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NR 394 Transcultural Nursing

Week 4: Course Project Part 2

Directions: Prior to completing this template, carefully review Week 4: Course Project Part 2 Directions paying attention to how to name the document and all rubric requirements.

1. Description of Issue, Indicator, and Focus

My focus was on black and African-American people whose hypertension is not under control. Chronic Diseases have more devastating impact in black-american population’s health due to lack of control, follow up and education. Communicable diseases are frequent too, but the possibility of treatments and immunization make them less incident in the new generations. According to CDC 61% of Black Americans in USA has Hypertension (CDC, 2017). "Hypertension (also known as high blood pressure) affects a sizable percentage of Black American adults. Chronic renal disease, heart attack, heart failure, and stroke are all avoidable with proper blood pressure management. It is important to get checked for high blood pressure and take the necessary steps to lower it through lifestyle changes and, if necessary, medication (Healthy People 2030, 2020). My everyday patients, many of whom are black or African-American, inspired me to focus on this health issue. Regardless of their background or culture, the vast majority of my patients have a history of hypertension, and even fewer have it under control (Cole, 2018). The reason high blood pressure is so deadly is that many people with it have no idea they have it until they go to the doctor. The lack of knowledge about the dangers of hypertension means that many people continue to let it worsen even after they have been diagnosed. Instruction in blood-pressure management for adults is crucial.

References:

African American Health, 2017. https://www.cdc.gov/vitalsigns/aahealth/index.html

Cole, H. V., Reed, H. E., Tannis, C., Trinh-Shevrin, C., & Ravenell, J. E. (2018).

Awareness of high blood pressure by nativity among black men: Implications for interpreting the Immigrant Health Paradox. Preventing Chronic Disease, 15. https://doi.org/10.5888/pcd15.170570

https://health.gov/healthypeople

2. References with Permalink

Boulware, L. E., Ephraim, P. L., Hill-Briggs, F., Roter, D. L., Bone, L. R., Wolff, J. L.,

Lewis-Boyer, L. P., Levine, D. M., Greer, R. C., Crews, D. C., Gudzune, K. A.,

Albert, M. C., Ramamurthi, H. C., Ameling, J. M., Davenport, C. A., Lee, H.-J.,

Pendergast, J. F., Wang, N.-Y., Carson, K. A., … Cooper, L. A. (2019). Hypertension self-management in socially disadvantaged African Americans: The Achieving Blood Pressure Control Together (act) randomized comparative effectiveness trial. Journal of General Internal Medicine, 35(1), 142–152.

https://doi.org/10.1007/s11606-019-05396-7

https://chamberlainuniversity.idm.oclc.org/login?

url=https://search.ebscohost.com/login.aspx?

direct=true&db=c8h&AN=141191626&site=ehost-live&scope=site

Cole, H. V., Reed, H. E., Tannis, C., Trinh-Shevrin, C., & Ravenell, J. E. (2018).

Awareness of high blood pressure by nativity among black men: Implications for interpreting the Immigrant Health Paradox. Preventing Chronic Disease, 15. https://doi.org/10.5888/pcd15.170570

https://chamberlainuniversity.idm.oclc.org/login ?

url=https://search.ebscohost.com/login.aspx?

direct=true&db=c8h&AN=132150357&site=ehost-live&scope=site

3. Summary

Cole, H. V., Reed, H. E., Tannis, C., Trinh-Shevrin, C., & Ravenell, J. E. (2018).

Awareness of high blood pressure by nativity among black men: Implications for interpreting the Immigrant Health Paradox. Preventing Chronic Disease, 15.

Black men were studied between 2010 and 2014 to ascertain whether or not they were aware of their hypertension. The data were analyzed to determine if there is an "immigration health paradox" for non-native black men (Cole, 2018). This study's authors note that other studies have found a health disparity between Latinos and Asians in the United States. The disparity arises from the fact that within each racial group, immigrants to the United States tend to have worse health than their native-born American counterparts (Cole, 2018). Data analysis led the researchers to the conclusion that black male immigrants were disproportionately affected by undiagnosed hypertension. The immigrant health paradox can be explained by these findings.

Pendergast, J. F., Wang, N.-Y., Carson, K. A., … Cooper, L. A. (2019). Hypertension self-management in socially disadvantaged African Americans: The Achieving Blood Pressure Control Together (act) randomized comparative effectiveness trial. Journal of General Internal Medicine, 35(1), 142–152.

Studies on the efficacy of preemptive measures to control hypertension in low-income African Americans were conducted. At 4 and 12 months, the results of the study's participants' exposure to the three therapies were evaluated (Pendergast, 2019). Patients were first provided with a blood pressure (BP) monitor and sent to a community health worker (CHW). The second was a community health worker who participated in the DoMyPART. Program, which included instruction in "decision-making skills." The third was also a CHW who had received instruction in independent problem solving (Pendergast, 2019). At the end of the study period, all patients who had completed the 12-month program had shown an improvement in their BP readings. However, the researchers did not collect sufficient data to draw sweeping conclusions about whether or not there were statistically significant changes in growth across the three therapies (Pendergast, 2019). Researchers have requested that I do additional studies with larger samples in order to fully grasp the nature of the problem.

4. Educational Plan

If I were to make a strategy to educate my coworkers in nursing on the necessity of teaching patients how to control their blood pressure, one of the first questions I would ask is how often they see patients with hypertension. The patient and I would go over the discharge paperwork, and I would inquire how many times they had verified with the doctor to make sure the patient's blood pressure was safe to release (Cole, 2018). I think it's important to emphasize the fact that many of our patients suffer from hypertension, and a significant percentage of them do not have it under control. I think it's important to note that a disproportionate number of hypertensive patients are people of African descent. Since this population is at a higher risk for getting hypertension, I would tell them how important it is to educate them on the condition and how to keep it under control even if they currently do not have any symptoms. One of the best things they might do is inform their patients about the importance of taking their drugs as prescribed. One last piece of advice I have for nurses is to stress the importance of promoting healthy eating and living to their patients. When it comes to each of my suggested best practices, I planned to have my nurses distribute educational materials and give talks. Care conflicts may arise if the recommended treatment is incompatible with the patient's usual methods of care delivery, and if the patient chooses not to comply for any number of reasons, including cost and convenience. As a result, individuals can decide not to receive any assistance or schooling at all. The nurses' ability to provide care for these patients may be hampered by all of these factors.