Cultural Competence in Nursing Care and Assessment

Introduction

Cultural competence is characterized as the capacity of professionals and service users to efficiently provide medical services that satisfy clients’ personal, social, and linguistic concerns. Thus, it is an essential value in nursing practice for optimal quality care (Henderson et al., 2018). The paper described culture-focused assessment and planning of nursing care. It also describes the interventions and the assessment of the implementation.

Assessment

The client presented to the clinic with signs and symptoms of major depression. The signs and symptoms present in the patient include a loss of interest in some activities that he had been interested in earlier such as playing football. The client had anxiety and sleep disturbances; he has a loss of appetite too. The patient is an African-American and has somatic complaints. The nurse should be aware of the patient’s race, religion, gender equality, and sexual orientation. The language of the client is critical in the communication and obtaining an appropriate history.

The client had a particular preference for food known as soul food for the specific dietary requirements. The patient’s culture supports fried food and fatty meats, especially in social gatherings. The patient said that the food signified the culture of the African Americans. The nurse should also assess any health conditions that the individual may have that contraindicate the patient from the food. The patient is a female, and her sexual orientation is heterosexual. She believes that mental health illness is a punishment by the gods for the possible wrongs. She also believes in traditional healing and claims that the customary healers have not been able to help, so they came for medical treatment. The family spokesman is the husband and is instructed for medical attention. The patient was not well conversant with English, and the nurse used an interpreter.

Diagnosis

The medical diagnosis is depression. The nursing diagnosis and the related comorbidities include; imbalanced nutrition less than body requirements related to reduced appetite and somatic dysfunction as evidenced by weight loss. The second one is disturbed sleep patterns related to depression, as evidenced by the patient’s verbalization. The third nursing diagnosis is impaired verbal communication related to a language barrier, as evidenced by misunderstanding and patient articulation that they do not understand English. The fourth one is that she has impaired social interaction and family processes related to depression, as evidenced by patient verbalization. Lastly is a risk for anxiety disorders related to depression.

Planning

The first step is maintaining the nutritional needs of the patients. The nurse can do that by ensuring come of the appointed nutritional reviews and educating the patient on increasing portions and taking foods that are culturally acceptable in their foods such as soul food. The next plan is the administration of antidepressants as prescribed by the physician. Also, collaboration with the physician. To relieve the sleep disturbance and other depressive symptoms, the nurse can collaborate with the psychotherapist and book cognitive-behavioral therapy (CBT) sessions for the client. Studies have shown that CBT in combination with antidepressants reduces depressive symptoms and is more efficacious in moderate to severe depression (Cuijpers et al., 2019). Educate the patient about depression and the coping mechanism for the relief of the symptom.

Implementation

The nurse should guide the patient on fresh and plant-based foods as they are natural sources of antioxidants. Fruits and vegetables reduce stress and some of the symptoms of depression. (Cuijpers et al., 2019) The patient should also incorporate the soul food as per the history to increase weight. The caregiver, with the help of a nutritionist, has to monitor the weight gain of the individual. The nurse should educate the client to increase portions and take them as per the cultural beliefs. With the help of a counselor, the nurse can counsel the patient on effective sleep patterns and assure that the anti-depressants that will be administered will reduce the depressive symptoms, which will improve sleep. The nurse in collaboration with the psychotherapist can book CBT sessions for the patient.

The nurse should be with the client when interacting and ensure simple language and gestures were possible for the interpreter to understand. Gestures will promote the person’s comprehension and understanding of the orders and plan of care. The nurse should gather information regarding the situations when the patient gets anxious and consider giving anti-depressants such as Fluoxetine to relieve symptoms. (Cuijpers et al., 2019)

Evaluation

The implementation was evaluated by weight gains every nutritional visit for two months. The evaluation of the antidepressants and CBT was evaluated by monitoring the reduction of one of the major symptoms, either depressed mood or loss of interest in other activities. The patient reduced the number of days she was in a depressed mood and started occasional participation in women’s welfare which was her favorite within five weeks. Also, the sleep patterns were evaluated by asking the patient to record the number of nights she had insomnia per week. She recorded only two nights in the fourth week which was a great achievement. The interventions and implementations were effective and the patient signs and symptoms were reduced. The client verbalized a decrease in anxiety levels.

Cultural competence is critical in handling patients with diverse cultural backgrounds. The client cooperated and was willing to accept the plan of care after establishing trust. She respected the orders of the nurse and established rapport. The interpreter helped the individual understand what the nurse said, and this promoted mutual respect. The patient increased portions of the culturally accepted diet, and this enabled weight gain. The client, too, understands the reasons for medication, which promoted relieving the anxiety symptoms and depression. The behavior modification was evident, and their relationship with the family members increased. The cultural and treatment needs of the patient were met.

References

Cuijpers, P., Quero, S., Dowrick, C., & Arroll, B. (2019). Psychological Treatment of Depression in Primary Care: Recent Developments. Current psychiatry reports, 21(12), 129. Web.

Henderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: A concept analysis. Health & Social Care in the Community, 26(4), 590–603. Web.