Cultural Competence

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Culture Competence in Nursing
Shannon Karlsson
California State University, Chico

Introduction
According to the United States Census Bureau (2010), over 30% of the total population in the United States is comprised of various ethnicities other than non-Hispanic Whites. This statistic highlights that the United States (US) has a significant multicultural population today. These diverse cultures bring with them new languages, religious beliefs and practices, social structures, and health care beliefs and practices. These cultural differences can create barriers in the healthcare industry and can be challenging to those healthcare providers who are caring for these individuals. As a result, these ethnic minorities often experience poorer access to care and lower quality of preventive, primary, and specialty care. The Hmong are one of the ethnic minority groups listed in the U.S. population. Currently there are more than 170,000 Hmong living in the United States. The majority of Hmong in the U.S. currently reside in California, Minnesota, Wisconsin, North Carolina, and Michigan.

In order to care for these individuals in a more effective manner, nurses must provide culturally competent care to their patients. By providing care that is based on patients’ cultural beliefs, values, and practices, the patient is more likely to adhere to the plan of care outlined by the nurse. History of the Hmong

Among those who have immigrated to the United States are the Hmong. The Hmong are a population of people who live in China, Burma, Thailand, and northern Laos. The Hmong of northern Laos were recruited and trained by the Central Intelligence Agency during the Vietnam Conflict to help prevent the North Vietnamese form invading Laos and South Vietnam through the Ho chi Min Trail. Though they played an important role during this conflict, they were not protected by the US when troops withdrew from the region in 1975. This resulted in many Hmong people being killed by the new communist regime in Laos. Those who did survive fled to refugee camps in Thailand. This population of Hmong form northern Laos were given preferred refugee status by the US in the 1980’s, resulting in a large immigration influx of Hmong into the United States. Hmong Culture

The cultural and ethnic backgrounds of patients can shape their views of health, wellness, and illness. When caring for a patient from another culture, it is important to explore their cultural background, taking into consideration their beliefs, values, daily practices, spirituality. Having a better understanding of how a patient understands illness, perceives treatment plans, and makes healthcare decisions are all significant to the nurse when assessing a patient and creating an appropriate plan of care for them. The Hmong are among those minority groups that continue to be challenge healthcare due to the barriers of language, medical and religious beliefs, medical practices, cultural beliefs, and social organization. Language

The Hmong have their own language called Hmoob; translated as Hmong in English. The Hmong language consists of many dialects, which creates difficulty in providing a quality interpreter when necessary. Also, a written form of the Hmong language did not exist until the 1960’s, creating another complication with communication. Many older Hmong are unable to read or write their own language and the language does not contain many medical terms that are needed for interpretation. Cultural Health Beliefs

Different cultural groups have diverse belief systems with regard to health and healing compared to Western beliefs of medicine and health. Westerners tend to attribute the cause of illness to the individual or the natural world, whereas non-Western peoples explain illness as a result of social and supernatural causes.

The Hmong believe in Animism, a belief where the spirit world is connected to all living things. If the body is...
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