NURS 6512 Discussion Diversity and Health

NURS 6512 Discussion Diversity and Health

NURS 6512 Discussion Diversity and Health

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The population in the united states is composed of people from diverse cultural backgrounds and this aspect is also duplicated in the healthcare system. To ensure the provision of quality and effective healthcare services to the diverse population, the healthcare providers must be competent, sensitive, and also be aware of the diversity of the patient cultures and other essential beliefs as well as avoid stigmatizing patients based on their cultural differences. When a healthcare provider is culturally competent, he or she accepts the diverse needs of their patients even though the diverse needs may be different from those of theirs. To ensure culturally competent healthcare services, the healthcare providers must be sensitive to the patient’s socioeconomic status, heritage and ethnicity. Distinct from cultural awareness and cultural sensitivity, cultural competence is the ability of healthcare providers to modify their practices such that they effectively meet the needs of the different cultural groups (Sharifi, Adib-Hajbaghery, & Najafi, 2019). On the contrary, cultural awareness and sensitivity highlight the ability to recognize the differences without necessarily modifying practices to meet the various needs of different patients.

You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:

1. Minority Health: http://www.cdc.gov/minorityhealt/index.html
2. Racial and Ethnic Minority Populations: http://www.cdc.gov/minorityhealt/populations/remp.html

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Case scenario

The case study presents Mono Nu, who is a 44- year old Filipino patient who started blood thinner medications a period of two weeks ago. The patient is from a low-income household and hence does not afford the prescribed medication. Besides, he has no adequate understanding on the working mechanism of the medications or why they are necessary. In addition, the patient lacks a social support network so that he can maintain his medications. His main diet is fish and tofu, which may lack in some essential nutritional components hence affecting the mode of action of the blood thinner medications.

Cultural Factors

Mono Nu is from the Philippines, so he has a different perspective on health and wellness than people from other cultures. The Philippines’ culture is such that they rely on family, friends, and their faith in God for healing (Cacho & del Castillo, 2022). This health and wellness culture denies the Philippines access to healthcare. As a result, the patient’s culture influences his health because it influences his willingness to take prescribed medications (Collado, 2019). Furthermore, the patient does not understand why his medications are producing the expected results, which may lead to frustration or a sense of helplessness. His diet selection, on the other hand, indicates that he values a specific diet that is essential to healthy eating. Some of the most sensitive issues to consider as a health practitioner when interacting with this specific patient include their age, cultural differences in health beliefs, the possibility of medication frustrations, and some potential medication side effects.

Alice Randall wrote an article for The New York Times in May 2012 about the cultural factors that encouraged black women to maintain a weight that was higher than what was considered healthy. Randall explained that, based on her observations and personal experience as a black woman, many African-American communities and cultures regard overweight women as more beautiful and desirable than women of a healthier weight. “Many black women are fat because we want to be,” she explained (Randall, 2012).

The population in the united states is composed of people from diverse cultural backgrounds and this aspect is also duplicated in the healthcare system. To ensure the provision of quality and effective healthcare services to the diverse population, the healthcare providers must be competent, sensitive, and also be aware of the diversity of the patient cultures and other essential beliefs as well as avoid stigmatizing patients based on their cultural differences. When a healthcare provider is culturally competent, he or she accepts the diverse needs of their patients even though the diverse needs may be different from those of theirs. To ensure culturally competent healthcare services, the healthcare providers must be sensitive to the patient’s socioeconomic status, heritage and ethnicity. Distinct from cultural awareness and cultural sensitivity, cultural competence is the ability of healthcare providers to modify their practices such that they effectively meet the needs of the different cultural groups (Sharifi, Adib-Hajbaghery, & Najafi, 2019). On the contrary, cultural awareness and sensitivity highlight the ability to recognize the differences without necessarily modifying practices to meet the various needs of different patients.

Case scenario

The case study presents Mono Nu, who is a 44- year old Filipino patient who started blood thinner medications a period of two weeks ago. The patient is from a low-income household and hence does not afford the prescribed medication. Besides, he has no adequate understanding on the working mechanism of the medications or why they are necessary. In addition, the patient lacks a social support network so that he can maintain his medications. His main diet is fish and tofu, which may lack in some essential nutritional components hence affecting the mode of action of the blood thinner medications.

Cultural Factors

Mono Nu is from the Philippines which makes him have a different understanding of health and wellness contrary to people from the western culture. The culture in the Philippines is such that they rely on family, friends, and faith in God for healing (Cacho & del Castillo, 2022). This culture of health and wellness prevents the Philippines from access to healthcare. The culture of the patient, therefore, has an impact on his health because it can dictate his willingness to adhere to the prescribed medications (Collado, 2019). In addition, the patient does not understand why his medications are producing the anticipated results meaning that the patient might be frustrated or, might be in a state where he feels helpless. His choice of diet however indicates that he appreciates specific diet which is essential to healthy eating. As a health practitioner, some of the most sensitive issues to take into account while interacting with this particular patient include their age, cultural differences in terms of health beliefs, the likelihood of frustrations with the medications, and some potential side effects of medications.

Photo Credit: Getty Images
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.

To prepare:

• Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
• By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
• Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
• Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

By Day 3 of Week 2

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.
Submission and Grading Information

Grading Criteria

To access your rubric:
Week 2 Discussion Rubric

Post by Day 3 of Week 2 and Respond by Day 6 of Week 2

To Participate in this Discussion:
Week 2 Discussion

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What’s Coming Up in Week 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition. You will also begin your first DCE: Health History Assessment which will be due in Week 4. Plan your time accordingly.
Overview of Digital Clinical Experiences (DCE) and Lab Components
Throughout this course, you are required to not only complete your standard course assignments and discussions, but you will also complete DCE and Lab Components that are either structured as optional or required assignment submissions. Please take the time to review your DCEand Lab Components for this course that are required submissions. See the table below and the attached table for specific DCE and Lab Components for the course.
Note: Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve a total score of 80% or better, but you must take all attempts by the Day 7 deadline. You must pass BOTH the Health History and Comprehensive (head-to-toe) Physical Exam of at least a total score of 80% in order to pass the course.

Week Digital Clinical Experiences Lab Components

Module 1: Comprehensive Health History
Week 1: Building a Comprehensive Health History
Module 2: Functional Assessments and Assessment Tools
Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment
Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children DCE: Health History Assessment (assigned in Week 3, due in Week 4) Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children
Module 3: Approach to System Focused Advanced Health Assessments
Week 4: Assessment of the Skin, Hair, and Nails DCE: Health History Assessment Lab Assignment: Differential Diagnosis for Skin Conditions (SOAP Note for differential diagnosis)
Week 5: Assessment of Head, Neck, Eyes, Ears, Nose, and Throat DCE: Focused Exam: Cough Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat (Episodic SOAP Note)
Week 6: Assessment of the Abdomen and Gastrointestinal System Lab Assignment: Assessing the Abdomen (Analyze SOAP Note)
Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System DCE: Focused Exam: Chest Pain
Week 8: Assessment of the Musculoskeletal System Discussion: Assessing Musculoskeletal Pain (Episodic SOAP Note)
Week 9: Assessment of Cognition and the Neurologic System DCE: Comprehensive (head-to-toe) Physical Assessment Case Study Assignment: Assessing Neurological Symptoms (Episodic SOAP Note)
Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal Lab Assignment: Assessing the Genitalia and Rectum (analyze SOAP Note)
Module 4: Ethics in Assessment
Week 11: The Ethics Behind Assessment Lab Assignment: Ethical Concerns
Next Week

To go to the next week:
Week 3

Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment

Diversity is not about how we differ. Diversity is about embracing one another’s uniqueness.
—Ola Joseph
Countless assessments can be conducted on patients, but they may not be useful. In order to ensure that health assessments result in the necessary care, health assessments should take into account the impact of factors such as cultures and developmental circumstances.
Learning Objectives
Students will:
• Analyze diversity considerations in health assessments
• Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment
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Learning Resources

Required Readings (click to expand/reduce)

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 1, “The History and Interviewing Process” (Previously read in Week 1)
This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.

• Chapter 2, “Cultural Competency”
This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

• Chapter 2, “Evidenced-Based Clinical Practice Guidelines”

Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi:10.3109/02770903.2014.906605
Credit Line: Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis by Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J., in Journal of Asthma, Vol. 51/Issue 7. Copyright 2014 by Taylor & Francis, Inc. Reprinted by permission of Taylor & Francis, Inc. via the Copyright Clearance Center.

The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma.

Centers for Disease Control and Prevention. (2015). Cultural competence. Retrieved from https://npin.cdc.gov/pages/cultural-competence

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This website discusses cultural competence as defined by the Centers for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website.

United States Department of Human & Health Services. Office of Minority Health. (n.d.). A physician’s practical guide to culturally competent care. Retrieved June 10, 2019, from https://cccm.thinkculturalhealth.hhs.gov/

From the Office of Minority Health, this website offers CME and CEU credit and equips healthcare professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.

Espey , D. K., Jim, M. A., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives. American Journal of Public Health, 104(Suppl 3), S303–S311.

The authors of this article present patterns and trends in all-cause mortality and leading cause of death in American Indians and Alaskan Natives.

Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., & Tanasugarn, C. (2016). Health literacy, medication adherence, and blood pressure level among hypertension older adults treated at primary health care centers. Southeast Asian Journal of Tropical Medicine and Public Health, 47(1), 109–120.

The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving healthcare services at primary healthcare centers.

Required Media (click to expand/reduce)

Module 2 Introduction

Dr. Tara Harris reviews the overall expectations for Module 2. Consider how you will manage your time as you review your media and Learning Resources for your Discussion, Case Study Lab Assignment, and your DCE Assignment (3m).
Functional Assessments and Cultural and Diversity Awareness in Health Assessment – Week 2 (10m)

Walden University. (n.d.). Instructor feedback. https://mym.cdn.laureate-media.com/2dett4d/Walden/WWOW/1001/pulse_check/instructor_feedback/index.html#/

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Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_6512_Week_2_Discussion_Rubric
• Grid View
• List View
Excellent Good Fair Poor
Main Posting Points Range: 45 (45%) – 50 (50%)
“Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. Points Range: 40 (40%) – 44 (44%)
“Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. Points Range: 35 (35%) – 39 (39%)
“Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. Points Range: 0 (0%) – 34 (34%)
“Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness Points Range: 10 (10%) – 10 (10%)
Posts main post by Day 3. Points Range: 0 (0%) – 0 (0%)
N/A Points Range: 0 (0%) – 0 (0%)
N/A Points Range: 0 (0%) – 0 (0%)
Does not post main post by Day 3.
First Response Points Range: 17 (17%) – 18 (18%)
“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. Points Range: 15 (15%) – 16 (16%)
“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. Points Range: 13 (13%) – 14 (14%)
“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. Points Range: 0 (0%) – 12 (12%)
“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response Points Range: 16 (16%) – 17 (17%)
“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. Points Range: 14 (14%) – 15 (15%)
“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. Points Range: 12 (12%) – 13 (13%)
“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. Points Range: 0 (0%) – 11 (11%)
“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. Points Range: 0 (0%) – 0 (0%)
N/A Points Range: 0 (0%) – 0 (0%)
N/A Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on three different days.
Total Points: 100

John Green, 33-year-old Caucasian male, presents to the office to establish as a new patient. John’s natal sex is female, but he identifies as a male. He transitioned from female to male 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has been obtaining testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smokes 3-6 marijuana joints every weekend (has an active green card) and does suffer from depression episodes. He is HIV positive for the last 3 years but remains virally suppressed at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks which prompted him to move back home with his parents. He takes Biktarvy once daily that comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and unemployed he will be a burden on his family, and he thinks his health may be declining.

There are several John Green’s economical, spiritual, behavioral, and cultural characteristics that I must consider as a nurse practitioner.

                                                                                                   Socioeconomic Factors

Due to financial constraints, John may not be able to continue receiving medical care and taking his prescribed medications. John’s experience is only one example of the many obstacles transgender persons face when trying to make ends meet. There is a higher rate of homelessness, poverty, and unemployment among transgender people compared to the general population. This may be due to the multiple challenges that transgender people face in the workplace and in society as large. Due to financial constraints, he must rely on buying testosterone from the internet, which may expose him to the risk of utilizing harmful and inefficient drugs. As he is HIV + and a smoker, he may end up costing his family more money for medical care than they can afford.

                                                                                                      Spiritual Factors

John’s spirituality and sense of self-worth may undergo profound changes because of his gender transition. The place of transgender individuals, defined by the religious and socio-cultural values especially of Muslim society.  the sacred faith (Islam – as experienced in Pakistan and Bangladesh) does not accept other options outside the male and female gender norms; however, any notion that is not translated by the Holy Quran, for example living outside the male-female range, is anti-Islamic and is dealt with by dangerous means of violence (Yasser et al. 2021). Thus, respect for his religious or spiritual practices is warranted because they may play a significant impact in his propensity to seek medical care and adhere to treatments.

                                                                                                       Lifestyle Factors

As a result of his smoking and marijuana use, John may be at an increased risk for developing lung cancer and other respiratory diseases. Therefore, it is crucial to inform him about the dangers that such behaviors may pose to his health. Medical schools, mental health counseling training programs, recovery and behavioral health services, and healthcare insurance companies need to be aware that the relationship between experiences with medical transition, age, and personal gender identity may impact rates of substance use within the transgender community (Redcay et al., 2022). It’s important to evaluate his mental health and provide the care he needs because his depressive episodes may have a wider influence on his welfare and quality of life. Transgender individuals experience, in addition to higher levels of anxiety and depression, increased suicidal behaviors when social supports are not in place. Research suggests that they do not attempt suicide because of their gender identity, but because of a lack of support (Jacob et al., 2017). Finally, John’s way of life is illustrative of the challenges transgender persons face. John is currently childless and does not have a partner. Finding a loving, supportive relationship can be difficult for transgender persons.

                                                                                                        Cultural Factors

John may face discrimination and stigma due to his HIV-positive diagnosis and his gender transition. There are many cultural challenges he faces that the rest of us don’t face. In some societies, men enjoy greater social status and political influence simply by virtue of their gender. This trend of health care discrimination coupled with avoidance of seeking care leads to poorer health for transgender people (Jacob et al., 2017). As his healthcare practitioner, it is my responsibility to foster an accepting and non-judgmental atmosphere, one that considers his individual values and cultural norms.

                                                                        Sensitive Issues During Provider – Patient interaction

Being mindful of John’s transition and the specific health concerns he may be experiencing as a result is essential while communicating with him. John may encounter stigma and discrimination because of his transgender status, and it’s crucial to be aware of this. Treating his medical history with dignity and inviting his queries is essential. Transgender individuals experience discrimination, stigmatization, and unethical and insensitive attitudes in healthcare settings. Therefore, healthcare professionals must be knowledgeable about the ways to deliver ethical and culturally competent care (Sundus et al., 2021).

                                            Targeted Questions to Build Patient Health History and Assess Health Risks

• Can you tell me more about your gender transition journey, including when you first realized your gender identity and the steps you took to transition?
• How long have you been smoking, and have you tried to quit in the past?
• How often do you use marijuana, and have you ever experienced any negative effects of using it?
• Can you describe your experience with depression, including how often you experience episodes and any triggers that you have noticed?
• How are you managing your HIV positive status, and have you ever experienced any side effects or difficulties with your treatment?

                                                                                  References

Jacob, M., Cox, S., & Cox, S. R. (2017). Examining transgender health through the International

Classification of Functioning, Disability, and Health’s (ICF) Contextual Factors. Quality

           of Life Research, 26(12), 3177–3185. https://doi.org/10.1007/s11136-017-1656-8Links to an external site.

Redcay, A., Counselman Carpenter, E., & Lally, K. (2022). The Impact of Gender Identity,

Medical Transition, and Other Substances on Marijuana Use for Transgender

Adults. Journal of Social, Behavioral, and Health Sciences.

Sundus, A., Shahzad, S., & Younas, A. (2021). Ethical and culturally competent care of

transgender patients: A scoping review. Nursing Ethics, 28(6), 1041–1060.

https://doi.org/10.1177/0969733020988307

Yasser, Q. R., Agrawal, R., & Ahmed, I. (2021). Transgender disclosure decisions and workplace

socio-cultural dynamics. Labour & Industry, 31(2), 87–105.

https://doi.org/10.1080/10301763.2020.1847023

Name: NURS_6512_Week_2_Discussion_Rubric