scholarly journals Validation of an Inventory for Providers to Self-Assess Their Engagement in Patient-Centered Culturally Sensitive Health Care

2017 ◽  
Vol 4 (3) ◽  
pp. 129-137
Author(s):  
Carolyn M Tucker ◽  
Julia Roncoroni ◽  
Guillermo Wippold ◽  
Whitney Wall ◽  
Michael Marsiske
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cultural Sensitivity ◽  
Culturally Diverse ◽  
The United States ◽  
Culturally Sensitive ◽  
Care Providers ◽  
Validity And Reliability ◽  
Patient Centered ◽  
Culturally Sensitive Care

Objective: Cultural sensitivity training of health-care providers could help eliminate health disparities. The Tucker-Culturally Sensitive Health-Care Provider Inventory (T-CSHCPI) is an inventory for providers to self-assess their engagement in patient-defined/-centered culturally sensitive health care. The T-CSHCPI is novel in that it assesses providers’ strengths and areas of growth in their efforts to provide culturally sensitive care as defined by culturally diverse patients. Methods: Using ratings on this inventory by a sample of culturally diverse providers (N = 291) from 67 health-care sites across the United States, a confirmatory analysis of the T-CSHCPI was conducted, and its validity and reliability were determined. Results: Factor analysis produced a final solution with 4 factors (interpersonal skills, conscientiousness, sensitivity, and disrespect/disempowerment) that were reliable. These 4 factors are associated with cultural competence, suggesting validity. Discussion: The T-CSHCPI measures independent dimensions of patient-centered care as identified by a national sample of health-care providers. The T-CSHCPI can be used to inform training that promotes patient-centered culturally sensitive health care by providers.

scholarly journals The United States Does CAIR About Cultural Safety: Examining Cultural Safety Within Indigenous Health Contexts in Canada and the United States

2016 ◽  
Vol 28 (3) ◽  
pp. 269-277 ◽  
Author(s):  
Francine Darroch ◽  
Audrey Giles ◽  
Priscilla Sanderson ◽  
Lauren Brooks-Cleator ◽  
Anna Schwartz ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Cultural Competence ◽  
American Indian ◽  
Health Care Providers ◽  
Cultural Sensitivity ◽  
Cultural Awareness ◽  
The United States ◽  
Cultural Safety ◽  
Care Providers

Purpose: This article examines the concept and use of the term cultural safety in Canada and the United States. Design: To examine the uptake of cultural awareness, cultural sensitivity, cultural competence, and cultural safety between health organizations in Canada and the United States, we reviewed position statements/policies of health care associations. Findings: The majority of selected health associations in Canada include cultural safety within position statements or organizational policies; however, comparable U.S. organizations focused on cultural sensitivity and cultural competence. Discussion: Through the work of the Center for American Indian Resilience, we demonstrate that U.S. researchers engage with the tenets of cultural safety—despite not using the language. Conclusions: We recommend that health care providers and health researchers consider the tenets of cultural safety. Implications for Practice: To address health disparities between American Indian populations and non–American Indians, we urge the adoption of the term and tenets of cultural safety in the United States.

“We’re a Little Biased”: Medicine and the Management of Bias through the Case of Contraception

2021 ◽  
pp. 002214652110032
Author(s):  
Jamie L. Manzer ◽  
Ann V. Bell
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Management Strategies ◽  
The United States ◽  
Care Providers ◽  
Patient Counseling ◽  
Patient Centered ◽  
American Health Care System ◽  
Centered Care

There is a wealth of literature demonstrating the presence of bias throughout the American health care system. Despite acknowledging such presence, however, little is known about how bias functions within medical encounters, particularly how providers grapple with bias in their patient counseling and decision-making. We explore such processes through the case of contraceptive counseling, a highly raced, classed, and gendered context. In-depth interviews with 51 health care providers reveal that providers use four primary strategies to navigate and minimize bias in their care—using scientific rationale, employing “safe” biases, standardizing counseling, and implementing patient-centered care. Paradoxically, using these strategies can exacerbate rather than resolve bias. Understanding these bias management strategies reveals provider-held biases, how they manifest within appointments, and the potential consequences for patients’ health autonomy. Such knowledge informs interventions that promote contraceptive use among women in the United States, addresses bias in health care broadly, and thus ultimately helps combat health disparities.

Patient Perceived Cultural Sensitivity of Clinic Environment and Its Association With Patient Satisfaction With Care and Treatment Adherence

2014 ◽  
Vol 8 (6) ◽  
pp. 421-429 ◽  
Author(s):  
Julia Roncoroni ◽  
Carolyn M. Tucker ◽  
Whitney Wall ◽  
Khanh Nghiem ◽  
Rachel Sierra Wheatley ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Treatment Adherence ◽  
Cultural Sensitivity ◽  
The United States ◽  
Culturally Sensitive ◽  
Satisfaction With Care ◽  
Patient Centered ◽  
The Relationship ◽  
Patient Satisfaction With Care

Research suggests that patient-centered culturally sensitive health care may be an important precursor to patient satisfaction and treatment adherence. Data from this study are a subset from the data collected for the Patient-Centered Culturally Sensitive Health Care and Health Promotion Research Project. The present study was designed to (a) explore the relationship between patients’ perceived patient-centered cultural sensitivity of their health care sites (ie, the physical and social environment and clinic policies) and their self-reported adherence to treatment and (b) investigate whether this relationship is mediated by satisfaction with health care experienced. Participants consisted of a low-income, culturally diverse sample of 1581 patients from 67 health care sites across the United States. A significant positive relationship between patients’ perceived patient-centered cultural sensitivity of their health care sites and their self-reported treatment adherence to a prescribed regimen was observed. Patient satisfaction with care partially mediated the relationship between these 2 variables. Assessing the level of patient-centered cultural sensitivity patients perceive in their health care sites might provide guidance to health care administrators as to how to make their sites more culturally sensitive from the perspective of patients. This, in turn, might increase patients’ treatment adherence, leading to improved health outcomes.

scholarly journals Prevalence, and health- and sociodemographic associations for visits to traditional and complementary medical providers in the seventh survey of the Tromsø study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Agnete E. Kristoffersen ◽  
Ann Ragnhild Broderstad ◽  
Frauke Musial ◽  
Trine Stub
Keyword(s):  
Health Care ◽  
Complementary Medicine ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Conventional Medicine ◽  
Care Delivery ◽  
Culturally Sensitive ◽  
Care Providers ◽  
Patient Centered ◽  
Conventional Health Care

Abstract Background Patient-centered culturally sensitive health care (PC-CSHC) has emerged as a primary approach to health care. This care focuses on the cultural diversity of the patients rather than the views of the health care professionals. PC-CSHC enables the patient to feel comfortable, respected, and trusted in the health care delivery process. As users of traditional and complementary medicine (T&CM) rarely inform their conventional health care providers of such use, the providers need to identify the users of T&CM themselves to avoid negative interaction with conventional medicine and to be able to provide them with PC-CSHC. Since the patterns of traditional medicine (TM) use are different to those of complementary medicine (CM), the aim of this study was to investigate the prevalence, and the health- and sociodemographic associations for visits to TM- and CM providers in an urban population. Method The data were collected through two self-administrated questionnaires from the seventh survey of the Tromsø Study, a population-based cohort study conducted in 2015–2016. All inhabitants of Tromsø aged 40 or above were invited (n = 32,591) and n = 21,083 accepted the invitation (response rate 65%). Pearson chi-square tests and one-way ANOVA tests were used to describe differences between the groups whereas binary logistic regressions were used for adjusted values. Results The results revealed that 2.5% of the participants had seen a TM provider, 8.5% had seen a CM provider whereas 1% had visited both a TM and a CM provider during a 12-month period. TM users tended to be older, claim that religion was more important to them, have poorer economy and health, and have lower education compared to CM users. We found that more than 90% of the participants visiting T&CM providers also used conventional medicine. Conclusion A considerable number of the participants in this study employed parallel health care modalities including visits to conventional, traditional, and complementary medicine providers. To offer patient-centered culturally sensitive health care that is tailored to the patients’ treatment philosophy and spiritual needs, conventional health care providers need knowledge about, and respect for their patients’ use of parallel health care systems.

scholarly journals Adherence and Communication

Communication ◽  
2019 ◽  
Author(s):  
Morgan Snyder ◽  
Kelly Haskard-Zolnierek
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Adherence ◽  
The United States ◽  
Care Providers ◽  
Medical Visit ◽  
Patient Centered ◽  
Treatment Regimens ◽  
Information Giving ◽  
Patient Will

Patient adherence is the extent to which an individual follows the treatment regimen that was prescribed during a medical visit. It is estimated that 25 percent to 50 percent of patients are nonadherent, with varying rates across different conditions and treatment regimens. Nonadherence is a widespread problem and can negatively influence health outcomes, including disease progression and worsening of symptoms. In addition to negatively influencing health, nonadherence can also be costly. It is estimated that several hundred billion dollars spent on health care annually in the United States is due to nonadherence. Many different factors play into whether a patient is adherent, including complexity of the regimen, side effects, mental health, level of social support, and cost. A significant factor that is known to influence adherence is the quality of provider-patient communication. Health-care providers play an important role in promoting adherence for their patients, through educating patients about their disease and regimens, sharing decisions about the course of treatment with the patient, conveying the important implications of adherence, and providing support when patients face barriers to adherence. Communication during the medical visit plays an important role in determining whether a patient will adhere. This article will provide an overview of the literature on communication and adherence, focusing on topics such as information giving, shared decision making, nonverbal communication, trust, empathy, patient-centered communication, and health literacy.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People

2021 ◽  
pp. 104973232110038
Author(s):  
Cecilie Fromholt Olsen ◽  
Astrid Bergland ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Anne Gudrun Langaas
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Transitional Care ◽  
Care Pathway ◽  
Patient Flow ◽  
Care Pathways ◽  
Care Providers ◽  
Patient Centered ◽  
Care For Older People

Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

Patients' Perceptions of Different Information Exchange Mechanisms: An Exploratory Study in the United States

2020 ◽  
Vol 59 (04/05) ◽  
pp. 162-178
Author(s):  
Pouyan Esmaeilzadeh
Keyword(s):  
United States ◽  
Health Care ◽  
Health Information ◽  
Health Care Providers ◽  
Information Exchange ◽  
The United States ◽  
Exchange Mechanism ◽  
Care Providers ◽  
Security Risks ◽  
Direct Exchange

Abstract Background Patients may seek health care services from various providers during treatment. These providers could serve in a network (affiliated) or practice separately (unaffiliated). Thus, using secure and reliable health information exchange (HIE) mechanisms would be critical to transfer sensitive personal health information (PHI) across distances. Studying patients' perceptions and opinions about exchange mechanisms could help health care providers build more complete HIEs' databases and develop robust privacy policies, consent processes, and patient education programs. Objectives Due to the exploratory nature of this study, we aim to shed more light on public perspectives (benefits, concerns, and risks) associated with the four data exchange practices in the health care sector. Methods In this study, we compared public perceptions and expectations regarding four common types of exchange mechanisms used in the United States (i.e., traditional, direct, query-based, patient-mediated exchange mechanisms). Traditional is an exchange through fax, paper mailing, or phone calls, direct is a provider-to-provider exchange, query-based is sharing patient data with a central repository, and patient-mediated is an exchange mechanism in which patients can access data and monitor sharing. Data were collected from 1,624 subjects using an online survey to examine the benefits, risks, and concerns associated with the four exchange mechanisms from patients' perspectives. Results Findings indicate that several concerns and risks such as privacy concerns, security risks, trust issues, and psychological risks are raised. Besides, multiple benefits such as access to complete information, communication improvement, timely and convenient information sharing, cost-saving, and medical error reduction are highlighted by respondents. Through consideration of all risks and benefits associated with the four exchange mechanisms, the direct HIE mechanism was selected by respondents as the most preferred mechanism of information exchange among providers. More than half of the respondents (56.18%) stated that overall they favored direct exchange over the other mechanisms. 42.70% of respondents expected to be more likely to share their PHI with health care providers who implemented and utilized a direct exchange mechanism. 43.26% of respondents believed that they would support health care providers to leverage a direct HIE mechanism for sharing their PHI with other providers. The results exhibit that individuals expect greater benefits and fewer adverse effects from direct HIE among health care providers. Overall, the general public sentiment is more in favor of direct data transfer. Our results highlight that greater public trust in exchange mechanisms is required, and information privacy and security risks must be addressed before the widespread implementation of such mechanisms. Conclusion This exploratory study's findings could be interesting for health care providers and HIE policymakers to analyze how consumers perceive the current exchange mechanisms, what concerns should be addressed, and how the exchange mechanisms could be modified to meet consumers' needs.

Sign in / Sign up

Export Citation Format

Share Document