Culturally Competent Care Healthcare Needs SampleIntroductionPatient presentation in a hospital setu

Culturally Competent Care Healthcare Needs Sample

Introduction

Patient presentation in a hospital setup varies from one individual to another. The difference in presentation is influenced by the patient’s culture, attitude, and beliefs (Paterick et al., 2017). Further, patients present with differences in healthcare needs and preferences. The needs often revolve around disease prevention, diagnosis, treatment, and patient education. The cultural group chosen involves Patients with Malaria and their healthcare needs. Malaria is an infectious disease spread by a bite from the Anopheles mosquito and passage of the Plasmodium spp parasite in the infected blood (Barrett et al., 2019). With 229 million cases reported annually worldwide, the disease is endemic in some parts of the world such as Sub-Saharan Africa (WHO, 2020). In the United States, the incidence is low with about 2000 cases reported annually, mostly in the immigrant populations or individuals who travel to endemic areas (WHO, 2020.). Patients with Malaria present with varied manifestations including fever, headache, joint pains, psychosis, hematuria, and jaundice (Mukry et al., 2017). Due to the diverse healthcare needs the patients have, provision of care requires culturally competent healthcare providers. The purpose of this paper is to discuss the various healthcare needs of patients with Malaria.

Patient Education

The Healthcare system has incorporated patient education offered the physicians and nurses as a way of reducing the incidences of infections, reducing the cost of healthcare, and preventing the severity of a condition (Paterick et al., 2017). In caring for malaria patients, education aims at changing the patient’s attitude towards the intervention and then to impart them with relevant knowledge necessary for managing malaria (Paterick et al., 2017). Besides nurses and the physicians, the distributors of the insecticide-treated nets, who are mostly community healthcare workers or public health workers, are also involved in patient and community education. According to Balami et al. (2019), these educators instruct the patients on how to use the insecticide-treated nets and even how to repair them in case of tears. For pregnant women, an antenatal care program is employed in malaria endemic areas to educate the patients on the use of treated mosquito nets. The aim of this intervention, as Aschale et al. (2018) observes, is to prevent poor outcomes of pregnancy such as stillbirths. Some of the education topics relevant to Malaria patients include preventive measures, medication adherence, lifestyle modification and home-based care (Balami et al., 2019).

Disease Prevention

In addition to designing patient education, there is need to tailor disease prevention to suit the specific patient needs. Healthcare sectors across the globe have implemented different measures to curb the spread of malaria. According to Aschale et al. (2018), the use of treated insecticide nets, insect repellants, and elimination of vectors are some of the methods used to curtail infection spread. However, the increasing incidence of malaria in some populations despite the preventative strategies is attributable to governmental policies such as decreased access to marginalized areas and low socioeconomic status (Aschale et al., 2018). In the nomadic pastoralist communities in West Armachiho District in Northwest Ethiopia, for example, there have been reports of new infections and increasing disease severity despite the government encouraging the citizens to use treated mosquito nets (Aschale et al., 2018).

However, Aschale et al. (2018) reiterate that the community’s marginalization by the government, characterized by reduced attention from the central government and the healthcare providers, means that few have understood the essence of adopting the preventive measures. The lack of proper housing facilities has also proved a challenge in controlling infection spread because individuals sleep outside in the fields where they easily sustain mosquito bites (Aschale et al., 2018). Increased supply of nets to the marginalized areas and conducting health campaigns that create awareness on the use of the mosquito nets are community-specific measures that could limit infection in such regions. In the same communities, zoo-potentiation, where the cattle provide meals and breeding grounds for mosquitos, has been implicated in the increasing spread of malaria (Hasyim et al., 2018). Chemoprophylaxis methods such as cattle spray and cattle dipping can therefore be initiated to eliminate the vectors that have been attracted by the cattle (Hasyim et al., 2018). Disease prevention is one of the most effective ways of managing infection rates both at the personal and community level.

Nutritional Needs

            Malaria and malnutrition have a vicious cycle of causation in most patients. According to Sakwe et al. (2019), the infection is associated with poor appetite and vomiting. Poor appetite results into reduced food intake with a sequela of acute or chronic malnutrition in the long run (Sakwe et al., 2019). The drugs used in the treatment of malaria have also been shown to cause poor appetite and malnutrition (Sakwe et al., 2019). Further, malnutrition affects most body systems including immunity. Specifically, it limits the immune reaction towards a pathogen by reducing the secretion of immune cells when a pathogen is recognized. It also reduces the effectiveness of antimalarial drugs used (Sakwe et al., 2019). The malaria parasite survives in the blood and then multiplies without immune resistance leading to chronic or severe malaria cases (Sakwe et al., 2019). Sakwe et al. (2019) asserts that this is particularly experienced in Sub-Saharan Africa where malnutrition stands at around 8.5%. Efforts should therefore be made to address the nutritional needs by giving nutrient supplements in the hospital, prescribing appetite-stimulating drugs, and teaching the patients better nutrition practices (Sakwe et al., 2019). Such measures are necessary for children under the age of 5-years where malnutrition is more prevalent, and pregnant women who are always at a higher risk of experiencing severe anemia with each malaria episode (Sakwe et al., 2019).

Diagnostic Needs

To ascertain malaria infection, patients with suggestive clinical features are subjected to different sets of clinical tests. These tests, according to Mukry et al. (2017), can determine parasite presence or detect the presence of malaria antigens using the pre-synthesized specific antibodies. Microscopy is one of such tests used to observe different life cycle stages of the parasite as well as to determine the specific species involved in the infection (Mukry et al., 2017). Performing the investigation requires an expert parasitologist to do a correct slide mounting and observation and then give a reliable interpretation of the clinical picture. However, due to the few available experts and the expensive test reagents such as Giemsa stains, the diagnosis is unachievable in some communities (Mukry et al., 2017).

For such populations, Rapid Diagnostic Test (RDT) kits are essential in making a diagnosis (Mukry et al., 2017). The RDT procedure takes less than 20 minutes thus is applicable for use in the communities with higher prevalence of the infection. Further, it requires few extra infrastructures and comes with an in-built quality control system that the results obtained are reproducible (Mukry et al., 2017). Since system requires no expertise before use, even non-medical staff such as Community Health Volunteers (CHVs) can use it, thus increased diagnosis and early treatment (Mukry et al., 2017). However, there is a need to budget for RDT kits to the for distribution in affected communities as well as to plan for training of the CHVs to enhance disease diagnosis and surveillance.

Treatment Needs

Effective elimination of malaria infection requires the use of drugs that target the specific life cycle stages of the Plasmodium spp. In the areas where malaria is endemic, some Malarial parasite species reside in the liver as inactive forms and are responsible for a relapse of the infections (Lacerda & Bassat, 2019). In such areas, the most appropriate intervention strategy is to adopt primaquine because it targets the pre-erythrocytic and erythrocytic stages of Plasmodium spp. Further, Lacerda and Bassat (2019) assert that studies have shown that primaquine has a proven record of being effective against Plasmodium vivax and Plasmodium ovale, the species responsible for relapse. The cost of treating individuals with malaria is relatively high in these malaria-endemic regions with each family spending around $5 during each hospital visit (Dalaba et al., 2018). Expanding health insurance services to cover such expenses, as Dalaba et al. (2018) notes, saves the patients and their families from incurring he relatively heavy hospital bills out of their own pockets.

Conclusion

            As broached in this paper, numerous factors influence a patient’s healthcare needs, among them the patient’s literacy level, economic status, and the place of residence. Malaria affects around 229 million individuals worldwide annually, with the greatest burden being in Sub-Saharan Africa where the disease is endemic. To effectively manage these cases, the healthcare system should seek to address the different patient needs including health education, nutrition, diagnosis, and treatment needs. Further, there is need for increased attention towards the socio-economic factors surrounding Malaria prevention strategies, management and treatment in the endemic regions of the world.

References

• Aschale, Y., Mengist, A., Bitew, A., Kassie, B., & Talie, A. (2018). Prevalence of malaria and associated risk factors among asymptomatic migrant laborers in West Armachiho District, Northwest Ethiopia. Research And Reports In Tropical Medicine, Volume 9, 95-101. https://doi.org/10.2147/rrtm.s165260
• Balami, A., Said, S., Zulkefli, N., Bachok, N., & Audu, B. (2019). Effects of a health education intervention on malaria knowledge, motivation, and behavioral skills: a randomized controlled trial. Malaria Journal, 18(1). https://doi.org/10.1186/s12936-019-2676-3
• Dalaba, M., Welaga, P., Oduro, A., Danchaka, L., & Matsubara, C. (2018). Cost of malaria treatment and health-seeking behavior of children under-five years in the Upper West Region of Ghana. PLOS ONE, 13(4), e0195533. https://doi.org/10.1371/journal.pone.0195533
• Hasyim, H., Dhimal, M., Bauer, J., Montag, D., Groneberg, D., Kuch, U., & Müller, R. (2018). Does livestock protect from malaria or facilitate malaria prevalence? A cross-sectional study in endemic rural areas of Indonesia. Malaria Journal, 17(1). https://doi.org/10.1186/s12936-018-2447-6
• Lacerda, M., & Bassat, Q. (2019). Primaquine for all: is it time to simplify malaria treatment in co-endemic areas?. The Lancet Infectious Diseases, 19(1), 10-12. https://doi.org/10.1016/s1473-3099(18)30612-1
• Mukry, S., Saud, M., Sufaida, G., Shaikh, K., Naz, A., & Shamsi, T. (2017). Laboratory Diagnosis of Malaria: Comparison of Manual and Automated Diagnostic Tests. Canadian Journal Of Infectious Diseases And Medical Microbiology, 2017, 1-7. https://doi.org/10.1155/2017/9286392
• Paterick, T., Patel, N., Tajik, A., & Chandrasekaran, K. (2017). Improving Health Outcomes Through Patient Education and Partnerships with Patients. Baylor University Medical Center Proceedings, 30(1), 112-113. https://doi.org/10.1080/08998280.2017.11929552
• Sakwe, N., Bigoga, J., Ngondi, J., Njeambosay, B., Esemu, L., & Kouambeng, C. et al. (2019). Relationship between malaria, anemia, nutritional and socioeconomic status amongst under-ten children, in the North Region of Cameroon: A cross-sectional assessment. PLOS ONE, 14(6), e0218442. https://doi.org/10.1371/journal.pone.0218442
• World Health Organization, WHO. (2020). A fact sheet about Malaria. Who.int. Retrieved, from https://www.who.int/news-room/fact-sheets/detail/malaria.

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