The Need for Cultural Competence in Nursing

Cultural competence is essential for those working in ethnically and culturally diverse countries. Increasing migratory movements have implications for the cultural composition of society and health care. Scientific evidence shows that cultural competence is a key element in health care quality accreditation standards and processes.  In this way, training in cultural competence receives greater attention from health administrators and educators, given its effectiveness and impact on the knowledge, attitudes and skills of professionals, as well as on patient satisfaction.

Primary Care for the Patients

Specifically in primary care, the health outcomes of culturally competent interventions in the control of chronic diseases, such as type 2 diabetes mellitus, have been documented, highlighting the difficulties of professionals to recognize racial and ethnic disparities and its effect on health. Some studies point to the lack of cultural competence in care as a cause of negative experiences and outcomes with immigrants and ethnic minorities. It is stated that having cultural knowledge and skills is not sufficient for culturally competent care, since it is often difficult to translate such knowledge into action.

The experience of nurses providing care to patients from other cultures reveals strengths and barriers in care, and suggests new meta-synthesis that explores specific cultural settings or groups. In response to this, a meta-synthesis was carried out on the experience of nurses in caring for families of diverse cultural origins, and the constant tension between barriers, cultural manifestations and the ethical responsibility of care was found, but with incipient elements of cultural competence, considering the usefulness of meta-aggregative approaches for decision-making in Evidence-Based Practice (EBP), as well as the evidence they offer of how cultural sensitivity, cultural awareness, behavior and personal experiences of the professional are presented as essential elements to understand cultural competence.

Improving Health tips

The review group defined public health as the set of interventions aimed at improving health through promotion, education, health guidance, prevention, diagnosis, treatment, rehabilitation and palliation of the disease in a setting intra or extra-hospital, both individually and collectively. For its part, cultural competence was considered the knowledge, skills, attitudes and behaviors of nurses to offer public health interventions to people, groups or families of cultures or ethnicities other than their own. Finally, the experiences were taken as everything witnessed, felt or remembered, described by nurses working in the public health area. It includes thoughts, feelings and reflections. In order to synthesize and strengthen this knowledge for public health, the objective of this review was to explore the experiences and impact cultural competence has in nursing.

Cultural Competence

The term cultural competence appears in the literature around the 70s, coming from anthropology. The concept is generated in the United States and England due to the large number of people from different parts of the world, when the “clash” generated between immigrants and service providers was evident. This is how the literature on cultural competence was developed by postgraduate health professionals in human sciences from which explanations have emerged to understand the interactions of the elements of culture and their influence on health. The production focuses on minority, ethnic or immigrant groups, likewise, to the professionals responsible for these services. From this framework, numerous concepts and models have been developed to approach the culture of caring for people.

Understanding of Cultural Competence

However, the proposal of this analysis is to call attention to analyze the benefits that the understanding of cultural competence can offer in the cultural context itself, in particular, if we accept that Latin America is a multicultural society that goes beyond minorities, of ethnic or religious groups. If we incorporate that the worldview is built by the way space, time, power relations, roles, social, economic and political conditions of people and groups are managed.

These patterns can be explicit or implicit, primarily learned and transmitted in the family, taught by other members of the culture, and it is an emergent phenomenon that changes in response to global dynamics. Culture is highly unconscious and has a powerful influence on health and disease.

Just as each family from which it comes prints a series of values ​​and beliefs, each profession modulates those values ​​and beliefs the same, generating a subculture that makes us different and similar to the users of health services. The call for health professionals, exercising in their own cultural context is to recognize the beliefs and practices of the people they serve, to take that meaning into account to design interventions adapted to those groups and to listen to what people understand about what that is proposed to them.

Invites interaction with people from various cultural backgrounds

These encounters can be with people or groups of the same culture, taking as a perspective the possibility of understanding regional differences, socio-economic status, educational or rural or urban origin. These possibilities of interaction make it possible to refine and modify one’s own existing beliefs about a cultural group or find similarities and differences in the same cultural context. It is important to be more sensitive to facial expressions, eye contact, use of touch, body language, and distance and proximity practices when in a cultural encounter.

Published by
Barry Lachey

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