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” The purpose of this article is to provide nurses with a set of culturally competent skills that will enhance the delivery of patient-centered care in the midst of a cultural conflict.I will begin by offering a conceptual framework for cultural competence and a description of the cultural skill needed to formulate a mutually acceptable and culturally relevant treatment plan for each patient. Vol16No02Man05 Key words: cross-cultural care, cross-cultural conflict, cultural assessment, cultural competence, cultural conflict, cultural differences, cultural encounters, cultural interactions, cultural skill, patient-centered care, patient centeredness Betancourt, Green, Carrillo, and Park (2005) have asserted that one of the factors leading to the emergence of cultural competence and patient-centered care as important issues in healthcare delivery was the publication of two landmark Institute of Medicine (IOM) reports — Crossing the Quality Chasm (IOM, 2001) and Unequal Treatment (Smedley, Stith, & Nelson, 2003), which highlighted the importance of patient-centered care and cultural competence.Next I will describe effective approaches for cultural encounters. The Institute of Medicine's Report, Crossing the Quality Chasm, identified patient-centered care as one of six aims for high quality healthcare, while Unequal Treatment emphasized the importance of developing cultural competence among healthcare providers so as to eliminate racial/ethnic healthcare disparities.Finally I will present a vignette that illustrates how the nurse can deliver patient-centered care when the patient’s health beliefs, practices, and values are in direct conflict with medical and nursing guidelines Vol. As cultural competence and patient-centered care have gained recognition and popularity, considerable ambiguity has developed in the definition and use of these two concepts across settings (Saha, Beach, & Cooper, 2008). (2008) have argued that advocates of patient centeredness contend cultural competence is merely one aspect of patient-centered care, while proponents of cultural competence have asserted the converse.Beach, Saha, and Cooper (2006) succinctly summarized the differences and similarities between these two approaches in the following way: Both patient-centeredness and cultural competence aim to improve health care quality, but each emphasizes different aspects of quality.The primary goal of the patient-centeredness movement has been to provide individualized care and restore an emphasis on personal relationships. Alternatively, the primary aim of the cultural competence movement has been to increase health equity and reduce disparities by concentrating on people of color and other disadvantaged populations (p. Despite these differences, there is consensus that there is an overlap in how patient centeredness and cultural competence are operationalized, and consequently in what they have the potential to achieve.Finally, the nurse works to negotiate a treatment plan, recognizing that it may be beneficial to incorporate selected aspects of the patient’s culture into the patient-centered plan. Sue, D., Bernier, J., Durran, A., Feinburg, L., Pedersen, P., Smith, C., & Vasquez-Nuttall, G.
For example, Berlin and Fowkes (1982) suggested the mnemonic, LEARN, in conducting a cultural assessment. CULTURAL DESIRE - The motivation of the healthcare professional to "want to" engage in the process of becoming culturally competent; not the "have to." CULTURAL AWARENESS - The deliberate self-examination and in-depth exploration of one's biases, stereotypes, prejudices, assumptions and “isms” that one holds about individuals and groups who are different from them.It involves the integration of cultural desire, cultural awareness, cultural knowledge, cultural skill, and cultural encounters.Table 1 lists the assumptions of the model, while Table 2 defines each of the constructs of this model.” The purpose of this article is to equip nurses with a set of culturally competent skills that will enhance the delivery of patient-centered care in the midst of cultural conflict. perceiving and evaluating health care from the patient’s perspective and then adapting care to meet the needs and expectations of patients” (p.vi), the process of cultural competence in the delivery of healthcare services model of cultural competence (Campinha-Bacote, 2007) has defined cultural competence as the ongoing process in which the healthcare professional continuously strives to achieve the ability and availability to work effectively within the cultural context of the patient (individual, family, and community).Campinha-Bacote’s (2007) model of cultural competence, called the process of cultural competence in the delivery of healthcare services, serves as a conceptual framework to deliver patient-centered care in the midst of cultural conflict. This model requires nurses to see themselves as becoming culturally competent rather than being culturally competent.
At the core of both patient centeredness and cultural competence is the importance of seeing the patient as a unique person.