Assessing Context and Culture Discussion

How context and culture affect the implementation of evidence with management of congestive heart failure in African American Males in the Primary care clinics

A fundamental factor in the delivery of quality care in a primary care setting is the implementation of evidence-based nursing practices. With increasing proof that treatment might be limited in efficiency in mental health, service providers have been pressurized to be liable and generate evidence how effective their services are (Riemer et al, 2012). Handling people with congestive heart failure in the day to day healthcare provision is complex as they usually present with numerous other conditions that necessitate multiple drug therapies and lifestyle modification. Management goals for Congenital Heart Failure (CHF) include relieving symptoms, minimizing hospital readmissions, improving survival and improving quality of life and physical activity (Ramli et al, 2013) Assessing Context and Culture Discussion.

Behavioral and lifestyle modifications are crucial to effective management of CHF. Thus, patients along with their families must be counseled and educated on diagnosis, prognosis, possible complication as well as goals of managing CHF and be endowed with skills to care for themselves (Ramli et al, 2013). According to Dickson et al (2013), African Americans and black people with CHF have lower rates of adherence to diet, medications and monitoring symptom in comparison to whites Assessing Context and Culture Discussion.

Culture is fundamental to the development and implementation of evidence-based self-care strategies among ethnic minority groups with CHF. Individuals make decisions that they are familiar with and meaningful to them on basis of the how they relate with the environment, the problem and the individual. Own-initiated care decisions such as symptom response, medication use, and dietary choices are context and situation specific (Dickson et al, 2013).

Social factors such as social norms and social support and health beliefs influence making decisions on self-care mainly via the development of experience, skill and if health-care decisions are compatible with personal values. Ethnic minorities, entailing African Americans hold the belief that heart failure is inevitable or caused by stress, a cultural belief that influences the manner in which people engage in maintenance of self-care and the way they interpret and respond to CHF symptoms (Dickson et al, 2013).


Dickson, V., McCarthy, M., & Howe, A., Schipper, J., & Katz, S.(2013). Sociocultural Influences on Heart Failure Self-care Among an Ethnic Minority Black Population. Journal of Cardiovascular Nursing, 28(2): 111-118.

Ramli, A., Jackson, B., & Toh, C et al. (2014). Management of Chronic Heart Failure in Primary Care: What Evidence do we have for Heart Failure with Preserved Systolic Function? Malaysian Family Physician, 5(2): 68-76.

Riemer, M., Kelley, D., Casey, S., & Taylor Haynes, K. (2012). Developing effective research-practice partnerships for creating a culture of evidence-based decision making. Administration and Policy in Mental Health, 39(4): 248-257 Assessing Context and Culture Discussion.

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