1. Communication Skills: Building Cultural Competence to Address Health Disparities Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD, GCNS-BC Duke University School of Nursing Geriatric Nursing Innovations in Education Lenoir County November 17, 2010

2. Health Disparities are Real Definition: population-specific differences in the presence of disease, health outcomes, or access to health care – Race – Gender – Age – Economic Status Additional resources: – http://www.nlm.nih.gov/medlineplus/healthdisparities.html#cat42 http://www.nlm.nih.gov/medlineplus/healthdisparities.html#cat42 – http://www.ahrq.gov/qual/nhdr09/Chap4.htm#racial http://www.ahrq.gov/qual/nhdr09/Chap4.htm#racial – http://statesnapshots.ahrq.gov/snaps09/index.jsp http://statesnapshots.ahrq.gov/snaps09/index.jsp Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 2

3. Emerging Evidence Jackson Heart Study: – Environmental, social and genetic factors related to cardiovascular disease and high rates of complications from hypertension in African Americans Los Angeles Latino Eye Study: – Latinos have high rates of diabetic retinopathy, open angle glaucoma Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 3

4. LEARNing to Grow Your Cultural Competence L isten with sympathy and understanding to the patient's perception of the problem. E xplain your perceptions of the problem. A cknowledge and discuss the differences and similarities (of these perceptions). R ecommend treatment. N egotiate agreement (on a plan of care) Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 4

5. A Closer Look at How L isten with sympathy and understanding to the patient's perception of the problem. Try asking the patient: What do you call your problem? What do you think causes your problem? Why do you think the problem started when it did? Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 5

6. Explain and Acknowledge E xplain your perceptions of the problem. A cknowledge and discuss the differences and similarities (of these perceptions). Discuss with your patient: What you call the problem Causes of the problem Why the problem started when it did? Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 6

7. Recommend Treatment R ecommend treatment. Ask your patient: How do you think we should treat this problem? What are your biggest concerns? What do you hope to receive from the treatment? Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 7

8. Negotiate Agreement N egotiate agreement (on a plan of care) Ask your patient: What are you willing to try? What do you think might happen if you don’t? Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 8

9. LEARN vs. Motivational Interviewing LEARN Approach Idea #1 Idea #2 Idea #3 Motivational Interviewing Approach Idea #1 Idea #2 Idea #3 Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 9 Patient centered

10. LEARNing to Grow Your Cultural Competence L isten with sympathy and understanding to the patient's perception of the problem. E xplain your perceptions of the problem. A cknowledge and discuss the differences and similarities (of these perceptions). R ecommend treatment. N egotiate agreement (on a plan of care) Emily O’Leary Egerton, PhD Eleanor McConnell, RN, PhD © Geriatric Nursing Innovations in Education 10