Cultural Assessment and Teaching In Nursing Education

Assessment and Teaching In Nursing Education Cultural Perspectives of Health Problems and Interventions

Cultural backgrounds significantly shape how individuals perceive health issues and their corresponding treatments. Understanding these cultural perspectives is essential when formulating action plans for short- and long-term behavioral changes. For instance, individuals from different cultural backgrounds may interpret illness and symptoms differently, affecting how they express their concerns verbally and non-verbally, which can present challenges in communication (Campinha-Bacote, 2003).

A critical component of culturally sensitive healthcare is assessing how patients view the cause of their health problems. Some may attribute illness to spiritual interventions, imbalances in nature, or curses, which are culturally rooted beliefs. Nurses should approach these explanations non-judgmentally, as they often reflect the patient’s support system and cultural context.

Culture also determines how illness is defined and treated within a community. For example, some cultures believe that once symptoms disappear, the illness has been cured, which can be problematic for conditions requiring ongoing treatment, such as infections that need a full course of antibiotics. These beliefs may also affect the management of chronic conditions, where periods of remission and exacerbation are misunderstood as recovery and relapse.

Assessment from the Person’s Cultural Aspects

Cultural perspectives also influence a person’s readiness to learn, and it is important to assess this readiness within a cultural framework. For example, some patients may comply with medical recommendations while in a hospital setting but fail to adhere to the prescribed guidelines once they return home due to cultural practices or expectations. Nurses should avoid assuming that patients prioritize the same values and health outcomes that healthcare professionals consider essential.

Cultural factors such as time perception, financial barriers, and environmental constraints can also impact a patient’s readiness to adopt new behaviors. For patients to embrace and sustain behavioral change, they must first believe that the changes are not only achievable but also beneficial (Kessels, 2003).

It is both practical and ethical to provide culturally specific programs and teaching interventions for patients from minority backgrounds. Studies have shown that health outcomes improve when education is tailored to the individual’s cultural context (Bailey et al., 2009; Hawthorne et al., 2008).

Cultural Specific Guidelines for Assessment

When conducting assessments, the following guidelines should be used regardless of the patient’s cultural background (Anderson, 1987):

1. Identify the patient’s primary language: Assess their ability to understand, read, and speak the language of the healthcare provider.
2. Observe family interactions: Determine who makes decisions, the primary caregiver, and culturally significant foods or objects.
3. Listen to the patient: Understand their desires and how they may differ from their family’s or the healthcare team’s expectations.
4. Consider communication patterns: Pay attention to speech rate, non-verbal cues, and your own behaviors that may be culturally inappropriate.
5. Explore customs or taboos: Clarify beliefs and practices that may conflict with the medical care being provided.
6. Understand time perceptions: Some cultures may have different orientations toward time that affect adherence to treatment plans.
7. Determine appropriate communication approaches: Identify culturally relevant symbols and activities that provide comfort to the patient.
8. Assess religious practices: Understand how the patient’s spiritual beliefs influence their perception of illness and treatment.

These steps foster mutual understanding between the nurse and the patient, creating a collaborative environment where both parties can learn from one another. The goal is to negotiate solutions that respect both cultural beliefs and healthcare needs.

LEARN Model for Cross-Cultural Assessment

The LEARN model is another effective framework for enhancing cross-cultural communication in healthcare settings. It encourages healthcare providers to approach patient interactions with cultural sensitivity and consists of the following steps (Berlin & Fowkes, 1983):

• L: Listen with empathy to the patient’s understanding of the health issue.
• E: Explain your own perceptions of the problem.
• A: Acknowledge and discuss both the similarities and differences in understanding.
• R: Recommend treatment options based on a mutual understanding.
• N: Negotiate a treatment plan that incorporates both perspectives.

This model is valuable for bridging communication gaps and ensuring that care plans are culturally appropriate and patient-centered.

Use of Interpreters

When there is a language barrier between the nurse and the patient, it is critical to use an interpreter. Ideally, professionally trained interpreters should be used, as they are more likely to provide accurate and complete translations than ad hoc interpreters, such as family members or friends. Research shows that family or friends acting as interpreters are more likely to make significant errors in translation, which can affect the patient’s understanding and care (AHC Media, 2012; Flores et al., 2012).

Family members and friends may also omit parts of the conversation they deem irrelevant or inappropriate, potentially leading to misunderstandings. Furthermore, using family members as interpreters can inhibit patient-nurse communication and violate privacy and confidentiality (Hadziabdic & Hjelm, 2013; Kaur et al., 2014).

Professional interpreters, on the other hand, are trained to convey information verbatim and adhere to ethical standards of confidentiality. Nurses should consider several factors when determining the need for an interpreter, such as the complexity of the information being conveyed, the patient’s language proficiency, and the availability of resources (Schenker et al., 2008).

If an interpreter is unavailable, technology-based options such as telephone interpreting services or translation apps (e.g., Vocre, My Language Pro) can be used to facilitate communication. These services are HIPAA-compliant and available 24/7, providing a practical alternative in many healthcare settings.

Strategies When Using an Interpreter

When an interpreter is not available, or the patient has partial fluency in English, the following strategies can be helpful (Juckett, 2014; Stanislav, 2006):

• Speak slowly and distinctly, allowing extra time for the session.
• Use simple sentences with an active voice rather than passive constructions.
• Avoid technical terms, medical jargon, and idiomatic expressions that may confuse the patient.
• Organize the information in a logical sequence.
• Verify the patient’s understanding using the “teach-back” method or asking for a return demonstration.

By implementing these strategies, nurses can improve communication and understanding when caring for patients with limited English proficiency.

Conclusion

Culturally sensitive healthcare is essential for achieving positive patient outcomes. Understanding cultural perspectives on health problems, conducting thorough assessments, and using frameworks like the LEARN model are crucial steps in providing culturally competent care. When language barriers exist, professional interpreters should be used whenever possible, and nurses must employ effective communication strategies to ensure that patients understand their treatment plans.

By fostering a culturally sensitive approach, nurses can build strong, respectful relationships with their patients, ensuring that care is both personalized and effective. Cultural competence in healthcare enhances patient satisfaction, improves adherence to treatment, and ultimately leads to better health outcomes.