Cultural Considerations with Diabetic Patients
Can I say something???
As nurse practitioners (or any provider for that matter), we must practice cultural awareness with EVERY single patient. Let me say that again…EVERY patient! Now saying that, I know that many people think I’m stating the obvious but let me break this down. Over the past week, I’ve come across a number of articles and other online postings that lead me to ask the question, “Do we really get it?” Whether it’s the dynamic between men & women, the various races & cultural, or even the different generations, we have to recognize that “culture” is nuanced & we can’t function in our bias. So this post is going to outline just some cultural considerations. I ask that you keep an open mind and remember that our goal is to achieve better patient outcomes. Patient-centered care not provider centered care.
With cultural awareness, I would offer that even within those groups, there needs to be an even deeper consideration. You see, even within races and cultures, every person in that group doesn’t have the same experience. I’ll give you an example: I am an African American woman. I was born and raised in Tennessee. I married an African American man from Ohio. We both identify as black and though we had some similar experiences growing up, there’s a lot about our lives that are very different. Just because we are black doesn’t mean that we are the same and when dealing with us in a clinical setting, a provider would need to understand that that black people across the diaspora are individuals that come with their own unique experiences. Now this is not to throw off that people of the same race, culture, gender won’t share similarities but all of this needs to be considered with dealing with our patients. I cannot stress how each patient needs to be addressed as an individual and not lumped into a collective.
I see this heavily with diabetes education and management. It is no secret that there are demographic groups that are more at risk for diabetes but what often gets overlooked, or not even considered, is that many of those factors are not because of the genetics of the group but of the circumstance of the group and with that in mind, the circumstance could translate to any person regardless of race, culture, or gender. In a recent blog post, Food Guidelines for Diabetes, I outlined some factors so make sure to go back and read that but here are some considerations to keep in mind as you go along your day to day:
The Patient is an Individual.
To elaborate on what I previously mentioned, while considering the patient’s background, also keep in mind the person is an individual with their own unique experiences. Even within our own country, we all have unique experiences. Let’s examine gender briefly, what may work for one woman won’t necessarily work for every woman & within that, the woman should be able to evolve. This could only be done by examining each person on a case by case basis. The same can be said for those apart of other like groups. Like I stated earlier, I’m from the south and my husband is from the north. The way of life is totally different in the two regions. The foods eaten, pace of life…complete opposites. Even though we are of the same race, WE ARE DIFFERENT! Bottom line: One person doesn’t represent the group and the group doesn’t represent the person.
Tailor Your Care Plan and Education Accordingly.
Keeping #1 in mind, simply put, tailor your management and education to the individual. You will get better patient outcomes if you approach it this way instead of lumping the patient into a group solely.
Ultimately, Set Your Patients Up for a Win!
Take this example: you have a Chinese patient that observes Chinese New Year with their family. If our goal is better patient outcomes through means like patient adherence, what good would it do to tell the patient to avoid all starchy foods when there’s a strong possibility rice will be eaten at the celebration. That’s not setting that patient up for success but actually failure. A better approach would be to educate over moderation and portion control & to monitor their blood glucose more frequently during that period. Now if we approach our patients as individuals and not just part of a collective, then as a byproduct, we would ultimately learn more about their culture to be able to understand the person’s beliefs & practices. At the same time, you could also have another patient who is Chinese that does not observe the holiday. Knowing that there can be marked differences within a cultural group is pertinent in your care plan.
Well guys, I could go on and on with this subject and I know to some this so obvious but like I said earlier, I wonder if people really know this! Feel free to view the post I mentioned earlier because it offers other ideals. Also, I would love to have you join my YouTube fam through my channel, Kim E. The Diabetes NP. Over there I put out weekly videos over all things diabetes & nurse related. As always, thanks for following along and I’ll catch you later!
