Literature Review on Cultural Competency Essay Example

nursing practice has been the growing demand by consumers for culturally competent healthcare in an increasingly diverse and multicultural environment. This trend is especially important for homecare nurses who work in high-stress and high-acuity settings. In order to establish rapport with patients, homecare nurses need to develop cultural competency and have the ability to create and implement nursing interventions that meet the diverse needs of homecare patients. As advocates for patients, homecare nurses must also support decisions made by patients or their families, even if those decisions reflect cultural perspectives that differ from typical healthcare initiatives.

Homecare nurses need to possess comprehensive knowledge of various cultural environments in order to deliver culturally competent care for all patients. This encompasses understanding the beliefs, values, customs, and traditions of different groups. The United States and European countries have seen a significant increase in ethnically and culturally diverse populations lately. Therefore, healthcare providers must adjust their practices to meet the specific care requirements of these communities.

The inner cities in Britain have experienced a rise in diverse and multi-ethnic populations, resulting in different healthcare needs. This poses challenges for healthcare professionals when it comes to providing culturally appropriate care, especially regarding health literacy. According to the World Health Organization, health literacy refers to the capacity to access, utilize, and comprehend health information for prevention and promotion purposes. The American Medical Association defines health literacy as the ability to acquire, process, and understand fundamental health information in order to make well-informed decisions about one's own care. Functional health literacy entails comprehending appointment details, prescription guidelines, and other crucial healthcare information through reading. The National Assessment of Adult Literacy describes health literacy

as the application of reading skills towards grasping healthcare information.

Research shows that over 50% of adults in the U.S. lack adequate health literacy, creating obstacles to receiving optimal care. This issue has a greater impact on ethnic minorities, particularly older individuals with limited education and low socioeconomic status who belong to racial or ethnic minority groups and hold low-income jobs. Therefore, it is crucial for homecare nurses to possess cultural competence in order to effectively care for patients from diverse cultural backgrounds with limited health literacy (Ingram, 2011).

Cultural Competence and Nursing Faculty

The American Nursing Association (ANA) recognized in 1986 the importance of incorporating multicultural content into nursing education. However, there was a lack of qualified faculty to teach this material at that time. Although teaching frameworks and strategies were available for faculty members to use, they were not being effectively employed. This can be attributed to the fact that historically, approximately 80% of university and college faculty, including those in nursing, consisted of white individuals who were middle-aged and from middle-income backgrounds.

The desire for learning about different cultures was not at risk when the majority of faculty members were studying. This was because nursing students in the 1960s and 1970s were influenced by the dominant American culture rather than the growing understanding of culture itself. As a result, the current assumption of cultural competence in the field of nursing may be too optimistic, making it difficult to implement effective strategies for addressing cultural competency issues, particularly among home care nurses (Kardong-Edgren, 2007).

Cultural competence often competes with other important competencies in nursing education. Many students fail to prioritize cultural issues in their education due to the

dominance of the medical model. Culture is often seen as an optional addition rather than an essential component of nursing education. Despite the importance of developing cultural competence in nursing, there is limited research on this topic.

The views of various faculties on teaching cultural content and educating students about caring for culturally diverse patients differ. Some faculties are receptive and willing to teach cultural content, while others oppose it. This lack of emphasis on teaching cultural content could be a contributing factor to the shortage of home care nurses who possess the necessary qualifications to provide culturally competent care (Kardong-Edgren, 2007).

Cultural Competency and Training

In recent years, policymakers and scholars in the U.S. have actively prioritized cultural competency in healthcare delivery.

According to research, cultural competency training is crucial in reducing healthcare disparities. Experts recommend comprehensive training programs that cover various aspects of cultural competency, such as folk medicine, worldview, health beliefs, ethnomedical beliefs, and culturally influenced factors like norms, values, gender roles, and religion. These factors have a significant impact on interactions between healthcare providers and patients. While there is ongoing debate among scholars regarding the advantages and disadvantages of cultural competency training in healthcare settings, there is a general consensus among researchers that it ultimately improves long-term patient satisfaction and adherence to treatment (Khanna, Cheyney & Engle , 2009).

The relationship between culture and health, particularly in healthcare delivery, has gained increasing interest among scholars. The healthcare industry recognizes the significance of cultural competency due to the growing diversity in ethnicity and resulting health disparities in the United States. Administrators, providers, policymakers, and insurers involved in healthcare delivery consider cultural competency essential for

providing excellent care to patients from diverse cultural backgrounds. To promote this objective, the Health Resources and Services Administration (HRSA) advocates for integrating language and cultural competence training, along with assessment protocols, into healthcare settings.

The institution supports the global implementation of Culturally and Linguistically Appropriate Services (CLAS) to National Standards. These standards are crucial in reducing racial and ethnic disparities in the healthcare system, while also serving as benchmarks for delivering linguistically and culturally competent healthcare to patients from diverse cultural backgrounds (Khanna, Cheyney, ; Engle, 2009). Despite claims of technological innovation and biomedical objectivity, medical care is inherently social and interactive. It is important to recognize that political and interpersonal factors influence the provider-patient relationship. This dynamic is shaped by the power imbalance between healthcare providers, who possess authoritative knowledge, and the cultural beliefs held by both providers and patients.

Policymakers and scholars recognize the influence of cultural traits on seeking and accessing healthcare services. They stress the significance of integrating linguistic and cultural competency in care delivery to improve healthcare utilization among patients from diverse backgrounds and decrease health disparities based on ethnicity and race (Khanna, Cheyney, ; Engle, 2009).

Cultural Competency and Nursing Education

Over the past two decades, there has been a notable change in the ethnic and racial makeup of the U.S. population. Currently, minorities make up around one-third of the population.

According to the Institute of Medicine (IOM), the population is projected to increase by more than 54 percent by 2050. However, over 80 percent of registered and licensed nurses in the country are non-Hispanic whites, indicating a lack of representation among black Hispanic, American Indian, and Native

nurses from Alaska. Additionally, ethnic and racial minorities make up less than 10 percent of the nursing faculty in the United States (Mareno ; Hart, 2014). The IOM emphasizes that this underrepresentation contributes to unequal treatment and poor health outcomes for minorities when they receive care.

The presence of disparities in culture, poverty, limited access to healthcare, and unemployment contributes to differences in health outcomes. The underrepresentation of diverse medical professionals has resulted in ongoing gaps in the delivery of care. According to Mareno and Hart (2014), the Institute of Medicine (IOM) recommends a more ethnically and racially diverse healthcare workforce to enhance patient satisfaction, address cultural obstacles, and improve access to care in underserved areas. To achieve this goal, nursing programs at both undergraduate and graduate levels should incorporate cultural competency training. This would equip nurses with the necessary skills to provide culturally sensitive care (Mareno & Hart, 2014). Thus, it is important for educational institutions to offer undergraduate and graduate programs for homecare nurses so they can effectively deliver adequate care to individuals from various multicultural backgrounds within different home settings.

Nursing Research and Cultural Competency

The U.S. Census Bureau reported in 2010 that the United States will undergo significant demographic changes in the next 50 years. Projections suggest that the non-Caucasian population will nearly double, growing from 116.2 million to around 241 million by 2060.

The Asian community is expected to make up 57 percent of the U.S. population, and it is projected to double within five years. This demographic will account for approximately 8 percent of the total population. Meanwhile, in America, the aging trend indicates that by 2060, around one-fifth of individuals will be

over 65 years old.

According to Cope (2015), the population of individuals aged over 85 is projected to triple, reaching around 18.2 million and constituting about 4 percent of the U.S. population. These demographic changes make it crucial for research and practice settings to prioritize cultural competency and sensitivity. Cultural competency plays a significant role in reducing health disparities and improving access to high-quality care, particularly for an aging population. In the field of nursing research, incorporating cultural competency into homecare nursing can greatly contribute to efficient care delivery for a diverse and aging population (Cope, 2015).

Additionally, there are diversity concerns within Europe's population due to global migration. Migrants are often compared with the host countries they migrate into.

The number of elderly immigrants in several European countries has increased as immigrants age and their parents also relocate. This poses challenges for healthcare provision, particularly in terms of culturally sensitive care. Policies have been implemented to address these challenges, but they struggle to keep up with the fast-paced social change and cultural diversity encountered daily. Consequently, the lack of suitable policies hampers the development of appropriate measures to cater to the growing diverse population in this area (Debesay et al., 2014). Diversity in healthcare is still relatively new, especially for home care nurses.

In European nations, there is a lack of appropriate development in comprehensive models and concepts. Additionally, there is limited understanding of the knowledge and skills that nurses need to effectively handle healthcare issues for culturally diverse patients. Existing research has focused predominantly on individuals, neglecting the importance of organizational frameworks that could support cultural competency in diverse healthcare settings. This is especially crucial in providing

adequate care to culturally diverse populations (Debesay, et al., 2014). Therefore, it is necessary to examine the challenges faced by nurses, particularly community nurses, when delivering home-based care services to ethnic minority individuals.

Incorporating Cultural Competency into the Curriculum

To effectively respond to patients, it is crucial for nursing competencies to include cultural sensitivity. Nurses have the most contact with patients and play a significant role in their care.

Despite the changing demographic patterns nationally and globally, the need for cultural sensitivity among health care providers has become evident. In response to this diversity, the majority of nursing programs now include a cultural competency requirement to meet the needs of patients and accreditation standards. However, even with over 50 years of research, theory, and practical knowledge on trans-cultural nursing, there is still a lack of formal or comprehensive education targeting nursing practice.

The current methods of incorporating cultural competency into the curriculum include initiatives such as deep cultural immersion, service-learning programs, inter-cultural cultural immersion, and stand-alone cultural courses. The most common method of integrating cultural competency into the curriculum is through the process of curriculum development. However, this approach is not efficient or comprehensive. When cultural competency is integrated into undergraduate programs, students' perceptions show a need for more emphasis on cultural competency education that does not solely focus on clinical application (Kardong-Edgren, et al., 2010). Integrating cultural competencies into learning processes and educational activities only results in a limited number of individuals showing commitment to the initiative.

It is important to note that without a solid curricular framework, the strategies and content could easily be lost, especially in the event of a change in teaching methods. Therefore, incorporating programs

with appropriate content and aligning it with the entire curriculum is crucial for integrating cultural competency. To ensure that home care nurses can efficiently provide effective care to patients, it is essential to introduce programs that have the right content and level it with the entire curriculum. This will enable homecare nurses to acquire the necessary skills to deliver optimal care to patients receiving care services at home.

Conclusion:

The nursing environment has placed significant emphasis on cultural competency. This is crucial because nurses are responsible for directly interacting with clients on a daily basis. Additionally, numerous countries, including the U.S. and those in Europe, are experiencing a rapid increase in diverse racial-ethnic groups. As these populations age, the demand for home-based care grows. Unfortunately, many home care nurses currently lack the necessary cultural competency skills to effectively address their patients' needs.

Most learning institutions lack sufficient training on cultural competency, leading to inefficiencies in providing care to diverse home-based patients. Therefore, it is crucial for these institutions to integrate cultural competency into their curriculum to effectively teach nursing students these skills. Additionally, policymakers, researchers, and scholars should align cultural competency requirements with patient needs and learning requirements. This will ensure that nurses, especially home care nurses, can provide optimal care despite the increasing disparity in care delivery.

References;

1. Cope, D. G. (2015). Cultural competency in nursing research. Oncology Nursing Forum, 43 (3),;306-306.
2. Debesay, J., Harslof, I., Rechel, B., ; Vike, H. (2014). Facing diversity under institutional;constraints: Challenging

situations for community nurses when providing care to ethnic minority patients. Journal of Advanced Nursing , 70 (9), 2107-2116.

(2011). Using Campinha-Bacote's process of cultural competence model to examine the relationship between health literacy and cultural competence. Journal of Advanced Nursing, 695-702. Kardong-Edgren, S. (2007).

The article "Cultural competence and Baccalaureate nursing faculty" in the Journal of Nursing Education (volume 46, issue 8, pages 360-366) by Kardong-Edgren, S., Cason, C. L., Brennan, A. M., Reifsnider, E., Hummel, F., Mancini, M., et al.

(2010). Cultural competency of graduating BSN nursing students. Nursing Education Perspectives, 31 (5), 278-284.

This text discusses two articles on cultural competency in health care. The first article, "Cultural competency in health care: Evaluating the outcomes of a cultural competency training among health care professionals," is from the Journal of the National Medical Association (101 (9), 886-892). The second article, "Cultural competency among nurses with undergraduate and graduate degrees: Implications for nursing education," is from Nursing Education Perspectives (35 (2), 83-88).