2016. In its 1994 report, the AAP Task Force on Minority Children's Access to Pediatric Care 9 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). 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. 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. According to ELNEC, over 12,000 nurses throughout the United States have completed the course. For example, rather than identifying and focusing on patients' culturally-bound beliefs or behaviors, pediatricians can: Communicate, by their attitude and behavior, an openness to different cultures. Thirty-seven articles met eligibility criteria. 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. Available at: Enter multiple addresses on separate lines or separate them with commas. Reliable and timely data to demonstrate long-term decreases in health care costs, appropriate use of health care services, and improved patient health outcome measures would provide a solid foundation for addressing valid concerns about the financial implications of providing culturally effective care. The use of patient-satisfaction scoring systems that assess shared decision-making, mutual respect, trust, and other culturally sensitive parameters should be encouraged. Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Culturally Sensitive Palliative Care This subject guide is a collaborative project with the Children's Medical Center Pediatric Palliative Care Team, the Lamar Soutter Library, and Interpreter Services. pediatric-primary-care-a-handbook-for-nurse-practitioners 1/3 Downloaded from www.patientscarebd.com on January 24, 2021 by guest [DOC] Pediatric Primary Care: A Handbook For Nurse Practitioners When somebody should go to the book stores, search creation by shop, shelf by shelf, it is in point of fact problematic. Evidence-based research findings familiarize students with the most current practices and interventions. 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. Cultural competence is the ability to collaborate effectively with individuals from different cultures; and such competence improves health care experiences and outcomes. Recognizing that institutional commitment is necessary to ensure the provision of culturally effective care, pediatricians must work with hospitals, offices, managed care organizations, and commercial and government insurance payers to develop policies and plans that address identified community needs and support community health efforts. Altilio, Terry A. •Health care workers need to be aware of, and sensitive to, cultural diversity, life situations, and other various factors that shape a. person’s identity. "figures": false, Strategies to overcome these barriers to eliminating health disparities are complex and often costly. "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 … The disparity in cultural attributes between health care professionals and their patients and patients' families or guardians will require educational interventions to ensure that pediatricians and other health care professionals are able to provide culturally effective care to a diverse patient population.3 The AAP, therefore, reaffirms the importance of establishing and promoting an organizational policy on the provision of culturally effective pediatric health care, which it regards as vital and a critical social value. Innate Cultural Attributes. Standard 4 states that “health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation.” Although the AAP supports this and other efforts to provide culturally effective pediatric health care, the AAP is opposed to unfunded mandates such as those pertaining to interpreter and/or translation services that will further erode the beleaguered health care delivery system and lead to access problems for Medicaid patients, most of whom are children.21 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. The American Psychiatric Association developed an outline for cultural formulation in DSM-IV to assist in enhancing cultural competence in mental health care. UPDATED! and UPDATED! Pediatric Nursing: An Overview 1. These are example slides from a program that was conducted in San Francisco and Oakland, CA. Another facet of the relationship between language and culturally effective pediatric care is health literacy. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Linz, Amanda L. CME Report 5-A-98, Boyd CB. The US Department of Health and Human Services, in its March 2001 National Standards for Culturally and Linguistically Appropriate Services in Health Care: Final Report,7 established 14 national standards, several of which concern services for individuals with limited English proficiency. Rather, the focus remains on strategies, whether universally applicable or specifically targeted, that can be applied to one or all of the components of culture to improve the delivery of culturally effective care. Walker, Gay The following article was published from support by the Center for Cancer Research, National Cancer Institute and the National Institute of Mental Health. 2016. State the four elements of cross cultural communication. Findings From The Commonwealth Fund 2001 Health Care Quality Survey. For example, the guidelines define professionalism as “demonstrat[ing] a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to diversity,” which includes “demonstrat[ing] sensitivity and responsiveness to patients' and colleagues' gender, age, culture, disabilities, ethnicity, and sexual orientation.”36 Language on culturally effective care also appears in the sections on patient care and interpersonal communication skills. Educational program for the M.D. Download for offline reading, highlight, bookmark or take notes while you read Study Guide for Introduction to Maternity and Pediatric Nursing - E-Book: Edition 7. 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. The AAP regards culturally effective pediatric care as vital and a critical social value. As the Future of Pediatric Education II Task Force noted, “These changing demographics are likely to have implica-tions for the utilization of medical services, as well as for the acceptance of interventions by caregivers. 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). Healthy People 2010. 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. Flerlage, Jamie E. These curricular programs also should teach health care professionals to understand their own cultural norms and how they relate to patient care activities. Available at: Medicaid Program, Managed care, Proposed rule. The medical literature on cultural competence and sensitivity provides guidance for enhancing cultural effectiveness in pediatrics. Educational programs may include a component that allows the individual participant to analyze personal beliefs and values. Study Guide for Introduction to Maternity and Pediatric Nursing - E-Book: Edition 7 - Ebook written by Gloria Leifer. In particular, stakeholders will have to advocate for the necessary financial, regulatory, and other support among decision-makers to implement necessary changes to the US health care delivery system. The APA adopted these 6 competencies of patient care: medical knowledge; practice-based learning and improvement; interpersonal and communication skills; professionalism; and systems-based practice. At the CME level, new programs emphasizing skills needed to care for an increasingly diverse patient population and address health disparities are already being offered. Available at: Liaison Committee on Medical Education. Jones, Barbara L. The pediatric nurses must consider and balance these ethical principles when dealing with families from a variety of cultural and religious backgrounds that are responsible for making all related health care decisions for their children. Pediatricians are not alone in seeking solutions to improve the delivery of pediatric health care. Lyman, Joanna A. and Cultural traditions are dynamic, never static, and cannot be generalized to all families. Pain in pediatric oncology: Do the experiences of children and parents differ from those of nurses and physicians? Read this book using Google Play Books app on your PC, android, iOS devices. Although Medicaid and other public insurers are placing increased emphasis on “cultural competence” and quality care,37 few tools exist for health care payers to measure the outcomes of processes implemented to ensure culturally effective care. Beyond residency training, pediatricians and other child health professionals can benefit from CME to enhance the provision of culturally effective health care. In addition, the Henry J. Kaiser Family Foundation and the Robert Wood Johnson Foundation, in collaboration with other key groups, have launched the Initiative to Engage Physicians in Dialogue About Racial/Ethnic Disparities in Medical Care to raise awareness among physicians about health disparities, starting with cardiac conditions among African American individuals, and to teach them to take a leadership role in addressing health disparities among patient populations at greater risk.47 The Objectives for Improving Health in Healthy People 2010 identify strategies for addressing language barriers, including health literacy, and call for the development of materials for individuals with low literacy. Many patient populations and communities suffer from poorer health compared with other populations. End-of-Life Care Indeed, training in the provision of culturally effective care may include teaching physician skills that are applicable to interacting with many cultural groups as well as those that are targeted at providing care to a specific cultural group. Most available information about drugs is derived from studies that use adult samples, small sample sizes, or samples with healthy children. 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. Research Focus boxes highlight current studies that impact pediatric nursing today. After this, the statement outlines educational imperatives to expand on the current system and provides specific AAP recommendations for improving culturally effective care through educational and health policy reform. ethical/legal issues; cultural considerations in end-of-life care; communication; loss, grief, and bereavement; and preparation for and care at the time of death. The goal is to raise awareness of the multifaceted dimensions of culturally effective pediatric care by ensuring that this topic is incorporated into CME activities appropriately. View all Google Scholar citations Child health affects the society’s health in both long and short run and plays a significant role in determining a society’s level of development [2,3]. Generic knowledge and skills of nurses outweighed the need for the nurses to have culture‐specific knowledge of their patients or relatives in cross‐cultural care encounters. Issues and Trends in Pediatric Nursing 2. Comprehensive literature searches were completed through an online search of nine databases for articles published between 1980 and 2011: PsychINFO, MEDLINE®, Journal of Citation Reports-Science Edition, Embase, Scopus, CINAHL®, Social Sciences Citation Index (SSCI), EBSCO, and Ovid. thigh or femoral . ; NEW! Total loading time: 1.458 Practices that might be considered unethical to an autonomous American (e.g. This component begins with … This response is an example of cultural a. collectivism. At a minimum, medical school curricula and pediatric residency education programs should include educational components that identify the implications of low English proficiency, low literacy, and low health literacy on pediatric health care and offer strategies for remediating these problems. and Culture plays a role and impacts children in various ways throughout their development. Exposure to Nontraditional Pets at Home and to Animals in Public Settings: Risks to Children, Follow American Academy of Pediatrics on Instagram, Visit American Academy of Pediatrics on Facebook, Follow American Academy of Pediatrics on Twitter, Follow American Academy of Pediatrics on Youtube, Racism and Its Effects on Pediatric Health, www.census.gov/population/projections/nation/summary/np-t4-e.txt, www.omhrc.gov/inetpub/wwwroot/cultural/cultural4.htm, www.healthypeople.gov/Document/HTML/Volume1/11HealthCom.htm#_Toc490471359, www.comsep.org/Curriculum/CurriculumCompetencies/index.htm, www.ama-assn.org/ama/pub/category/9059.html, www.ama-assn.org/ama/pub/category/9913.html, www.lcme.org/functionslist.htm#educational%20objectives, Committee on Pediatric Workforce, 2004–2005, Copyright © 2004 by the American Academy of Pediatrics. "lang": "en" Introduction to Maternity & Pediatric Nursing par Gloria Leifer. 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 … 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. There is a dearth of literature addressing cultural considerations in the pediatric palliative care field. Additionally, financial and other incentives from insurers, government agencies, and other payers to reward physicians and hospitals for delivering culturally effective care have been meager and have not supplied the impetus and support to encourage fundamental systemic changes, which are often costly. From a quality-of-care perspective, moreover, this research would allow policy makers to identify patient populations at risk and to develop strategies to address health disparities at national, regional, state, and local levels. Low health literacy for pediatric patients and their families, similar to limited English proficiency, is a barrier to the provision of optimal pediatric health care. The individual pediatrician needs educational tools; the pediatric community needs the results of outcomes research to bolster, validate, and sustain their effort; institutions need support and encouragement to provide appropriate and effective education and training; foundations and other organizations need to have a pediatric perspective in all health care and policy development considerations; and the legislative arena, including federal and state agencies, needs to provide the funding and infrastructure necessary to implement and evaluate mandates. Close this message to accept cookies or find out how to manage your cookie settings. 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. 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. As a result, less is known about the effects, uses, and dosages of pediatric drugs, and nurses must investigate pediatric drugs carefully to provide knowledgeable nursing care for children. The APA began the revision of this important document in 2002, with a particular emphasis on tailoring the guidelines to support and mirror the 6 core competencies for residency education in all specialties established by the Accreditation Council for Graduate Medical Education. A variety of programs, seminars, workshops, and residency curricula already exist across the country with great variation in educational content, focus, priorities, faculty support, and availability and with limited and/or variable descriptions of outcome measures. Steineck, Angela The AAP has played and must continue to play a pivotal role in all these important health policy deliberations. Children are affected by cultural, social, and spiritual aspects of the environment they live in [1]. When the pediatrician and his or her patient and patient's family do not speak the same language with fluency, there is a potential for misunderstandings such as an inaccurate history, misunderstanding of therapies, and deferred medical visits.18,19 This barrier could be addressed through the use of medical interpreters or bilingual pediatricians and other pediatric health care professionals to meet the needs of children whose parents are not proficient enough to interact with members of the health care system in English.20 Some pediatricians, medical educators, and policy makers have identified concerns with the use of medical interpreters, including concerns about the lack of required or standardized training. For Assessing cultural, social, and Environmental Influences on the use of Sign... Other resources exist that may be helpful in identifying important components for educational activities “ pediatricians ” not! 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