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Application of the Nursing Process to Deliver Culturally Competent Care

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This paper provides a detailed explanation of a research study that discusses the experiences of African Americans with healthcare. From their experiences, the paper identifies their needs, which include fair treatment when seeking for healthcare services. Cuevas, O’Brien and Saha (2016) have written the research article, which provides various steps that the researchers have followed in identifying the needs of the Africa Americans through studying their experiences. The researchers have provided the background of the research that can enable the reader to understand its aim. Then, the researchers cite various research studies in the literature that support the experiences of the African Americans and their needs. Then, the investigators assert that the aim of the research which is to study the experiences of the minority group. Focus groups were utilized, which were appropriate for the research since they could provide an adequate explanation of the experiences, which could lead to the identification of the needs of African Americans. The role of the nursing process in ensuring culturally competent care is also explained in this paper.

Keywords: culturally competent care, nursing process, African American

Nursing Process Application in the Delivery of Culturally Competent Care: Healthcare Needs of African Americans

African Americans form a part of the minority groups in the United States that experiences significant challenges regarding seeking healthcare services. According to Shin and Doraiswamy (2016, p. 1), African American population comprise 32% of the entire U.S. population. Therefore, considerable challenges in health among them can affect the healthcare system considerably. For example, Shin and Doraiswamy (2016) provide an explanation of the effect of Alzheimer’s disease on the minority group. The authors suggest that Alzheimer’s disease is a threat not only to African Americans but also to the entire U.S. population. Therefore, the healthcare system has to address health concerns of this minority group, including delivering culturally competent care to guarantee appropriate health services to all Americans. Indeed, Cuevas, O’Brien, and Saha (2016) agree that African Americans have challenges seeking health services and thus, healthcare providers should consider their needs together with those of other minority groups to ensure an efficient health care system. Discussing the Cuevas’ et al. (2016) article with a focus on the background, purpose, study approach, literature review, and implication to nursing practice can promote an understanding of health care needs of African Americans.


African Americans have various healthcare needs but they do not feel that the healthcare system takes them into consideration. In the background section of the article, Cuevas et al. (2016) provide a detailed explanation of the way African Americans often feel regarding their health needs. For instance, Cuevas et al. (2016) cite various articles and explain that the minority group always perceives that physicians often neglect to address their critical demands on health. Cuevas et al. (2016) further demonstrate that members of the minority group have a desire to be respected when they seek health services in the healthcare settings. Additionally, Goosby and Heidbrink (2013) agree with these sentiments and explain that this minority group forms a part of the marginalized groups in the U.S.A, and that they do not receive proper health services due to an inadequate access to health facilities, low literacy in terms of appropriate health services, and discrimination by health care providers. Cuevas et al. (2016) further cite reliable evidence in the background section, which shows that white patients receive higher quality health services compared to their black counterparts. The evidence provided in the background section and the assertions of the authors indicate that indeed, African Americans have various health needs in the healthcare facilities, which require attention without bias.

The authors further explain the problem of poor perceptions of the healthcare system by the minority group, which leads to the aim of the study. For instance, Cuevas et al. (2016) explain some of the barriers to effective patient-provider relationships. The authors justify the barriers by citing various research articles and suggest that poor communication and medical mistrust contributes to inadequate health services among African Americans. Therefore, although African Americans experience various challenges on getting proper health services, some barriers exist, which must be considered in solving the problems regarding their needs for proper health care. The authors conclude the background section of the article by clarifying that the research has sought to study the experiences of African Americans, which could lead to understanding their healthcare needs and further help in reducing health care disparities. Nurses can thus understand specific needs of African Americans and incorporate them in the nursing process as problems, which can enhance culturally competent care.


Although the article does not have an independent section describing the aim of the study, the authors state the objective clearly towards the end of the background section. Cuevas et al. (2016) recognize the importance of understanding the perceptions of African Americans in satisfying the healthcare needs of this minority group. The authors further justify the aim of the study in the background section by suggesting that literature regarding the experiences of African Americans with the healthcare system is limited. Additionally, the authors indicate that little is understood concerning the barriers to proper health services among this minority group. Therefore, the aim of the research is to consider appropriately the experiences of African-American patients, which is significant in identifying the health care needs of the minority groups.

Research Methods

The authors of this article indicate that the most appropriate way to understand the experiences of African Americans was to utilize the focus groups. According to Cuevas et al. (2016), this approach used to complete the study employed focus group facilitators from the local community. Then, the researchers picked a sample of sixty participants from the community. This strategy was significant since it would solve the problem of the language barrier and further increase the confidence of the participants in answering the questions and discussing their experiences. Indeed, Dilshad and Latif (2013) support the utilization of focus groups and explain that they are valuable tools for collecting qualitative data. Moreover, Dilshad and Latif (2013) assert that utilizing focus groups limits biases in the information given by the participants since it can help the researchers to determine the credibility of the information. Therefore, this method was effective in collecting reliable information for this research. Cuevas et al. (2016) assert in the procedure section that they divided the participants by gender because they felt that if they were together, it could affect the delivery of the information. The inclusion criteria involved the participants who had been in different healthcare settings. This selection was important since the participants could state their experiences with various healthcare providers, which could further lead to a proper understanding of their health care needs. Finally, the authors indicate in the analysis section that they taped the group discussions and gave a freelance transcriptionist to transcribe them. This approach was effective because it led to easier analysis of the responses, which facilitated identification of various themes. Consequently, the themes could provide different needs typical to African Americans that nurses can take into accounts while creating a culturally competent plan of care.

Review of Literature

The authors review the literature after discussing the background of the research. This part is divided into various sections to provide a detailed explanation of the challenges that African Americans experience regarding their search for appropriate healthcare services. According to Cuevas et al. (2016), available evidence relating to the aim of this research can be described in four sections, which include perceived favoritism, medical mistrust, poor communication, and the role of discordance. Regarding the perceived favoritism, Cuevas et al. (2016) cite various research articles and explain that individuals who experience unfairness in the healthcare facilities are less likely to receive appropriate healthcare services. Then, the researchers indicate that African Americans have significant challenges regarding the receipt of proper health services due to the increased perceptions of discrimination amongst them. The researchers conclude this section by asserting that the available evidence regarding discrimination can help in understanding health inequalities among African Americans.

On medical mistrust, the researchers cite the research evidence, which indicates that when individuals perceive discrimination, they are likely to lack trust in healthcare providers and thus, become dissatisfied with health care services. Consequently, Cuevas et al. (2016) indicate that such patients are more likely to underuse the effective methods for promoting health and preventing diseases. Additionally, the investigators provide further research evidence and argue that if healthcare providers understood the needs of African Americans and considered their experiences, they would identify the best approaches to delivering appropriate health care that would improve the health of this minority group.

Regarding poor communication, the researchers argue that healthcare providers overlook the ethnicity of African Americans, which is necessary for delivering culturally competent care. According to Cuevas et al. (2016), various researchers have discovered that African American patients provide less information on incurable diseases such as HIV/AIDS. Additionally, Cuevas et al. (2016) illustrate different studies and contend that most healthcare providers dominate the discussions without considering the experiences of African American patients. Consequently, the researchers conclude the section by advocating for the consideration of patients experience with the disease regardless of their race, which can enhance the seeking of health services and improve health outcomes of the patients.

Finally, about the role of race discordance, the researchers ascertain that African Americans that are in race discordance relationships have various challenges such as adherence to medications and health care communication. The researchers cite various research studies, which suggest that African Americans in concordant relationships experience improved health outcomes due to collaboration in solving their health problems. Therefore, the researchers advocate for understanding the experiences of concordant and discordant relationships for the appreciation of the needs of African Americans.

Considerably, the literature review section is comprehensive and analyzes current research. The literature review provides reliable evidence for this research thus clarifies the intent that the researchers aim to achieve. Ultimately, most research studies that the researchers have discussed in the literature review have been conducted within five years thus making sure that the evidence is current and reliable.

Implications for Nursing

This research study applies to nursing practice since it discusses various needs that nurses have to take into consideration for creating a plan of care that is culturally competent. For example, according to Loftin, Hartin, Branson, and Reyes, (2013), reliable evidence on an appropriate instrument to measure culturally competent nursing care is limited. Therefore, Loftin et al. (2013) advocate for understanding the perceptions of patients and their needs, which can be instrumental in creating an appropriate plan of care that is culturally competent. Based on the results of the article, Cuevas et al. (2016) identified that most individuals felt that healthcare providers did not respect their culture and that healthcare providers treated them with less courtesy. Additionally, the researchers discovered that the individuals did not utilize health care services appropriately due to the perceptions that healthcare providers treated them unfairly due to their ethnicity. According to Loftin et al. (2013), the understanding the background of the patients and the treatment with respect are the best approaches to delivering culturally competent care, which can enhance the seeking of health care services by patients from different cultural backgrounds. Therefore, the research conducted by Cuevas et al. (2016) identified valid concerns, which nurses have to include in the assessment step of the nursing process before identifying appropriate nursing diagnoses. Then, nurses have to implement it into the nursing process while considering the values and preferences of the patients from the minority groups such as African Americans, which can improve their perceptions of health care and further encourage them to embrace better health practices.


The healthcare system in the United States should consider the needs of minority populations because the country is ethnically and racially diverse. Most individuals from minority groups, particularly African Americans, perceive the health care services negatively, which is harmful to their health outcomes. Their negative perceptions of healthcare are some of the most major barriers to seeking proper medical treatment. Therefore, healthcare providers, particularly nurses, have to discover the experiences of the patients to identify their healthcare needs and then consider their cultural values in providing care. Nurses can utilize the assessment step in the nursing process to identify those experiences and provide care with courtesy, which can enhance the patients’ perceptions of healthcare and further improve their health outcomes.


Cuevas, A. G., O’Brien, K., & Saha, S. (2016). African American experiences in healthcare: “I always feel like I’m getting skipped over”. Health Psychology, 35(9).

Dilshad, R. M., & Latif, M. I. (2013). Focus group interview as a tool for qualitative research: An analysis. Pakistan Journal of Social Sciences, 33(1), 191-198. Retrieved form

Goosby, B. J., & Heidbrink, C. (2013). The Transgenerational consequences of discrimination on African?American health outcomes. Sociology Compass, 7(8), 630-643. Retrieved from

Loftin, C., Hartin, V., Branson, M., & Reyes, H. (2013). Measures of cultural competence in nurses: an integrative review. The Scientific World Journal, 2013

Shin, J., & Doraiswamy, P. M. (2016). Underrepresentation of African-Americans in Alzheimer’s trials: A call for affirmative action. Frontiers in Aging Neuroscience, 8. doi: 10.3389/fnagi.2016.00123