Nursing Care and Ethnogreriatric Aspects
Ethnogeriatrics, Demographics Effects,Historical Review
Ethnogeriatrics
Ethnogeriatrics
is an evolving multidisciplinary subspecialty in geriatrics which examines
health and aging issues in the context of cultural beliefs, values, and
practices among racial and ethnic minority elders.
Demographics Effects
Demographic effects,
heterogeneity, barriers to access and utilization of services, interaction of
culture based practices and formal systems, impact of public policies, and
culturally sensitive patient-provider relationships are key concepts in the
field (Harper, 1990; McBride, Morioka-Douglas, & Yeo, 1996; Richardson,
1996).
They provide useful information to guide health care delivery systems
and service providers in reducing health disparities. Because nursing science
is deeply rooted in integrative and holistic perspectives.
It is well positioned
to explore multifaceted conceptual frameworks such as the explanatory model
(Kleinman, Eisenberg, & Good, 1978) and transtheoretical models (Plowden
& Miller, 2002; McBride et al. , 1998), and blend them into established or
evolving nursing theories (Chen, 1996; Leininger, M., & McFarland, M.,
2002).
Historical Review
A
review of literature from 1996-2002 on. African-American and Asian-American
older adults was summarized according to: what is known about access to
community based health care, issues raised by research findings, and gaps in
research (McBride & Lewis, 2004).
The limited research on chronic diseases
shows variations in type of illness, prevalence of disease, and quality of care
(eg) Baumann, Chang, & Hoebeke , 2002; De la Cruz, McBride, Compas , Calixto,
& Van Derveer , 2002; Ness, Nassimiha , Feria, & Aronow , 1999).
Information on cohorts of older African Americans is predominantly on
individuals born in the United States and descendants of slaves from Africa.
In
contrast, studies on cohorts of older Asian Americans, whose ethnic origins are
from over 50 countries, consist of a mix of recent immigrants, long-stay
residents, and US born.
Important differences between and within groups (or
heterogeneity) in terms of cultural beliefs and historical experiences are
seldom measured and examined as factors contributing to disparities in access
and utilization of services.
Descriptive, exploratory, cross-sectional studies
dominate the research effort on African-American and Asian-American older
adults to identify unmet needs; few focus on culturally appropriate
interventions. In some large databases, health status is often measured by
self-reports (McBride & Lewis).
However, it is unlikely that the
information is verified by clinical data or linked with culture-based
practices, particularly for those who are monolingual, low acculturated, or
less educated older people.
In view of the projected 12% increase in racial and
ethnic minority elders by 2030 and a continuing climate of rapidly diminishing
resources, pursuing well designed longitudinal intervention studies with
randomized samples using culturally relevant research designs (eg, case study
designs) which are critical to improving quality of care for racial and ethnic
minorities is a serious challenge to current and future nurse scientists.