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Culturally Competent Health Care

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COURSE SYLLABUS |Course Number |Course Title | |NU 304/HPR 308 |Tran cultural Concepts in Health and Illness | |Fall Semester | Spring Semester |Summer Semester |Year | |XXXX | | |2012 | Name of Instructor | |Dr. Judith M. Clear PhD, R. N. | |Meeting Day, Time, and Room Number | |Monday: 10:15-1:00 pm Ballston 503 | |Thursday 3:30-6:15 pm Room 2012 | |FINAL EXAM: Monday Section: Dec. 12 (Wed. ) 9:00-11:30 Room 204 | |Thursday Section- Dec. 3 (Thursday) 3:00-5:30 Room 2012 | |Office Hours/Phone | |Caruthers Hall 2026 | |703 284 1588 | |Monday 3:00-5:30 pm | |Thursday 1:00-3:00 pm | |E-mail judith. [email protected] du | I. BROAD PURPOSE OF COURSE: This course introduces the learner to Tran cultural theories, concepts, and principles prerequisite to the provision of culturally competent health care.

Culturally competent health care is based on an awareness and utilization of Tran cultural knowledge and theories that help to explain the health care needs and responses of individuals and groups within the context of their culture and subcultures.

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The emphasis in this introductory course will be on the conduct of culturally competent health and wellness assessments based on the belief that no culture is either inferior or superior to another, that behavior needs to be evaluated in relation to the cultural context in which it occurs, and that respect, equality, and justice are basic rights for all cultural groups.

In addition, the learner will be encouraged to confront personal cultural stereotyping and ethnocentrism and to examine the impact these beliefs can have on patient and client care, if left unexamined.

Students are encouraged to see and utilize the best evidence available to organize and structure the knowledge base of Tran cultural health and wellness care. The course is designed within the framework of the Marymount University undergraduate curriculum. The nursing component is based upon The American Association of Colleges of Nursing Essentials of Baccalaureate Education for Professional Nursing Practice and the American Nurses Association’s (ANA) Scope and Standards of Practice (2009).

The focus of this combined framework provides students with clear direction that address patient values, communication, critical thinking, health care systems and policy, illness and disease management and information/health care technologies. University Requirement: Global Perspective: Students will: A. Study and evaluate how culture shapes identity, development, values, assumptions, social interaction and health care practices by the study of selected cultural groups. B. Develop the ability to communicate and interact successfully with people from cultures other than their own by exploring the communication patterns of different cultures.

II. COURSE OBJECTIVES: Upon successful completion of this course students will be expected to: A. Analyze selected frameworks used in Tran cultural health care B. Utilize a theoretical framework to perform a cultural assessment C. Review cultural values, beliefs, customs, norms and health promotion practices of selected groups. D. Compare values, beliefs, customs norms and health practices of different cultural groups with one’s own for potential culture conflict. E. Describe standards of care, ethical and legal influences related to health care delivery with emphasis on the provision of safe, quality and culturally appropriate care.

F. Examine how culture influences the health of individuals, families and communities. G. Describe the impact of culture and subculture on health care delivery in the United States. Discipline-Specific Outcomes for General Students A. Students will examine personal cultural values, belief, customs, norms and health practices. B. Students will be able to discuss the relationship of cultural values, beliefs, customs, norms, and health care practices. C. Students will compare values, beliefs, customs, norms and health practices of selected cultural groups. D.

Students will be able to describe appropriate communication techniques when interacting with clients with various cultural backgrounds. E. Students will discuss the use of ethical principles associated with conducting competent health assessment. III. TEACHING STRATEGIES: A. Lecture/discussion to present new material, integrate prior learning, and provide opportunities for clarification and supplementation of the literature. B. Small group work to provide an opportunity for applying group process, for sharing information, and for receiving feedback from peers and faculty.

C. Verbal and written critique of assignments by course faculty to provide the learner feed-back and assistance in developing skills in oral and written presentations. D. Experiential activities to enhance awareness of cultural activities, values, and practices. E. Guest lecturers to present expertise in specialized areas and to provide differing approaches to Tran cultural health care. F. Use of blogging to encourage communication and participations’ well active student learning. IV. COURSE REQUIREMENTS: A.

Completion of assigned readings to broaden mastery of course content and to prepare for class participation. B. Participation in class discussion to share relevant tran cultural experiences and to develop skill in applying Tran cultural concepts from the theoretical and research literature in the analysis of these experiences. C. A Marymount email account and access World Wide Web resources. D. Participation in small group activities to facilitate the critique of Tran cultural theory and research, and to refine group process skills, and give and receive evaluative feedback.

E. Completion of written assignments to demonstrate knowledge of content areas and skills in critical thinking and written communication F. Completion of an oral presentation to demonstrate knowledge of content and skills in critical thinking and oral communication. G. Written examinations to demonstrate a satisfactory mastery of course content. V. GRADING and EVALUATION: Grading Scale: A95-100C75-77. 99 A-91-94. 99C-70-74. 99 B+88-90. 99D+68-69. 99 B85-87. 99D65-67. 99 B-81-84. 99D-60-64. 99 C+78-80. 99F59. 99 and below

Evaluation is based on successful completion of the following assignments: Written Video Analysis: 5% Personal Ethnicity Reflection Journal10 % Cultural/Ethnic Group Research & Presentation. 20%. Field projects: 15% 1. Ethnic event and 2. visit to Botanica or Chinese herb shop or other traditional healer includes written and oral reports Book review and participation in group discussion. 15% Class and Active Participation 15% Final Exam (multiple choice) 20% Total = 100 Students are expected to be present and prepared for class and assigned presentations.

Final course grades will be computed when all required assignments and activities have been completed but no later than the date of the final exam. The minimum successful grade for the course is established by the student’s major department. Nursing department requirement is 78% At the beginning of each semester, all students are responsible for obtaining and reviewing the following reference documents for additional information regarding University and School of Health Professions policies in general, and grading policies in particular: . Current Marymount University Catalogue 2. Current Marymount University Student Handbook 3. Current School of Health Professions Nursing Student Handbook, if applicable VIII. REQUIRED TEXT: Spector, Rachel E. (2012) Cultural diversity in health and illness 8th ed.. Upper Saddle River, N. J. , Pearson Prentice Hall. IX. RECOMMENDED TEXTS: American Psychological Association (2009). Publication manual. (6th edition). Washington, DC Geiger, J. N. & Davidhizar. (2008) Tran cultural Nursing: St. Louis: C. V. Mosby Co.

Helman, C. G. (2007). Culture, health and illness (5th ed. ). New York: Oxford University Press Purnell, L. D. (2009). Guide to culturally competent health care (2nd ed. ). Philadelphia: Davis Co. XCOURSE REQUIREMENTS: A. General: Enrollment in NU 304/HPR 308: Trans cultural Concepts in Health and Illness constitutes a contract between the course faculty and the learners to assume joint accountability for the teaching-learning activities necessary for the achievement of the course objectives.

The faculty accept responsibility for designing and providing teaching-learning opportunities which will facilitate the learners’ acquisition of an introductory trans cultural knowledge and skill base; one upon which they can develop their future roles as health care professionals in a rapidly changing and evolving health care environment. The learners, in turn, accept responsibility for actively and consistently participating in the available teaching-learning activities and for becoming increasingly self-directed in creating additional learning opportunities for themselves and others. B. Class and Participation: 1.

Familiarity with the literature in one’s field of specialization and skill in communicating expert knowledge are critical for the successful role enactment of health professionals. It is expected, therefore, that all learners in this course will read assigned readings and view and/or review all assigned audio-visual materials prior to each class session. Active participation in class discussions is intended to help students focus on thoughtful exploration of sensitive topics and increase potential for the development of self reflective practice. 2. ABSENCES: The course faculty must be notified of any absence by email.

It is the student’s responsibility to make up any missed work C. Assignments/Projects N. B. Please note that 5 points per day will be taken off for un excused late papers or assignments 1. Film Analysis: The film Babies will be viewed in class and will be followed be followed by in class discussion in small group. This assignment is intended to inform the student about the similarities and differences in the ways babies are raised and develop around the world. This documentary offers an up-close-and-personal glimpse of four babies from vastly different cultures in their first year of life.

In a two-three page report, students should answer: 1. What similarities did all the babies share? What differences did they share? 2. Next, analyze and discuss one of the ethnic groups (American, Japanese, African, Mongolian) in the film to identify and record: – the cultural beliefs, values, world view, customs, & norms; cultural conflicts; – communication styles; – role of family, spousal relationships, & parenting styles – work & leisure styles & practices – religious & dietary practices – What interested you the most about this culture? You can describe specific scenes in the film that shocked or amused you) 2. Cultural Assessment Interview: EACAT NOT REQUIRED FALL 2012 Each learner will individually conduct a culturally competent health assessment of an individual from a different culture than his/her own using the Echols-Armstrong Cultural Assessment Tool (EACAT) (see handout). Specific directions for the written presentation of the project are outlined in Guidelines for Written Materials and Cultural Assessment Guidelines, in your syllabus, and the EACAT. Students must come prepared to discuss his/her cultural assessment in class. . Cultural Group Research Project and Presentation: Fall 2012 Learners will develop and present a selected cultural group. Cultural groups and presentation dates noted in the Class Schedule. Specific directions for the project and evaluation criteria are noted in the Cultural Group Research Presentation Guidelines See below. Each group is required to provide an electronic and hard copy of the presentation to the instructor due the day of the presentation. Presentations are as scheduled no changes. NU 304/HPR 308: Cultural Group Presentation Guidelines

Directions: The cultural group presentation assignment is the development of a profile of a cultural/ethnic group to be presented in oral format. Objectives are to be stated at the beginning of the presentation. Students are encouraged to be creative (videos, skits, role play, etc). Presentations should not exceed 45 minutes. References must be in APA format. Focuses on information that is helpful to know to provide competent care. The three areas: #2, #4 and #6. -language and communication styles, childrearing and birthing rituals, and death and bereavement rituals are important considerations.

Content to be Included: 1. Ethnic group affiliation & racial background: -Country of origin: (e. g. , Australia, Egypt, China, etc. ) Brief overview of country re: location, geography, economics, etc. -Primary ethnic groups: (e. g. , African, Hispanic, Asian, American Indian, etc. ) -Racial groups? (e. g. , White/Caucasian, Black/Negroid, Mongoloid) -Ethnic/race specific or endemic diseases – differentiate between those prevalent in country of origin (and thus seen among new immigrants) from those that are genetic Ethnic/race specific physical differences: skin & hair color, physical size, musculoskeletal characteristics, etc. 2. Language and communication styles: -Major languages: include national language, economic or business language, dialects, literacy rate -Communication styles: Note the intonation, rhythm, speed, use of silence, facial expressions, eye contact, eye and head movements, body posture, and how warmth and humor are expressed, as well as the style and types of feedback: Are there special ways of showing respect or disrespect?

Are there any cultural preferences or restrictions related to touching, social distance, making eye contact, or other verbal or nonverbal behaviors when communicating? Are there culturally appropriate forms of greeting, parting, initiating or terminating an exchange, topic restrictions, or times to visit? Is there any significance to the structure and format of names? Are there significant variations in word meanings across and within cultural and ethnic groups? Are there any other ‘rules’ for communication that may be culturally unique? 3. Major cultural value orientations: Time orientation: past, present, or future -Basic nature of human beings: basically good, evil but perfectible, good and evil, or neutral, or neither good or evil -Primary purpose in life: being, becoming-in-being, or doing -Purpose of human relations: Linear, collateral, or individual -Relationship of human beings to nature: dominate nature, live in harmony with nature, or subjugated to nature. 4. Role of the family, spousal relationship, & parenting styles: -Composition of the family – who is considered to be a member of the family, status in family, dominance patterns Family roles and responsibilities: how each family member (including extended family members) interacts in relation to decision-making, chores, mealtimes, child care, recreation, and other family-oriented responsibilities -Major family events: special beliefs and customs practiced by the family related to marriage, conception, pregnancy, childbirth, breast feeding, baptism, child care (including attitude toward children, discipline, showing affection), puberty, separation, divorce, health, illness, and death (choose 2-3 of these events that most interest you and explain) Social groups: importance of social groups, purpose served, quality of their social contact, and social support provided 5. Work and leisure styles and social patterns: Attitudes toward work and leisure activities, identification with work or leisure social groups, friendship patterns. 6. Religious influences or special rituals: Major religions; religious beliefs and rituals about birth, death, illness, health, etc. ; about diet and food practices; and about health care and practices. 7. Dietary practices: Characteristic food choices and methods of preparation; hot and cold foods (see table on hot-cold conditions, foods, and treatments) . Health values and beliefs: Beliefs about health, mental illness, chronic disease, handicapping conditions, pain, dying, and death (nature and causes); orientation toward prevention of illness, health promotion, disease and illness treatment; personal role in health care; primary health care decision maker and primary health care teacher 9. Health care customs and practices: -Major source of health care: predominant sick care practices – provided by natural, supernatural, metaphysical, or scientific practitioners; nature of health care system in country of origin, national childhood and adult immunizations, etc. Use of specific folk care practices: such as hot & cold substances, medicinal herbs, rituals -Pain reactions and response to illness: -Relationships with health providers: Respect for, expectations of, restrictions on families’ role in home and hospital care: 10. Implications for nursing care and professional services *** 11. Bibliography/Reference list (APA format) displayed at end of presentation if using power point 4. Field Project: Visit to a Botanica, Chinese medicine shop or Cultural Event: (See guidelines below) NU 304/HPR 308

Visit to a Botanica and/or Chinese medicine shop This field work assignment is intended to inform the student about traditional/alternative remedies that are used by clients to prevent or treat illnesses and deal with adverse life circumstances. When you arrive, please explain to the store owner or sales associate why you are there (educational purposes). In a two-three page report, students should: 1. Identify the collection of herbs, tonics, lotions, powders and other merchandise used for health purposes and mitigation of adverse life circumstances. 2.

Take a sample of three to five different herbs, teas and tonics, and list the ingredients of each; then briefly define them by investigating on the internet or using books and journal articles. 3. Report the meaning and or use, and location of live plants, figures, statues, books and other objects sold by the store. 4. If possible, interview the owner or sales person asking about the most popular remedies, and whether they offer clients advice or recommendations. 5. If possible, observe who the clients are, what they buy, and for what purpose(s). 6. Observe what other merchandise is sold at the store. 7.

Describe any other observations that you find interesting and/or health and culture related. The written component of the assignment should be typed, double spaced, using APA format. Only hard copies will be accepted no e-mail submissions. Students should be prepared to share their findings with classmates. Addresses of places that may be visited: 1. Botanica Boricua 2634 Columbia Pike. Arlington, VA. Telephone: (703) 271-1248 2. Botanica Tres Potencias Willston Shopping Center II 6112-D Arlington Boulevard Falls Church, VA 22044 Telephone: (703) 533-9133 3. New Da Hsin Trading Inc. 811 7th Street N. W.

Washington, DC 20001 Telephone: (202) 789-4020 (This shop is located at the Gallery Place/China Town Metro station) NU 304/HPR 308 Assignment: Ethnic Festival/Event Project The written component of the assignment should be typed, double spaced, using APA format.. Only hard copies will be accepted no e-mail submissions. Students should be prepared to share their findings with classmates. In a two-three page report, students should: A. Select an ethnic festival or event scheduled during the semester when you are enrolled in this course. Choose an event that is celebrated by an ethnic group that is different from your own.

The event should focus on one particular group. A multi-cultural festival isn’t an appropriate choice. Similarly, while an Oktoberfest organized by a German ethnic group or church is acceptable, one organized by Clyde’s or another commercial enterprise isn’t. B. Attend the festival a. Identify and sample the foods b. Participate in the activities c. Observe the dress. Are the participants dressed in clothing representative of their group or are they wearing mainstream US dress d. Listen to and identify the music. Is the sound pleasant to your ear? e. If there is dancing, does it resemble any other type of dance you are familiar with. . Identify the languages spoken g. What age groups are in attendance? Are the activities focused on adults, children, or both? h. Consider the feelings that you experience during the festival. Are you comfortable or do you feel like an outsider? C. Prepare a report, addressing a. The name. date, and location of the event b. The purpose of the event. Does it commemorate an historical event, a saint’s feast, a special season, a military victory, harvest, a national holiday, the day colony earned independence? c. The primary cultural group for which this event has meaning d. The reason you choose to attend this particular event. e.

A brief summary of the areas addressed in Part B. a-g. f. What did you learn about this group from attending the festival? g. What did you learn about yourself? h. Did attendance at the festival encourage you to do additional reading and learn more about this ethnic group? 5. Book Review Assignment See blackboard post- same assignment wording may be a slightly different. NU 304/HPR 308 Book Review Assignment The book review assignment for this course is intended to inform the student about works of interest in the field of health and culture. Choose one of the suggested titles or consult with the instructor about another title.

The 750 to 1200 word review briefly and objectively describes the contents and the author’s/editor’s stated objectives. The review should include: 1. Identify the author(s) editor(s) stated purpose(s) of the work. 2. Provide an objective description or summary of the contents. 3. Identify strengths and weaknesses of the work. 4. Succinctly present the reviewer’s evaluation of the work’s worth and impact on practice or professional preparation. 5. Identify four important points from your review and discuss on blog. The assignment is typed using APA 6th edition revised format. Points will be taken off for lateness.

See posted class schedule. Only hard copies will be accepted no email submissions. Suggested Titles Fadiman, Anne (1997). The spirit catches you and you fall down. New York: Farrar, Straus and Giroux. Kidder, Tracy. (2004). Mountains beyond mountains. New York: Random House. If you have another title that you are interested in reviewing discuss with the course instructor. NU 304/ HPR 308 REFERENCES Andrews, M. M. and Boyle, J. S. (2008). Transcultural concepts in nursing care. (5th edition) Philadelphia: J. B. Lippincott. Affara, F. A. (2000). When tradition maims. American Journal of Nursing, 100 (8). 52-62.

Benkert, R. , Hollie, B. , Nordstron, C. K. , Wickson, L. b. E. (2009). Trust, mistrust, racial identify and patient satisfaction in urban African-American primary care patients of nurse practitioners. Journal of Nursing Scholarship, 41 (2), 211-220. Bindler, R. C. and Ball, J. W. (2007). The Bindler-Ball healthcare model: A new paradigm for health promotion. Pediatric Nursing, 33 (2), 121-127. Boone, L. R. , Mayberry, R. M. , Betancourt, J. R. , Coggins, P. C. , and Yancy, E. M. (2006). Cultural competence in the prevention of sexually transmitted diseases. American Journal of Health Studies, 21 (3-4), p. 199.

Campinha-Bacote, J. (2005). A biblically based model of cultural competence in healthcare delivery. Journal of Multicultural Nursing and Health,11 (2), p,16. Campinha-Bacote, J. (2006). Cultural competence in the nursing curricula: How are we doing 20 years later? Journal of Nursing Education, 45 (7), 2-4. Chang, M. & Kelly, A. E. ((2007). Addressing cultural diversity and health literacy issues. Urologic Nursing, 27 (5), 411-418. College of Saint Benedict and Saint John’s University (2004). Culture & health: Online and print sources. Retrieved 3/15/04 from: http://www. csbsju. edu/library/internet/nsgcultr. tml D’Avanzo, C. E. , Geissler, E. M. (2003). Pocket guide to cultural health assessment. (3rd edition). Philadelphia: Mosby. Echols, J. L. (2005). Cultural assessment. In M. E. Estes. (editor). Health assessment and physical examination. (3rd ed). Albany, NY: Delmar Publishers. Ensuring culturally effective pediatric care: Implications for education and health policy (policy statement). Pediatrics, 114 (6), 1677. Fiscella, K. , Franks, P. , Gold, M. R. , & Clancy, C. M. (2000). Inequality in quality: Addressing socioeconomic, racial, and ethnic disparities in health care.

Journal of the American Medical Association. 283(19), 2579-2584. Freeman, H. P. (2004). Poverty, culture, and social injustice: Determinants of cancer disparities. CA Cancer Journal for Clinicians. 54, 72-77. Giger, J. , Davidhizar, R. E. , Purnell, Harden, J. T. , et al. (2007). American Academy of Nursing expert panel report. Journal of Transcultural Nursing, 18 (2), 95. Giger, J. N. , Davidhizar, R. (2002). Culturally competent care: Emphasis on Understanding the people of Afghanistan, Afghanistan Americans, and Islamic culture and religion. International Nursing Review. 49(2), 79-86. Geishir-Cantrell, B. 2002). Utilizing traditional storytelling to promote wellness in American Indian communities. Journal of Transcultural Nursing. 13 (1), 6-11. Hodge, F. S. , Pasqua, A, Marquez, CA, & Geishir-Cantrell, B. (2002). Utilizing traditional storytelling to promote wellness in American Indian communities. Journal of Transcultural Nursing. 13 (1), 6-11. Hunt, L. M. (2005). Health research: What’s culture got to do with it? The Lancet, 366 (9486), p. 617. Johnson, P. H. and Dahl, T. (2007). Chinese culture and cigarette smoking” Why is smoking so prevalent in China? Research Quarterly for Exercise and Sport, 78 (1), 30.

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Vivian, C. , Dundes, L. (2004). The crossroads of culture and health among the Roma (Gypsies). Journal of Nursing Scholarship. 36(1), 86-91. Young D. R. , Gittelsohn, J. , Charleston J, Felix-Aaron, K. , Appel, L. J. , (2001). Motivations for exercise and weight loss among African-American women: focus group results and their contribution towards program development. Ethnicity & Health. 6(3-4):227-45 Yu, S. M. , Huang, Z. J. , Singh, G. K. (2004). Health status and health services utilization among US Chinese, Asian Indian, Filipino, and other Asian/Pacific Islander children. Pediatrics. 13(1 Pt 1), 101-107. Bibliography . Ahrold, T. , & Meston, C. (2010). Ethnic differences in sexual attitudes of U. S. college students: Gender, acculturation, and religiosity factors. Archives of Sexual Behavior, 39 (1), 190-202. Amaro, H, de la Torre, A. (2002). Public health needs and scientific opportunities in research on Latinas. American Journal of Public Health. 92(4), 525-529. Brown, L. , Edwards, J. , & Hartwell, H. (2010). A taste of the unfamiliar: Understanding the meanings attached to food by international postgraduate students in England. Appetite, 54 (1), 202-207. *Brown, SA, Becker, HA, Garcia, AA, Barton, SA, Hanis, CL. (2002). Measuring health beliefs in Spanish-speaking Mexican Americans with type 2 diabetes: Adapting an existing instrument. Research in Nursing and Health. 25(2), 145-158. *Buscemi, C. (2002) Diabetes: A Cuban-American perspective. Home Healthcare Nurse. 18(10), Campinha-Bacote, J (1999a). A model and instrument for addressing cultural competencein health care. Journal of Nursing Education. 38(5). 203-207. Campinha-Bacote, D. (1999). A framework for providing culturally competent health care services in managed care organizations.

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Dillinger, T. L. , Barriga, P. , Escarcega, S. , Jiminez, M. , et al. (2000). Food of the gods: Cure for humanity? A cultural history of the medicinal and ritual use of chocolate. The Journal of Nutrition, 130 (8S), 2057s-2063. Farmer, P. E. (1999). Infections and inequalities: The modern plagues. Berkeley: University of California Press. Fiscella, K. , Franks, P. , Gold, M. R. , & Clancy, C. M. (2000). Inequality in quality: Addressing socioeconomic, racial, and ethnic disparities in health care. Journal of the American Medical Association. 283(19), 2579-2584. Gertner, E. J. Sabino, J. N. , Mahady, E. , Deitrich, L. M. , et al (2010). Developing a culturally competent health network: A planning framework and guide. Journal of Healthcare Management, 55 (3), 190-204. Gillland, SS, Azen, SP, Perez, GE, Carter, JS. (2002). Strong in body and spirit: lifestyle intervention for Native American adults with diabetes in New Mexico. Diabetes Care. 25(1),78-83. Graham, I. (2004). Developing health and social care under the reforms of Tony Blair and Celemnt Atlee, Prime Ministers of Great Britain and Northern Ireland. Journal of Allied Health, 33 (1), 42-47.

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Davis. **Yu, S. M. , Alexander, G. R. , Schwalberg, R. , Kogan, M. D. (2001). Prenatal care use among selected AsianAmerican groups. American Journal of Public Health. 91(11), 1865-8 Zoucha, R. D. (1998). The experiences of Mexican Americans receiving professional nursing care: An ethno nursing study. Journal of Transcultural Nursing, 9(2), 34-44. Journals and Newsletters Closing the Gap Holistic Nursing Practice Journal of Cultural Diversity Journal of Gender, Culture, and Health Journal of Immigrant Health Journal of Trans cultural Nursing Western Journal of Nursing Research World Wide Web Sites ttp:www. access. gpo. gov ( Government Printing Office). http:www. ahrg. gov/clinic/epsix. htm (Guide to clinical preventive services). http:www. ahrq. gov (Agency for Healthcare Research and Quality (formerly AHCPR)). http:www. cdc. gov/nccdphp/about. htm (Burden of Chronic Disease on Women and Minority Populations) http:www. gov/nccdphp/minority. htm (Chronic Disease Prevention – Minority & Ethnic Groups) http:www. nih. gov (National Institutes of Health). http:www. nlm. nih. gov (National Library of Medicine). http:www. os. dhhs. gov (Department of Health and Human Services) http:www. mhrc. gov/OMH/sidebar/usa-regions. html (Office of Minority Health Resource Center, Regional Minority Health Consultants (RMHCs) Map) http:www. raceandhealth. omhrc. gov (US DH&HS Initiative to Eliminate Racial & Ethnic Disparities in health)http:www. web. health. gov/healthypeople (Healthy People 2010). http:www. who. ch (World Health Organization). ACADEMIC INTEGRITY By accepting this syllabus, you pledge to uphold the principles of Academic Integrity expressed by the Marymount University Community. You agree to observe these principles yourself and to defend them against abuse by others.

SPECIAL NEEDS AND ACCOMMODATIONS Please advise the instructor of any special problems or needs at the beginning of the semester. If you seek accommodation based on disabilities, you should provide a Faculty Contact Sheet obtained through disability Support Services located in Gerard Hall, (703) 284-1605. ACCESS TO STUDENT WORK Copies of your work in this course including copies of any submitted papers and your portfolios may be kept on file for institutional research, assessment and accreditation purposes. All work used for these purposes will be submitted anonymously. UNIVERSITY POLICY ON EMERGENCY/WEATHER/ CLOSINGS

Snow closings are generally announced on area radio stations. For bulletins concerning Marymount emergency or weather closings, call (703) 526-6888. Unless otherwise advised by radio announcement or by official bulletins on the number listed above, students are expected to report for class and clinical experiences as near normal time as possible on days when weather conditions are adverse. Decisions as to snow closing or delayed opening are not generally made before 5:00 AM of the working day. Students are expected to attend class if the University is not officially closed. LEGAL LIMITATIONS OF LICENSURE

State laws regulate the practice of nursing. Questions concerning licensure in a specific state should be directed to the Board of Nursing in that particular state. Applicants for nursing licensure in Virginia are required to notify the State Board of Nursing if they have: Been convicted of (or pled Nolo Contendere) to the violation of any federal or state law. Been hospitalized or received treatment for chemical dependency during the two years preceding application to complete the licensing examination. Have a mental or physical condition that could interfere with the ability to practice.

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Culturally Competent Health Care. (2016, Sep 27). Retrieved from https://graduateway.com/morning-routine/

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