Being culturally competent as you provide care is essential for providing high quality patient care for patients coming from different cultural backgrounds. This concept is defined as a the knowledge and unique set of skills and attitudes that is applied in the clinical practice in a transcultural context (Cerveny et al., 2022). In addition, to provide culturally competent care, providers must be sensitive to the patient’s heritage, sexual orientation, socioeconomic situation, ethnicity, and cultural background. As future APRNs, it is important to note that culturally competent care is achieved when we recognize one’s own culture, values, and biases so we can use effective, patient-centered communication skills (Ball et al., 2018).
The case study that was assigned was that of Paloma Hernandez who is a 26 year-old, Spanish speaking patient who presents to the clinic for the last 2 days in a row complaining of abdominal pain that is getting worse. The first visit the staff relied on her younger bilingual daughter to translate. She was treated with Omeprazole and encouraged to take OTC medication. Today she presents with the same problem. Her daughter states it is the same problem but worse today. This discussion will provide an explanation of socioeconomic, spiritual, lifestyle, and other cultural factors that are associated with the patient described in the scenario. In addition, it will explain issues that would need to be sensitive when interacting with the patient. Finally, this discussion post will provide five targeted questions I would ask to build the patient’s health history and assess her health risks.
Cultural Factors Associated with the Scenario
As healthcare providers, it is important to be cognizant of cultural practices when it comes to caring for Hispanic patients, as many the health care beliefs and practices differ from those of Western medicine (Showstack et al., 2019). Proper communication with differing cultures is important, as there are a variety of cultural variations in communication. Recognizing differences and taking about them earlier rather than later can result in a positive experience for both the patient and the provider (Ball et al., 2018).
According to Showstack et al. (2019), Hispanics who are monolingual in Spanish are reported to experience poor health care outcomes in comparison to individuals that are monolingual in English or bilingual in English and Spanish with the authors citing language to be undoubtedly a key component. Often, untrained interpreters, such as family members and office staff, often take place of trained professionals. Untrained interpreters may not be familiar with key medical terminology and lack the proper training and experience necessary. Doing so, could like to unnecessary and potentially dangerous errors in communication and emotional difficulties (Showstack et al., 2019). In this case, Ms. Hernandez’s young daughter was tasked with interpreting for her mother. Although she may have tried her best, she was not properly trained and may have lacked key medical terminology meaning specific details could have been lost in translation, leading to potential misdiagnosis or inaccurate communication of discharge instructions. When we encounter language barriers when communicating with our patients, its important that we are aware of the resources available and know how to effectively use interpreters (Ball et al., 2018).
In addition, it has been well established that Hispanic women potentially face barriers to healthcare due to lower incomes, lower education, and lack of health insurance. This can lead to unfamiliarity in navigating the medical system which as the potential to influence medical adherence to the treatment plan (Roncancio et al., 2022). Although Hispanic women desire to adhere to exercise, a healthy controlled diet, and medication regimen, a strong barrier to a healthy lifestyle for them is cited to include long work days, cost of healthy food being more expensive, cost of medications, and lack of time for exercise (Titus & Quiles-Pollard, 2022).
It is important as healthcare providers that we understand the complexity of family impact on Hispanic women’s health. Although strong, multi-generational family relationships are known to reflect high levels of social support, it also can lead to family obligation stress, which is associated with worse health and greater unmet healthcare needs. Often, Hispanic women prioritize family relationships above one’s self (Molina et al., 2020).
In conclusion, five targeted questions would specifically ask the patient are directed toward details listed in the case study.
- Are you comfortable with an interpreter assisting with this visit to ensure open communication?
- What is the nature of your abdominal pain? Does anything intensify the pain or improve it?
- Have you ever had this type of pain before? If so, what was the cause of it and what improved it?
- What is your support system like at home?
- Do you have any barriers to making steps toward a healthy lifestyle?
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2018). Seidel’s Guide to Physical Examination: An Interprofessional Approach (9th ed.). Mosby.
Molina, Y., Henderson, V., Ornelas, I. J., Scheel, J. R., Bishop, S. J., Doty, S. L., Patrick, D. L., Beresford, S. A., & Coronado, G. D. (2019). Understanding Complex Roles of Family for Latina Health. Family & Community Health, 42(4), 254–260. https://doi.org/10.1097/fch.0000000000000232
Roncancio, A. M., Ward, K. K., & Berenson, A. B. (2011). Hispanic Women’s Health Care Provider Control Expectations: The Influence of Fatalism and Acculturation. Journal of Health Care for the Poor and Underserved, 22(2), 482–490. https://doi.org/10.1353/hpu.2011.0038
Showstack, R. E., Guzman, K., Chesser, A. K., & Woods, N. K. (2019). Improving Latino Health Equity Through Spanish Language Interpreter Advocacy in Kansas. Hispanic Health Care International, 17(1), 18–22. https://doi.org/10.1177/1540415318818706
Titus, S. K. F., & Quiles–Pollard, G. (2022). A Study of Immigrant Latinas Perspectives of Caring for their Diabetes. Journal of Racial and Ethnic Health Disparities. https://doi.org/10.1007/s40615-022-01404-5