In the years since the 1994 report, discussions of health disparities among other minority patient populations and their families have emerged and expanded the discussion of culturally effective health care. End of lifeThe pediatric nurses who are supporting Muslim children"s end-of-life care should take into consideration, respect cultural values and beliefs in order to make appropriate care decisions around whether it is ethically justifiable to cease further medical treatments that whilst may prologue the child"s life may impact upon their quality of life (Silberman et al., 2012). The AAP is committed to advocating for pediatric patients and families by participating in public policy deliberations pertaining to the delivery of culturally effective health care. "lang": "en" Because pediatricians are committed to lifelong learning, education that will enhance the provision of such care must be available at all levels, from premedical education and medical school through residency education and CME. Beyond residency training, pediatricians and other child health professionals can benefit from CME to enhance the provision of culturally effective health care. Third-party payers, health care organizations, industry, and charitable foundations should be encouraged to establish incentive programs that reward physicians for demonstrating improved outcomes in providing culturally effective health care. The mission of the American Academy of Pediatrics (AAP) is to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults. This is a concern for racial and ethnic minority children, for example, because according to standard indicators of child health status (including low birth weight, infant mortality, and immunization rates), these children are, in general, less healthy than are white children. At the same time, the cultural attributes of the pediatrician may differ from that of the patient or family or the pediatrician's colleagues. These are example slides from a program that was conducted in San Francisco and Oakland, CA. Issues and Trends in Pediatric Nursing 2. Nurses who are informed about cultural values and norms of the Hmong and their family and social structures, as well as their spiritual and traditional practices, will be able to establish trust with their pediatric patients and their caregivers. Ferrell, Betty Get a solid foundation in maternity and pediatric nursing! Available at: Medicaid Program, Managed care, Proposed rule. Cultural content , integrated throughout the text and highlighted in Cultural Considerations boxes, exposes you to customs and beliefs of different cultures that influence child care, enhancing your ability to provide quality nursing care to ALL children and their families. 2. The use of patient-satisfaction scoring systems that assess shared decision-making, mutual respect, trust, and other culturally sensitive parameters should be encouraged. When carefully designed to reflect the health and wellness values of the specific community being surveyed, such outcomes-driven efforts will allow greater focus on the effectiveness of interventions designed to monitor and ensure quality care. Culture is defined as a set of shared beliefs, norms, values, and behaviors exhibited by a group. Available at: Ambulatory Pediatric Association. One approach is not endorsed in lieu of another. 2015. Quality of Health Care for Asian Americans. Culturally effective pediatric health care can be defined as the delivery of care within the context of appropriate physician knowledge, understanding, and appreciation of all cultural distinctions leading to optimal health outcomes. In addition, other special populations—including homeless children, children in migrant families, and children in foster care—will reflect even more cultural and ethnic diversity and will require sensitive attention from the pediatricians and other child health professionals who provide care for them.”2(p173). New article for cultural and religious considerations in pediatric palliative care. Background on these issues was provided to demonstrate how addressing these topics will improve cultural effectiveness of health care. Findings From The Commonwealth Fund 2001 Health Care Quality Survey. Indeed, the most recent data from the US Census Bureau project that by the year 2020, 44.5% of American children 0 to 19 years of age will belong to a racial or ethnic minority group.1 Consideration of cultural attributes in addition to race and ethnicity would greatly increase this projection of diversity. and The AAP regards culturally effective pediatric care as vital and a critical social value. Research Focus boxes help you remain abreast of current studies that impact pediatric nursing today. Hispanic Patients' Double Burden: Lack of Health Insurance and Limited English. IV site. 63. 2016. To promote the provision of culturally effective health care to pediatric patients, the AAP recommends the following: The AAP, along with health care organizations at all levels, should continue to participate in the development and evaluation of curricular programs, such as toolboxes, that teach health care professionals to be supportive of cultural diversity and sensitive to cultural differences and behavior. Broad-based participation will ensure that a pediatric focus and perspective are brought to bear on decisions that have a direct effect on the quality of care that is delivered to children. You will be redirected to aap.org to login or to create your account. This is especially vital when end-of-life care is needed during childhood. The AAP believes that the education of pediatricians about cultural attributes and about the importance of implementing culturally effective practices and policies is essential. Projections of the Total Resident Population by 5-Year Age Groups, Race, and Hispanic Origin With Special Age Categories. Since adoption of the Report of the AAP Task Force on Minority Children's Access to Pediatric Care,9 the AAP has strengthened its commitment to ensure that all infants, children, adolescents, and young adults have access to optimal and culturally effective pediatric care, ideally through a medical home.56 Additionally, the AAP acknowledges that culturally effective pediatric care is multifaceted, complex, and often costly. pediatric patients. In 1995, the APA published its “Educational Guidelines for Residency Training in General Pediatrics,”36 which soon became an essential tool for educators of pediatric residents. The following article was published from support by the Center for Cancer Research, National Cancer Institute and the National Institute of Mental Health. Feature Flags: { Jones, Barbara L. Chicago, IL: American Medical Association; 1998. The pediatric nurse practitioner is surprised to learn that some of the families are Jewish and not Catholic. 2015. Standards of Practice and Ethical Considerations. and Cultural Considerations; Labs & Diagnostics; Learn to C.U.S. avoiding direct eye contact), or curious to a nutritionist (e.g. Indeed, because the delivery of health care services in the United States is regulated and directed by many entities at many levels, the provision of culturally effective pediatric care will depend on a coordinated effort by all stakeholders in child health. and Cultural traditions are dynamic, never static, and cannot be generalized to all families. The AAP opposes the use of children and adolescents as medical interpreters for their parents and family members and calls for adequate funding to defray the cost of using professionally trained medical interpreters and/or translation services. The AAP is currently and will continue addressing this topic through research, education, and other appropriate venues. Recent years have seen a noteworthy increase in the number of federal, state, national, and community organizations/agencies that are generating reports, guidelines, and strategies to address various facets of culturally effective health care delivery.2,7,16,22,38,41,43,45,47–50,52. In addition, communication with families dependent on the use of American Sign Language and/or lip reading may pose significant challenges. Psycho-Social-Cultural Assessment of the Child and the Family 3. For example, as clinical locations are established, faculty members need to be aware of transportation problems that may affect students from certain neighborhoods, such as lack of access to mass transit. Davis Edge. Issues and Trends in Pediatric Nursing 2. Team Works; Therapeutic Communication; Nursing Care Plans . Pediatric Primary Care, 6th Edition guides readers through the process of assessing, managing, and preventing health problems in infants, children, and adolescents.Key topics include developmental theory, issues of daily living, the health status of children today, and diversity and cultural considerations. There is a dearth of literature addressing cultural considerations in the pediatric palliative care field. Aboul-Hosn, Nisrine K. Culture plays a role and impacts children in various ways throughout their development. 1998 Sep;10(3):339-46. Language, preferred diet, specific customs, family roles, and religious beliefs are often shared among those with the same. Walker, Gay 2016. Influence of culture on truth-telling and patient care, Pain in ethnic Chinese cancer patients: Role of cultural factors in assessment and treatment, Cancer disclosure in Japan: Historical comparisons, current practices, Creole Religions of the Carribean: An Introduction from Vodou and Santeria to Obeah and Espiritismo (Religion, Race, and Ethnicity), When Children Die: Improving Palliative and End–of-Life Care for Children and Their Families, Barriers to health care access for Latino children: A review, Access barriers to health care for Latino children, Archives of Pediatrics & Adolescent Medicine, The importance of language and culture in pediatric care: Case studies from the Latino community, General Conference of Seventh-Day Adventists, Transcultural Nursing: Assessment and Intervention, Pediatric palliative care: A family-centered model for critical care, Critical Care Nursing Clinics of North America, Hospice usage by minorities in the last year of life: Results from the national mortality followback survey, Journal of the American Geriatrics Society, Patient-Related Barriers to Pain Management: The Barriers Questionnaire II (BQ-II), When disclosing a serious diagnosis to a minor conflicts with family values, Journal of Developmental and Behavioral Pediatrics, Racial disparities in the use of hospice services according to geographic residence and socioeconomic status in an elderly cohort with nonsmall cell lung cancer, Shades of truth: Cultural and psychological factors affecting communication in pediatric palliative care, Medical progress – Pediatric palliative care, Crossing the Quality Chasm: A New Health System for the 21st Century, National Academies of Science. Any program needs to be culturally relevant for providers and patients. Toward Culturally Competent Care: A Toolbox for Teaching Communication Strategies. Key terms included: culture, transcultural, spiritual, international, ethnic, customs or religion AND end-of-life, palliative care, death, dying, cancer, or hospice, and children, pediatrics, or pediatric oncology. Many pediatric institutions have adopted a "bill of rights" for children"s health care. Survey instruments should use quality measures that are within the scope of responsibility of the health care professional, and the results of these surveys should be used to identify priorities for continuing education. Health care payers and health care professionals should not be mandated to defray the costs of these programs out of their own pockets at a time when reimbursement for health care services is declining and weakening the financial viability of health care systems. Garee, Amy M. However, the education of pediatricians has the potential to improve the provision of culturally effective care. UPDATED! Diverse Communities, Common Concerns: Assessing Health Care Quality For Minority Americans. Patients and families that have different cultural attributes may experience difficulties in their interactions with health care professionals, and these difficulties may have an adverse effect on the delivery of health care. Chicago, IL: American Medical Association Foundation; September 19, 2002. Pediatricians should assume a leadership role in advocating for culturally effective health care for all infants, children, adolescents, and young adults by ensuring that all public policy on these issues is in consonance with the best interests of pediatric patients and their families. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. 2014. and Cultura… The AAP has played and must continue to play a pivotal role in all these important health policy deliberations. Another attribute that has proven to affect health care is gender, as 1 study14 recounts the influence it has on patient-physician communication and consequently on health care. "Beginning with brief overviews of cultural competence and pediatric palliative care, this article reviews the relevant literature, describes the influence that culture and religion can have on end-of-life pediatric care … In particular, sexual orientation,10 socioeconomic status, religion, and gender have been identified as cultural factors that affect the delivery of health care. Elk Grove Village, IL: American Academy of Pediatrics; April 2, 2002. Integrating an appreciation for cultural diversity into a nurse’s decision-making process can foster a positive nurse-patient relationship and encourage safer and healthier environments in care facilities. Cultural Considerations in the Biomedical Workplace series events. González-Juárez, L. An appreciation of cultural change and the significance of intracultural diversity (variation among individuals within the same culture) helps to prevent cultural stereotyping.39 Programs aimed at enhancing the provision of culturally effective health care should be tailored to the demographics of the pediatric population or community the pediatrician serves. Nehring WM(1). As members of a specific culture often do not ascribe to the same religious traditions, the purpose of this article was to explore and review how culture and religion informs and shapes pediatric palliative care. 11 This segment introduces the general concepts of cultural competency, disparities in health care and social determinants of health. These curricular programs also should teach health care professionals to understand their own cultural norms and how they relate to patient care activities. To this end, the AAP recognizes that the increasing cultural diversity of the patient population has implications for the provision of pediatric health services and for conducting child advocacy, health policy, and health services research. Pediatricians therefore should find opportunities to partner with institutions such as third-party payers, hospitals, health departments, and education departments to advocate for the culturally specific needs of their patients and, thereby, increase patient satisfaction and quality of health care. and Close this message to accept cookies or find out how to manage your cookie settings. Wang, Wei-Shu Weaver, Meaghann S. Endowed by alumni donor support, the purpose of this workshop series is to increase participants’ knowledge and awareness of cultural considerations in academic medicine in order to engage Stanford faculty to foster an environment that respects and embraces cultural diversity. 2014. Flerlage, Jamie E. Introduction to Maternity & Pediatric Nursing par Gloria Leifer. A growing multicultural society presents healthcare providers with a difficult task of providing appropriate care for individuals who have different life experiences, beliefs, value systems, religions, languages, and notions of healthcare. Faculty members should avoid clinical assignments that accentuate a student's difference, such as assigning older students to older patients or hearing-impaired students to unconscious patients. End-of-Life Care The primary care pediatric nurse practitioner provides well childcare for a community of immigrant children from Central America. In its 1994 report, the AAP Task Force on Minority Children's Access to Pediatric Care9 expressed concern that the health services provided by many institutions in the United States reflect the values of the racial and ethnic majority culture (ie, white European). Watson, Anne The AAP encourages child health care professionals other than pediatricians to embrace the concepts presented here and implement them accordingly, because this topic concerns the health and well-being of children, regardless of the individual providing health care services. Wolfe, Joanne In support of the latter component, the AAP Committee on Continuing Medical Education is engaged in the creation of CME guidelines that will assist physician volunteer CME program planners in including culturally effective pediatric care within the program design and CME faculty in preparing their materials and learning how they, too, might incorporate this topic through individual presentations. Although mandates from government agencies and regulatory bodies have served as important policy leverage or motivation to promote the provision of culturally effective care, these mandates have been largely unfunded, implying that academic institutions, hospitals, pediatricians, and other physicians must defray the costs of their implementation.6,7,53,54 Decreasing reimbursement to physician practices for clinical care and decreasing hospital operating margins have rendered these mandates largely impracticable. Pediatric considerations in homecare Crit Care Nurs Clin North Am. 7. US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Morrison, Wynne E and Howard, Scott C At the level of the individual pediatrician, culturally effective health care requires acquisition of knowledge, development of skills, and demonstration of behaviors and attitudes that are appropriate to care for patients and families with a wide variety of cultural attributes. The multiple dimensions of high-tech pediatric homecare require more than provision of technical nursing services. A number of AAP policies ranging from hearing detection23 to Medicaid24 have addressed these issues and call for materials to be produced in languages other than English for patients and families of diverse cultures and for consumers with low literacy. Government mandates to improve the provision of culturally effective health care must be accompanied by the funding and infrastructure necessary to implement these programs and achieve the identified outcomes. 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