Cultural Barrier Viviana VanrelCOM200September 14,.docx

Cultural Barrier
Viviana Vanrel
COM/200
September 14, 2015
Shea Brooks
*
Personal Background John Smith is an American who is thirty
years old.He is an African-American.Works as a janitor in
Texas.
John Smith is one of the African Americans who have been
working hard to ensure that the do make the ends meet. At the
age of thirty year old, he has been able to open a business of
janitorial services thus employing twenty people. His hard work
has placed him a the position of the best companies in Texas
offering these services. His family is known to have come to
Texas in over fifty years ago. After completing the college, he
chose to offer janitorial services to people of the region. He is
known to be an honest man who does his duties diligently.
*

Where he Lives
The man has lived in Texas for better part of his life. He has
been interacting with different people both professionally and
socially. Texas is his home and he has businesses at this region
John is a person who has lived in Texas all of his life. In fact,
most of his schooling was conducted in this region. This areas
is known to have many people of different cultures which has
forced him to learn to tolerate. This region is also known to be
culturally rich compared to other parts of the area. The business
that he operates has been opened in this region.
*
Cultural FactsThis person has undergone through most of
the African Americans rites of passage. He underwent through
thorough shaving by that was a must to conducted.He had to
learn different cultures so as to interact with the neighbors
freely.
Learning to adapt to different culture is a difficult task that
each person has to give a try. As for John, this was the only way
he could have survived to live in this region. Therefore, this
was a choice he could have made earlier or later in life and
there was no way out of it. The most interesting of all was being
asked to be shaved at the age of thirteen to symbolize that he
was about to be recognized by the society as a fully grown man.
In addition, understanding different cultures was to his
advantage because he was now capable of interacting with
different cultures(Castillo, 2006).
*

Experiences in adapting new cultureLanguage barrier Emotional
constraintsBehavior constraints
While learning these cultures, John encountered different
experiences including the one for language barrier. It was
difficult for him to figure out what some of the words meant so
that he could have understood that culture more. Emotional
constraints were other experiences that he encountered while
adapting. Finally, there were behavior constraints that gave him
the perfect experience for understanding that particular
culture(Tosi, 2013).
*
Comparison between both Johns culture and mineThese cultures
all give us a way of thinking, hearing, and seeing the
world.Additionally, both cultures trigger a different
interpretation to the world.However, the portrayal of emotions
is different in the two cultures.
Cultural relativism is an aspect that entails comparing different
cultures and evaluating in details the major similarities and
differences in the cultures. These cultures are both symbolic
because they help us view the world differently from different
perspectives. In addition, these cultures have made it possible
to interpret the world differently based on the belief of each and
every culture. My culture is different from John’s in the manner
in which they portray their emotions towards different
circumstances.
*

Reference Castillo, E. D. (2006). Reducing cultural barriers
through Promotores de Salud.Tosi, A. (2013). Crossing barriers
and bridging cultures: The challenges of multilingual translation
for the European Union. Clevedon ; Toronto: Multilingual
Matters.
*
Create a 2-3-slide ONLY. NO MORE THAN 3 slides
Microsoft® PowerPoint® presentation, including detailed
speaker notes, based on the techniques of the research process
from Weeks Two and Three.
· Conclusions: Explain some ways to integrate the future trends
of health care research and consumerism.
Weeks 2, 3
_ sponsored research
-therapeutic and no therapeutic research
-inferential analysis
-hypothesis testing
-analysis of variance
examples
Abstract
TranslateAbstract
Despite extensive research on defining and measuring health
care quality, little attention has been given to consumers'

perspectives of high-quality health care. The purposes of this
study were to (a) identify the importance to consumers of
attributes of health care quality and nursing care quality, and
(b) examine the relationship of consumer perspectives to health
status and selected demographic variables.
Exploratory. Consumers (N = 239) were recruited from waiting
rooms of clinics and in neighborhoods of a large metropolitan
area in the Midwestern United States that included both urban
and suburban populations.
Participants completed the Quality Health Care Questionnaire
(QHCQ) and the SF-36 Health Survey. On the QHCQ, they rated
the importance of 27 attributes of health care and nursing care
quality. The SF-36 is a 36-item instrument for measuring health
status in eight general areas.
The most important indicators of high-quality nursing care to
consumers were: being cared for by nurses who are up-to-date
and well informed; being able to communicate with the nurse;
spending enough time with the nurse and not feeling rushed
during the visit; having a nurse teach about the illness,
medications, treatments, and staying healthy; and being able to
call a nurse with questions. The lowest-rated item was having
an opportunity to be cared for by nurse practitioners. Ratings
differed by race, age, years of education, income, and health
status.
The importance that consumers place on teaching by the nurse
was emphasized, particularly among people with less education,
low income levels, and chronic illnesses.
Full text
· TranslateFull text
·
Headnote
Purpose: Despite extensive research on defining and measuring
health care quality, little attention has been given to consumers'
perspectives of high-quality health care. The purposes of this
study were to (a) identify the importance to consumers of
attributes of health care quality and nursing care quality, and

(b) examine the relationship of consumer perspectives to health
status and selected demographic variables.
Design: Exploratory Consumers (N = 239) were recruited from
waiting rooms of clinics and in neighborhoods of a large
metropolitan area in the Midwestern United States that included
both urban and suburban populations.
Methods: Participants completed the Quality Health Care
Questionnaire (QHCQ) and the SF-36 Health Survey On the
QHCQ, they rated the importance of 27 attributes of health care
and nursing care quality. The SF-36 is a 36-item instrument for
measuring health status in eight general areas.
Findings: The most important indicators of high-quality nursing
care to consumers were: being cared for by nurses who are up-
to-date and well in formed; being able to communicate with the
nurse; spending enough time with the nurse and not feeling
rushed during the visit; having a nurse teach about the illness,
medications, treatments, and staying healthy; and being able to
call a nurse with questions. The lowest-rated item was having
an opportunity to be cared for by nurse practitioners. Ratings
differed by race, age, years of education, income, and health
status.
Conclusions: The importance that consumers place on teaching
by the nurse was emphasized, particularly among people with
less education, low income levels, and chronic illnesses.
Headnote
(Key words: quality of nursing care, quality of health care,
consumer health information, patient education)
Extensive research has been done to define and measure health
care quality, yet less attention has been given to consumers'
perspectives of high-quality health care. Many investigators
have examined the type of information valuable to consumers in
choosing among varied health plans, such as how a health plan
works, its costs, benefits covered by the plan, quality of care,
and patient satisfaction. Whether consumers understand this
information and will actually use it to make health care
decisions have not yet been established through research

(Edgman-Levitan & Cleary, 1996; Longo et al., 1997; Oermann,
1999). Although research is available on patients' expectations
of and satisfaction with nursing care in hospitals, less is known
about their perspectives of care in ambulatory settings, where
more care is being delivered.
Learning about what consumers want from their health care and
what quality care means to them gives us a better understanding
of their expectations. What people expect from their health
plans and providers influences their satisfaction with care
(Concato & Feinstein,1997; Conway & Willcocks, 1997;
Kravitz, 1996; Pascoe, 1983; Sofaer 1997).
Kravitz (1996) developed a model to link expectations and
patient satisfaction with a medical encounter. This model
indicates that patients' expectations for care are formed before
the encounter and include expectations for care in general and
for the specific visit. These expectations are influenced by
demographic characteristics, prior health care experiences, and
concerns related to the patient's specific health problems.
Patients evaluate their visit with the provider by comparing the
events and their expectations. An understanding of these
expectations is important because meeting them may lead to
greater satisfaction with care (Kravitz, 1996).
Thus, this study was designed to (a) identify the importance to
consumers of attributes of health care quality and nursing care
quality, and (b) examine the relationship of quality of care
importance ratings to health status and selected demographic
variables.
Background
American consumers want information about the quality of their
health plans and care in general. Isaacs (1996) reported on a
survey of 1,081 adults from across the United States. Fifty
percent of the subjects were enrolled in fee-for-service plans,
23% in health maintenance organizations (HMOs), 11% in
preferred provider organizations (PPOs), and the remaining 16%
were unsure how to characterize their coverage. Many (67%)
people did not understand the differences between traditional

fee-for-service and managed-care plans. Consumers were
interested in information about specialists, the quality of
physicians in the health plan, and certain illnesses and
conditions.
In a telephone survey sponsored by the Kaiser Family
Foundation (1996), 42% of the 2,006 adult participants rated
quality of care as their major concern. Responses to the survey
indicated that ease of access to specialists (68%) and range of
benefits offered (66%) are major determinants of consumers'
ratings of the quality of health plans. Other factors important to
participants were percentage of physicians with complaints filed
against them by patients (64%), percentage of plan members
who get regular preventive screenings (62%), and patient
satisfaction (57%).
Hibbard and Jewett ( 1996, 1997) examined how consumers
viewed different quality indicators, the majority of which were
taken from the Health Plan Employer Data and Information Set
(HEDIS). Quality of physicians and hospitals were more
important to consumers than was information about the health
plan itself. Indicators of preventive care were the most
important factors to consumers, followed by patients' ratings of
quality and satisfaction.
Although consumers reported high interest in having
information about the quality of health plans, their stated
preferences for this information were inconsistent with actual
choices (Hibbard & Jewett, 1996). Participants were given a
sample report card comparing two plans with hypothetical data
about their quality. When asked to choose between the plans,
participants did not select the plan that was consistent with their
earlier ratings of quality indicators. For example, they chose the
plan with more favorable ratings for events such as hospital
death rates after a heart attack, instead of choosing preventive
care. Consumers reported that they could provide their own
preventive care, but undesirable events, such as those following
surgery or a heart attack, were not under their personal control.
Many of the published report cards contain information not

readily understood by consumers. To provide more meaningful
information to consumers, researchers at the Foundation for
Accountability (FACCT) developed and tested a model for
reporting quality information derived from FACCT, HEDIS, and
Consumer Assessment of Health Plans (CAHPS). Twelve focus
groups (n = 112) and eight interviews were held with Medicare
beneficiaries (FACCT, 1997). The researchers identified these
five categories for reporting information to consumers: (a)
basics of good care, such as access and communication with
providers, (b) staying healthy, such as reduction of health risks
and early detection, (c) getting better, including appropriate
treatment and follow-up, (d) living with illness, such as
receiving needed assistance with an ongoing illness, and (e)
changing needs, including support and care when health needs
change (FACCT, 1997, 1999; Lansky, 1998). In an extension of
the research, federal employees and retirees confirmed that
FACCT's five performance categories were wellsuited for
providing information about quality to them (Bethell & Read,
1998).
Oermann (1999) interviewed consumers in the community about
their perspectives of quality health care and quality nursing
care. Consumers were asked four open-ended questions about
their definitions of health care and nursing care quality and
were asked to describe experiences that they felt represented
high-quality care. These interview questions were consistent
with the methodology used by FACCT researchers who began
by asking consumers to define quality health care and identify
characteristics of health care experiences that represented
quality care.
Consumers described high-quality health care as having access
to care (n = 143), having competent and skilled providers (n =
104), and receiving the proper treatment (n = 100). Consumers
defined high-quality nursing care as having nurses who were
concerned about them and demonstrated caring behaviors (n =
148), were competent and skilled (n = 115), communicated
effectively with them (n = 99), and taught them about their care

(n = 97). Consumers in both fee-for-service plans and HMOs
reported that access to care was the most important indicator of
good health care. They defined high-quality nursing care
similarly, although 10.8 % of people in HMOs added that an
important role of nurses was to be liaisons for them concerning
their physicians and other care providers.
Other research in nursing related to consumer assessment of
health care quality has been focused predominantly on patient
satisfaction with care, particularly nursing care in hospitals
(Chang, 1997; Hinshaw & Atwood, 1992; Jacox, Bausell, &
Mahrenholz, 1997; Minnick & Young, 1999) and outpatient care
settings (Ketefian, Redman, Nash, & Bogue,1997). Patient
satisfaction is influenced by patients' expectations and how they
define quality of care. Providers' perceptions of quality,
however may differ from patients' perceptions (Larrabee,1995;
Lynn & McMillen, 1999; Lynn & Moore, 1997).
Studies of consumer perspectives of health care quality have
shown limited information about how consumers define quality
nursing care. Because the predominant focus of studies has been
on choosing a health plan, few studies have addressed consumer
views of quality nursing care.
Methods
This exploratory study included a convenience sample of 239
consumers recruited from waiting rooms of clinics and from
neighborhoods of a large metropolitan area in the Midwest, with
both urban and suburban populations. Participants were over 18
years of age and were able to write and speak English. None of
the consumers had been hospitalized within the last 6 months.
The Quality Health Care Questionnaire (QHCQ), developed by
the investigators, included demographic and background
information and 27 attributes of health care and nursing care
quality. Consumers rated the importance of each of these
attributes in their views of quality care. A Likert scale of 1 (not
at all important) to 5 (very important) was used. The attributes
were identified from the literature on health care quality,
research on consumers' perspectives of quality care, and

research on patient satisfaction with nursing care.
Factor analysis was done using principal component analysis.
All factors with Eigenvalues greater than 1 were retained,
resulting in six factors that accounted for 64% of the variance:
medical care, teaching by the nurse, provider competence,
choice of provider, nurse-patient interaction, and convenience
of appointments. Medical care included nine items, such as
getting the information needed about treatments, being included
in decisions about care, and having access to specialists. The
factor teaching by the nurse included five items, such as having
a nurse teach about the illness, medications, and treatments. The
provider competence factor included three items relating to
physicians and nurses being up-to-date and competent to
provide care. Choice of provider included four items, such as
choosing my own physicians and having an opportunity to be
cared for by nurse practitioners. The factor nurse-patient
interaction included three items on communicating with the
nurse. The factor convenience of appointments included two
items related to getting appointments easily and not waiting too
long past the appointment time. These factor scores were
standardized to a mean of 50 and a standard deviation of 10.
Because previous research has shown differences in definitions
of quality care for people with chronic conditions, health status
was measured using the SF-36 Health Survey. The SF-36 is a
36-item instrument for measuring health status in eight general
areas: physical functioning, role limitations because of
physical-health problems, bodily pain, general health, vitality
(energy or fatigue), social functioning, role limitations because
of emotional problems, and mental health. Another concept
measured is health transition, whether general health is reported
as better or worse than for the previous year. For norm-based
scoring of the SF-36 each scale was standardized to a mean of
50 and standard deviation of 10 in the general population
(Ware, 1997). In this study the alpha coefficients for the scales
ranged from .84 to .90.
Neighborhoods within census tracts in a large metropolitan area

were selected to include a broad spectrum of consumers,
including both African Americans and Caucasians and varied
socioeconomic levels. The first half of the sample was obtained
by surveying individual households, door-to-door; this group of
consumers (n = 117, 49%) completed the instruments in their
own homes. The second half of the surveys were completed by
consumers (n = 122, 51%) recruited from the waiting rooms of
clinics in these same neighborhoods.
Findings
The sample included 149 women (63.1%) and 87 men (36.9%).
The ages of the consumers varied widely, from 18 to 92 years;
the mean age was 50.8 (SD = 15.05) years. One-half of the
subjects (n = 120, 50.2%) were married. About half (49.4%) of
the consumers had a high school education; level of education
ranged from less than highschool (n = 17, 7.1%) through post-
graduate (n = 49, 20.5 % ).
Slightly over half of the participants (n = 134, 56.1%) were
currently employed. Most consumers had private health
insurance through an employer (n = 140); some had Medicare (n
= 68), were covered as veterans (n = 39), had Medicaid (n =
18), or a combination of coverage. Participants had been seen
by a physician in the last year (M = 6.68 times), a nurse
practitioner (M = 1.14 times), or an RN in a physician's office
or clinic (M = 1.95 times).
Consumers rated the importance of 27 attributes of health care
and nursing care quality to them personally. Ratings ranged
from a low of 3.43 (SD = 1.16) for having an opportunity to be
cared for by nurse practitioners to the most important indicators
of quality health care: getting better (M = 4.92, SD = 0.34) and
being cared for by physicians who are up-to-date and well
informed (M = 4.92, SD = 0.32).
Other important indicators of quality health care to consumers
were: understanding my physicians' explanations of my illness,
treatments, and options (M = 4.91, SD = 0.36), having access to
specialists when needed (M = 4.89, SD = 0.41 ), being able to
communicate with the physician (M = 4.89, SD = 0.36), being

included in decisions about my care (M = 4.88, SD = 0.42), and
getting the tests I need to find diseases early (M = 4.88, SD =
0.42).
The most important indicators of quality nursing care to
consumers were: being cared for by nurses who are up-todate
and well informed (M = 4.84, SD = 0.50); being able to
communicate with the nurse (M = 4.70, SD = 0.55); spending
enough time with the nurse and not feeling rushed during the
visit (M = 4.51, SD = 0.71); having a nurse teach me about my
illness, medications, and treatments (M = 4.43, SD = 0.86);
having the nurse help me cope with my illness and maintain my
usual activities (M = 4.31, SD = 0.88); being able to call a nurse
with questions (M = 4.23, SD = 0.94); and having a nurse teach
me how to avoid illness and stay healthy (M = 4.15, SD = 1.04).
Some differences were found in importance ratings based on
race, age, years of education, income, and health status.
Participants included 163 (68.2%) Caucasians and 66 (27.6%)
African Americans. As shown in Table 1, the factor medical
care was reported a's less important to African Americans than
to Caucasians (F [1,229] = 9.95, p < .01), but teaching by the
nurse was significantly more important (F [1,229] = 6.77, p <
.01). Convenience of appointment also was more important as
reported by African Americans in their view of quality health
care than by Caucasians (F [1,229] = 12.24, p = .001). The
African Americans in this study reported significantly lower
scores than did Caucasians on every SF-36 scale (Oermann,
1999), and they reported more chronic illnesses (F [1, 229] =
7.26, p = .008).
Age was negatively correlated with choice of care provider (r =
-.33, p < .0001), see Table 2. The opportunity to choose a care
provider was reported as more important to younger subjects
than to older people.
Years of education was positively related to the medical care
factor (r = .22, p < .001) and negatively correlated with
teaching by the nurse (r = -.19, p = .004 ). Consumers with less
education rated teaching by the nurse as more important than

did people with more education. Participants with lower income
levels also rated teaching by the nurse as more important in
their care (r = -.25, p < .001 ).
Participants reported various chronic health problems,
predominantly visual problems, arthritis, hypertension, and low
back pain. The mean number of chronic illnesses was two.
Number of chronic illnesses was significantly related to the
importance of teaching by the nurse (r = .25, p < .001 ), choice
of provider (r = .24, p < .001 ), and convenience of
appointments (r = .14, p = .03 ), Table 2.
The mean scores on all the SF-36 scales were below the norms
for the general population (Ware, 1993) except the mental
health scale which was at the mean. The Pearson r formula was
used to calculate relationships between healthstatus scores and
importance factors. Participants with low scores on emotional
health, indicating problems with work and other daily activities
as a result of emotional problems, rated teaching by the nurse as
more important than did people with good emotional health (r =
-.161, p = .015). Similarly, a negative correlation was found
between the mental health scale and importance of teaching by
the nurse (r = -.16, p < .05), Table 2.
Although general health was not found to be related to medical
care quality, a statistically significant negative correlation was
found between the general health scores and importance of
teaching by the nurse (r = -.27, p < .001). Consumers with
poorer health rated teaching by the nurse as more important
than did people with better general health. Teaching by the
nurse also was related to consumers' ratings of the quality of
nursing care they received in the last 6 months in ambulatory
care settings (r = .16, p = .03).
Convenience of appointments was inversely related to physical
function (r = -.15, p = .02) and general health (r = .16, p = .016)
scores. People with limited physical functioning and poor
general health rated the ease of getting appointments and not
waiting too long past their appointment times as important
indicators of quality care.

For consumers who had health coverage programs, 97 (49.5%)
were in fee-for-service programs and 99 (50.5%) were in an
HMO or PPO. No statistically significant differences were
found in any of the importance factors between these groups.
Participants were asked if they read any information about
health care quality in the last 6 months. Most consumers (n =
139, 81.8%) had read something about health care quality in the
newspaper. People had also read information about health plans
from their employers (n = 35, 20.6%) and advertisements (n =
34, 20.0%). Although the majority had recently read
information about health care quality, few (n = 64, 26.8 % )
reported using this information when making health care
decisions, such as changing health plans or deciding on a
hospital or clinic. A related finding was that nearly half of the
consumers in this study (n = 117, 49.0%) had a choice of
different health plans.
Consumers recruited from clinics had less education (t = 3.35, p
= .001 ), lower incomes (t = 3.23, p = .001 ), and were in poorer
health (t = 4.16, p = .001 ) than were participants who
completed the surveys in their homes. Most notably, the views
of these two groups did not differ except concerning the' two
factors on nursing care. Consumers recruited from clinics
placed more importance on teaching by the nurse (t = 3.48, p =
.001 ) and interacting with the nurse (t = 2.12, p = .03) than did
the consumers surveyed in their homes.
Discussion
The attributes of health care important to consumers in this
study are consistent with findings from other research in
ambulatory care. Edgman-Levitan and Cleary (1996) reported
patients receiving care in physicians' offices, outpatients
clinics, community health centers, and other ambulatory settings
are concerned about access to care, coordination of services,
education, being treated with respect, and processes of care
such as waiting times for appointments.
What has not been reported in other studies, however, is the
importance consumers place on teaching by the nurse. Because

most of the research is in the context of choosing a health plan,
few investigators have asked consumers about the importance of
nursing care in their views of quality. Teaching about illness
and management of care at home, teaching about preventive
care, having a nurse help patients cope at home with their health
problems, and being able to call a nurse with questions were
important to consumers. Although understanding the physician's
explanation of the illness and treatment options was important,
consumers looked to the nurse for their health education.
Effective teaching requires knowledge and expertise, ability to
communicate with patients and families, and ability to assess
learning needs, plan and deliver the instruction, and evaluate its
outcomes (Oermann, 1997; Oermann & Gaberson,1998). Being
cared for by nurses who were up-todate and well informed,
being able to communicate with them, and not feeling rushed
during their visit were important to consumers and relate to
effective teaching.
For consumers with limited education and income levels,
teaching by the nurse was more important than to other
consumers. Patients who were not well educated placed greater
importance on the nurse providing information about their
health problems. This view was true particularly for African
Americans for whom health education by the nurse was central
to their view of quality nursing care.
People with limited physical functioning, relatively poor
general health, and more chronic illnesses rated the ease of
getting appointments and not waiting too long past their
appointment times as important indicators of quality care,
consistent with results from other studies (Concato & Feinstein,
1997; Edgman-Levitan & Cleary, 1996).
When asked about selecting a new health plan, participants
indicated that they would ask for recommendations from their
regular physician or other physicians (n = 107, 47.3%) or from
family and friends (n = 65, 28.8%). Few reported that they
would rely on quality information provided by their employers
(n = 11, 4.6%). These findings are consistent with the Kaiser

Family Foundation ( 1996) survey in which people reported that
they relied on personal recommendations from their physicians
(59%) and from family and friends (57%) for making health
care choices. In the Kaiser survey, 6 out of 10 people said that
employers were not good resources because they could not be
trusted to provide reliable information about the quality of
different health plans. While consumers might read about health
care quality, they might not always use this information in
making health related decisions (Chernew & Scanlon, 1998;
Hibbard & Jewett, 1996). The information available might be
too complex and detailed for many people to understand
(Oermann & Huber, 1999).
Conclusions
Nurses have important responsibilities for teaching patients
about health problems, self-care, and prevention. Nurses also
have a role in helping people understand quality information,
how they might use it in their decisions, and how to determine
if they are receiving high-quality care from their providers. The
tradition of educating patients about their health care, combined
with the importance consumers attribute to teaching by nurses,
make nurses key people for carrying out patient education as an
important component of quality of care.
References
References
References
Bethell, C., & Read, D. (1998, January). Meeting the health care
informational needs of federal employees & retirees: An
evaluation of a framework for communication. Portland, OR:
Foundation for Accountability.
Chang, K. ( 1997). Dimensions and indicators of patients'
perceived nursing care quality in the hospital setting. Journal of
Nursing Care Quality, 11(6), 26-37.
Chernew, M., & Scanlon, D.E ( 1998 ). Health plan report cards
and insurance choice. Inquiry, 35, 9-22.
Concato, J., & Feinstein, A.R. (1997). Asking patients what
they liked: Overlooked attributes of patient satisfaction with

primary care. The American Journal of Medicine, 102, 399-406.
Conway, T., & Willcocks, S. (1997). The role of expectations in
the perception of health care quality: Developing a conceptual
model. International Journal of Health Care Quality Assurance,
10(3), 131140.
Edgman-Levitan, S., & Cleary, PD. ( 1996). What information
do consumers want and need? Health Affairs, 15(4), 42-56.
References
Foundation for Accountability (FACCT). (1997, December).
Reporting quality information to consumers. Portland, OR:
Author.
Foundation for Accountability (FACCT). (1999). FACCT
mission [On-line]. Available:
http://www.facct.org/about/mission.html
Hibbard, J.H., & Jewett, Jj. (1996). What type of quality
information do consumers want in a health care report card?
Medical Care Research and Review, 53(1), 28-47.
Hibbard, J.H., & Jewett, J.J. (1997). Will quality report cards
help consumers? Health Affairs, 16(3), 218-228.
Hinshaw, A.S., & Atwood, J.R. (1992). A patient satisfaction
instrument: Precision by replication. Nursing Research 31, 170-
175.
Isaacs, S.L. (1996). Consumers' information needs: Results of a
national survey. Health Affairs, 15(4), 31-41.
Jacox, A.K., Bausell, B.R., & Mahrenholz, D.M. ( 1997).
Patient satisfaction with nursing care in hospitals. Outcomes
Management for Nursing Practice, 1 ( 1 ), 20-28.
Kaiser Family Foundation. (1996). Americans as health care
consumers: The role of quality information [On-line].
Available: www.ahapr.gov/ qual/kffhigh.htm
Ketefian, S., Redman, R., Nash, M.G., & Bogue, E. (1997).
Inpatient and ambulatory patient satisfaction with nursing care.
Quality Management in Health Care, 5(4), 66-75.
Kravitz, R.L. (1996). Patients' expectations for medical care:
An expanded formulation based on review of the literature.
Medical Care Research and Review, 53(1), 3-27.

Lansky, D. (1998). Measuring what matters to the public.
Health Affairs, 17(4), 40-41.
References
Larrabee, J.H. (1995). The changing role of the consumer in
health care quality. Journal of Nursing Care Quality, 9(2), 8-15.
Longo, D.R., Land, G., Schramm, W , Fraas, J., Soskins, B, &
Howell, V (1997). Consumer reports in health care: Do they
make a difference in patient care? JAMA, 278, 1579-1584.
Lynn, M.R., & McMillen, B.J. (1999). Do nurses know what
patients think is important in nursing care? Journal of Nursing
Care Quality,13(S), 65-74.
Lynn, M.R., & Moore, K. (1997). Relationship between
traditional quality indicators and perceptions of care. Seminars
for Nurse Managers, 5,187-193.
Minnick, A., & Young, W B. (1999). Comparison between
reports of care obtained by postdischarge telephone interview
and predischarge personal interview. Outcomes Management for
Nursing Practice, 3, 32-37.
Oermann, M.H. (1997). Professional nursing practice. Norwalk,
CT: Appleton & Lange.
Oermann, M.H. (1999). Consumers' descriptions of quality
health care. Journal of Nursing Care Quality, 14(1), 47-55.
Oermann, M.H., & Gaberson, K. ( 1998 ). Evaluation and
testing in nursing education. New York: Springer.
Oermann, M.H., & Huber, D. (1999). Ignorance is bliss but not
in health care: Teaching consumers about quality care.
Outcomes Management for Nursing Practice, 3, 47-48.
Pascoe, G.C. (1983). Patient satisfaction in primary health care:
A literature review and analysis. Evaluation and Program
Planning, 6, 185-210.
Sofaer, S. (1997). How will we know if we got it right? Aims,
benefits, and risks of consumer information initiatives. Journal
on Quality Improvement, 23, 258-264.
Ware, J.E. (1997). SF-36 health survey: Manual and
interpretation guide. Lincoln, RI: Quality Metric.
AuthorAffiliation

Marilyn H. Oermann, RN, PhD, FAAN, Lambda, Professor;
Thomas Templin, PhD, Statistician; both at the College of
Nursing, Wayne State University, Detroit, MI. This study was
funded by Wayne State University Faculty Research Grant,
Detroit, MI. Correspondence to Dr. Oermann, 168 North
Cranbrook Cross, Bloomfield Hills, MI 48301-2508. E-mail:
[email protected]
Accepted far publication November 18, 1999.
Copyright Sigma Theta Tau International, Inc., Honor Society
of Nursing Second Quarter 2000

Cultural Barrier Viviana VanrelCOM200September 14,.docx

Recommended

Recommended

More Related Content

Similar to Cultural Barrier Viviana VanrelCOM200September 14,.docx

Similar to Cultural Barrier Viviana VanrelCOM200September 14,.docx (20)

More from MARRY7

More from MARRY7 (20)

Recently uploaded

Recently uploaded (20)

Cultural Barrier Viviana VanrelCOM200September 14,.docx