Culturally Competent Care for Native Americans

In research from Grandpierre et al., Native Americans comprise the fastest-growing ethnic groups in the United States and have various health and social concerns (2018). This means that it is essential to know the native persons’ history to be culturally competent and determine the best practices. Some strategies to discover culturally competent care encompass a variety of techniques. According to Stanley et al., given the substantial trauma that Native Americans face, conventionally, post-traumatic stress disorder should be prioritized during differential prognosis (2017). In other care services, the condition will be misdiagnosed as borderline personality or depression. Again, healthcare providers should concede the trauma intergenerationally encompassing coerced incorporation and the loss of their sacred lands along with family estrangements (Browne et al., 2016). Therefore, health providers need to validate and emphasize the prominence of the surviving natives.

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Healthcare providers, they must recall the vitality of an environment that is welcoming and inviting. This, according to Purnell & Fenkl, means placing decorations such as baskets, pottery, art, or rugs obtained locally (2019). Other ways to encompass translating intake forms to the native language used by the indigenous persons in the region. However, the healthcare staff should not inflict the forms if the indigenous persons are not ready for them, primarily based on the clinical mistrust placed on clinics overseen by the national administration’s primary, secondary rationales (Cruz et al., 2016). As conceded by Grandpierre et al., the assessment should be scrupulous to alleviate misdiagnosis and stereotypes (2018). A healthcare provider should allow the patient to narrate their story and motivate them to share their heritage. Stereotypes healthcare providers must do away with assuming that the native persons do not speak their native language or do not practice their religion. In this respect, as conceded by Browne et al., healthcare providers should engage with patients instead of holding the stereotype that they share a common religion and embrace their beliefs. as they attend to them (2016). However, some traditional preferences require some to discuss their creeds, while others do not disclose their beliefs. In this respect, healthcare providers should discern the difference and respect individual preferences if they wish to provide culturally competent care.

Another strategy that healthcare providers can employ is by utilizing the cultural formulation interview, which helps healthcare providers understand their patient’s preferences, thereby allowing them to approach each patient effectively. According to research, a native patient can tell his story because, typically, storytelling is the native way of passing on their traditions from one generation to the next (Cruz et al., 2016). Also, as Stanley et al. stated, to initiate culturally competent care, there should be a transition from treatment to a soft handoff to the healthcare provider (2017). This approach tends to be an integrative strategy where the primary care provider closely collaborates with other healthcare professionals to provide care to the patient. The intervention process has to be attuned to the native persons and not to the clinic. Also, as conceded by Purnell & Fenkl, the medication should be provided in a manner that respects the person’s beliefs (2019). If any of the components of the medication are considered unholy or holy, they should not be consumed by the natives, and the provider should seek another acceptable treatment for the patient. Lastly, the discharge process should respect the patient’s creeds so that culturally competent, high-quality, patient-centered care can be provided to each Native American.

References

Browne, A. J., Varcoe, C., Lavoie, J., Smye, V., Wong, S. T., Krause, M., Tu, D., Godwin, O., Khan, K., & Fridkin, A. (2016). Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study. BMC Health Services Research, 16(1), 544. https://doi.org/10.1186/s12913-016-1707-9.

Cruz, J. P., Estacio, J. C., Bagtang, C. E., & Colet, P. C. (2016). Predictors of cultural competence among nursing students in the Philippines: A cross-sectional study. Nurse Education Today, 46, 121–126. https://doi.org/10.1016/j.nedt.2016.09.001.

Grandpierre, V., Milloy, V., Sikora, L., Fitzpatrick, E., Thomas, R., & Potter, B. (2018). Barriers and facilitators to cultural competence in rehabilitation services: a scoping review. BMC Health Services Research, 18(1), 23. https://doi.org/10.1186/s12913- 017-2811-1.

Purnell, L. D., & Fenkl, E. A. (2019). Handbook for Culturally Competent Care (pp. 1-6). (1st ed. 2019 ed.). Springer.

Stanley, L. R., Swaim, R. C., Kaholokula, J. K., Kelly, K. J., Belcourt, A., & Allen, J. (2017). The Imperative for Research to Promote Health Equity in Indigenous Communities. Prevention Science, 21(S1), 13–21. https://doi.org/10.1007/s11121-017-0850-9.

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