Josepha Campinha-Bacote

Significant literature exists that focuses on cultural competence at the individual level, while cultural competence at the organizational level is rarely addressed. In addition, there is extensive literature separating and distinguishing cultural competence from cultural humility. The lack of intersectionality between individuals and organizations and the perceived division between cultural competence and cultural humility impedes the delivery of quality and equitable services. Part II of this two-part series on cultural competemility applies an intersectionality approach to the process of cultural competemility and offer strategies for nurses to actively challenge and address inequalities in their journey towards cultural competemility. In Part II the authors discuss the problem of silo thinking, after which they present an intersectionality perspective of cultural competemility, offer practice, educational, and administrative, and research applications, and conclude that a lens of intersectionality allows healthcare providers to consider new ways to overcome the division between individuals and organizations so as to promote delivery of quality and equitable healthcare services.

For over 30 decades, cultural competence has commanded significant attention, being viewed as the cornerstone of fostering cross-cultural communication, reducing health disparities, improving access to better care, increasing health literacy and promoting health equity. However, a medley of definitions and conceptualizations has created intense debate, questioning its true ability to address cross-cultural problems in healthcare delivery. One ongoing debate centers around the relationship between cultural competence and cultural humility. Part I of this two-part series on cultural competemility will revisit this debate by discussing competing views of this relationship. A new paradigm of thought regarding the relationship between cultural competence and cultural humility will be proposed, one necessitating that cultural humility and cultural competence enter into a synergistic relationship. This synergistic relationship is embodied in a term coined "cultural competemility.” This article presents the debate regarding cultural competence verses cultural humility, defines the term cultural competemility, explains the relationship between cultural humility and cultural competence, describes the process of permeation and concludes by proposing a synergistic relationship between cultural competence and cultural humility to create the process of cultural competemility. Part II of this series will apply an intersectionality approach to the process of cultural competemility and offer strategies for nurses to actively challenge and address inequalities.

At the core of both patient centeredness and cultural competence is the importance of seeing the patient as a unique person. For the purpose of this article, cultural competence is viewed as an expansion of patient-centered care. More specifically, cultural competence can be seen as a necessary set of skills for nurses to attain in order to render effective patient-centered care. However, a vexing question remains, “How does the nurse deliver patient-centered care when the patient’s health beliefs, practices, and values are in direct conflict with medical and nursing guidelines?” The purpose of this article is to provide nurses with a set of culturally competent skills that will enhance the delivery of patient-centered care in the midst of a cultural conflict. I will begin by offering a conceptual framework for cultural competence and a description of the cultural skill needed to formulate a mutually acceptable and culturally relevant treatment plan for each patient. Next I will describe effective approaches for cultural encounters. Finally I will present a vignette that illustrates how the nurse can deliver patient-centered care when the patient’s health beliefs, practices, and values are in direct conflict with medical and nursing guidelines

Nursing has received funding to create model programs for the recruitment and retention of minority/disadvantaged nursing students. In examining these programs, the philosophy guiding the mentoring component of these programs is often based on traditional mentoring principles. The purpose of this article was to enhance the mentoring component of recruitment and retention programs for minority/disadvantaged nursing students by proposing a culturally conscious model of mentoring based on Campinha-Bacote's model of cultural competence.

People from minority backgrounds who have a mental illness experience double discrimination associated with both mental illness and race. In 2001, the Surgeon General's landmark report on race, culture, ethnicity, and mental health compellingly documented racial and ethnic disparities in mental heath care related to issues of misdiagnosis, underuse, overrepresentation, and improper treatment. The report called for sound research, including investigation into the area of psychopharmacology, to determine the extent to which the variability of an individual's response to medications is accounted for by factors related to race, ethnicity, age, gender, family history, or lifestyle. This article will focus on the realm of ethnic psychopharmacology and propose a practice model for nurses to become culturally competent in the area of ethnic psychopharmacology.

Diversity. The changing demographics and economics of our growing multicultural world, and the long-standing disparities in the health status of people from culturally diverse backgrounds has challenged health care providers and organizations to consider cultural diversity as a priority. The purpose of this article is to present a model that will be helpful in providing culturally competent care. The concept of cultural competence is discussed, The Process of Cultural Competence in the Delivery of Healthcare Services Model is described, and a mnemonic to guide in providing culturally competent care is presented.

Nge of human experiences and responses to health and illness” (Association of Rehabilitation Nurses, 1996, p.1). Rehabilitation nurses must become strongly aware of the role that culture plays in this process. This article presents a conceptual model of practice with which to address cultural competence in rehabilitation nursing. The model's constructs of cultural awareness, cultural knowledge, cultural encounters, cultural skill, and cultural desire are discussed. Examples from the field of rehabilitation nursing are presented in the discussion of these constructs. 11108 Huntwicke Place, Cincinnati, OH 45241, e-mail meddir@aol.com. Dr. Josepha Campinha-Bacote is president and founder of Transcultural C.A.R.E. Associates in Cincinnati. Her specialty areas are ethnic psychopharmacology, biocultural ecology, and ethnomusic therapy. © 2001 Association of Rehabilitation Nurses....