The topic I have selected is diabetes in the minority population. I have chosen this topic because it is of immediate relevance to nursing care, especially given increasing globalization which contributes to increasing diversity within the population. Given this increasing diversity, the need for culturally competent care likewise is increasing. Furthermore, research has demonstrated that “the burden of diabetes disproportionately falls on ethnic minority groups who recurrently experience higher morbidity and mortality than majority populations” for reasons which have been described as “complex cultural, physiological, and linguistic” (Zeh, Sandhu, Cannaby, & Sturt, 2012, p. 1237). This suggests that culturally competent care in the context of diabetes management is a critical topic for nursing.
The article chosen for this paper is Zeh et al.’s (2012) “The Impact of Culturally Competent Diabetes Care Interventions for Improving Diabetes-Related Outcomes in Ethnic Minority Groups: A Systematic Review” from the journal DIABETICMedicine. This article was chosen for several reasons. First, it focuses specifically on diabetes care – both interventions and outcomes. Second, it focuses on diabetes care in the context of several ethnic minority populations including African Americans, South Asians, and Latino groups. Third, the authors carefully considered the issue of culturally competent care and scored the included studies in their reviews to fully ascertain whether the articles they were considering for inclusion were truly culturally competent. That is to say, the authors did not simply take the words of the authors of the articles they identified during the retrieval process as being culturally competent; Zeh et al. (2012) were determined to make sure the research they included was genuinely culturally competent.
Of the 320 studies retrieved, only 11 studies were ultimately included. The authors report that 64% of these studies (that is, 7 studies) were highly culturally competent, scoring 90-100% on the authors’ cultural competence scoring rubric, while the remaining 36% (that is, 4 studies) were moderately culturally competent. Of the 11 studies, 10 identified the fact that “interventions that were structured, coupled with the fact that the service providers adapted teaching and learning methods that met cultural and community needs, fundamental to good care” (Zeh et al., 2012, p. 1249). There were also findings that support the notion that culturally competent care enables patients to improve their understanding which in turn contributes to improved patient outcomes. Communication was identified as a key element; since communication is influenced by culture, as are identity and beliefs about illness and health, care which supports these elements of a person is important for good outcomes.
The evidence from this study has a significant impact on nursing care within the community for population health in that it clearly makes a connection between the role and importance of culture in an individual’s health and how that factor should be ‘invoked’ in nursing care. Nurses who truly want to help their patients have to do so on the patient’s terms to make the experience meaningful. Zeh et al.’s findings demonstrate that diabetes care which includes meaningful elements of culturally competent care makes a discernable difference in the outcomes of minority diabetes patients. Nurses who work with such populations should be mindful to modify their teaching/learning methods to meet the needs of the minority ethnic populations with which they work. These findings also underline the need for culturally competent care in general. For my own practice, I will seriously endeavor to broaden my cultural horizons so that I am able to provide culturally competent care in a meaningful way, especially since it is evident that such care improves patient outcomes.
- Zeh, P., Sandhu, H. K., Cannaby, A. M., & Sturt, J. A. (2012). The impact of culturally competent diabetes care interventions for improving diabetes‐related outcomes in ethnic minority groups: A systematic review. Diabetic Medicine, 29(10), 1237-1252.