Being culturally competent as you provide care is essential for providing high quality patient care for patients coming from different cultural backgrounds. This concept is defined as a the knowledge and unique set of skills and attitudes that is applied in the clinical practice in a transcultural context (Cerveny et al., 2022). In addition, to provide culturally competent care, providers must be sensitive to the patient’s heritage, sexual orientation, socioeconomic situation, ethnicity, and cultural background. As future APRNs, it is important to note that culturally competent care is achieved when we recognize one’s own culture, values, and biases so we can use effective, patient-centered communication skills (Ball et al., 2018).

The case study that was assigned was that of Paloma Hernandez who is a 26 year-old, Spanish speaking patient who presents to the clinic for the last 2 days in a row complaining of abdominal pain that is getting worse. The first visit the staff relied on her younger bilingual daughter to translate. She was treated with Omeprazole and encouraged to take OTC medication. Today she presents with the same problem. Her daughter states it is the same problem but worse today. This discussion will provide an explanation of socioeconomic, spiritual, lifestyle, and other cultural factors that are associated with the patient described in the scenario. In addition, it will explain issues that would need to be sensitive when interacting with the patient. Finally, this discussion post will provide five targeted questions I would ask to build the patient’s health history and assess her health risks.

Cultural Factors Associated with the Scenario

As healthcare providers, it is important to be cognizant of cultural practices when it comes to caring for Hispanic patients, as many the health care beliefs and practices differ from those of Western medicine (Showstack et al., 2019). Proper communication with differing cultures is important, as there are a variety of cultural variations in communication. Recognizing differences and taking about them earlier rather than later can result in a positive experience for both the patient and the provider (Ball et al., 2018).

According to Showstack et al. (2019), Hispanics who are monolingual in Spanish are reported to experience poor health care outcomes in comparison to individuals that are monolingual in English or bilingual in English and Spanish with the authors citing language to be undoubtedly a key component. Often, untrained interpreters, such as family members and office staff, often take place of trained professionals. Untrained interpreters may not be familiar with key medical terminology and lack the proper training and experience necessary. Doing so, could like to unnecessary and potentially dangerous errors in communication and emotional difficulties (Showstack et al., 2019). In this case, Ms. Hernandez’s young daughter was tasked with interpreting for her mother. Although she may have tried her best, she was not properly trained and may have lacked key medical terminology meaning specific details could have been lost in translation, leading to potential misdiagnosis or inaccurate communication of discharge instructions. When we encounter language barriers when communicating with our patients, its important that we are aware of the resources available and know how to effectively use interpreters (Ball et al., 2018).

In addition, it has been well established that Hispanic women potentially face barriers to healthcare due to lower incomes, lower education, and lack of health insurance. This can lead to unfamiliarity in navigating the medical system which as the potential to influence medical adherence to the treatment plan (Roncancio et al., 2022). Although Hispanic women desire to adhere to exercise, a healthy controlled diet, and medication regimen, a strong barrier to a healthy lifestyle for them is cited to include long work days, cost of healthy food being more expensive, cost of medications, and lack of time for exercise (Titus & Quiles-Pollard, 2022).

It is important as healthcare providers that we understand the complexity of family impact on Hispanic women’s health. Although strong, multi-generational family relationships are known to reflect high levels of social support, it also can lead to family obligation stress, which is associated with worse health and greater unmet healthcare needs. Often, Hispanic women prioritize family relationships above one’s self (Molina et al., 2020).

Targeted Questions

In conclusion, five targeted questions would specifically ask the patient are directed toward details listed in the case study.

Are you comfortable with an interpreter assisting with this visit to ensure open communication?
What is the nature of your abdominal pain? Does anything intensify the pain or improve it?
Have you ever had this type of pain before? If so, what was the cause of it and what improved it?
What is your support system like at home?
Do you have any barriers to making steps toward a healthy lifestyle?

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.

God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

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