Lincoln, Ch. 5 & 6

Ch. 5.

Disparities in health

1. Did the statistics surprise you?
2. Who are the people in your patient/client population?
3. Do they reflect the statistics?
4. What questions do you need to ask during an assessment?

Trust & Mistrust

1. Have you ever been in a situation with a HCP where trust was an issue?
2. Think of your patients and their histories, are there issues of trust?
3. In what way could you initiate a dialogue about trust and treatment?

Thoughts on previous experience

1. Think about a positive encounter with someone different from yourself- what aspects made it that way?
2. A negative encounter, what do you think made it that way?
3. What would you do differently?

From the patient’s perspective

1. How easy is it for your patients to “navigate” through your facility?
2. Are you familiar with the cultural beliefs and healthcare practices of your patients?
3. Are there flexible clinic appointments at your facility?
4. Is transportation readily available to your patients?
5. What would you change at your facility to improve access to resources?

Education

1. Have you had the opportunity to discuss influences of history, past and current, on healthcare decisions?
2. Does your institution provide educational seminars on the cultural characteristics of ethnic and cultural groups?
3. Are there discussions that help you understand the ways in which language and culture may influence healthcare behaviors and practices?
4. If so, what are you and your institution doing to narrow and eventually eliminate those disparities?

Research

1. Think about your patient population, where do you see healthcare disperities?
2. If given the opportunity to discover way to eliminate disparities where would your research be focused?
3. How would you disseminate your finding?
4. How would you design your program?
5. How would you orient it to educate both patients and HCPs?

Ch. 6.

Thinking outside of the box

1. In what ways can we increase access to care?
2. Are our hours of operation meeting the needs of our patient/patient population?
3. Have our interpreters received medical and cultural training?
4. Do we involve the community in our decision-making process?
5. Does our educational material meet the learning needs of our patients?
6. Does our staff reflect the diversity of our patient population?

Health insurance

1. Have you ever gone without health insurance?
2. What was your greatest concern or fear during that time?
3. Think about your patient population, what percent are uninsured?
4. What resources are in place within your organization to meet these needs?

Language

1. Have you ever been traveling in a foreign country, gotten sick and sought medical care?
2. How did you get your message across to the HCP in that situation?
3. What is the predominate language of your patients spoken at your site?
4. Do you speak another language? If not, which one would you like to learn?
5. Is there a translator class offered by your organization?
6. What percentage of HCPs is bilingual and bicultural?

Education and Literacy

1. What is the literacy level of our patient population?
2. Does our education material match the literacy level of our patients?
3. How do you encode and take in information?

Summary: The purpose of the weekly reflective journal exercises is to allow for analysis, synthesis and evaluation of nursing theory using guided questions. Reflection has been referred to as a process that happens internally, privately or in isolation (Hill & Watson, 2011).  Also a useful definition of reflection has been referred to as the examination of an issue of concern, as a consequence of experience, creating clarity and meaning in terms of self, and which results in a change of perspective ( Boyd & Fales, 1983).