This paper provides credible information that appertains to cultural and religious practices of Indians and Native Americans. It focuses on the two communities due to their diverse cultural and religious practices that distinguish their way of life. The two communities have deeply-rooted norms that define how they operate and execute various activities. The norms also define how they seek for medical interventions. Indeed, individuals from these communities subscribe mostly to native ideals and processes of treatment as opposed to modern Medicare systems. They hold that modern nursing care assistance does not provide holistic treatment to chronic diseases as affirmed by modern medical officials. Notably, the paper adopted California as the region under study where California health center has been used as the interdisciplinary institution.
Firstly, the paper provides detailed background information about the selected population. This is followed by discussion on the physiological, environmental and psychosocial factors that influence communication between members of different groups. Similarly, the paper has covered key barriers that influence the provision of culturally competent health care where race, ethnicity, socioeconomic status and poor communication have been highlighted. The paper also covers ethical health care dilemmas that affect delivery of health services. The evident health care dilemmas highlighted include poor practitioner-client relationship and stigmatization. Cultural assessment model that is appropriate in addressing cross-cultural issues and how it is applied is also discussed in the paper.
This has seen the adoption of trans-cultural assessment model that was developed in 1988. Variably, advancement of communication and education of individuals are cited as key culturally sensitive strategies that can help in mitigating the evident gap between native believers and medical officials. Indeed, the information contained in this paper is meant to promote understanding among society members with strong cultural values and medical officials. It will help in creating amicable understanding between the two groups on the importance of nursing care especially in the modern world.
Background information on the Selected Population
Religion and cultural practices of Native Americans are difficult to explain. This is because they have deeply rooted cultural practices and religion principles that define their way of life. Indeed, the religion of Native Americans focuses majorly on teachings that revolves around nature. The teachings focus mostly on landscape, animals, plants and other environmental elements. They are set with a purpose to enable the locals to understand their historical background and what binds them together as society members. As noted, the nature of Native American religion is based on various practices, ceremonies and traditions as compared to the nature of Indian religion system that focuses more on ceremonies and traditions. Notably, Native Americans have deeply -rooted cultural practices that are different from the Indian cultural practices. The practices influence how they relate with others socially, how they view medical activities and how they execute their economic activities.
Conversely, Indians have a set of beliefs that shape their operations and engagement with others. The beliefs that they tend to uphold with great passion define their way life, worship and decision making on diverse issues. The beliefs that form their shared norms also influence how they view various initiatives in diverse institutions including health centers (Martin & Nicholas, 2010). This is evident since some Indians and Native Americans do not believe in medical assistance that is sought in hospitals. They tend to subscribe to their religious teachings that hold that god is there healer. The also tend to subscribe to ancient treatment practices where natural medicines were used to cure diverse diseases. Strong subscription to cultural practices is preventing them from accepting evident changes that are emerging in diverse spheres of operation.
Indeed, health practices of Indians and local Americans are completely different. The differences are based on their divergent cultural practices and religious beliefs. In particular, Native Americans still believe in traditional Medicare systems. They hold that best treatment can only be achieved when one uses natural medicine. They are not fully against going to the health centers for medical assistance, but their emphasis is on traditional Medicare systems. However, Indians believe that there is no need for one to make several rounds of visits to hospitals. They do not prefer visiting hospitals when they suffer from chronic diseases since they no that healing is from their maker.
Physiological, environmental, psychosocial factors that influence communication within members of different groups
There are various factors that influence communication between individuals who subscribe to certain beliefs and those who does not. This is because individuals in specific groups have shared ways by which they view things that may be completely different from others (Martin & Nicholas, 2010). For instance, achieving absolute agreement between medical officials and individuals who subscribe to certain societal norms has never been easy. The two groups of individuals always engage in deliberations on various issues, but they seem not to find each other on the same path when it comes to discussions on medical issues.
Their disagreements are based heavily on physiological, environmental and physiological factors. These factors influences how individuals reason and how they plan to execute various activities. In particular, environmental factors seem to be causing a lot of complications in various groups. The factors that include structural changes in the environment, technological advancements and new ways of disease diagnosis, affect how people reason especially believers and non believers. Religious believers have always viewed changes in the environment as irrelevant things in their lives (Odom, Owen, Valley & Burrell, 2011). They tend to prefer ancient ways of operation especially treatment processes where they like natural medicine compared to modern medical care systems. This issue has been a major contentious mater between medial officials in California and Indians who live in the region. The contention has been due to lack of agreement about the importance of receiving medical attention for chronic illnesses.
Barriers that influence the provision of culturally competent health care
Evidently, the provision of culturally competent health care is dependent on how well medical officials and society members are able to solve their differences and work with a common plan to enhance health status of individuals. They should eradicate key barriers that have been eroding the provision of quality health care among society members especially in California. The barriers that include race, ethnicity, socioeconomic status and language should be mitigated effectively (Haghshenas, Patricia & Rotem, 2011). They have been key factors that have been influencing the provision of culturally competent medical care to patients especially in California. This has been due to lack of understanding between doctors and locals. It is also because of lack of proper harmonization of cultural practices and religious expectations with modern health care solutions. Firstly, race has been a major issue that has been affecting the provision of competent health care in most settings (Haghshenas Patricia & Rotem, 2011). This is because racism has been promoting unfair treatment of specific individuals who are perceived to be aliens. It has also promoted discriminatory service delivery in most medical centers. Language barrier is another element that has been compromising quality service delivery in hospitals. Other factors that require holistic synchronization include ethnicity and socioeconomic status.
Ethical dilemma in the delivery of health care
As noted, delivery of quality health care must be based on clear principles, guidelines and ideals. The ideals should be socially relevant and culturally acceptable to everyone to avert possible ethical dilemmas that may arise. This is essential in ensuring that everyone in a society is able to receive quality medical assistance without reservations that are based on cultural beliefs (Wilson, Mutha & Swedish, 2010). Key ethical dilemmas that society members and health officials must deal with effectively include practitioner- client relationship and stigma- illness related issues. These are evident ethical issues that affect delivery of quality Medicare in diverse settings. The complications arise when there is lack of trust and understanding among individual’s especially medical practitioners and patients. They also arise when there is high stigmatization in a society.
This makes various individuals to fear from going for treatment in medical centers because they feel that the society would look down upon them. They also feel inferior especially when they are treated unfairly with medial officials (Wilson, Mutha & Swedish, 2010). Stigmatization has been a major issue that has been making most individuals not to seek medical help even in California. Persons who suffer from severe chronic illnesses such as cancer are hardly seeking for treatment due to fear of being stigmatized.
Cultural assessment model
Generally, Culture is defined as traditions or shared norms that shape and influences decision making in various communities. It is a key pillar in ensuring proper integration of competent health programs and their acceptance by the community members towards mitigating the spread of chronic diseases (Odom, Owen, Valley & Burrell, 2011). In this regard, this section discuses culture as a key element that affects the provision of quality health care to the residents of California. It focuses on trans-cultural assessment model that presents essential incentives that aid the understanding on how cultural practices impede delivery of health services.
Description of the model and its elements
According to Paolisso & Dery (2010), trans-cultural assessment model is a culturally competent model that was developed in 1988. Its development was in response to the need for nursing students to understand basic ways by which they can adopt to promote delivery of medical services among native believers. The model has been instrumental in helping medical officials to understand the needs of individuals who subscribe to cultural ideals in various settings. This has enabled medical officials to design special kind of treatment procedures that embraces cultural dynamics. In particular, the model provides six step procedures under which nursing assessment can be carried out. The steps include communication, space, social organizations and time. Others include environmental controls and biological variations. Firstly, communication is an integral element that facilitates the provision of culturally competent health services. It facilitates proper coordination of activities and understanding between doctors and community members (Paolisso & Dery, 2010).
In reality, poor communication has been a key hindrance to the provision of quality Medicare in California and other areas. It has been the reason why proper understanding has not been realized between key stakeholders in the medical sector. Communication is important since it enables medical officials to understand the needs of patients culturally or otherwise and make requisite modalities to accommodate their concerns. Space evaluation forms the second step in the model. It entails establishment of the available space in an institution (Roussel, 2013). This is essential in ensuring that patients are well taken care of and that they are not mixed or subjected to sharing various medical equipments. Space availability is significant because cultural beliefs and religious principles of some individuals do not allow them to share various items.
Therefore, to change the mindset of Native Americans and Indians who are strongly opposed to medical care, they must be assured of their independence by medical officials. Consequently, social organizations and time forms the third and fourth steps respectively. They entail provision of timey services in recognition to social background and status of individuals. Variably, environmental controls and biological variations are key elements that nurses must consider to enable them influence individuals with deeply-rooted cultural practices to find it necessary to receive nursing care. The elements entail understanding of individual’s social orientation, demeanor, religious values and educational patterns.
Application of the model in the identified cultural group, plan of care, health care needs, interdisciplinary approach and healthcare professionals
Clearly, trans-cultural model holds the capacity of revolutionizing delivery of healthcare services in various settings including California. This is evident since it holds the capacity of enabling individuals with strong beliefs against nursing care to understand the imperativeness of modern treatment systems (Morales & Ladhari, 2011). It would enable health officials in California heath center that provides quality Medicare to patients to influence Indians and other local Americans to find it necessary to seek treatment in hospitals. To achieve this, health officials in the institution are expected to apply the model holistically. They should implement all the steps within the model to ensure that proper understanding is attained between the stakeholders. The model should also be applied appropriately to ensure that key barriers that impede healthcare delivery are eradicated.
Proper implementation of this model is bound to enable California heath center to provide quality health care services to every individual in the community irrespective of cultural background or religious affiliation. That is it will facilitate proper mitigation of chronic complications that include cancer, diabetes, heart diseases and asthma that have been affecting most individuals (Roussel, 2013). The services will be provided by well trained and proficient medical officials who include nurses, doctors, surgeons and others. The services are also to be provided using effective equipments such as effective diagnosis and therapeutic machines. Conversely, the implementation of the model will take a chronological sequence where communication between stakeholders will be enhanced first. This will be executed to promote detailed understanding of patient’s needs, social orientation and religious values. This will be followed by space evaluation and social organization respectively. Putting up proper environmental controls and understanding of biological variations will follow.
Two culturally sensitive /competent strategies, their appropriateness and strategies to curb barriers of healthcare
As a cultural broker, it is prudent for communities that are facing challenges in the health sector due to cultural diversities to embrace universal approaches that are socially acceptable. The strategies should be well developed to ensure that they provide the needed incentives towards building cohesive societies (Morales & Ladhari, 2011). They should promote understanding, enable locals to embrace environmental changes and facilitate understanding on the need for the acquisition of specialized treatment when one is sick. For instance, California authorities should develop clear-cut strategies that can steer social integration and understanding among community members.
The strategies should be able to influence the mindsets of Indians and Native Americans who are not ready to embrace emerging advancements or changes in the medical sector. Probable strategies that can help in transforming the level of engagement between individuals and help in eradicating cultural influences are improvement of literacy levels or education and enhancement of communication. The strategies hold the capacity of ensuring that individuals are well enlightened on key changes that take place in their surrounding (Morales & Ladhari, 2011). They will also ensure that proper information is disseminated to various individuals about the irrelevancy of cultural practices. In particular, education will help Indians and other native individuals to be able to communicate well, to establish the significance of nursing care and to ascertain the dangers of relying on traditional medication. Consequently, effective communication will ensure that right information is passed at the right time and to the right people for the right purpose. Variably, evident strategies that can be used to eradicate barriers to health care include enhancement of cultural competence levels and economic status of individuals.
A tool for the evaluation of the effectiveness of the health care plan
The implementation process of the identified strategies or plans that are aimed at improving delivery of heath care services in California should be assessed using a pertinent performance evaluation tool. The assessment should be done to ensure that the objectives of the strategies are obtained without complications. Indeed, benchmarking technique will be adopted to drive the evaluation process. The technique that is regarded as a viable performance measurement tool is to be used since it provides requisite incentives that support performance assessment processes ((Morales & Ladhari, 2011). It enables users to establish the level of performance and productivity. Further, it enables users to establish how well the intended objectives are being met in an institution.
This is evident since it provides credible standards at which performance levels are pegged. The tool is appropriate for this project since it will ensure that all the processes are executed well. Firstly, it will foster detailed assessment on communication systems and if the communication goals are attained. Similarly it will help in establishing health care needs of patients and how the needs can be met adequately. Thirdly, it will facilitate the assessment of how time is utilized because time is a key resource that determines the number of patients that are treated in a setting. Fourthly, the tool will help health officials in setting standards of measuring the effects of biological variations including the magnitude of their effects.
Imperatively, medical institutions and individuals who have deeply-rooted cultural practices should come together and develop viable medical procedures that are acceptable to all. They should build proper medical structures that integrate the needs and expectations of various groups of individuals. In particular, there must be mutual understanding on the need to build a competent health care system that takes into consideration the concerns of every group of people.
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