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Health care providers and organizations attainment of cultural

competency have been proposed as complementary strategies to improve the

quality of care delivered to patients from diverse groups in an effort to reduce

health care disparities.11-14 Interpersonal cultural competency has been defined

as the ability of individuals to establish effective interpersonal working

relationships that supersede cultural differences.

Organizational cultural competency allows a health care organization and

its providers to understand the strengths and weaknesses and the unique needs

of the population being served. Characteristics ascribed to organizational cultural

competency include having health care practitioners, leaders, and staff who are

ethnically or socially similar to the community served; collecting and tracking data

on quality of care, stratified by race; and engaging communities (eg, using

advisory boards, hiring CHWs) in the design and delivery of health care facilities

and services. Provider and organizational cultural competency may have

synergistic effects on health care disparities and health outcomes. The extent to

which cultural competency of heath care providers may influence the

incorporation of nursing into chronic disease care is unknown.


The study aims to assess the cultural competence and perceptions of

Filipino nurses on effectiveness of reducing health care disparities.

1. It will identify the profile of the respondents in terms of age, gender, point

of origin, religion and area of specialization?

2. How do they assess their cultural competency in reducing health care

disparities in terms of cultural motivation, power and assimilation, cultural

behavior and cultural preparedness?

3. Is there a significant difference on the assessment of cultural competency

when grouped according to their profile variable?

4. Based on the result, what program may be proposed to enhance the

cultural competence among Filipino nurses on effectiveness of reducing

health care disaparities?



Cultural competency is at the core of high quality, patient-centered care,

and it directly impacts how care is delivered and received. According to the

Institute of Medicines report, Unequal Treatment Confronting Racial and Ethnic

Disparities in Healthcare, a consistent body of research indicates a lack of

culturally competent care directly contributes to poor patient outcomes, reduced

patient compliance, and increased health disparities, regardless of the quality of

services and systems available. In addition to improving care quality and patient

satisfaction, delivering culturally competent care increases job satisfaction and

contributes to staff retention.

Multiple definitions of cultural competence abound in health care literature.

Culture refers to the learned patterns of behavior and range of beliefs attributed

to a specific group that are passed on through generations. It includes ways of

life, norms and values, social institutions, and a shared construction of the

physical world. Competence is used to describe behaviors that reflect

appropriate application of knowledge and attitudes. A health care professional

who has learned cultural competence engages in assistive, supportive,

facilitative, or enabling acts that are tailor-made to fit with individual, group, or

institutional cultural values, beliefs, and lifeways in order to provide quality health

care. In other words, they demonstrate attitudes and behaviors that enable them

to effectively work with individuals with diverse backgrounds. Integrating skills in

culturally competent care meets six aims for quality of health care: safe, effective,
patient-centered, timely, efficient, and equitable. Most important, care that is

patient-centered means that all care providers truly know the patient and take

into account cultural differences, knowledge level, and preferences.


The study aims to assess the cultural diversity and holistic care among

patient and families with advance progressive illness. Specifically it will:

1. Identify the profile of the respondents in terms of:

2. How do the respondents assess the cultural diversity being experienced

by the patient and families?

3. What is the holistic care that must be provided among the patient with

advance progressive illness?

4. Is there a significant difference on the cultural diversity and holistic care

when grouped to profile variable?

5. Based on the result, what nursing program may be proposed to address

the weakness of the study




Comfort is associated by nursing responsibilities with a firm and strong

concept. This is given traditionally to patient and families with the use of comfort

measures. It is intended to provide comforting measures in order to strengthen

the patient and their families. Nurses show proper care because of their abilities.

There are no certain measures to the effects of caring however, there some

measures to take place in the effects of comfort interventions (ANA, 2016).

Kolcaba (1994, 2001, 2003) (cited in Fitzpatrick and MacCarthy, 2014)

has defined comfort as "the immediate state of being strengthened through

having the human needs for relief, ease, and transcendence addressed in four

contexts of experience (physical, psychospiritual, sociocultural, and

environmental)". The terms relief, ease, and transcendence are derived from the

above dictionary definitions plus a review of the professional literatures in

medicine, theology, ergonomics, psychology, and nursing. Relief is the state of

having a discomfort mitigated or alleviated. Ease is the absence of specific

discomforts. To experience ease a child or family does not have to have a

previous discomfort, although the nurse may be aware of predispositions to

specific discomforts (e.g., the tendency for shortness of breath in an asthmatic

child or acute anxiety in family members). Many medical and psychological

conditions disturb homeostatic mechanisms, and nurses must be aware of risk

factors for depression, stress-related illness, dehydration, bleeding, or vomiting to

name a few examples.

Kolcaba (2003) defines comfort as the immediate state of being

strengthened by having the human needs for relief, ease, and transcendence

(types of comfort) addressed physically, psychospiritually, socioculturally, and

environmentally (contexts in which comfort is experienced). This definition

emphasizes that although nurses may not be able to fully meet all of their

patients needs for comfort, they can continue to address them in a proactive

fashion throughout the continuum of care. Kolcaba identifies 3 types of comfort.

The first type, relief, is the state of having a specific discomfort relieved.


This study aims to assess the nurses perspectives about comfort and

comforting during nursing intervention when dealing with patients with Alzheimer


Specifically, it will seek to answer the following

1. How do they assess the level of comfort needs during nursing intervention

in terms of:

1.1 Physical;

1.2 Psycho-spiritual;

1.3 Sociocultural; and

1.4 Environmental?

2. How do they assess the level of comforting perspective during nursing

intervention based on the following:

2.1 Relief;

2.2 Ease; and

2.3 Transcendence?

3. What outcomes of comforting strategy were used by the nurses in terms


3.1 Immediate and competent technical/physical care;

3.2 Positive talk;

3.3 Vigilance; and

3.4 Attending to discomforts and attending to family?

4. Is there a significant relationship between the comfort needs and comfort

perspective during nursing intervention among pediatric patients?

5. Is there a significant relationship between the level of comforting

perspectives and patient outcome of comforting strategies used by nurses

during nursing intervention among pediatric patients?

6. Based on the results, what measurement may be proposed to enhance

the comfort and comforting perspective of the staff nurses?