Cultural Competency and Research Analysis

Cultural Competency and Research Analysis

From the case study involving Lucia, Elena, and Dr. Bhandari, there is a communication barrier between Dr. Bhandari and Lucia, considering that the doctor spoke in a thick Indian accent, which made Lucia struggle understanding what she said. In addition to this, there also exists a cultural gap between Lucia and Dr. Bhandari and Elena and Dr. Bhandari, considering that they come from different cultural backgrounds even though the doctor overlooks this difference and continues to address his clients without letting them know of his accent or even making an effort to improve it. In addition to this, the case study also presents a case of ignorance in giving patients informed consent considering that Dr. Bhandari never insisted on knowing whether Lucia had understood that she wanted to tests for Elena and didn’t explain the tests to Elena. Therefore, this paper seeks to apply theoretical concepts to the addressed case study, link research findings to the situation in the case, and apply cultural competency knowledge to improve the situation in the case.

Application of Theories

As the case study identifies, Lucia and Martin suspect that Elena had Alzheimer’s disease after being lost and forgot where her granddaughter lived. To effectively understand Elena’s condition of memory loss and forgetfulness, which are assumed to be a result of Alzheimer’s disease, the cognitive theory of mind can be applied. According to the cognitive theory of mind, unwanted behaviors, emotions and attitudes arise from poor cognitive abilities (Chainay & Gaubert, 2020). The cognitive theory focuses on how people think and how what people think leads to disturbing emotions and behaviors. In addition to this, the cognitive theory gives a pivotal role to cognitive abilities, which shape human behavior, attitudes and emotions. The cognitive theory framework forms a triangle where cognitive aspects influence behavior and emotions (Chainay & Gaubert, 2020). Therefore, the cognitive theory can explain Elena’s memory loss and forgetful nature by suggesting that her poor cognitive abilities cause it. According to the cognitive theory, poor memory, processing speed, reasoning and logic and low working memory can explain why she was found miles away in a grocery parking lot and why she forgot where her granddaughter lived. However, the cognitive theory suggests that to overcome behavioral problems, an individual’s cognitive abilities should be improved since this would bring about desirable behavior, emotions, and attitudes (Chainay & Gaubert, 2020).

The other theory that is relevant to the addressed case study is the behaviorist theory. According to this theory, an individual’s behavior is determined by their interaction with the environment through conditioning. According to the latter theory, behaviors are learned when interacting with the environment and adopted through reinforcement or punishment (Miller, 2016). Therefore, the behaviorist theory explains the situation in the case study by proposing that Elena’s forgetful nature arises from her interaction with the environment considering that she gets negative reinforcement inform of not being reminded where her granddaughter lives, not being engaged in decision making and also not being asked frequently to give directions about where her granddaughter lives. Therefore, due to this interaction with the environment, Elena’s forgetful nature has developed and her memory has degraded. According to the behaviorist theory, possible solutions to behavioral problems can be developed by creating a suitable environment through appropriate reinforcement or punishment to affected persons to make them develop desirable behaviors (Miller, 2016).

The cognitive theory can help us understand Elena by linking her cognitive abilities to her behavior. Through the cognitive theory, we can analyze Elena’s cognitive abilities and aspects, which are most likely the existing explanation for her forgetful behavior and characteristic of losing the memory of her granddaughter’s house. In addition to this, the cognitive theory can direct Dr. Bhandari to a possible solution by making him understand the important role of cognitive aspects and abilities in a person’s behavior, which means that his focus would now be on how to improve Elena’s cognitive aspects and abilities as this would solve her forgetful behavior. On the other hand, the behaviorist theory helps us understand Elena by explaining the link between her interaction with the environment and how it affects her behavior. Through analyzing the connection between Elena’s interaction with the environment, we would better understand her forgetful behavior. The latter theory can direct Dr. Bhandari to a possible solution by making him understand the important role of Elena’s interaction with the environment on her behavior, which means that his focus would be on improving the environment and her interaction with it to solve her forgetful nature.

Understanding of Research Methods and Application of Findings

Two journal articles will be analyzed to better understand the situation in the third case study and potential leads to interventions in the case study. One of the research studies is an article titled “Informed consent process: A step further towards making it meaningful!”. Authored by Rashmi Ashish Kadam and published in 2019, the study seeks to review challenges that affect the informed consent process and explore various innovative strategies to enhance the process (Kadam, 2017). The latter study adopts a review research design where information is gathered from past studies, including journals, websites, brochures and reports. Therefore, the secondary data collection method is applied for the entire research study through a literature review. Some of the findings which Kadam gathered from his research included that the challenges that faced the informed consent process included those relating to the research team which includes poor communication techniques, lack of time for the informed consent process, inability to detect lack of patient comprehension and legal outlook towards the consent process (Kadam, 2017). Other categories of problems were hose related to patients and they included anxiety and fear of new procedures, health status, cognitive impairment and denial of the disease state. The other category of challenges was relating to the informed consent document and they included complex language, medical terminologies, legal nature, and lengthy consent documents (Kadam, 2017).

Other than this, Kadam also found out that to improve the informed consent process, some of the innovative strategies that could be used included simplification of consent documents assessment of the patient’s comprehension, use of printed brochures and printed sheets, use of multimedia and audio-visual presentations, extended discussions with patients and use of decision aids to help patients in decision making (Kadam, 2017). The latter findings related to the case study as they present the various challenges that Dr. Bhandari could encounter in the informed consent process with other clients and Elena too and also provide various innovative strategies that he could use to minimize various challenges that he has faced or could in giving Elena future clients an informed consent. Kadam’s findings of various innovative strategies to enhance the informed consent process act as examples of the strategies that could bring solutions to the informed consent challenges arising in the case study.

The other research study that helps us understand the case’s situation is the article titled “Communicating Risks and Benefits in Informed Consent for Research: A Qualitative Study.” Written by Lika Nusbaum, Brenda Douglas, Karla Damus, Michael Paasche-Orlow and Neenah Estrella-Luna, the research study purposed to explore the opinions and attitudes of informed consent experts about conveying risks and benefits to inform the development of a survey about the perspectives of research nurses who are responsible for obtaining informed consent for clinical trials (Nusbaum et al., 2017). The latter study adopted a qualitative descriptive study design where direct answers were obtained from clinicians, regulators, researchers, and patient advocates. On the other hand, the research study employed semi-structured, open-ended individual in-depth interviews as its data collection method (Nusbaum et al., 2017). Nonetheless, the interviews were both telephonic and face-to-face. Data analysis was, however, done using the Qualitative Data Analysis Miner v.4 software.

The latter study’s findings included that the research community was making efforts to improve the effectiveness of the consent process and that the improvements were mainly from simplifying consent forms (Nusbaum et al., 2017). Other than this, the authors also found out that individuals usually fail to fully appreciate the risks and benefits when they provide consent, evaluating comprehension of the risks and benefits was not routinely done and that consent administrators were not so good at making sure that the potential participant understands (Nusbaum et al., 2017). The above findings related to the third case study b show the current situation about the attitudes of various stakeholders who give informed consent like Dr. Bhandari, which would be vital if an institution was to improve its informed consent stakeholders’ attitudes about the latter process. The discussed findings also help us formulate a potential solution in the case by offering background information about the current attitudes of various stakeholders who deal with the informed consents, which would be vital if we were to develop strategies to improve Dr. Bhandari’s adherence to informed consent ethics.

Cultural Competency

There are different cultural competency models, and one of the major models applied in the healthcare sector is the Campinha-Bacote Model. The latter model was developed in 1998 and later revised in 2002 (Albougami, 2016). The above model identifies five major elements crucial to achieving greater efficiency and the ability to work in a culturally diverse environment. One of the competencies or elements that the Campinha-Bacote Model proposes is cultural awareness, which requires healthcare professionals to consciously acknowledge their cultural backgrounds to avoid biases towards other cultures (Albougami, 2016). The other competency is cultural skill, which involves the ability to obtain the necessary information from patients via culturally-appropriate conduct and physical assessment. The third competency in the Campinha-Bacote Model is cultural knowledge, which is healthcare professionals’ ability to open their minds to understand variations in cultural and ethnic traits. The fourth competency is avoiding stereotyping during a cultural encounter with clients of different cultures (Albougami, 2016). Finally, cultural desire is the last competency and it involves becoming educated, skilled, competent, and aware of culture.

About the analyzed case study, Dr. Bhandari can apply cultural awareness, thus being aware of his cultural background and how it affects him, to help Elena and Lucia effectively. On the other hand, Dr. Bhandari can use cultural skills by using culturally-appropriate conduct and physical assessment when attending to Lucia and Elena. Other than this, Dr. Bhandari can apply cultural knowledge by opening their mind more when attending to the clients in the case in to understand that there exist cultural and ethnic variations between him and the clients, thus overcoming the language barrier. Other than this, Dr. Bhandari can also use avoiding stereotyping about every client understanding his thick Indian accent, thus improving the existing language barrier with Elena and Lucia. Lastly, Dr. Bhandari can apply cultural desire by being more motivated to learn bout other cultures and gain knowledge and skills on how to improve his language and overcome the existing barrier.

One of the guidelines that will help me develop cultural sensitivity is listening and observing foreign colleagues since this will give me a better cultural orientation towards clients (Di Stefano et al., 2019). This will also help me understand the various cultural aspects to expect in the future from clients from the countries and cultures like those of my colleagues. Apart from this, practicing good managers such as saying thank you and using polite language will help me avoid cultural insensitivity and rudeness, especially among patients who are culturally sensitive to manners. On the other hand, letting go of ethnocentric beliefs will help me avoid stereotypes towards specific clients, which may be culturally offensive to some clients (Di Stefano et al., 2019).  To further grown my cultural competencies, I will associate and learn from colleagues and friends from various cultural backgrounds, which will make me familiar with the cultural aspects of various persons. In addition to this, I will research different cultures and their characteristics in to be aware of how to address people from different cultures. Lastly, I will also attend diversity-focused conferences and get trained on how to handles persons from different cultures.

From the above analysis, it is evident that Elena has a development challenge, which causes her forgetfulness. As mentioned, the problem may be cognitive related and also behavioral related as the analyzed theories suggest. Therefore, improving her cognitive aspects and abilities and her interaction with the environment could help solve the issue (Miller, 2016). Apart from this, Dr. Bhandari and Lucia ignored the informed consent during Elena’s treatment. Thus the concepts addressed in the proposed research findings could be used to solve the issue. Finally, by becoming more culturally competent, Dr. Bhandari could improve how he handles his patients in the third case study considering that his cultural incompetence makes his treatment ineffective.

References

Albougami, A. S. (2016). Comparison of four cultural competence models in transcultural nursing: A discussion paper. International Archives of Nursing and Health Care, 2(4), 1-5.

Chainay, H., & Gaubert, F. (2020). Affective and cognitive theory of mind in Alzheimer’s disease: The role of executive functions. Journal of Clinical and Experimental Neuropsychology, 42(4), 371-386.

Di Stefano, G., Cataldo, E., & Laghetti, C. (2019). The client-oriented model of cultural competence in healthcare organizations. International Journal of Healthcare Management, 12(3), 189–196.

Kadam R. A. (2017). Informed consent process: A step further towards making it meaningful! Perspectives in clinical research, 8(3), 107–112.

Miller, P. H. (2016). Theories of developmental psychology (6th ed.). Macmillan Higher Education.

Nusbaum, L., Douglas, B., Damus, K., Paasche-Orlow, M., & Estrella-Luna, N. (2017). Communicating risks and benefits in informed consent for research: A qualitative study. Global Qualitative Nursing Research, 4(3), 1-13.