Janice Phillips

American Academy of Nursing Expert Panel Report Developing Cultural Competence to Eliminate Health Disparities in Ethnic Minorities and Other Vulnerable Populations

The members of the Expert Panel on Cultural Competence of the American Academy of Nursing (AAN) envisioned this article to serve as a catalyst to action by the Academy to take the lead in ensuring that measurable outcomes be achieved that reduce or eliminate health disparities commonly found among racial, ethnic, uninsured, underserved, and underrepresented populations residing throughout the United States. The purposes of this article are to (a) assess current issues related to closing the gap in health disparities and achieving cultural competence, (b) discuss a beginning plan of action from the Expert Panel on Cultural Competence for future endeavors and continued work in these areas beyond the 2002 annual conference on Closing the Gap in Health Disparities, and (c) provide clearly delineated recommendations to assist the Academy to plan strategies and to step forward in taking the lead in reshaping health care policies to eliminate health care and health disparities.

Breast cancer control and african american women: A review

The beginning of the new millennium finds breast cancer to be a continuing public health problem for women in the United States. Breast cancer is the most common cancer among women in the United States, accounting for almost one-third of all cancers diagnosed in American women (1). Although the incidence rate of breast cancer is highest among Caucasian women, African American women (AAW) are at greater risk of dying from breast cancer than are Caucasian women. This is especially true for AAW who are less than 50 years of age (2,3). Considerable progress has been achieved in the reduction of breast cancer mortality over the last two decades. However, the morality rate decrease has been greater in Caucasian women than in AAW (1). The national health promotion and disease prevention objectives related to reduction in breast cancer mortality

Where's the evidence? An innovative approach to teaching staff about evidence-based practice.

Preparing nurses to incorporate research and evidence-based findings into nursing practice is important to meet the needs of patients and their families in todays healthcare arena. This article highlights the use of a mock trial as an innovative approach to educating staff nurses on evidence-based practice and identifies future implications for educating staff nurses on incorporating evidence into nursing practice.

The Meaning of Breast Cancer Risk for African American Women

PURPOSE To describe African American womens experience of being at high risk for breast cancer. DESIGN A hermeneutic phenomenological approach was used to guide in-depth interviews and analysis. Methods to ensure trustworthiness and rigor were included. METHODS Open interviews were conducted with 20 African American women who were at high risk for breast cancer (family history, personal history, genetic mutation). They were recruited from a cancer risk clinic and community-based settings. Data were transcribed verbatim, and themes were labeled among and between all interviews. FINDINGS Five themes were identified: (a) life-changing experience; (b) relationships: fears, support, and concerns; (c) the healthcare experience; (d) raising awareness; and (e) strong faith. CONCLUSIONS Young women at high risk for breast cancer have unique emotional and support needs that are shaped by stage in life, relationships with significant others, their faith, and interactions with the healthcare delivery system. CLINICAL RELEVANCE Breast cancer does occur in young women. This highlights the need for timely and sensitive approaches to care when young women present with breast health concerns or abnormal breast findings.

Eliminating cancer-related disparities: how nurses can respond to the challenge.

OBJECTIVES To review disparities in cancer incidence and mortality among several distinct population groups in the US and the challenges nurses face in eliminating these disparities. DATA SOURCES Journal articles, books, and government reports. CONCLUSION Despite the phenomenal progress in cancer detection and control, many populations in the US suffer needlessly and die from potentially curable cancers. IMPLICATIONS FOR NURSING PRACTICE Nurses can address cancer care needs of population groups at increased risk for developing and/or dying from cancer.

Nursing morbidity and mortality conferences: A tool for enhancing quality patient care

Morbidity and mortality conferences have been used to educate healthcare providers, to critique staff performance, and to improve patient outcomes since the early 1900s. Historically well documented in physician-focused journals, the use of morbidity and mortality conferences is less predominant in the nursing literature. This article highlights one hospitals experience with planning, implementing, and evaluating a nursing morbidity and mortality conference and identifies implications for use in professional nursing development.

Rural African American women's descriptions of mammogram quality.

The voices of rural women are frequently absent in discussions of quality healthcare. This study utilized a phenomenological research design to examine rural African American womens descriptions of mammogram quality. Twenty-three women in rural Georgia communities were interviewed. Participants desired quality mammogram experiences in which they were treated with kindness and respect, were given explanations of the mammogram procedure and outcome, and were cared for by health professionals who were competent in their roles.

Breast Cancer Biology and Behavior in Older Women Biobehavioral Perspectives

In the United States, breast cancer is the most common cancer and second leading cause of cancer deaths in women. As age increases, so does the incidence of breast cancer. In the United States, every 3 minutes a woman is diagnosed with breast cancer and every 13 minutes a woman dies of breast cancer. Despite these harsh facts, there is good news. Because of advances in biomedical research, biobehavioral health, and medicine, 65% of women diagnosed with breast cancer in the United States are living long-term, that is, 5 or more years after diagnosis, cancer-free. A goal of this chapter is to provide gerontologists and other health professionals and researchers with a baseline of knowledge regarding some of the more common health challenges of older women diagnosed with breast cancer and how some of the more imperative challenges might be addressed by inclusive multidisciplinary and broad biobehavioral perspectives. Literature is reviewed on breast cancer incidence, mortality, and survival among older women, as well as issues of disparities affecting women of racial and ethnic diversity. Biology of breast cancer to include information on heredity is presented. A brief overview of quality of life and the science of well-being provide theoretical perspectives and add emphasis to the need to balance illness and disability with quality and well-being. Various health promotion and disease prevention strategies are reviewed including lack of and need for education and information on breast cancer risk factors in older women, diet and nutrition, obesity, issues of tobacco use, health literacy and provider communications, salience of health provider recommendations, health equity and disparities, and culture and cultural competence. Further research is warranted and topics are proposed throughout the text.