Intra-ethnic differences in cultural beliefs, customs, and traditions

Learning Outcomes
1. Discuss the barriers that may impede the delivery of equitable health care.
2. Examine the intra-ethnic differences in cultural beliefs, customs, and traditions within subgroups of diverse populations.
3. Apply the concepts of cultural factors that influence health and illness of African/Black Americans.

Introduction
The patient’s cultural beliefs and values are important to consider in the delivery of health care. Nurses must be able to utilize assessment skills to evaluate patients’ health status and cultural needs. It is imperative to understand that cultural beliefs can affect the patient’s health just as much as the treatment plan. However, there are times when barriers exist to the delivery of culturally competent care. It is our responsibility to identify these barriers whether they are based on process, system, or financial aspects. The nurse plays an integral role in facilitating the best health outcomes for the patient. Knowing and understanding each cultural group ensures the patient receives quality care.

Intra-ethnic differences in cultural beliefs, customs, and traditions Required Resources
Text
Dayer-Berenson, L. (2014). Cultural competencies for nurses: Impact on health and illness (2nd ed.). Burlington, MA, Jones & Bartlett Learning.
• Chapter 5: Black Americans

Articles
Douglas, M. K., Pierce, J. U., Rosenkoetter, M., Pacquiao, D., Callister, L. C., Hattar-Pollara, M., & Purnell, L. (2011). Standards of practice for culturally competent nursing care: 2011 update. Journal of Transcultural Nursing, 22(4), 317. doi:10.1177/1043659611412965
• The full text of this article is available in the Sage database in the Ashford University Library. This article reviews the barriers to providing culturally competent care.
Eggenberger, S., Grassley, & J., Restrepo, E. (July 19, 2006). Culturally competent nursing care for families: Listening to the voices of Mexican-American women. OJIN: The Online Journal of Issues in Nursing. 11(3). doi: 10.3912/OJIN.Vol11No03PPT01.
• The full-text version of this article is available at the following url: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume112006/No3Sept06/ArticlePreviousTopics/CulturallyCompetentNursingCare.html. This article reviews the communication techniques for Mexican subcultures.
Jimenez, R. L. (2014). Cultural competence and communication. AAOS Now, 8(9), 14-16. Retrieved from http://www.aaos.org/aaosnow/
• The full text of this article is available in the EBSCOhost database in the Ashford University Library. This article considers how culturally competent training influences a health care practitioner’s – in this case a doctor – relationship with patients. The author suggests that cultural competency is important but it is not the complete picture to providing the best care for diverse patients.
Paschal, A. M., Lewis-moss, R., Sly, J., & White, B. J. (2010). Addressing health disparities among African/Black Americans: Using the stages of change model to document attitudes and decisions about nutrition and physical activity. Journal of Community Health, 35(1), 10-7. doi:http://dx.doi.org/10.1007/s10900-009-9197-x
• The full text of this article is available in the ProQuest database in the Ashford University Library. This article reviews the poor diet and exercise habits, and the effects of these habits, on the health of African/Black Americans in order to design effective interventions.
Purnell, L. (2002). The Purnell model for cultural competence. Journal of Transcultural Nursing, 13(3), 193-196. doi:10.1177/10459602013003006
• The full text of this article is available in the Sage database in the Ashford University Library. This article reviews Purnell’s model of cultural competence.
Singleton, K. & Krause, E. (2009). Understanding cultural and linguistic barriers to health literacy. OJIN 14(3). doi: 10.3912/OJIN.Vol14No03Man04.
• The full-text version of this article is available at the following url: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No3Sept09/Cultural-and-Linguistic-Barriers-.html. This article addresses the nurse’s role in conveying health care knowledge to patients through an understanding of the patient’s culture and language. Additionally, it shares case studies of patients’ experiences.

Multimedia
Films Media Group. (2006). Now is our time: Healthy living for black women 40-55 [Video file]. In Films on Demand. Retrieved from http://digital.films.com.proxy-library.ashford.edu/PortalPlaylists.aspx?aid=18596&xtid=30916
• This video looks at the incident rate of certain illnesses in African/Black American women. It focuses on diabetes, heart disease, and cancer, as well as how women can be more aware of their health and wellness.
Practice Activity. (2015). Transcultural Nursing. Burlington, MA: Jones & Bartlett Learning Navigate.
• The practice activities provide an opportunity to reinforce the concepts presented in the textbook readings.
• Complete the following practice activities: 5.1, 5.2, 5.3, 5.4, 6.1, 6.2, 6.3, 6.4

Intra-ethnic differences in cultural beliefs, customs, and traditions Recommended Resources
Text
Dayer-Berenson, L. (2014). Cultural competencies for nurses: Impact on health and illness (2nd ed.). Burlington, MA, Jones & Bartlett Learning.
• Chapter 1: Birth of Transcultural Nursing to Current Theories and Conceptual Models for Cultural Diversity
• Chapter 4: Organization of Health care Delivery in the 21st Century
• Chapter 6: Hispanics/Latinos
• Chapter 7: Asians/Pacific Islanders
• Chapter 8: Native Americans/Alaska Natives
• Chapter 9: Whites (Non-Hispanic)
Articles
Health Research & Educational Trust. (2013). Becoming a culturally competent health care organization [PDF file]. Retrieved from: http://www.hpoe.org/Reports-HPOE/becoming_culturally_competent_health_care_organization.PDF
• This PDF document discusses the health care organization’s role in the community, and how becoming culturally competent will improve patient engagement, education, access to services, and compliance with health care advice.
Tripp-Reimer, T., Choi, E., Skemp Kelley, L. and Enslein, J. (2001). Cultural barriers to care: Inverting the problem. Diabetes Spectrum. 14(1). doi: 10.2337/diaspect.14.1.13
• The full-text version of this article is available at the following url: http://spectrum.diabetesjournals.org/content/14/1/13.full. This article reviews cultural barriers related to a diabetic patient.