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1. The goal of understanding the concepts of culture is to make it possible for the nurse to provide culturally congruent care, this means providing care that fits the life patterns, values and set meanings of the patient. To achieve this kind of care the nurse needs to learn the defining characteristics of the patient’ culture, their health care practices and their perceptions of health care and wellbeing. In order to apply cultural concepts, one must first identify potential conflicts between the patients’ needs, their practices and their cultural values (Andrews & Boyle, 2016).

To achieve a culturally competent practice Leininger suggested three different modes. Cultural care preservation where one retains relevant care values. Cultural care accommodation, where one negotiates with the patient and family for a beneficial health outcome, and Cultural care repatterning, where one has to change the patient lifestyle for a new and beneficial health care pattern (Andrews & Boyle, 2016). 

Specialized community interventions tailored to the people that is being served are more likely to be in accordance to the community needs and have a better chance of success. Developing these interventions is a collaboration between providers, community leaders and consumers. It is important that these approaches are designed so we can address the needs of individuals, families and the aggregates in the communities. (Andrews & Boyle, 2016)

2. To understand the factors that affect the health or illness of a group one must perform a community assessment, factors like the demographics, number of people, average age, social class and morbidity. Also, the location of the community, urban, rural, weather, diseases characteristics of the area, economic, religious, political systems. All of these factors will play a role in how people do in regards to health care, the availability of services that are convenient and culturally compatible with the patient will determine the likelihood that the patient seeks treatment or care when needed (Hunt, 2013).

Additionally. the nurse should be aware of the subcultures (aggregates that establish different rules from the mainstream group), each subculture needs to be understood in order to plan and provide care in a culturally sensitive way (Andrews & Boyle, 2016).

3.  In order to take care of the refugee population we have to keep in mind that these individuals left their place of origin with a conviction that their lives were in danger, so they are escaping persecution of some kind. In these cases, a thorough assessment needs to be performed before planning to provide care. Factors that need to be known to the nurse include the amount of time the family or the patient has been in the US, if they spent time in other places, camps, or rural areas, languages spoken, religious practices, ethnic identity, family roles and social support available. Once this assessment has been completed the nurse can begin to plan interventions that are culturally sensible for the family (Andrews & Boyle, 2016).

Is important for refugee communities to get access to preventive care, planning dental care, mammography, pap smears, prostate and testicular exams may be a new concept for them and they may need education and assistance to get this kind of care. It is not uncommon that refugees come from cultures where they do not have access to these interventions and they may not be aware of their existence or need. Also is important to keep in mind that for many refugees is important the gender of the provider, women may have been abused or raped in their country, and may avoid healthcare completely if they cannot find a female provider, careful assessment needs to be performed in order to not aggravate an already existing trauma. Another type of trauma to keep in mind when dealing with refugees includes the mental distress and possible residual PTSD from tortures and stressed suffered when fleeing their countries (Andrews & Boyle, 2016). 

4.  Health equality, the idea that every individual should have access to the same level of care and that all individuals must be care for without discrimination due to race, ethnicity or cultural background. (Andrews & Boyle, 2016). 

Diversity should be present in the healthcare workforce, having a mixture of different ethic backgrounds, sexual orientations, socioeconomic levels allow the patient to feel accepted being different, since a mix of different workers exist in the healthcare facility (Andrews & Boyle, 2016). 

Partnership the idea of creating a good and beneficial relationship between the providers and community members and community organizations, these partnerships include reciprocal relationships, focus on prevention education, and understanding community needs (Andrews & Boyle, 2016).

Empowerment moving people of different backgrounds that share a vulnerability, having them work together to achieve the care they need results in empowerment of the individual and the community to take control of their health (Andrews & Boyle, 2016). 

If we can built a healthcare system that is composed of a diverse workforce that will allow our community members to not feel threatened because of being different, that also promotes equity in health services in a community that participates in a partnership with the providers and feels empowered in their health decisions we would have successfully breach the culture barriers that many minorities face in our country. 

Reference

Andrews, M. M., & Boyle, J. S. (2016). Transcultural Concepts in Nursing Care. Alphen aan de Rijn, Netherlands: Wolters Kluwer.

Hunt. R. R. (2013). Introduction to Community Based Nursing (Fifth ed.). Philadelphia, PA: LWW.

Purnell, L. D. (2014). Guide to Culturally Competent Health Care. Philadelphia, PA: F.A. Davis Company.