable the patient to feel accepted and ready to relate with the health care provider. Respect for the patient’s spiritual and religious belief is also vital. The patient should be asked about any spiritual belief that may affect his healthcare when sick or dying. Also, the APRN should inquire about spiritual or religious groups that the patient may belong that could be supportive in providing some assistance to his healthcare. Spirituality and faith help Asian-Americans manage the turmoil of adapting to a new country, by providing a safe environment where immigrants can socialize and be of assistance to one another (Lee & Eun-Kyoung, 2017).

Sensitive Issues

            I will inquire if the patient is compliant with taking his medications as prescribed and access for the use of over the counter, herbal, or traditional medications. This is especially important as the patient takes lisinopril 10mg QD, prilosec 20mg QD, B12 injections monthly, and cipro 100mg QD. To avoid drug interactions, it is important to ask about additional medications that the patient may be taking. Examples of Chinese herbal medicine include astragalus, ginger, licorice, panax ginseng, and schizandra. Traditional medicine is used across Asian societies for daily health maintenance, and treatment of certain medical conditions. Also, in China, Japan, and Korea, traditional medicine has become almost or equivalent to conventional medicine (Mu et al., 2020).

            Furthermore, the functionality of the patient will be accessed to determine the level of dependency on the daughter. Activities of daily living like feeding, bathing, wearing clothes, grooming will be accessed. Asking about financial assistance with purchasing medications, proper feeding and housing is vital to ensure the overall needs of the patient are catered for. Due to socioeconomic status and financial constraint of the patient and his caregiver (daughter), I will recommend the help of a social worker to provide the services of a home health nurse and home health nursing assistant. This will ensure that patients’ needs are met, and the patient takes his medications in a timely manner thereby relieving the responsibility on the patient’s daughter.  In addition, the services of physical and occupational therapy will be sorted to help strengthen any weak muscles or extremities to ensure some dependence with physical activities. I will explain to the patient that my recommendation for a social worker is to help him meet his daily needs and not to disrespect him. This will maintain patients pride and ego.

Targeted questions to assess health risks

1. Do you have health insurance, or do you pay out of pocket for your medications?
2. Do you take your medications as prescribed?
3. Do you check your blood pressure at home?
4. Would you want to receive help with feeding, clothing, bathing, or moving around your home?
5. Do you experience any pain or difficulty in urinating?
6. In the las two weeks have you experienced sleep disturbances, decreased appetite, feeling of sadness, hopelessness, or guilt, thoughts of committing suicide and poor concentration.
7. In what way do you think you are a burden to your daughter?
8. How often do you eat and what type of food do you eat?
9. Do you take any herbal, traditional or over the counter medications?

            The questions above are used to access the patient’s access to his medications and if he is compliant with taking his medications. The need to access for patient’s knowledge about checking his blood pressure due to his history of hypertension. Accessing patient’s willingness to receive outside resources like home health assistance is essential to providing the needed healthcare. Question about urinating accesses the history of prostatitis. Accessing for depression in the elderly is crucial to determine the patient’s mental state. Elderly Asian immigrants in the US are at risk of depression (Seungah & Eun-Kyoung, 2017). Evaluating the patients feeding habits and if the patient takes any medication outside his prescribed medications determines the patient’s health risk.

References

Ball, J., Dains, J., Flynn, J., Solomon, B., Stewart, R. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Lee, R., Eun-Kyoung, O. (2017). Faith, spirituality, and values among Asian-American older adults: An exploratory factor analysis of the multidimensional measures of religion and spirituality. Mental Health, Religion & Culture, 19 (8), 920–931.    doi:10.1080/13674676.2017.1290593

Miyawaki, C. (2015). A review of ethnicity, culture, and acculturation among Asian caregivers of older adults. SAGE Journals. https://doi.org/10.1177/2158244014566365

 https://journals.sagepub.com/doi/full/10.1177/2158244014566365

Ryu, S., & Lee, O. E.-K. (2016). Faith, spirituality, and values among Asian-American older adults: An exploratory factor analysis of the multidimensional measures of religion and spirituality. Mental Health, Religion & Culture, 19 (8), 920-931. https://doi- org.ezp.waldenulibrary.org/10.1080/13674676.2017.1290593

Uono, S., Hietanen, J. (2015). Eye contact perception in the West and East: A cross-cultural study. Plus One. https://doi.org/10.1371/journal.pone.0118094

Xin, B., Mu, S., Tan, T., Yeung, A., Gu, D., Feng, Q. (2020).  Belief in and use of traditional Chinese medicine in Shanghai older adults: A cross-sectional study. BMC Complement Medicine and Therapies 20 (128). https://doi.org/10.1186/s12906-020-02910-x. https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-020-  02910-x

Reply 1

Re: Topic 5 DQ 1

Patient-centred care allows the patient to have more say in their wellbeing and include personal interest, including spirituality in the treatment plans. Spirituality has a positive impact on promoting the health of a patient. This paper goes through spiritual care in nursing.

Spiritual Care in Nursing

Spiritual care is the part of the care that touches the inner part of a person and their faith to give them a positive outlook and hope in the period of illness. Its purpose to seek resolution, transcend physical and consciousness. Spiritual care is basically on the healing process; it is intrinsically essential throughout human life.

My definition is close to the description of the topic readings is to provide spiritual care as an integral part of caring for a patient incorporating religion in nursing assessment. It should be understood by taking into consideration the diverse religious aspect that is available worldwide (Gone & Giske, 2017). Different patients have different spiritual needs, which might be strange to a healthcare provider. It is important to know patient religion and their views, some people believe in witchcraft in Africa, others such as atheists who question the existence of God, and the agnostic who question the existence of God may need emotional care and more listening. Nurses should always be sensitive when assessing patients’ spiritual needs, referral to a pastoral caregiver can be another better option or intervention from a relative (Timmins & Caldeira,2017).

Conclusion

From the above findings, spiritual care knowledge is essential to all healthcare providers. The patient needs to feel, love, hope, peace, and gratitude. Nurses need to understand a variety of faith and religion to be successful.

References

Cone, P. H., & Giske, T. (2018). Integrating spiritual care into nursing education and practice: strategies utilizing open journey theory.

Timmins, F., & Caldeira, S. (2017). Understanding spirituality and spiritual care in nursing. Nursing Standard, 31(22).
Reply 2

Re: Topic 5 DQ 1

Spiritual care can be defined in different manners depending on the situation. When it comes to me, I define it as the care that responds and recognizes what the human spirit need in times of challenges such as sadness, sickness, and disease, trauma as well as recovering from the loss of a loved one. I believe that in administering spiritual care, one should focus on restoring things like the meaning of life, self-worth, self-acceptance, faith, and hope, and generally be supportive. In nursing practice, a practitioner should ensure that they are conversant with the spirituality of a patient before engaging in a spiritual case. Many individuals belong to different cultural backgrounds and religious backgrounds, where there are certain specific practices in their spirituality that they believe in or abide by. As such, a practitioner should ensure that they understand the spirituality of the individual before administering spiritual care for maximum results.

My definition relates to Shelly and Miller’s explanation of how spiritual care should be and handled. According to Shelly and Miller (2006), spiritual care involves the use of an individual belief in religion to instill faith and hope in their caregiving process. The researchers insist that spiritual care goes hand in hand with a patient’s religion as well as the practitioner’s practices. Religious patients tend to put much faith in their religion for healing and overcoming the diseases. Based on the principle of respect for autonomy, it is upon a practitioner to respect the decision that the patient makes. As such, if a patient is religious and requires spiritual care, it is upon the practitioner to ensure that they achieve this type of care.

Reference

Shelly, J.A. & Miller, A. B (2006) Called to Care: A Christian worldview for nursing (2nd ed.). Downers Grove, Illinois.