The Hispanic population in the U.S has been growing significantly over the past decades. Hoffman (2011) has reported that the U.S Hispanic community accounts for 16% of the entire U.S population. The principal concern is the persistence of disparities in the U.S healthcare system. The Hispanic population continues to experience adverse health outcomes just like the other minority groups (Whittemore, 2007). As such, it is imperative to develop and promote feasible strategies that enhance healthcare quality and access (Bourque, 2011). The provision of culturally competent care will play a fundamental role in decreasing poor health outcomes and health disparities in the Hispanic population.
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The primary function of a cultural broker in nursing is to mediate the inherent cultural divides that exist in contemporary healthcare settings. The essence of cultural brokering is to reconcile traditional beliefs and perceptions with conventional nursing practices (Saha, Beach, & Cooper, 2008). According to Hoffman (2011), ethnicity, race, and language constitute the prominent factors that shape individual behavior and beliefs about health and wellbeing. Other components include socio-economic status, gender, education, and sexual orientation (Douglas et al., 2011). The promotion of health equity among the Hispanic population will necessitate the implementation of the following culturally sensitive strategies.
The first strategy will entail facilitating efficient communication using certified and competent medical interpreters. Whittemore (2007) has demonstrated that the majority of people from the Hispanic community have limited proficiencies in both spoken and written English. Communication and language barriers undermine the quality and amount of care that patients from minority groups receive (Lurie et al., 2008). For example, Hoffman (2011) has found out that American Latinos who speak Spanish alone are less likely to seek medical or preventive care than the es do. In addition, Whittemore (2007) has asserted that more than 50% of non-English speakers do not have access to interpreters whenever they seek health services.
Communication and language limitations lead to poor quality of care, patient dissatisfaction, and lack of adherence. According to Douglas et al. (2011), Spanish-speaking Latinos report dissatisfaction and problems with the health care services they receive than the English speakers. Thus, the level of satisfaction with the healthcare system depends on the type and quality of interpretation services that are available to patients (Whittemore, 2007). Bourque (2011) has argued that bilingual providers and professional interpreters enhance patient satisfaction significantly. Conversely, patients are dissatisfied when care providers use family or non-professional interpreters because they do not adhere to ethical standards and guidelines (Hoffman, 2011).
Effectual communication strategies are essential owing to the high levels of illiteracy among the Hispanic population. Poor health literacy is one of the factors that influence health care access and disparities (Bourque, 2011). Although most Americans have low health literacy, this limitation affects people from ethnic and racial minorities disproportionately. Whittemore (2007) has posited that language and cultural barriers, coupled with differing education opportunities have contributed to the lower levels of literacy in these population groups. It is essential to ensure that the Hispanic population understands prescription orders, insurance forms, and health education materials. These strategies will not only support adherence to medication but also reduce medical costs (Douglas et al., 2011).
The second strategy will be to acknowledge the cultural beliefs that the Hispanic population attaches to diseases and treatment options. Some people within the Latino community continue to rely on traditional healers and folk medicine (Douglas et al., 2011). Nonetheless, these cultural practices do not replace conventional medicine completely. On the contrary, the Latinos use herbal therapies and other non-allopathic remedies together with Western medicines (Whittemore, 2007). It is crucial to understand and appreciate the influence of cultural norms on health-seeking behaviors among the Hispanic population. Although most Latinos do not adhere to folk medicine exclusively, it is necessary to ascertain the relationship between cultural beliefs and health outcomes (Bourque, 2011).
Differences in the articulation and ordering of social and cultural norms affect the clinical experiences of Latinos in the health care system (Bourque, 2011). The widespread values in the Hispanic community include politeness (simpatia), warm personal interactions (personalismo), respect (respeto), family ties (familismo), and resignation to fate (fatalismo). The preceding attributes are broad and may not necessarily apply to a given situation or patient (Whittemore, 2007). Conversely, knowledge of these larger cultural inclinations is critical to understand patients’ actions and behavior (Saha, Beach, & Cooper, 2008). For instance, a nurse may perceive the lack of eye contact as inattentiveness. By contrast, this kind of behavior signifies respect for authority in the Hispanic community (Whittemore, 2007).
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The most fundamental aspect within the Hispanic community is the value of communal inclinations and collectivism. For instance, Whittemore (2007) has indicated that group interest and mutual empathy supersede individual preferences in this population group. On the other hand, Lurie et al. (2008) has asserted that Latino cultures place more emphasis on family-centered rather than autonomous decision-making processes. The significance of this cultural norm is that Western medicine stresses person-centered care. Consequently, patients from this community receive unsatisfactory services if clinicians separate individual needs from those of their families and communities (Hoffman, 2011). Whittemore has argued that Latino families play an enormous role in the recovery process.
Bourque B. R. L. (2011). A critical lens on culture in nursing practice. Nursing Ethics, 18(4), 548-559.
Douglas, M. K., Pierce, J. U., Rosenkoetter, M., Pacquiao, D., Callister, L. C., Hattar-Pollara, M., … Purnell, L. (2011). Standards of practice for culturally competent nursing care: 2011 update. Journal of Transcultural Nursing, 22, 317-333.
Hoffman, N. A. (2011). The requirements for culturally and linguistically appropriate services in health care. Journal of Nursing Law, 14(2), 49-57.
Lurie, N., Fremont, A., Somers, S. A., Coltin, K., Geltzer, A., Johnson, R., … Zimmerman, D. (2008). The national health plan collaborative to reduce disparities and improve quality. Joint Commission Journal on Quality and Patient Safety, 34(5):256-265.
Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence and healthcare quality. Journal of National Medical Association, 100(11), 1275-1285.
Whittemore, R. (2007). Culturally competent interventions for Hispanic adults with type 2 diabetes: A systematic review. Journal of Transcultural Nursing, 18(2), 157-166.