Role Of Family In Mental Health Social Work Essay

Job Of Family In Mental Health Social Work Essay As a potter molds dirt to frame a wonderful creation, so does the solid family backing and great qualities does. Family bonds are a connection from the earliest starting point and manual for future. Early impacts are crucial to singular turn of events. Everybody needs to have a place and feel acknowledged. A feeling of having a place is gotten from the solid obligation of family. Family is the place roots grab hold and develop. We are formed inside a unit, which sets one up for the encounters of the world and responses to those encounters. A nearby family bond resembles a sheltered harbor where one discovers asylum. From believing that somebody will get us when we fall, as a baby, to somebody being there for us as we experience the tempests throughout everyday life. Family bonds help to impart trust, expectation and faith in ourselves. The other hand if family doesnt have connection, helpless relationship, uncertainty and outrage can prompt negative results like disengaging, low ment al self portrait, outrage and torment inside them. On the off chance that one isnt cherished as a kid, they may later look for affection and acknowledgment in a manner that brings them hurt. This not just influences the passionate, physical and social prosperity. The helpless mental self portrait might be with the patients all through life, making failure settle on positive decisions or be near others. Solid family bonds help us to flourish in all parts of life. Absence of these bonds can prompt perpetually looking for that something which is absent and one ought not underestimate the estimation of family bonds for conceded. Along the homestead obligations, family ordinarily faces loads. Howl (2005) recognized three kinds of weights in family care giving of people with psychological maladjustment. Target troubles are money related weights, time and exertion in care giving of family parental figures. Emotional weights are sentiments of misfortune, disgrace, stress, outrage, and sadness of family parental figures towards their family members with psychological maladjustment. At last, there are troubles in the board of issue practices like ambush, emotional episode, capriciousness, and other negative side effects because of dysfunctional behavior of a relative. Alongside the weights, there are benefits when family remain with intellectually sick individual. Frequently patients tune in to their family since they are near one another and each malady needs fix and family is the significant help. They can help their relative to include in the social and family exercises, by including them in recovery program, empowering other relatives and companions to welcome the evil relative to go along with them in exercises and by regarding the need of isolation. Situation: My patient was a 17 years of age female, forward among seven kin, with the analysis of schizophrenia. Her pre bleak character was that she was consistently an alternate kid, very and continually thinking. She had no companions and was never intrigued to converse with her sisters also. She never partook in family errands and when requested to help, she used to blow up, and never took an interest. She had an envy part in her as the mother consistently appreciated her senior sister and debased her. Before hospitalization she even had mind flights and fancies. While conversing with the patient, she verbalized that I dont like my sisters since everybody contrasts them and me. Patients mother additionally acknowledged that she had consistently offered significance to the senior sister and called attention to the customer that she is the laziest individual of the family. May be this could be an explanation of patients outrage, dissatisfaction and not having a mindful demeanor towards family . Noteworthiness of family support in Pakistani setting: Family support is a significant piece of our whole Pakistani country. Family support is given a ton of significance as far as family holding, love and fondness. Then again there are barely any families which don't focus on this significant issue. The family support is significant on the grounds that it consequences for physical, mental and social prosperity of a person. In the Pakistani setting no such investigation is been done on familys job in ones life. As indicated by Mansoor (2008) Family framework in Pakistan expresses that every individual from a Pakistani family has regard for the more established relatives. The guardians feel liable for showing their youngsters the essential convictions of the picked religion. Taking a gander at the situation referenced over the family has given less consideration to the youngster due to tremendous family, house hold obligations and low financial framework. As per my understanding when a kid develops in a nearby pack family they figure out how to welcome all the individuals from family and never delay to go with their older folks or youngers in broad daylight. I accept that solid family bond fills in as catalysis for everyones bliss. This is on the grounds that the family has its standards and guidelines and when these principles and guidelines are carefully tailed it carries euphoria to the entire family and aides in network building. There is consistently the conviction that great families can make a decent society. Solid family bonds make an air of impedance in the undertakings of each other. For instance a solid and joined family the older folks don't desert the family, however they continue dealing with their folks and their more youthful ones in the midst of difficulties. Criticalness of family support in western world is on addendum 1. Investigation of idea in the light of writing: During the 1950s, Murray Bowen gave family framework hypothesis. Hypothesis certifies that the individual can change conduct if mindful of the effect of current and authentic family conduct. It chips away at family just as on the enthusiastic strength of a person. Bowen summed up his hypothesis utilizing seven interlocking ideas. Initial three ideas apply to by and large family and other four are identified with family qualities. Separation of self The idea of separation of self estimates all human working on a continuum from the best enthusiastic combination of self limits to the furthest extent of separation or self-governance. In my patients situation self was stifled from the youth in the consequence of that her family relationship were not solid. A ton of family analysis was there. Youngsters were not permitted to take their own choice; rather they need to do whatever guardians inquired. The model is common investigations were undermined and the customer was placed in Madrasa to learn and present Quran. Accordingly the family holding went down. Her issue were not given significance and taken as a least notable individual of the family. She was never focused for whatever she did; the explanation could be enormous family, less contrasts among kids and destitution. The continuum of separation of self is talked about additional in detail in informative supplement 2. Triangles Triangle is an anticipated passionate procedure that happens when trouble exists in a huge relationship, and the third element is incorporated. In my patients situation, the triangle has three finishes. One is father, another mother and the third is the patient. The contentions between guardians greatly affect youngster and that can leave long lasting consequences for ones life. In my customers situation the guardians had clashes among them and exploration demonstrates that the more extended parental clash proceed, more prominent the strain between the guardians, the more noteworthy the probability that mental challenges will result for kids, for example, enthusiastic and conduct issues, nervousness, melancholy, rest issues, low confidence, school issues and various different troubles. The case of family triangle is on informative supplement 3. Family unit Emotional System These are examples of association between relatives and how much these examples advance passionate combination. In my customers picture she was constantly anticipated that she never takes an interest in house hold errands and is the laziest individual of the family. This to be sure prompted low confidence and sadness. The vast majority of the patients create sadness due to disgrace and blame of being poor. As per Patel Kleinman (2003) expressed that sadness is a center encounter: it is related with life partner and family misuse, constrained relationships, restricted instructive and work possibilities, disgrace for neglecting to deliver a child, and the relocation of spouses to urban regions for business. The family projection process It is the projection of life partners issue onto at least one youngsters to maintain a strategic distance from serious enthusiastic combination between the mates. This additionally fits into the customers situation that due to destitution and low financial status parent and kid couldn't make bond between them. The monetary stressors, for example, joblessness, low salary, and absence of reasonable lodging, are bound to go before mental illness.(Hudson, 2005 ) Multigenerational Transmission Process This alludes to the transmission of a family projection process. The nature and level of force of passionate reactions are passed down from age to age. Levels of separation are influenced through ages dependent on levels of separation of accomplices as they wed. This was not actually investigated during the association however it could be a piece of patients ailment. Enthusiastic cutoff The idea of enthusiastic cutoff portrays individuals dealing with their uncertain intense subject matters with guardians, kin, and other relatives by diminishing or thoroughly cutting off passionate contact with them. In my patients case she got detached from the family. This could be on the grounds that she has a few worries from the family however they were rarely tended to and she got genuinely cutoff from it. Kin position There is an effect of kin position on advancement and conduct. More often than not it is polished that more seasoned youngster is the pioneer and the youngers are the adherents. My patient follows precisely in this classification. She is forward among seven kin. She never loved her mom to state that resemble your senior sister and never preferred to follow her senior sisters. (Stuart, 2001) See indeces 4 for the elements left. Mediation: At singular level,

Swarovski Branding Strategies & Products

SWAROVSKI. Marking for extravagance merchandise Group G. Individuals: Truong Anh Bao Nguyen Yunkyung Choo Lilit Nagapetyan CONTENT: 1 History 2 Concept 3 Brand Strategy 4 Marketing Mix 5 Positioning 6 Services 7 Target Consumer 8 CBBE Pyramid 9 SWOT investigation 10 Competitors 11 Recommendation 12 References 1. HISTORY: 1882 Daniel Swarovski (1862-1956) imagines a progressive machine that permits precious stones to be cut more exactly than with existing manual techniques. 1895 Daniel Swarovski establishes the organization in Wattens, Tyrol, with the vision of carrying satisfaction to individuals through crystal.His core value is still trailed by the organization today: â€Å"To continually improve what is acceptable. † 1949 SWAROVSKI OPTIK is established, and proceeds to turn into a main maker of exactness optical instruments for chasing and nature perception (optics, telescopes, rifle scopes, run discoverers, and night vision and optronic gadgets). 1956 The first Swarovski p recious stones for ceiling fixtures and lighting are propelled, and in 1977 are enlisted under the STRASS Swarovski Crystal name.Today they enhance old style ceiling fixtures, suche as those in the Palace of Versailles and the Metropolitan Opera, New York, just as progressively current lights. Swarovski begins to produce exactness cut gemstones. 2002 Swarovski creates Crystal Fabric: innumerable little precious stones make a fragile sparkle over an assortment of materials. 2003 In conjuction with driving style and gems architects, â€Å"Runway Rocks† is established †an assortment of interesting gems pieces including precious stone for the catwalk, displaying structure and development 2009 At the â€Å"Baselword† watch and jewerly show, Swarovski dispatches its first watch assortment. . Idea More than a century back, Daniel Swarovski, its organizer, once said â€Å"A jewel of everyone† that shimmers everybody's lives, Swarovski today has been flourishing for the best to serve its clients, being one of the best gem makers in today’s worldwide industry. Crucial the dominance of the verse of exactness we keep on being market pioneer, main impetus and solid accomplice inside our industry to meet people’s want for embellishment and pleasure since 1895 as * maker, advertiser, and retailer of premium gems and client items extending from enhancing articles to lighting and extras. producer and advertiser of premium adornments stones for clients. * Swarovski gives top notch items and benefits and envision, satisfy and surpass consumers’ wants and customers’ needs. * Swarovski offers our associates and groups satisfying difficulties that move them to be inventive and imaginative. 3. BRAND STRATEGY: Not such a long time ago Swarovski was not extremely celebrated and didn't have any marking procedures. ‘For quite a while Swarovski didn't â€Å"brand† its item. What's more, in those days it wasn't generally a bout marking as it is nowadays.We needed to build up a no-nonsense correspondences system †a PR methodology †which we pitched to the editors and fashioners. ‘ said Nadja Swarovski, Swarovksi Vice leader of International Communications. Today, Swarovski is practically ubiquitous wherever from style grants, catwalk appears, film debuts; its precious stones are utilized by style fashioners from the edgiest Central Saint Martins graduate to the blessed ateliers of Armani, Dior and Chanel. This is the place the genuine accomplishment of Swarovski lies: by adjusting the organization to the most cutting edge youthful style talent.When the most sweltering British architects of the time, Alexander McQueen, Philip Treacy and Julien Macdonald utilized Swarovski gem work †a fine fishnet bandage studded with little precious stones †in his catwalk appear, it quickly changed individuals' impression of the brand. ‘The McQueen show gave a visual that was altogether di fferent to the standard thought individuals had of us,' Nadja says. The organization at that point started to restore the organization's connections with the style world, supporting more youthful planners who are needing funding to make their mark take off.Nearly ten years after the fact this triumphant equation is as yet delivering outcomes. Architects, regardless of how restless or cool, all appear to need to utilize Swarovski precious stones and acknowledge sponsorship. ‘If you're a youthful originator beginning an assortment, it's incredible to have precious stone in there in light of the fact that it makes it more high fashion,' Nadja says. ‘It includes style, an earnestness, validity. In style, in the event that you have something to demonstrate, at that point couture, or possibly craftsmanship, is the correct track. â€Å" Not just enchanted the design world, Swarovski likewise proceeded onward to the film industry.Some of Swarovski's most prominent ventures have been Moulin Rouge, where the sets and outfits moaned under the heaviness of Swarovski precious stones, Titanic and the ongoing Bond films. During Oscar season Nadja sets up camp in Los Angeles, and beauticians can peruse the Swarovski adornments, shoes and satchels with the end goal of dressing their customers on honorary pathway. Nowadays Swarovski gems decorate everything from iPods and cell phones to Maria Sharapova's new Nike tennis dress. They even secured, murmur it, Jordan's wedding dress. 4.Marketing Mix Products: The Swarovski Crystal extend incorporates gem glass models and miniatures, gems and couture, home stylistic theme, and ceiling fixtures. They're most popular for emulating â€Å"colored germs† All models are set apart with a logo. The first Swarovski logo was an edelweiss blossom, which was at long last supplanted with the present swan logo in 1988 Subsidiary organizations: Swarovski Fashion frill and precious stone based trimmings. Daniel Swarovski Jewelry , purses, adornments and inside structure objects. Swarovski Optik Optics.Atelier Swarovski Fashion and adornments planners. Swarovski Crystal Palace Avant-garde lighting and structure (ceiling fixtures and so on ). Swarovski Elements Crystal structures. Swarovski Gemstone Business Gemstone structures. Swarovski Lighting Swarovski completed the process of lighting items and arrangements with precious stone for design. Tyrolit A reinforced pounding and dressing apparatuses organization. Swareflex A street security items authority. Schonbek A gem crystal fixture maker. Touchstone Crystal Swarovski's immediate deals organization for instant gems PlaceAll boutiques are wonderfully set up and strategically placed in the design shopping center/heart of huge 19 metropolitan urban communities from Dubai, Madrid, Hongkong to New York City more than 20 nations in North America, Europe, Asia and Australia. Additionally online site is accessible with advantageous transportation administrations Price 100$ to $42,800/thing Promotion is through press, interpersonal organization (Twitter, Facebook, Youtube) just as by means of customary and on-going sponsorship for youthful skilled specialists/creators to utilize Swarovski precious stones in any sorts of their structures in design appear, film grants, etc.Therefore, the best season to advance Swarovski gems is during the style week (two times per year-January to March and from September to October) and film/film grant functions seasons (October to February) 5. Situating Swarovski is situating itself as an extravagance style by making a client experience to tell individuals Swarovski’s brand estimations of development and innovation. They might want to situate themselves as making premium, top notch items for the customers. They are attempting to be a market head in the extravagance gems industry by advancing continuously.Recently, Swarovski recruited Yellowdoor as held office, which will concentrate on situating as a m oderate extravagance brand. * Luxury design brand * Market pioneer in the rich gem industry * Multi-faceted business * Affordable extravagance brand 6. Administration * Collection of rings, pins, studs, pendants, pieces of jewelry, hair gems, sleeve buttons, charms, pins, arm bands, bangles and endowments. * Large assortment of shading choices * Vast choice of endowments accessible for less than $100 * Magazine and gathering for Swarovski devotees. * Free transportation standard on orders more than $95 * Customized blessing messages Free blessing wrapping and pack * Scheduled conveyance * Right to return (multi week merchandise exchange) * Product guarantee * After deals administrations 7. Target Customer Swarovski's objective client is â€Å"every female† from 17 to 71 in wording both of purchasing or blessing getting in light of the fact that they offer various items to such an expansive scope of individuals. Despite the fact that each gathering (tweens, ages X,Y and Baby B oomers) has its own needs and qualities, Swarovski meets a large portion of them. Swarovski Jewelry puts together a large portion of its market with respect to ladies old enough 25 or more by making wedding, business, old style and complex collections.It likewise incorporate men extras, for example, arm bands and watches, and obviously kids more than 6 years of age. Additionally, one of the greatest Swarovski's market target today is style industry. Swarovski gems are fastened to everything from Victoria's Secret bra sets and Kawasaki cruisers, to the apparel assortments of, for example, Dolce ; Gabbanna and cutting edge vintage revisionists Imitation of Christ. 1) Women assortment of * Sophisticated * Business * Classical * Bridal assortments 2) Men MEN’s assortment * Rings * Bracelets * Necklaces 3) Kids * Disney assortment Hello Kitty assortment 4) Other Industries: Swarovski precious stones are appended to everything. * Victoria's Secret bra sets * Kawasaki cruisers * Clo thing assortments * DJ Headphones 8. CBBE Pyramid Resonance: HIGH LOYALTY Brand reverberation is high because of dynamic unwaveringness of clients Consumer Judgments: GLOBAL BRAND WITH RICH HERITAGE Perfect and inventive gem items High quality creation Consumer Feeling: PRESTIGIOUS ELEGANCE Prestigious, exquisite, delicate, committed, ageless Humble and advanced Feels like a pixie Brand Performance: EXCELLENT SERVICESExtremely tough, useful Offers ageless, great precious stone items Innovative product offerings: Optik gears, and so forth. Brand Imagery: Glamorous sumptuous gem items Women/youngsters with

Victorian society Essay Example for Free

Victorian culture Essay How does Arthur Conen Doyle control the shows of the class and a crowds desires and convey the ethical messages that Victorian culture would have expected? The two stories that I have considered, The Man with the turned lip and the experience of the Speckled Band are both composed by the creator, Sir Arthur Conan Doyle between the years 1859 1930. They likewise both component in the story Sherlock Holmes, alongside a side kick, Doctor Watson. Sherlock Holmes stories were not at first distributed in books, they were imprinted in Serial structure in the Strand magazine. The Contempory crowd at the time would have been acquainted with the characters and the story being told from Doctor Watsons perspective, and the manner by which the examinations are done. The Generic desires for homicide secret stories is that there would be a lowlife and a casualty, the wrongdoing is normally by a forceful man who has a thought process and is rough, irritable and known as a gold digger. The scoundrel is likewise expected to be male and cunning. The casualty is normally a female and is ordinary of the nonexclusive desires for a homicide secret. She would be helpless and a hairness who had cash. The analyst would not be a piece of the law and would direct his examination in a proper way. The wrongdoing is typically atypical and would for the most part be a weapon and all around arranged and executed and wrongdoing fathomed by Holmes, and equity is constantly done, and the individual who perpetrates the wrongdoing is constantly rebuffed. The pieces of information and the proof of the story is engage, following signs and the peruser anticipating the end. The scene and the setting of the wrongdoing would be a tranquil spot, encased and dull. The examination of the wrongdoing would be atypical, it would be the means by which and not who did it and the specialist does the examination as a pastime. A group of people would likewise hope to discover proof, hints and a thought process that prompts an examination and typically an answer. The examination and wrongdoing would be understood by a criminologist, with a collaborator next to him. The Villains in the two stories seem, by all accounts, to be regular of the shows or desires for a killer, a run of the mill killer in a homicide secret story is male, forceful, sanctuary, disagreeable and has something to pick up from the demise of his casualty. In the Adventure of the Speckled band the scalawag is Dr. Roylott, uncle to the main casualty. Helen Stoner who was his stepfather and stood apart to Doctor Roylott as her mom was wealthy so Helen remained to acquire cash which made her an objective for Doctor Roylott. Helen Stoner depicts Doctor Roylott as Uncontrollable in his displeasure, this makes the peruser feel that he is terrifying to this since she doesnt know how he will respond at a specific time. Through Watsons portrayal of Roylott, Conan Doyle makes a picture of a wild creature, a tracker, a savage mammoth. Roylott is portrayed as a furious old fowl of prey and on leaving the condos, he growled at Holmes at Watson like a horrendous pooch. In the man with the curved lip the scalawag is Hugh Boon, whom the writer portrays him as having a bull hound jawline which causes the peruser to accept that he is hound like, savage and horrible. He is an ordinary miscreant with a savage and harsh past, he creases unbelievable with cruel highlights. The statements like bile shot eye gives the peruser the feeling that he is extremely irate and incensed. Thoughout the story Boon is portrayed as a perputial growl by Doctor Watson, an old Scar by Watson and horrendous offensiveness by Doctor Watson. The essayist was undercutting our conventional desires since we don't hope to know who the reprobate is toward the beginning, nonetheless, the author acclimates our nonexclusive desires in light of the setting, the thought processes and the homicide strategy. In The Adventure of the spotted band the casualty is Helen Stoner, step girl of Dr Roylott. Her mom was very wealthy so Helen remained to acquire cash salary of à ¯Ã¢ ¿Ã¢ ½250 which made her a perfect objective for her stepfather. In the man with the contorted lip Neville St Clare, who was an atypical casualty was the obvious casualty. He was an atypical casualty due to the monetary profit. Neville St Clare was additionally a miscreant, and he needed to cover this up, he was found in a window looking extremely upset. The wrongdoing and examination in the two stories sabotages the conventional desires. In The Adventure of the dotted band the examination is atypical on the grounds that Holmes in researching how not who. There is no weapon in the wrongdoing, its a snake which does the harm and undermines the nonexclusive desires, so its atypical to the conventional desires. In The Man with the Twisted Lip, there is no wrongdoing submitted despite the fact that it is a homicide secret. Sherlock Holmes examines the puzzle and finds the miscreant was the person in question. The analysts in the two stories are atypical in light of the fact that Holmes does it for a pastime, the satisfaction and mental incitement. At long last, Neville St. Clare was banished from asking until the end of time and Doctor Roylott was raise by his own petard. In Conclusion, I imagine that these two stories are both run of the mill in most of the routes in a homicide secret sort since the two of them stick to the conventional desires for a homicide, criminologist story.

Quarter Wit, Quarter Wisdom The Power of Deduction on GMAT Data Sufficiency Questions

In a previous post, we have discussed how to find the total number of factors of a number.  What does the total number of factors a number has tell us about that number? One might guess, Not a lot, but it actually does tell us quite a bit!  If the total number of factors is odd, you know the number must be  a perfect square. If the total number of factors is even, you know the number is not a perfect square. We know that the total number of factors of a number A (prime factorised as X^p * Y^q *†¦) is given by (p+1)*(q+1)†¦ etc. So, if we know that a number has, say, 6 total factors, what can we say about the number? 6 = (p+1)*(q+1) = 2*3, so p = 1 and q = 2 or vice versa. A = X^1 * Y^2 where X and Y are distinct prime numbers. Today, we will look at a data sufficiency question in which we can use factors to deduce much more information than what we might first guess: When the digits of a two-digit, positive integer M are reversed, the result is the two-digit, positive integer N. If M N, what is the value of M? Statement 1: The integer (M N) has 12 unique factors. Statement 2: The integer (M N) is a multiple of 9. With this question, we are told  that M is a two-digit integer and N is obtained by reversing it.  So if M = 21, then N = 12; if M = 83, then N = 38 (keeping in mind that M must be greater than N).  In the generic form: M = 10a + b and N =10b + a (where  a and b are single-digit numbers from 1 to 9.  Neither can be 0 or greater than 9 since both M and N are two-digit numbers.) We also know that no matter what M and N are, M N. Therefore: 10a + b 10b + a 9a 9b a b Lets examine both of our given statements: Statement 1: The integer (M N) has 12 unique factors. First, lets  figure out what M N is: M N = (10a + b) (10b + a) = 9a 9b Say M N = A. This would mean  A = 9(a-b) = 3^2 * (a-b) The total number of factors of A where A = X^p * Y^q * can be calculated using the formula  (p+1)*(q+1)* We know that A  has 3^2 as a factor, so X = 3 and p = 2. Therefore, the  total number of factors would be (2+1)*(q+1)*†¦ = 3*(q+1)* = 12, so (q+1)* must be 4. Case 1: This means q may  be 3 so that (q+1) is 4. Since a-b must be less than or equal to 9  and must also be the cube of a number, (a-b) must be 8. (Note that a-b cannot be 1 because then the total number of factors of A would only be 3.) So, a must be 9 and b must be 1 in this case (since a b).  The integers will be 91 and 19, and since M N, M = 91. Case 2: Another possibility is that (a-b) is a product of  two prime factors (other than 3), both with the power of 1.  In that case, the  total number of factors = (2+1)*(1+1)*(1+1) = 12 Note, however, that the two prime factors (other than 3) with the smallest  product is 2*5 = 10, but the difference of two single-digit positive integers cannot be 10.  This means that  only Case 1  can be true, therefore, Statement 1 alone is sufficient. This is certainly not what we expected to find from just the total number of factors! Statement 2: The integer (M N) is a multiple of 9. M N = (10a + b) (10b + a) = 9a 9b, so  M N = 9 (a-b) . This is already a multiple of 9. We get no new information with this statement; (a-b) can be any integer, such as 2 (a = 5, b = 3 or a = 7, b = 5), etc.  This statement alone is insufficient, therefore our answer is A. Don’t take the given data  of a GMAT question at  face value, especially if you are expecting questions from the 700+ range. Ensure that you have deduced everything that you can from it before coming to a conclusion. Getting ready to take the GMAT? We have  free online GMAT seminars  running all the time. And, be sure to follow us on  Facebook,  YouTube,  Google+, and  Twitter! Karishma, a Computer Engineer with a keen interest in alternative Mathematical approaches, has mentored students in the continents of Asia, Europe and North America. She teaches the  GMAT  for Veritas Prep and regularly participates in content development projects such as  this blog!

Compare/ Contrast Appalachian Stereotypes - 1192 Words

Combating Stereotypes vs Truths of the People of Appalachia The people of Appalachia are often characterized as ignorant, lazy, uneducated, drug addicted, and incestuous. Many believe that this impoverished area is full of hicks, hillbillies, and rednecks, but when examining the truths one might find an enriched culture with generous people who are hardworking, artistic, and family oriented with a strong religious faith. In the documentary, The Wild and Wonderful Whites of West Virginia, a family is followed for one year to expose corruption, poverty, and West Virginias environmentally and culturally devastating coal mining culture that helped shape the family, a dying breed of outlaws preserving a dying form of dance (Doering et†¦show more content†¦Although the people of District 12 do not have any choice in their circumstances, due to governmental control, most people of Appalachia do not feel they have a choice either when decades after decades the circle repeats itself and without positive encouragement it does not seem to change. Until the Civil War, those in Appalachia enjoyed largely self-reliant existence. At this time, railroads and coalmines invaded Appalachia, forcing many mountain people to abandon farming and go to work for the railroad or coal mines to feed their families. To this day, most still have some connection to the mines (Innes, 2012). However; you still had to have somewhat of an education in order to work in the coal mines or on the railroads. When families were looking for a means of income and this was not a viable solution for them, many turned to moonshine. These ingenious individuals did not have to pay taxes on their moonshine and were able to come up with imaginative ways to distill and distribute their products, while evading law enforcement (also known as revenuers). In fact, one of America’s favorite pastimes, NASCAR, was born of the need for moonshiners to out run the revenuers (Wachyter, 2011). The faith of the people of Appalachia is very strong. There are more than 80 different varieties of Baptist and Pentecostal faiths found in Appalachia. A unique church, found only in Appalachia is the snake handling church. They believeShow MoreRelatedThe Great Gatsby Analysis5626 Words   |  23 Pagesof Doctor T. J. Eckleburg best exemplify this idea. 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Colombian Corruption - 1109 Words

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Transculture in Nursing

Question: Discuss about the Assessments of Cultural Competence Initiatives Available in your Organization. Answer: Introduction The increase in racial and ethnic diversity in countries is bringing in opportunities as well as challenges for health care providers. They are constantly under pressure to deliver culturally competent care and this can be achieved by developing cultural competence skill in health care professionals. Cultural competence is the ability to deliver health care services to meet the social, cultural and linguistic needs of diverse group of people. To promote health and well-being of patients, health care providers need to respond to diverse values and health belief of patients (Huey et al., 2014). However, conflict situation or negative health outcome may arise when health care staffs fail to manage the socio-cultural difference and health beliefs of patient. Hence, the assessment of cultural competency within health care system is needed to improve the quality of care and eliminate racial and ethnic disparities in care. The goal of health care organization should be to create a culturall y competent environment. This is possible by having key elements in health system such as defined values and principles of cross-cultural interaction, conducting cultural competency assessment to develop the ability to manage diversity and assimilate cultural knowledge and integrate them in daily practice (Ring, Nyquist, Mitchell, 2016). With this challenges present in health care to respond to the needs of culturally diverse patient, the purpose of this report is to analyze the cultural competent initiative available in a health organization in Saudi Arabia and assess how they respond to the needs of culturally diverse group. It will help to gain idea about current challenges in Saudi Health care system and their preparedness to promote culturally competent care. Detail of health care organization This report is focused on examining the cultural competent initiative in King Fahad Military Medical Complex (KFMMC) of Saudi Arabia. The KFMMC hospital is located in Dhahran city of Saudi Arabia with 350 beds and 5000 employees. It was founded in 1989 and has different specialties like accident and emergency care, intensive care unit, operating room, cardiac center, physiotherapy, haemodialysis center, internal medicine, ophthalmology and many others. Other specialized department includes kidney transplant, nephrology, specialty clinics and kidney transplants. The rapid changes in economical, technological, social changes and customer-related demands have an impact of the nature and quality of care and KFMMC is highly reliant on international workforce. Presence of diverse cultural group can create risk in delivering health care and lead to medical error (Inocian, 2015). Hence, to eliminate this barrier in effective care practice, the purpose of KFMMC is to carry out comprehensive c ultural competence assessment to determine the level of knowledge about Saudi Cultural aspect in workforce and evaluate whether they practice in a culturally sensitive way or not. Rationale for cultural competence initiative in hospital of Saudi Arabia Cultural diversity presents the major challenge to health care workforce of Saudi Arabia. As patients and heath care staffs come from different linguistic and cultural background, it often leads to conflict. Staffs recruited in Saudi Arabian healthcare system are mainly non-Saudi who come from different parts of the world and they are unaware of the culture and beliefs of Saudi Arabian citizens. This factor makes care process inadequate and leads to misunderstanding which has an impact on therapeutic relationship as well as interaction with patients. Similar challenge is also experience by clinicians and nurses in King Fahad Military Medical Complex. Hence, due to the resultant mix of culturally and linguistically diverse health care staffs and patient in hospital, KFMMC felt the need to evaluate and assess the cultural awareness knowledge of nurses and other staffs. The problem of inadequate cultural awareness in health care setting can be addressed if health care organization takes steps to educate health professionals about all aspects of Saudi culture to minimize conflict and improve the quality of care and similar strategy is also proposed by the management of KFMMC hospital (Karout et al., 2013). The complexities in health care system can cultural competency have been studied by various researchers. One such analysis of research literature by Karout et al., (2013) revealed the experience of Saudi women admitted in private hospital of Saudi Arabia. Muslim cultural life, values and beliefs are different from other cultural groups and this creates a misfit in ethical codes of practice. Diversity in the clinical context leads to inconsistency in the expectation of care and delivery of care. There are certain Muslim practices such as concern for modesty, evil-eye and food taboos which non-Muslim nurses are not aware about and it is the responsibility of current health care system to provide in-service education to the staffs to enhance the quality of culturally competent care. Another example of cultural disparity is that breast cancer incidence is rising but the breast cancer screening rate is low in Arab women. This is because of Arab womens attitude and beliefs prevented them f rom adopting health preventive behavior. The interview with this group of patients revealed that fear or embarrassment was the reason why they did not go for mammogram. This problem can be addressed by culturally appropriate intervention and awareness program. Hospitals of Saudi Arabia like KFMMC need to pay more attention to the cultural competent skill of nurses and clinician to develop the understanding of Arab culture, beliefs and practices (Donnelly et al., 2013). The concept of an ideal culture can be understood by the quantitative phenomenological study which explored the perception of Saudi women in cultural diversity in heath care team. The biggest problem reported by the participants was related to linguistic diversity as the difference between English spoken nurse and Arabic speaking patients was leading to problem in communication. Second theme arising from the study was religious diversity issues where women were not comfortable in uncovering their body parts to non-Muslim service providers. Furthermore, there was also value and belief conflict as women participants were not satisfied with care as it overlooked their traditional values on health practices. Therefore, this experience suggest that health care workforce may struggle in providing culturally appropriate care to diverse population groups and this may affect the quality of care delivered. As lack of religious and cultural knowledge is a major barrier in efficient nursing care , it has become paramount for hospitals of Saudi Arabia to assess cultural competence of their workforce and training nurse to culturally competent health care practice. Nursing education programme will also have to strengthen their curricula by including cultural competency concept in quality care. Nurses and other staffs need to be conversant with Saudi Expression, terminology, belief and values to engage in appropriate care practices (Karout et al., 2013). Components of cultural competence assessment profile The cultural competence assessment profile is a set of analytic framework and indicators for examining cultural competence in health care service in hospitals. Use of such profile is effective in internal assessment of cultural competence at the hospital. It may involve quality review, performance monitoring and compliance with set cultural competence standards at the hospital. The major components of an assessment profile for the hospital include the following: Domain of cultural competence and focus areas- The main domain involved in cultural assessment includes organizational values, staff development, and governance, planning evaluation, hospitals infrastructure and interventions. Organizational values can be judged by the attitude and commitment towards culturally competent care and the main focus areas under this domain will be leadership role, data regarding cultural competence and level of flexibility in the organization. Governance domain can be assessed by looking at policies used at hospital to deliver culturally competent care. Planning process for cultural competence at the hospital can be judged by the presence of short-term and long-term policy and system to track level of cultural competence. Furthermore assessment of culturally competent oral and written communication will help to understand whether culturally appropriate communication process is present or not. Tracking training content and commitment is also an important d omain to evaluate if staffs have the skill to deliver culturally competent care service. Another important focus area is the process of care planning and treatment that is delivered in a culturally competent manner (Shen, 2015). Indicators of cultural competence- Indicators are any measureable characteristics that determine the level of cultural competence in a hospital. Structural indicators are related to factors used to assess organizations preparedness to cultural competence. Example of this indicator may include culturally appropriate setting, infrastructure, financial resource, governance and administrative system present at the hospital. Similarly process indicators give an idea about activities and procedures at the hospital that reflects culturally competent care. Output indicator is the positive or negative outcome of policies in a multi-cultural and multi-lingual work environment. Other indicators may include provisions of care and response to care in culturally competent manner (Linkins et al., 2017). Assessment of cultural competence initiative KFMMC is a recognized for the quality of care provided and it is under the government agency. Like KFMMC, there are other 15 military hospitals across the country and KFMMC provides primary and advanced health care in the city of Dhahran. The nursing workforce in this hospital are mainly expatriate coming from countries like U.K., Australia, Malaysia, Middle East countries, South Africa and North America. The entire nurse irrespective of their nationality need to get registered with Saudi Commission for Health Specialist to practice in the country and the registration is renewed every three years. The major problem seen in Military Hospitals in Saudi Arabia includes increased reliance on expat nurse, however not paying attention to psychosocial and communication competency to deal with Saudi patients. Due to this problem in health care system, the goal of KFMMC was to arrange for a cultural competence initiative at the hospital to enhance psychosocial and communication skill in their workforce (Aldossary, 2017). The main objective behind the KFMMCs cultural competent initiative was to analyze the experience of patient and nurse in psychosocial and communication performance, identify the barriers that affect their performance and then plan strategies to make them culturally competent (Aldossary, 2017). They considered initiating the cultural competence program from health care professionals due to the rise in cultural misunderstanding between patients and expatriate health care provider. This problem is most likely to lead to poor quality of care, increased patient satisfaction with care and rise in ethical dilemmas within the hospital. This will ultimately have an impact on the reputation of the hospital and to avoid this issue cultural competence assessment was necessary to evaluate current responsiveness to patients needs and preference and take relevant corrective action as far as possible (Almutairi, 2015). This initiative was started by identifying the factors that challenges nurses and clinicians in carrying out their responsibilities. This challenge was mainly related to communication problem such as language difference, cultural difference and low health literacy between patients and care providers. The health care workforce could have surpassed these challenges if they were given institutional support such as cultural competence training and seeking help from interpreters. However, the hospitals of Saudi Arabia have failed to provide support to staffs leading to experience of prejudices and ethnocentrism in practice (Inocian, Atallah, Moufleh, 2017). The positive aspect is that KFMMC recognized the importance of culturally appropriate care and they took the responsibility to arrange a culture competence assessment and training program at their institute. The culture of Saudi Arabia is a combination of Arabic and Islamic influence and peoples lifestyle highly revolves around the Islamic cultural values. They follow Islamic obligations as well as Arabian community traditions and customs. The problem for health care workforce is aggravated due to the rise in the number of expatriate health care professionals and little attention on expanding their knowledge about Saudi culture. The first priority of cultural assessment was to assess the language proficiency of nurses and other staffs. All were found toe proficient in English, but the patient were not proficient in English and they mostly used Arabic language. This linguistic difference might lead to health and safety issues in care. Furthermore cultural competence assessment also revealed work related violence in health care. The gap in cultural and language awareness among expatriate health professionals often put them in risk situation while giving instruction to patients or during ma nagement of patients with different ailments (Almutairi, 2015). Hence, KFMMC identified two major problem during cultural competence assessment at their institute and that was linguistic and communication barrier in practice. They realized the fact that if health care providers are given the necessary knowledge about cultural customs of Saudi Arabia, then it will empower their workforce to address misunderstanding among colleagues and patient and enhance the quality care. They are planning to address this problem faced by nurses by conducting extensive training to develop the linguistic and cultural competency skill of staffs according to the cultural values of Saudi Arabia. To initiate the cultural competence initiative at the hospital, special attention should be given to nursing problems and their complexities in the hospital. This is because Saudi Arabian citizens are highly influence by Islam culture and nursing workforce in Saudi Arabia is mostly foreign in origin. If nurse are aware of different dimensions of culture, it may help them in linking the culture with patients and avoiding any conflicts arising due to cultural misunderstanding. Hence, hospitals of Saudi Arabia should pay special attention to developing the skills of nurse in grasping the cultural attributes of patient. There is a need to enhance the knowledge related to cultural values of Saudi citizen to deliver respectful and holistic care. Cultural shock confronts nurses and staffs in Saudi Arabia in a significant way and this issue should be immediately addressed to prevent risk of errors. Lack of cultural sensitivity may have an influence on the care-giving process and so emphasizi ng on staff development in the area of cultural competence is an important responsibility for hospitals (Inocian, 2015). Main feature of cultural competence initiative Given is the list of steps followed to assess cultural competence of staffs at the hospital- Evaluation of cultural competency skill of staffs- An internal survey was done to assess the psychosocial and communication aspects of care at the hospital. The members involved in this initiative consulted the culturally and linguistically appropriate service (CLAS) guidelines to carry to access skills of staffs and it was measured by a Cultural Competency Assessment tool for Hospitals (CCATH). According to CLAS guideline, there areas that can be evaluated are culturally competent care, availability of language access service and organizational support for cultural competence. This assessment will be a roadmap to judge the health disparities present within the health care system and act accordingly (Weech-Maldonado et al., 2012). The main elements evaluated through this cultural competence initiative were as follows: Workforce diversity and level of training at the hospital- The first step for managers of KFMMC was to assess the workforce diversity at the hospital. There is shortage of health care workforce in Saudi Arabia, so international health professionals and nursing staffs are mainly recruited at hospitals of Saudi Arabia. They come from countries like U.K., U.S., Australia, Malaysia, Middle East countries and many others. This reflects that the multi-lingual and multi-cultural environment is present at the hospital. It can lead to a crisis situation unless and until properly planning is done to manage culturally diverse workforce and patients (Al Hosis, Plummer, O'Connor, 2012). The training domain for culturally diverse workforce was evaluated by the human resource practice at the hospital. Their recruitment and retention activities were judges to find how they put extra effort in pursuit of a culturally appropriate work culture. Ideal retention strategies might have included creating a supportive work environment for international workforce, maintaining the work-life balance and providing opportunities for flexibility in the job process. However, this aspect was missing and training needs for expatriate staffs was ignored. To override this issue, the plan was to provide in service training to all staffs and modify the staff training curriculum to develop the skills required for culturally competent clinical care. However, just conducting training programs may not serve the purpose unless and until the impact of training program is assessed by the effectiveness of staffs in meeting the cultural needs of patients in care. It might be possible that people fro m diverse cultural background may resist in accepting service or care protocols and they may be vulnerable to cross-cultural conflicts. Hence, experienced cultural competence training staff may help in resolving conflicts and handling grievances, legal and ethical issues in care (Weech-Maldonado, 2012). Assessment of cultural competence skill of staff- After making a profile of workforce diversity, individual profile was made in terms of age, nationality, length of service and educational qualification. This would help to measure skill and performance on different parameters. Secondly, the cultural competency was assessed by their ability and attempt to learn key word and colloquialisms of the Arabic language used by patients and by their manner of communication with patients and family members. They were also interviewed for the effect of their own cultural background and prejudices in their performance. If they had ever got an interpreter, it was judged whether they could utilize this opportunity effectively or not. If staffs are found to be highly competent in this area, their competency will be further developed by bringing adaptive changes in them to better serve the diverse cultural group of patients and family members. Another strategy was to assess cultural competence accord ing to age, gender, education, nationality and length of service to determine whether skills occurs due to individual weakness or due to lack of organization preparedness for culturally competent care (Inocian, Atallah, Moufleh, 2017). This assessment strategy would help to gain an understanding of the improvement needed to support expatriate staffs to recognize Saudi Culture and enhance cultural competence. The challenges and issues in care would help to design the health service at the hospital in accordance with the needs of patient and connect with patients in an appropriate manner (Koh, Gracia, Alvarez, 2014). Assessment of patient-provider communication at the hospital- Managing any type of illness in a multicultural environment is difficult due to the communication barrier seen between patients and health care professionals. Health care staff has the responsibility of conveying complex information to the patient as well as managing their emotions. However, different cultural beliefs, health-related values and customs affect how a patient perceive treatment and diagnosis process. Similarly, difference between health beliefs of clinicians and nurses from patients also has an impact on the delivery of care and health outcome. Cultural incompetency often contributes to disparities in health care. Hence, cultural competence is the strategy to eliminate disparities and improve the quality of care. Patient-provider communication is the most important factor in culturally competent care and communicating with awareness and knowledge about socio-cultural factors helps to efficiently manage care p rocess (Brown et al., 2016). To evaluate level of patient-provider communication at the hospital, the method and approach of communication between patient and health staffs was assessed. The assessment process identified gap in communication as most of the staffs were from other countries and there was no provision for training them in culturally appropriate care. Hence, improvement was needed in patient-staff communication at the military hospital (Aldossary, 2017).To address this gap in service, the corrective action that is proposed is to arrangement for interpreter service and translated materials to pass on to those patients and staff who have low proficiency in English. This interpreter service will come handy in improving provider and staff communication with patients. In that case, there will also be a need to evaluate the quality of interpreter service to see how interpreter are effective in reducing gap in patient-provider communication. Another effective corrective action proposed is to translate writ ten materials like treatment instruction, consent form and prescription into the common language of the population (Weech-Maldonado, 2012). Assessment of supporting mechanism for culturally competent care- Supporting mechanism for culturally competent care implies the physical environment of the hospital and its link with supportive service. It may also involve application of tools to promote culturally relevant information on health beliefs and practices. The hospital was lagging behind in this area. Taking cues from past action and research on organizational strategy to reduce health disparities might help in modifying the physical environment of the hospital. In this context, the research by Weech-Maldonado et al., (2012) gives guidance regarding the process to develop a culturally competent environment in hospital setting. Supporting mechanism for culturally competent care is present in those hospitals that are committed to a system approach of change. System level cultural competency is achieved when congruent behavior and cultural competence policy is present within health care system. Adopting a system approach helps in easy integration of cultural competence practices throughout the hospitals. The initial step to adopting the system approach is to assess whether hospital structure and process is appropriate to meet the relevant needs of diverse patient group. The Cultural Assessment Tool for Hospitals CCATH) is an example of tools for organizational assessment. The main aim of this tool is to evaluate six areas at the hospital and they are- Role and function of leaders at the hospital Level of culturally competent training for staffs Strategy for management system and operations Engagement of local community in service Approach to patient-provider communication Presence of supporting mechanism at the hospital Plan for achieving cultural competence To achieve the objective of holistic cultural competence assessment, the strategy of military hospital is to prepare a checklist of strength and weakness of nurse based on assessment of their cultural competency skill and then analyzing the baseline data of workers to plan improvement areas. This will lead to positive outcome in care process and eliminate culture shock and language barrier in care (Purnell, 2014). The cultural competence initiative might lead to many positive outcomes for KFMMC. After conducting complete cultural assessment of health care staffs, their plan for improving communication skill in nurse in daily care were as follows: Having set standard of culturally competent care- The standards for the hospital is that they want to ensure that their staff members deliver respectful and effective care to patients compatible with their cultural beliefs and language spoken. Another set standard for them will be to implement strategies to retain culturally diverse staff by providing them supportive mechanism to overcome challenges in care process. Another standard is to make sure that all staff receives adequate training in culturally and linguistically appropriate care (Ring, Nyquist, Mitchell, 2016). Enhancing culturally competent care- Taking cue from cultural competence initiative in other health care organization, KFMMC hospital need to ensure that nurses approach patient in efficacious and courteous manner. This is the first step to establishing a relation with patients and any wrong notion or attitude should not be passed on to the patients. Secondly, they need to be given training linguistic skills and for KFMMC, the immediate need for nurse will be to learn basic Arabic language. They can start with interpreters and then handle patients singlehandedly once they learn to easily converse in local language of the country. Furthermore, to promote culturally competent care, it will be necessary for health care staffs to respect cultural practices and issue of Saudi patients (Lord, 2015). Apart from this effort health care staffs to inculcate culturally competent care in practice, the human resource manager of the hospital will also play an influential role in recruiting, sustai ning and managing a diverse workforce. They will ensure that all staffs entering the hospital are given the necessary information to follow the work culture of the hospital and create a patient-friendly environment at the hospital (Albougami, 2015). Increasing the provision for language access service- The cultural assessment of nurses and other staffs at the hospital revealed linguistic difference as a major problem and the hospital plan to arrange for programs and service to address linguistic difficulty faced by employees working at the hospital. Phenomenological study examining the experience of nurse in care also revealed nurse faced many difficulties in communicating with Arabian patients due to language difference and this was the reason why patients were not satisfied with their service. The lack of clarity in communicating post-discharged information lead to dissatisfaction in many patients (Almutairi, 2015). Considering this difficulty in hospitals of Saudi Arabia, the plan was to introduce language aid service for health care staffs where they to easily comprehend information and patient queries. Interpreter and multilingual staffs may help staffs and patient who have low command over English or Arabic language (Albou gami, 2015). Promoting organizational support for building a culturally competent work environment at the hospital- To ensure that cultural competence skills and initiative is maintained and sustained in the hospital, a well-written plan will be executed that clearly mentions all the operational level demands and defines the responsibility to deliver culturally appropriate care. The assessment of activities in diverse group should be done regularly to monitor whether linguistic and cultural practices are incorporated by staffs in care or not. The internal audit will be beneficial in judging patient satisfaction level measured by staff and develop opportunities for performance enhancement of different clinical staffs at the hospital. While executing any new service at the hospital, the health care organization will review the local community profile such as cultural and demographic factors of the area. This will ensure that they are prepared to respond to the linguistics and culture of the hospita l. There is also plan for collaborative association with local communities to resolve conflicts and issues raised by the patient (Albougami, 2015). Eliminating the ethical barrier faced by nurses and clinicians at the hospital- There will be special focus on nurses responsibility in care as nurses spend the maximum amount of time with patients. This will be done after interacting with nurses regarding the external and internal barriers in care. External barriers may result due to communication difficulties occurring due to language difference and cultural difference between nurse and patient. Due to this barrier, newly placed international nurse in Saudi Arab hospital may find the job demanding and it may lead to stress and burnout. As this barrier has a negative impact both on nurses as well as patient, the plan is to make nurses aware of culturally competent policies and make them learn basic colloquial terms and Arabic language to converse with patients. They will also be provided support with interpreter service in the beginning. The advantage of removing external barrier is that it will help to remove internal barriers for nurse which results due to experience of cultural shock. Hence, support given to nurse with additional tools help to overcome instability in the job. Developing flexible attitude will help them to implement interventions according to cultural preference of patients and family members (Murcia Lopez, 2016). Creating opportunities for better understanding of patients- This can be achieved by improving existing system of staff-patient interaction at the hospital. Skill in interacting with patients will help in explaining serious disease and rationale for any treatment process to patients. There is rise in problem of staff-patient interaction in Saudi Arabia due to large number of foreign staffs in health service, little orientation on local traditions and health related beliefs of Saudi people. Problem also arises due to rise in number of expatriate consumer in health care of Saudi Arabia. Hence, the need to train and orientate health care staffs is significant for KFMMC. To make nurses aware of the importance of staff-patient interaction, it is necessary to include in their curriculum or training program the detail on orientation on medical humanities to broaden understanding of social traditions of patients. Regular training program will be arranged for staffs to make them aware of Arab ian colloquial language, health traditions and belief of Saudi citizens. It will help to correct and modify any misconception regarding patients (Ahmad et al., 2016). Conclusion The report presents the importance of culturally competent health care environment to provide holistic care to patients and highlights the cultural competence initiative at KFMMC in Saudi Arabia. The analysis of the challenges faced by nurses and clinicians practicing in health care setting showed that there is great disparity in health service due to rise in number of expatriate health care professionals and wide cultural difference between patient and care provider. KFMMC realized that cultural incompetency is leading to high level of patients dissatisfaction with service and it is hampering therapeutic interaction with patients. The presence of linguistically diverse workforce was also a reason for conflict and error in service. The rationale for the cultural competence initiative at the hospital is also understood from recent research based evidence investigating the barrier in health care service of Saudi Arabia. There are example of Saudi women perspective of breast cancer scre ening, their perception of incompatibility with service and other issues which reflects immediate action to enhance physical environment of hospital and develop cultural competence skill among staffs (Ahmad et al., 2016). With this rationale, KFMMC utilized a cultural assessment profile and framework to assess the health care practice, skill and procedure at the hospital. The cultural assessment profile of the hospital consisted of cultural competence domain of organizational values, policies, governance, hospital infrastructure, system support, tools, training and staffs skills and the main focus area of each domain was assessed. Furthermore, the hospital also included structural, process and output indicator to analyze the performance of hospital in delivering culturally appropriate care. The main objective behind the cultural competence initiative was to measure psychosocial and communication performance at the hospital and the program was initiated by collecting data on diverse workforce and nature of work at the hospital. Key problems and complexities arising at the hospital during health care delivery were monitored and systematic process of cultural assessment was followed. Many improvement areas in care process was identified such as lack of cultural orientation in staff, no arrangement for training regarding cultural competency and linguistic awareness in staffs and lack of tools or support system to help overcome challenges in care process. Based on this assessment, several strategic plans were proposed to maintain the quality of care and provide patient-centered care in a multi-cultural environment. References Ahmad, A. M. K., Alghamdi, M. A. S., Alghamdi, S. A. S., Alsharqi, O. Z., Al-Borie, H. M. (2016). Factors Influencing Patient Satisfaction with Pharmacy Services: An Empirical Investigation at King Fahd Armed Forces Hospital, Saudi Arabia.International Journal of Business and Management,11(9), 272. Al Hosis, K., Plummer, V., O'Connor, M. (2012). Nursing management in Saudi Arabia: Evaluating strategies for succession planning.Asia Pacific Journal of Health Management,7(1), 19. Albougami, A. (2015). 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