Nursing Case Study Example: Navigating Cultural Barriers in Healthcare for Enhanced Patient Well-being

Part 1: The Case Study

Communicable diseases are those infectious illnesses that are spread from one person to the other or sometimes from animals to people. They are the most commonly reported illnesses in healthcare. They are preventable; however, when the preventive or curative measures are delayed, death may result. They are common among disadvantaged populations or those with low education statuses because they mostly lack access to modern healthcare facilities for prompt curative measures. The most common aetiological factors of these diseases are hygiene or sanitary issues and nutritional problems. Examples of the most commonly reported infectious diseases are malaria, tuberculosis, and pneumonia. This case study is a scenario of a young adolescent mother ( name withheld because of confidentiality issues) I met during my community nursing weekend rounds to promote the fight against malaria in pregnant women and nursing mothers in Ethiopia, Africa. Africa has had very many reported cases of outpatient and inpatient cases of malaria. In Ethiopia, for instance, all types of malaria reported as per the Ethiopian Ministry of Health, 1993, are leading in outpatient cases by 10.4%.

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Moreover, all types of malaria were also leading in inpatient cases by 14.8%. Tuberculosis, pneumonia, and other bacterial infections, such as sexually transmitted infections, were also central communicable infections. However, malaria, especially in the vulnerable population, was an alarming one. In the case study, I used narrations, interviews, and observational strategies to get clear and more information from the interviewee.

The young mother I met was only sixteen and a mother of three. She was a housewife and depended on her husband for most of her and the children's needs because she was a farmer of vegetables and tomatoes. Her three children were a year, two years, and three years respectively, all were male. Her husband, who was only twenty years, was a taxi driver who earned a maximum of 100 dollars a week, which barely catered for their daily basic needs. Their home indicated their socioeconomic status was survival for the fittest one. On enquiring about her family, she seemed like she did not want to talk about it because they felt disappointed when she left school and got married at a young age. She reported that they were well off but could not support her because it was her choice. Being a young and adolescent mother and wife, she reported having had a tough life both socially, emotionally, physically, and financially.

After assessing her family situation, I assessed her family's well-being and health, which was my main agenda of the visit. I first asked her whether she gave birth to her two children in the hospital, which she denied. Curiosity took the better part because public hospitals and especially maternal care were free in Ethiopia unless the mother got other delivery complications, which needed more care and attention. "He would beat me to death if I went to the hospital," she said. "Who?" I asked. "My father," she replied. On asking why he would do that, yet they already abandoned her after conceiving, she narrated her family's religious belief that going to the hospital for treatment would be blasphemy. She moreover said that they believed that prayer would heal all of their illness, but if one passed away, it was God's will.

I furthermore asked her how she manages to attend to her family's health needs if she is paranoid about her father's beliefs. "I mostly ask friends to help me take my children to the hospital. They pretend to be guardian angels for them in abusive homes if doctors ask why they took that step." "Of course they are," I interrupted. "What about you? What do you do when you need check-ups or feel unwell?" I asked. "Often, I ask my husband to accompany me so that in case my father shows up; I have a savior. However, when my husband is not home, I bake bread and cookies and enter the hospital in the name of 'selling bread and cookies' and get treated then get back home." She said. "You are brave and strong, but you deserve better health management," I said. "Right now, both my children are sick. It is malaria, I presume." She said. "Why do you think so?"

I asked. She narrated that the friends who would have helped her get the free mosquito nets and children's treatment moved to another city." It is luck that you have shown up." She giggled with tears of joy running down her face. I pitied and had empathy for the young family. Although I did not carry anything for her malaria diagnosis, treatment, or prevention, I had pamphlets that had all about health awareness and a lot about malaria as a common infectious disease in Ethiopia. I promised her to come back the following day with mosquito nets and a laboratory technician to diagnose treat and prevent any other occurrences of malaria in her home.

On narrating her story to my colleagues from diverse disciplines, we were all motivated to help not only her but the entire community from infectious diseases and harsh community, societal, religious, or spiritual beliefs that threatened their wellbeing. We organized a health promotion campaign that would involve the entire clinical department and administration. The nurses would incite fellow nurses in the district to promote and prepare to educate the people on the importance of prioritizing health. The laboratory technicians were to prepare to diagnose the illnesses simply during the promotion as the pharmacists dispensed and advised on treatment and preventive measures. Several weeks from the promotion dates, fewer cases were reported of communicable diseases, infections, admissions, and deaths.

Part 2: The Case Study Analysis

An analysis of this case study, a holistic approach to the young mother's problems would be appropriate to analyze efficient solution methodologies. Before the examination, the major issues of the mother should be identified. Using the observational strategy, a low economic status livelihood was already one of her problems. They survived by her husband's taxi hustle and her vegetable hustle. Then, she felt emotionally tortured because of her family's attitude towards her because of conceiving at an early age instead of advancing her education. Her parents were also a problem in her healthcare services because of their religious beliefs, which meant she hid or used hiding mechanisms to get away from them every time she needed healthcare facility services. Therefore, in identifying her significant problems, I think her low socioeconomic status and her parents' religious beliefs on healthcare services are her major problems. Even though the two problems stand out in her narration, I think her emphasis was on the latter. Especially when she said, "He would beat me to death if I went to the hospital," just because he thinks it is blasphemous. Also, her parents' attitude about her going to seek medical intervention affected even her young children is overwhelming to the mother. Depending on folks to assist in immunizations, et al., makes her even more vulnerable and dependent. This dependence makes her desperate and more worried and stressed when these friends are no more. This is shown when she says that luck dropped by because both her children were ill, which she presumed was malaria. According to me, this was her major problem, then her needy nature.

Solving Diversity of Religion in Clinical Practice

Diversity in culture and religion are among the significant challenges healthcare providers deal with worldwide. To provide quality care to all patients, they should be culturally and spiritually competent (Anderson, 2012). This means they should have the ability to deliver comprehensive healthcare services, meeting the patients' cultural, social, and religious beliefs or practices (Epner et al., 2012). This competency step would clear out every view and attitude the patients have regarding hospital care or surgeries. Hence, improving both the quality of care administered to the patients and their outcomes, of course. These religious and cultural competencies will only be met if the clinicians undergo cultural and religious competence training (Gabbay et al., 2017). Furthermore, the development of policies, protocols, and procedures that decrease the religious and cultural barriers for their service populations would be another excellent solution.

Why should clinicians be the ones to train on cultural and religious competency, yet the patients are majorly the ones with beliefs? It is essential because as LPNs, or other health care providers, it is our sole duty to prioritize patient health and safety and practice the nursing ethical principles; autonomy, beneficence, non-maleficence, and justice (Epner et al., 2012). Therefore, to deliver such improved quality of care and the application of ethical principles, the LPNs and other clinicians should have the knowledge skills, and techniques to respond to every need doubt, or ignorance the patient has, in a very thoughtful and skillful way. According to The Joint Commission (TJC), healthcare providers and hospitals are expected to account for maintaining patients' rights (Gabbay et al, 2017). Also, clinicians are expected to care for the patients' entire well-being; body, mind, and spiritual. This is why the LPNs and clinicians are responsible for even the spiritual well-being and respect of their patients and the entire population (Anderson, 2012).

As an LPN, I would understand that most patients we care for often turn to their religious and spiritual beliefs before making their medical decisions. Therefore, in the young mother I met, I would have acted slowly regarding the parents' beliefs and attitudes about healthcare. Sometimes, some ill-treatment they got at some healthcare facility led to their attitude (Klein & Albani, 2007). I would first care for the patient's immediate needs and her children by providing mosquito nets and taking them for comprehensive tests for malaria and treating them. It requires a deep understanding of their religion and its beliefs to intervene for the parents (LeDoux et al., 2019). This is because caring for her also meant I should care for her family's needs. The very first step of convincing them or approaching them into healthcare, I will apologize for any mistakes made in the past by any healthcare providers that may have led to their strong attitude towards healthcare (Polzer et al., 2012). I will give my utmost respect to their religious beliefs and recognize their values, but in a way, tell them how these values may affect those they care for, like their daughter. Also, I would try and include in their care the understanding of their unique practices, for instance, if they pray before injections or if they are not allowed to get treatment on their days of worship. Besides, I will ask them for anything more they would require during medical visits so that their experience may be more positive.

Approaching the patient's family would not be enough. This is because other healthcare providers and the public still have prejudice of their religious beliefs and healthcare attitudes. Even though this is more of a hospital's duty than an LPN, I would create awareness of this subject's sensitivity to my colleagues. This will be through our casual talks, banners in the hospital corridors, and my nursing practice rooms. The educational strategy or awareness will include the importance of respect and respectful dialog when such patients are present in the hospital. They will also remind them that caring for their cultural or religious beliefs is caring for their health, because either way, there is a significant impact on them.