The Three CCCs of Dysphagia Management: Culturally Competent Care

2020 ◽  
Vol 5 (4) ◽  
pp. 1000-1005
Author(s):  
Kellyn D. Hall ◽  
Leslie W. Johnson
Keyword(s):  
Multicultural Literature ◽  
Linguistically Diverse ◽  
Cultural Humility ◽  
Culturally Competent ◽  
Patient Centered ◽  
Optimal Care ◽  
Speech Language Pathologist ◽  
Cultural Variables ◽  
Centered Care ◽  
Make Health Care

Purpose Patient-centered care is a healthcare approach that values an individual's right to make health care choices. For patients with dysphagia, honoring choices that carry significant health risks is challenging. This article presents strategies adapted from the multicultural literature to enhance patient engagement and help balance choices for quality of life while mitigating potential negative health consequences. The goal is to provide clinicians with knowledge gleaned from multicultural resources to deliver optimal care that considers both cultural and ethical factors. Method The authors use a hypothetical case of an older adult woman with dysphagia whose family is disagreeing with diet recommendations to introduce the concepts of culture, cultural humility, cultural competence, and ethical considerations. The authors present strategies for working with culturally diverse patients to show that these strategies can be adapted for use with any patient, regardless of cultural background. Conclusion Adopting a perspective that every patient presents with many cultural variables that can influence dysphagia management encourages the speech-language pathologist to approach each patient through a multicultural lens. Strategies and approaches for working with culturally and linguistically diverse patients can be adapted and inform the speech-language pathologist on ways to establish a dynamic of shared decision making for successful outcomes.

Home Health Nurses’ Journey Toward Culture-Sensitive/Patient-Centered Skills: A Grounded Theory Study

2021 ◽  
pp. 108482232110278
Author(s):  
Mary Curry Narayan ◽  
Robert Kevin Mallinson
Keyword(s):  
Grounded Theory ◽  
Patient Centered Care ◽  
Home Health ◽  
Care Planning ◽  
Culturally Competent ◽  
Patient Centered ◽  
High Quality ◽  
Culturally Competent Care ◽  
Home Health Nurses ◽  
Centered Care

Introduction. Home health patients, who are members of minority and vulnerable groups, suffer disparate outcomes. Patient-centered care (PCC) and culturally-competent care (CCC) aim to facilitate high-quality, equitable care. How home health nurses incorporate PCC and CCC principles into their assessment and care-planning practices has not been -investigated. This study answers the question, “ What is the process by which home health nurses develop their culture-sensitive/patient-centered assessment and care planning skills?” Methods. Home health nurses (n= 20) were recruited into this grounded theory study from agencies around the United States via flyers, websites, and contacts. We conducted in-depth recorded interviews using a semi-structured interview guide to ask questions about nurses’ assessment and care-planning practices, their understanding of CCC and PCC principles, and facilitators/barriers to CCC and PCC practice. Results. Participants primarily gained their CCC and PCC assessment and care-planning skills through a “seat of your pants,” trial-and-error process, with little educational or agency assistance. They combined caring, diverse patient experiences, and critical, creative self-reflection on their experiences to gradually learn helpful, though not optimal, CCC and PCC strategies. However, they reported numerous barriers that discouraged or distressed them in their quest to deliver culturally-competent and patient-centered care. Only a few nurses demonstrated the resilience to overcome these challenges creatively and happily. Conclusion. If we accept that patient-centered care and culturally competent care are key elements of high-quality, equitable care, this grounded theory may help home healthcare clinicians, administrators, educators, and policy-makers identify impact points for enhancing CS/PC practices.

scholarly journals Telemedicine and the Interdisciplinary Clinic Model: During the COVID-19 Pandemic and Beyond

2020 ◽  
Vol 163 (4) ◽  
pp. 673-675 ◽  
Author(s):  
Lisa A. Zughni ◽  
Amanda I. Gillespie ◽  
Jeanne L. Hatcher ◽  
Adam D. Rubin ◽  
John Paul Giliberto
Keyword(s):  
Care Delivery ◽  
Upper Airway ◽  
The Novel ◽  
Speech Language Pathology ◽  
Patient Centered ◽  
Speech Language Pathologist ◽  
Centered Care ◽  
Language Pathology ◽  
Novel Coronavirus ◽  
Improve Access

The emergence of the novel coronavirus disease 2019 (COVID-19) and the subsequent need for physical distancing have necessitated a swift change in health care delivery. Prior to the COVID-19 outbreak, many institutions utilized an interdisciplinary clinic model including both a laryngologist and a speech-language pathologist for the evaluation of patients with voice, swallowing, and upper airway disorders. To improve access, many providers are pursuing the use of interdisciplinary telemedicine to provide individualized patient-centered care while allowing for physical distancing. The purpose of this commentary is to review the current literature regarding telemedicine in laryngology and speech-language pathology as well as the current and future states of practice for interdisciplinary tele-evaluations.

It's Not Such a Small World After All: The Intersection of Food, Identity, and the Speech-Language Pathologist

2021 ◽  
pp. 1-9
Author(s):  
Paula Leslie ◽  
Bridget Xia ◽  
Jaemin Yoo
Keyword(s):  
World View ◽  
Small World ◽  
Well Being ◽  
Cultural Humility ◽  
Optimal Care ◽  
Speech Language Pathologist ◽  
Starting Point ◽  
Swallowing Problems ◽  
Health And Illness ◽  
Food And Drink

Purpose Working with patients and families with different cultural backgrounds is now commonplace in all areas of speech-language pathology. This includes supporting those with eating, drinking, and swallowing problems. Becoming more culturally sensitive as clinicians requires us to think less of them versus us, and instead what matters to them, and how best for us to provide expert care. Our starting point for this important topic is not how we tweak our clinical recommendations to fit someone's “culture.” Rather, let us examine what is culture and how should it factor into our professional work? We need to understand how our patients and families view health and well-being, or lack thereof, in general. This will enable us to frame our support and offer optimal care to all stakeholders. This leads naturally to a consideration of the concepts of autonomy, informed consent, and how these factor into person-centered care, and shared decision making. Conclusions As well as gaining an understanding of the frameworks of health and illness, we consider how food and drink are much more than mere nutrition and hydration. Foods signal our individual and collective identities. Thus, to be a respectful and professional clinician, we need to appreciate our role as a cultural guest with all whom we serve. We propose that there is no such thing as being “culturally competent.” Expert clinicians possess a respect for the patient and their expertise-by-experience of health and illness. Such respect is founded in the position of cultural humility, to be a guest of someone's world view, in the same way that we respect being a guest in a patient's physical home.

Nutritional Considerations in Dysphagia to Prevent Malnutrition

2014 ◽  
Vol 23 (4) ◽  
pp. 157-165
Author(s):  
Melissa Kline ◽  
Deborah Hutcheson
Keyword(s):  
Oral Intake ◽  
Care Plan ◽  
Nutrition Status ◽  
Registered Dietitian ◽  
Therapeutic Approaches ◽  
Patient Centered ◽  
Speech Language Pathologist ◽  
The Social ◽  
Centered Care

As partners in patient care the speech-language pathologist (SLP) and the registered dietitian (RD) work together to treat patients with dysphagia and should be able to communicate and address the patient's nutrition status in their diagnostic and therapeutic approaches. Avoiding deterioration of nutrition status (malnutrition and dehydration) through early intervention and treatment is key to decreasing the associated costs and declines in quality of life. Gaining an understanding of the social and physiologic factors that impact oral intake and nutritional status throughout the lifespan assists the SLP to better collaborate with the RD to develop a patient-centered care plan to improve the quality of care and facilitate positive patient outcomes in this population.

scholarly journals A community-engaged approach to examining barriers and facilitators to accessing autism services in Korean immigrant families

Autism ◽  
2021 ◽  
pp. 136236132110340
Author(s):  
Vanessa C Fong ◽  
Bo Sang Lee ◽  
Grace Iarocci
Keyword(s):  
Linguistically Diverse ◽  
Barriers And Facilitators ◽  
System Level ◽  
Service Access ◽  
Culturally Competent ◽  
Korean Immigrant ◽  
Negative Attitudes ◽  
Behavioral Challenges ◽  
Korean Parents ◽  
Centered Care

This study adopted a community-engaged approach to explore Korean parents’ perceptions of barriers and facilitators to accessing autism services in British Columbia, Canada. Understanding the experiences of culturally and linguistically diverse families and their children may help facilitate the development of more inclusive, appropriate, and culturally sensitive services. Semi-structured interviews with 20 Korean parents of autistic children were analyzed using a thematic approach. Barriers and facilitators at the system, provider, and family/cultural level were identified. Barriers at the system level included delays and waitlists for services, and ineffective school policies to address child behavioral challenges. At the provider level, barriers included a lack of qualified professionals, negative attitudes, and lack of guidance navigating services. For family/cultural-related barriers, language and communication difficulties, out-of-pocket costs, and stigma impeded service access. Facilitators at the system level included family-centered care and prioritization of mental health supports. At the provider level, strengths included culturally competent and bilingual professionals. The family/cultural-related facilitators identified were informal support networks, characteristics of the parent, and connections to cultural community organizations. The findings emphasize the need to understand and consider diverse experiences, preferences, and values in the design and provision of autism services for families and their children. Lay abstract Perceptions and experiences of culturally and linguistically diverse groups in accessing autism services in Canada are extremely limited. Thus, this study partnered with a community member to explore Korean immigrant parents’ perceptions of barriers and facilitators to accessing autism services in British Columbia, Canada. Interviews were conducted with 20 Korean parents of autistic children. Barriers and facilitators at the system, provider, and family/cultural level were identified. Barriers at the system level included delays and waitlists for services, and ineffective school policies to address child behavioral challenges. At the provider level, barriers included a lack of qualified professionals, negative attitudes, and lack of guidance navigating services. For family/cultural-related barriers, these included language and communication difficulties, out-of-pocket costs, and stigma impeded service access. Facilitators at the system level included family-centered care and prioritization of mental health supports. At the provider level, strengths included culturally competent and bilingual professionals. The family/cultural-related facilitators identified were informal support networks, characteristics of the parent, and connections to cultural community organizations. The findings emphasize the need to understand and consider diverse experiences, preferences, and values in the design and provision of autism services for families and their children.

scholarly journals Time's Up! Needed Cultural Changes in Athletic Training Education and Clinical Practice

2021 ◽  
Vol 16 (1) ◽  
pp. 87-93
Author(s):  
Destinee Grove ◽  
Jamie Mansell ◽  
Dani Moffit
Keyword(s):  
Clinical Practice ◽  
Cultural Competence ◽  
Athletic Training ◽  
Athletic Trainers ◽  
Holistic Approach ◽  
Athletic Training Education ◽  
Culturally Competent ◽  
Patient Centered ◽  
Cultural Changes ◽  
Centered Care

Context Culturally competent care has been on the radar of peer health care professions for many years. The unique patient populations that athletic trainers work with lend us to be at the forefront of delivering truly patient-centered care. However, we have not yet appropriately incorporated this tenet of evidence-based practice. Objective To convey the importance of culturally inclusive care and education to athletic training clinical practice and educational programs. We also present a novel way to intertwine inclusivity in the classroom and the clinic in a way that is accessible at any point in one's cultural competence journey. Background Historically, cultural competence in athletic training education has focused on ethnicity and race. The students we teach and the patients we treat share a variety of cultures that are often forgotten yet need to be included for a more holistic approach. Recommendation(s) Athletic trainers and athletic training educators need to continue the journey toward delivering culturally inclusive care. This journey also needs to extend to the classroom, from the delivery methods of teaching to the way we interact with our students. Teaching priorities should include a focus on the cultures around and within our profession.

Students Involvement in Multilingual and Multicultural Community Services

2015 ◽  
Vol 22 (2) ◽  
pp. 77-89 ◽  
Author(s):  
Ying-Chiao Tsao
Keyword(s):  
Service Learning ◽  
Cultural Competence ◽  
Linguistically Diverse ◽  
Community Services ◽  
Cultural Humility ◽  
Self Assessment ◽  
Multicultural Community ◽  
Raising Awareness ◽  
Hands On ◽  
Teaching Learning

Promoting cultural competence in serving diverse clients has become critically important across disciplines. Yet, progress has been limited in raising awareness and sensitivity. Tervalon and Murray-Garcia (1998) believed that cultural competence can only be truly achieved through critical self-assessment, recognition of limits, and ongoing acquisition of knowledge (known as “cultural humility”). Teaching cultural humility, and the value associated with it remains a challenging task for many educators. Challenges inherent in such instruction stem from lack of resources/known strategies as well as learner and instructor readiness. Kirk (2007) further indicates that providing feedback on one's integrity could be threatening. In current study, both traditional classroom-based teaching pedagogy and hands-on community engagement were reviewed. To bridge a gap between academic teaching/learning and real world situations, the author proposed service learning as a means to teach cultural humility and empower students with confidence in serving clients from culturally/linguistically diverse backgrounds. To provide a class of 51 students with multicultural and multilingual community service experience, the author partnered with the Tzu-Chi Foundation (an international nonprofit organization). In this article, the results, strengths, and limitations of this service learning project are discussed.

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