Lincoln, Ch. 5 & 6
Disparities in health
- Did the statistics surprise you?
- Who are the people in your patient/client population?
- Do they reflect the statistics?
- What questions do you need to ask during an assessment?
Trust & Mistrust
- Have you ever been in a situation with a HCP where trust was an issue?
- Think of your patients and their histories, are there issues of trust?
- In what way could you initiate a dialogue about trust and treatment?
Thoughts on previous experience
- Think about a positive encounter with someone different from yourself- what aspects made it that way?
- A negative encounter, what do you think made it that way?
- What would you do differently?
From the patient’s perspective
- How easy is it for your patients to “navigate” through your facility?
- Are you familiar with the cultural beliefs and healthcare practices of your patients?
- Are there flexible clinic appointments at your facility?
- Is transportation readily available to your patients?
- What would you change at your facility to improve access to resources?
- Have you had the opportunity to discuss influences of history, past and current, on healthcare decisions?
- Does your institution provide educational seminars on the cultural characteristics of ethnic and cultural groups?
- Are there discussions that help you understand the ways in which language and culture may influence healthcare behaviors and practices?
- If so, what are you and your institution doing to narrow and eventually eliminate those disparities?
- Think about your patient population, where do you see healthcare disperities?
- If given the opportunity to discover way to eliminate disparities where would your research be focused?
- How would you disseminate your finding?
- How would you design your program?
- How would you orient it to educate both patients and HCPs?
Thinking outside of the box
- In what ways can we increase access to care?
- Are our hours of operation meeting the needs of our patient/patient population?
- Have our interpreters received medical and cultural training?
- Do we involve the community in our decision-making process?
- Does our educational material meet the learning needs of our patients?
- Does our staff reflect the diversity of our patient population?
- Have you ever gone without health insurance?
- What was your greatest concern or fear during that time?
- Think about your patient population, what percent are uninsured?
- What resources are in place within your organization to meet these needs?
- Have you ever been traveling in a foreign country, gotten sick and sought medical care?
- How did you get your message across to the HCP in that situation?
- What is the predominate language of your patients spoken at your site?
- Do you speak another language? If not, which one would you like to learn?
- Is there a translator class offered by your organization?
- What percentage of HCPs is bilingual and bicultural?
Education and Literacy
- What is the literacy level of our patient population?
- Does our education material match the literacy level of our patients?
- How do you encode and take in information?
Summary: The purpose of the weekly reflective journal exercises is to allow for analysis, synthesis and evaluation of nursing theory using guided questions. Reflection has been referred to as a process that happens internally, privately or in isolation (Hill & Watson, 2011). Also a useful definition of reflection has been referred to as the examination of an issue of concern, as a consequence of experience, creating clarity and meaning in terms of self, and which results in a change of perspective ( Boyd & Fales, 1983).