Cultural competence with african american patients with audio lecutre

Janice K. Warrington, MSNEd, RN, SD/CLTC

One of largest ethnic groups in United States37 million (12.1% population)

Expected to increase to 40.2 million by 2010Multiple racial/ethnic identifiers

Age related differences in preferenceNegro, Black American, person of color, colored

Largely descendants of slavesAfrican American denotes pride in both African

and American heritage

U.S Census Bureau (2009)

Everyculture.com (2008)

Segregation/DesegregationHigh school drop out rate highHigh valueWomen more likely than men to earn

higher degreeUnderrepresented in managerial positionsOver represented in blue collar

Conant, J.B. (1961)

Dominant language EnglishHigh contextDemonstrative and loud-may be

misunderstood as angryDirect eye contact can be seen as

aggressionPresent orientedPrefer to be addressed by surnameMistrust healthcare providers

High percentage MatriarchalGrandparents raising childrenGender roles and childrearing vary widelyValue self-relianceRespect for eldersSocial status is importantValue the Afrocentric Framework

Nguzo Saba The Seven Principles

of KwanzaaUmojo-unityKujichagula-self-determinationUjimaa-Cooperative economicsUjima-collective work responsibilityKummba-creativityNia-purposeImani-faith

Karenga, M. (1999-2009 ) The Nguzo Saba (the seven principles) http://www.officialkwanzaawebsite.org/7principles.shtml

Long history of disadvantage“Glass Ceiling”Absence of African American leadershipIncreased stress

Different assessment techniques required to detect cyanosis, pallor, rashes, and jaundice

Overgrowth of connective tissue leading to keloids

Long bones are longer, bone density is greater than that of Asians, Hispanics, and European-Americans

Greater incidence of birthmarks

Unprotected sexSmokingDrugsAlcoholSedentary lifestyleViolenceDelayed health care

Soul foodHigh fat (fried)Encourage infants to eat early (usually before

2 months)Important to “have meat on their bones”“High blood/Low blood”Dietary deficiencies

Elders provide advicePicaNo picturesInfant clothingReachingInducing laborBelly bands / coins

Very family orientedBig “send off”Long “lay out”Intact body“Falling out”Less likely to have advance directives

Use of prayerReligious affiliation importantTrust in GodCoping mechanism

Suspicious of healthcare providersNatural vs. Unnatural illnessNon compliant with treatmentFolk medicineLow health literacyLack of accessCultural response to health and illnessBlood transfusion/organ donation

Folk practitioners Grandmothers, respected women, elders in the

community, church leaders, root doctors, or voodoo priests and priestesses, who remove hexes

Preference for care provider of the same gender

Folk practitioners held in high esteemPrefer Western healthcare providers who are

familiarMust establish trust