¶ … cultural diversity issues and its impact on nursing professionals' practice. It assesses a client hailing from a different culture, and employs information derived from the assessment determining and reflecting on health practices and beliefs of the client's culture. Lastly, nurses' role in the care of patients hailing from diverse backgrounds care is analyzed, and a conclusion is drawn. Client Interview Data

Client's health beliefs in relation to cultural diversity

The client comes from a family-focused background, in which she plays the role of chief household organizer and attends to her family and their needs. She believes one ought to lead a life of a good and virtuous individual, and support one's family, particularly in times of need. In her opinion, sickness must be tended to, for preserving life. She believes in healthcare professionals and services they offer, for leading a healthy life. She is comfortable having healthcare professionals take care of her health needs.

The client's culture impacts her appearance, though not to a significant extent. With regard to healthcare services, the client has a few cultural and personal preferences; for instance, she is very particular when it comes to maintaining her modesty and prefers certain tests/physical examinations to be conducted by a female healthcare provider. The client believes in always appearing feminine and presentable.

How you anticipate changing this person's health behavior and what are the risk factors presented?

The patient's behavior change must occur in five steps (i.e., the 5C intervention):

Construction of problem definition: The behavior change process ought to begin with considering the affliction of the patient. This principle lies at the core of patient-centered healthcare delivery. When any patient suffers from an issue that troubles him/her, starting with his/her problems is a good idea unless the healthcare team has detected additional problem(s) that proves to be immediately debilitating or life-threatening. This strategy, when applied to the client in question, will increase her confidence in her own capacity to change, whilst increasing clinician influence and credibility. The second part of this step is specifying the patient's problem. As the client possesses crucial information with regard to her problem, one must, as a clinician, play the part of facilitator for her self-examination, and aid her in correctly defining her health problem so that healthcare providers can help resolve it.

Collaborative objective setting: Specific goals must be set and the basis for these must be concrete actions (for instance, taking care not to snack after dinner) instead of mere values (such as healthy eating). Furthermore, targets need to be measurable (i.e. questions such as how often or how much need to be addressed; for instance, she may be instructed to take a 30-minute walk thrice a week). Also, behavior should be addressed (e.g. exercise), and not physiology (for instance, weight loss). Lastly, goals must be action oriented, realistic, and challenging. Care must be taken to ensure goals are neither extremely difficult (as this may discourage the patient), nor overly easy to accomplish (as such goals will not provide any sense of accomplishment).

Collaborative resolution to the problem: This involves formulation of strategies for achieving the goal and identification of obstacles to goal achievement.

Committing to bring change: At this stage, commitment to the established objectives and strategies must be made, and when the client will begin must be decided. Usually, it is helpful if one formulates a clear written agreement, or "behavioral contract," regarding what the client and the clinician are expected to do. The agreement is not strictly enforceable; rather, it serves the purpose of making responsibilities explicit. A copy of this agreement must be provided to the patient for serving as reminder to her.

Continuing support: Studies demonstrate that interventions of a long-term nature prove more successful in diabetes care those that are short-term. This must be expected with all chronic health conditions, but not in case of acute ailments. Therefore, it is imperative to engage in relapse prevention planning, as every patient will be prone to relapse at some point of time. In other words, they will experience instances in which their level of self-care will revert to suboptimal stage (Peyrot & Rubin, 2007).

Personal reflection

Illness beliefs and customs

The client in question is a Portuguese Azorean, hailing from the island of Sao Miguel Acores, off the Portuguese coast.

The client displays a generally positive attitude. Her background is quite family-oriented. She plays the role of chief household organizer and attends to her family and their needs. The client's overall beliefs about life are that one ought to lead a life of a good and virtuous individual, and support one's family, particularly in times of need. In her opinion, we should tend to sickness, for preserving life. She is comfortable having healthcare professionals take care of her health needs. She first gauges her feelings before deciding on seeking assistance...

The women of her culture prefer the services of female healthcare professionals in deference to their husbands, irrespective of whether they are living or not. The client can process, to a fair degree, what the clinician explains to her; in case she does not, her daughter (who accompanies her to her medical appointments) translates and explains the healthcare provider's message. Client takes care to mention if she has not understood, and if she requires any additional education/information. She believes her genetic makeup contributes partly to the diseases she is diagnosed with. However, she also believes that nothing can be done to avert what has been planned for her by God. The client has no problem with her weight (i.e., she does not believe she ought to weigh less) or care better for her well-being; however, these opinions are not culture-related. In addition to availing herself of the services of modern clinicians and their medication, the client makes use of medical rubs, herbal remedies, and prayers when it comes to handling sickness.
Interpersonal relationships

The client in question is a private person, in every aspect of life. Thus, in the medical/healthcare setting, she is naturally reserved. She prefers to have female healthcare professionals tend to her. She wishes to receive an explanation with regard to any physical examination prior to its performance, as well as to understand what the clinician requires of her. She is not opposed to physician/nurse touch for comfort and for the purpose of physical examination. She has no issues with having healthcare providers of different social classes or age groups attend to her healthcare needs. She opens up to providers of nationalities other than her own, as she believes all individuals have something unique to offer, and individuals from other cultural/ethnic backgrounds can potentially provide insightful ideas that may assist her with diabetes management.

Spiritual/religious beliefs and practices

The culture of the client is very indicative of her religion and spirituality. She is Roman Catholic, firmly believes in the higher God, prays the rosary on a daily basis, and expresses her religious beliefs without having others' opinions and thoughts influencing them. While she does endeavor to attend church once every week, this does not always happen.

Worldview beliefs and social structures

Family constitutes the social network of the client. Her family members often jeopardize her health concerns by claiming that food she is supposed to abstain is not really very detrimental to her health. They try to reason that everybody deserves cheat days, and anything eaten in little quantities ought not to make any difference. She believes her family is supportive, and defines support as caring for and being around her, taking care of family needs in the event she cannot do so herself, and supporting her when in need.

Differences between literature regarding the culture's traditional health and interview data and possible explanations

None

Potential health care problems/concerns for the client and their cultural / diversity group

Eye Problems

Diabetics have an increased likelihood of developing eye-related issues, such as:

Cataracts

Cataracts refer to clouding and thickening of eye lens. The lens forms the component of the human eye that aids focusing on the objects we see. Diabetics are more prone to developing cataracts, which tend to impair one's night vision and blur one's vision in general. Cataracts that begin interfering with an individual's vision may be removed through surgery.

Retinopathy

Diabetic retinopathy -- an eye problem unique to diabetic patients -- involves a change in their retina, which is a light-sensitive membrane at the rear of the human eye. This modification of retina arises from abnormal growth in, or damage to the tiny retinal blood vessels, and is believed to be connected with persistent high levels of blood sugar. Normally, such changes are not apparent until a child reaches adolescence and has been a diabetic for many years. Initially, an individual suffering from retinopathy might not have problems with vision, but if the problem worsens, the patient may even lose eyesight.

Diabetic Nephropathy or Kidney Disease

High levels of blood sugar have a damaging effect on blood vessels within the kidneys, resulting in diabetic nephropathy or kidney disease, wherein the kidneys, whose function is filtering wastes present in the body, cease…