HEALTH CARE MANAGEMENT

Health Care Management

Health Care Management

According to recent Census information, the number of Mexican Americans is on the rise in the United States. Given this information, it is the duty of health care professionals to become culturally competent in the values and beliefs that affect the health and well-being of Mexican Americans (Zoucha, 2000). It is also necessary to understand the significance their culture plays in the treatment of health issues in order to enhance the effectiveness of care and improve treatment outcomes. Not meeting the health care needs and preferences of culturally and diverse populations can increase delays in clients seeking care, create obstacles for the nurse, make it difficult to obtain information, cause problems in making an appropriate diagnosis and developing treatment plans, and cause ineffective communication between the client and the healthcare provider (Lancaster, 2004). Certain guidelines should be followed by the nurse in order to establish a good assessment. The assessment should be family focused, considerate of values and traditions, understanding of educational level and socioeconomic status, overcome language barriers, and take into consideration of the client's interpretation of the health problem and prognosis. Organizational factors within the culture, coping patterns and strategies, and culturally sensitive interventions also need to be assessed to provide the client with appropriate care.

The scenario to be looked at is a 22-year-old Hispanic woman who is native to Mexico, Olivia Garcia, has 12 years of schooling and does not speak English. She is married to Gilberto, a 29-year-old Initiating Hospice Care food service worker with a degree from a Mexican university. Gilberto previously worked in Mexico as a tax auditor. He speaks some English. The couple is legal immigrants living in the United States, living with their extended family of 12 members in a two-bedroom dwelling.

During Olivia's first pregnancy, she had no antenatal care and developed a urinary tract infection that resulted in toxic shock and a premature delivery. After a complicated labor, Maria was born at 26 weeks, weighing 1020 grams. Increased intracranial pressure due to hemorrhage developed and a ventriculo-peritoneal shunt was inserted. Olivia also developed a postpartum complication of disseminated intravascular coagulation. Mom and baby were discharged home after mom's recovery and the case was referred to public health nursing for follow-up.

The public health nurse (PHN) found that the baby was cared for by the relatives during the first visit. Communication with the family was difficult as the nurse did not speak Spanish. Olivia stated that she did not want to have any more children. Even though the father stated that they realized Maria would need special care and that they would do their best to take care of her, Maria had not been given any immunizations and had missed two physician appointments by age three months. Family and relatives were devastated when the PHN reported the case to Child Protective Services for negligence and risk to the child's life.

Successful cultural assessment integrates the nurse's knowledge of their own culture and an awareness of the culture of the ...