Transcultural Nursing Framework for Homosexual Males, Coursework Example

Introduction

HIV and AIDS impacts millions of people throughout the world. Although advances in diagnosis and treatment have prolonged many lives, a number of populations remain vulnerable to the disease and its impact on their lives. Nurses provide support and guidance to patients on a global scale and support the development of strategies to identify and work with vulnerable populations to promote prevention and effective treatment for patients. Due to the challenging nature of the disease and how it impacts quality of life, nurses must expand their involvement with vulnerable populations and utilize their available resources effectively to support these groups. To be specific, gay males continue to be one of the most significant populations affected by HIV and AIDS, in spite of the knowledge and information that is available. Therefore, nurses at the advanced practice level should be involved in education and prevention, high risk behaviors, diagnosis and treatment, and other discussions regarding the health status of this population. Most importantly, nurses must utilize a transcultural approach to address policies, social and cultural factors, ethical and human rights concerns, and other issues that have a direct impact on the gay male community and the influence of HIV and AIDS in their lives.

HIV/AIDS is a critical health issue in many cultures and in specific populations who are vulnerable to the disease as related to high risk behaviors and/or limited access to treatments could save their lives. Both areas are of primary concern to many nurses, particularly as they aim to address the conditions under which HIV/AIDS is a serious health threat. To be specific, some population groups possess a higher level of risk than others, such as gay males and specifically, those of Hispanic origin (Cowen & Moorhead, 2011). Under these conditions, lack of knowledge and an understanding of what entails high risk behavior may be part of the problem, but poverty is also a primary concern that contributes to a host of health problems that go beyond HIV and AIDS, such as alcoholism (Cowen & Moorhead, 2011). In this context, nurses must be cognizant of their responsibility to perform outreach and to recognize the importance of advancing education within these communities in order to alleviate of the risks and to promote greater awareness among gay males of all cultures regarding high risk behaviors and the threat of HIV/AIDS within their lives (Cowen & Moorhead, 2011).

Definition of Terms

Health Belief Model: High-risk behaviors impact vulnerable population groups, and nurses must play an important role in educating these groups to improve these behaviors and improve health outcomes (de Chesnay & Anderson, 2012).

Social Justice: Addressing the needs of individuals across different groups to ensure that they are treated fairly and equitably in a social context through nursing advocacy, using nursing-based strategies and support systems to demonstrate a commitment to underserved populations and those who not treated with the level of respect and care that they deserve (National League for Nursing, 2014)..

Transcultural Nursing Framework: A practice strategy in which nurses identify methods of achieving cultural competence to provide greater equality in care for all patients (de Chesnay & Anderson, 2012).

Health Belief Model and HIV/AIDS

The gay community is particularly vulnerable to a number of conditions that impact their overall health and wellbeing; therefore, nurses and social advocates have aimed to target this population with respect to understanding high risk behaviors and how they impact the life span (de Chesnay & Anderson, 2012). The Health Belief Model supports the idea that different types of high-risk behavior have an impact on some vulnerable populations, and these factors also demonstrate a high level of necessity to integrate nurses into the process of evaluating and educating individuals (de Chesnay & Anderson, 2012). Nurses must serve as advocates and stewards to the HIV/AIDS community in different ways and may serve to advance a vulnerable population’s understanding of the disease and how their own behaviors might be high risk (de Chesnay & Anderson, 2012). At the same time, advanced practice nurses must serve as experts in cultural competence and provide information to vulnerable populations regarding how to manage core values and beliefs in the context of health concerns, such as HIV/AIDS (de Chesnay & Anderson, 2012).

Spiritual, Cultural, and Social Justice Factors

Nurse leaders play a critical role in shaping opportunities to expand knowledge and resources in the area of policy development and improvements, as they provide expert clinical, research-based, and educational knowledge in the practice setting, all of which may translate effectively to the policy arena (Leavitt, 2009). From this perspective, nurse leaders must work in the capacity of advocating for change within the healthcare policy arena, particularly for vulnerable populations (Leavitt, 2009). Nurses are able to contribute to the identification and minimization of health disparities, along with other factors that encourage discussions regarding vulnerable populations and how they are impacted by education, knowledge, and behavioral outcomes (Leavitt, 2009). These conditions require nurse leaders with high levels of experience to advocate for improving public policies to support vulnerable populations and to be apprised of matters that may improve social justice for these groups, enabling them to have the same rights and opportunities as others (Leavitt, 2009).

Supporting advocacy for social justice is a critical factor in modern nursing practice, as experts in the field with expert knowledge must assume responsibility for advancing these principles throughout healthcare (Grace & Willis, 2012). Powers & Faden established a model of social justice that identifies some of the risks associated with vulnerable populations and how they are socially underserved, which is a significant injustice to these groups (Grace & Willis, 2012). Social justice is elusive at best for some populations, and in these instances, they do not possess the knowledge, resources, or support that is required, thereby contributing to a high level of injustice that is difficult to overcome (Grace & Willis, 2012).  Arguments regarding social justice also involve a concept known as moral agency, whereby individual choices are viewed in the context of whether or not they are beneficial and preserve the greater good of humankind, while also preserving the individual freedom to make decisions (Grace & Willis, 2012). The Powers and Faden model also supports the belief that individuals are connected to their environments on many levels, and the decisions that are made have an impact on themselves and on others within these environments (Grace & Willis, 2012). Although many people from vulnerable populations lack control over their surroundings due to a variety of circumstances, it is also evident that there are opportunities to become removed from these issues and to overcome adversity to improve quality of life and make decisions that will have a lasting positive impact on their lives (Grace & Willis, 2012).

Advanced practice nurses must exercise sound and reasonable judgment in order to support vulnerable populations. This requires a high level understanding of the issues and challenges that impact individuals based on their individual circumstances, and also demonstrate the importance of working with vulnerable populations and in identifying specific issues that impact the life span in different ways. The concept of grounded theory is appropriate for the HIV/AIDS population, as it represents a means of examining vulnerability and how it impacts individuals who are at risk of or who already have HIV infection (DeSantis & Barroso, 2011). The authors indicate that there are a number of factors directly associated with vulnerability that impact individuals, such as relationships, physical and mental health, social support, discrimination, access to healthcare services, and HIV prevention, among others (DeSantis & Barroso, 2011). These factors support the ongoing development of strategies that are designed to facilitate an understanding of how vulnerabilities are addressed in the context of HIV and several conclusions were drawn regarding mortality, physical and psychological changes, a change in spirituality, a shift in socialization, and a lack of psychosocial support as necessary to improve health status and general wellbeing (DeSantis & Barroso, 2011). These factors support an understanding of the different issues that impact vulnerable gay males currently with HIV and how it impacts their quality of life in different ways that also includes a higher level of stigma and limited support from the local community (DeSantis & Barroso, 2011). These factors support the development of a support network that includes nurses in order to address the challenges that are associated with improved outcomes and the minimization of vulnerabilities through nursing-based interventions (DeSantis & Barroso, 2011).

Ethical, Human Rights, and Legal Issues

HIV/AIDS has introduced many important issues to the public arena that require further evaluation and focus. To be specific, it is evident that “All engaged in HIV work must pay more attention to the health disparities that MSM encounter. Additionally to biological risks, reasons for the increased risk for HIV and sexually transmitted infections (STIs) in MSM include individual factors (eg, depression and substance use) that might be a reaction to homophobic experiences and the stresses of societal pressures to conform to heterosexual norms, as well as structural factors, including systematic underfunding of HIV prevention for MSM, and scarcity of access to primary health services and culturally sensitive counselling” (Beyrer et.al, 2012). Based upon these conditions, it is important to identify specific tools and resources that might be effective from a nursing-based perspective in order to guide patients in addressing HIV and its impact on those who are infected, as well as those who are at risk of infection (Beyrer et.al, 2012). The ethical nature of this discussion is challenging on many levels and requires nurses’ input and guidance in advancing agendas related to HIV, as well as other factors that have an impact on individual outcomes within this vulnerable population of homosexual men (Beyrer et.al, 2012). Men in this category who do not receive the proper health services because of their sexuality is discriminatory and is ethically irresponsible on many levels, thereby creating an environment that is conducive to inequality and lack of respect for vulnerable individuals (Beyrer et.al, 2012). In spite of the advances made in accepting homosexuals in the United States in recent years, there continues to be a difficult uphill battle that requires further input and guidance from nurses, as they are able to provide expert knowledge, education, and resources in order to potentially improve quality of life for those persons with whom they interact (Beyrer et.al, 2012). Homosexual males are one group who are likely to benefit from these opportunities and should be provided with a framework for addressing high-risk behaviors that could contribute to negative and even fatal outcomes (Beyrer et.al, 2012).

Finally, it is necessary to develop strategies that will be used to improve outcomes for individuals who face a high risk of HIV/AIDS due to their vulnerable state. Each of these individuals should be free of stigmas and other complications that infringe upon their human rights, and they should also be provided with a framework that will encourage and support their ability to obtain access to education, knowledge, and medically necessary services that will positively impact their quality of life (Meier et.al, 2012). Human rights violations against these individuals should not be permitted under any circumstances, and their personal choices should not be the subject of negative backlash and discrimination that could impact the remainder of their lives (Meier et.al, 2012). These issues are instrumental in shaping discussions regarding HIV and AIDS throughout the world, and they demonstrate a high level understanding of the complications that may arise among vulnerable populations who face a higher risk of infection throughout their lives (Meier et.al, 2012).

Personal and Professional Perspectives

HIV and AIDS are significant within the gay community and require its members to exercise responsible and appropriate behaviors in order to prevent these risks. At the same time, education and outreach are of critical importance in shaping the response to HIV and AIDs in a manner that is consistent with nursing-based practices and principles. It is evident that nurses must work collaboratively within the gay community to spread the word and to support a viable yet practical approach to HIV prevention and behavioral modifications. Nurses often experience personal experiences with HIV and AIDS that impact their lives in profound ways; therefore, these experiences should serve as the catalyst towards new directions and approaches to working with this community to recognize the risk of the virus and how it impacts their lives. Personal connections to HIV and AIDS are instrumental in advancing actions to expand the message that is shared with this population.

Conclusion and Recommendations

It is important to identify the tools and resources that are necessary to support patient care quality and to be respectful of the challenges and considerations that require nurse involvement in HIV and AIDS prevention and education. These professionals are likely to have a significant impact on vulnerable populations, such as those at high risk of HIV infection, particularly when they provide support and comfort to those populations and encourage others to accept them and enable them to have the same rights and freedoms as other groups. This is an important step towards the discovery of new ideas and approaches that nurses may provide to vulnerable populations that could impact their lives in different ways, and also support greater involvement in enhancing their quality of life and preventing stigma and discrimination as best as possible.

Nurse leaders and advanced practice nurses must demonstrate the ability to work effectively with vulnerable populations and to recognize the importance of advancing agendas to educate vulnerable populations, such as homosexual males, regarding HIV and AIDS and how their behaviors might lead to a higher risk of infection. The identification of a cure is the pinnacle of change in eradicating the disease; however, at this juncture, this is not a likely event. Therefore, nurses must be responsible for advocating gay males to obtain routine HIV testing and to recognize the importance of behavioral modifications as necessary. The Health Belief Model is essential to this cause because it encourages individuals to examine their behaviors more closely and to recognize that when they are in a vulnerable position, other options must be considered.

Nurses also face professional risks in working with this population that may impact their wellbeing, such as the emotional context of HIV and AIDS and how it impacts personal perspectives. Therefore, nurses must advocate for improved resources to work with these groups, along with emotional support and guidance in advancing the agenda to address disparities that impact gay males. Nurses must determine how to address these issues and to be cognizant of the challenges related to working with this population, including the advantages of helping vulnerable populations, as well as the emotional challenges of this process and how it impacts nurses’ own wellbeing.

References

Beyrer, C., Sullivan, P. S., Sanchez, J., Dowdy, D., Altman, D., Trapence, G., … & Mayer, K. H. (2012). A call to action for comprehensive HIV services for men who have sex with men. The Lancet, 380(9839), 424-438. Cowen, P.S., & Moorhead, S. (2011). Current Issues in Nursing, Eighth Edition. St. Louis: Mosby.

De Chesnay, M., & Anderson, B.A. (2012). Caring for the Vulnerable: Perspectives in Nursing Theory, Practice, and Research, Third Edition. Burlington: Jones & Bartlett Learning.

De Santis, J. P., & Barroso, S. (2011). Living in silence: A grounded theory study of vulnerability in the context of HIV infection. Issues in mental health nursing, 32(6), 345-354.

Grace, P.J., & Willis, D.G. (2012). Nursing responsibilities and social justice: an analysis in support of disciplinary goals. Nursing Outlook, 60, 198-207.

Leavitt, J.K. (2009). Leaders in health policy: a critical role for nursing. Nursing Outlook, 57, 73-77.

Meier, B. M., Brugh, K. N., & Halima, Y. (2012). Conceptualizing a human right to prevention in global HIV/AIDS policy. Public health ethics, 5(3), 263-282.

National League for Nursing (2014). What is advocacy? Nursing is social justice advocacy. Retrieved from http://www.nln.org/facultyprograms/publicpolicytoolkit/advocacy.htm