Application of Leininger Theory

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Prostate cancer is a leading cause of mortality and medical expense in men age forty and above. However, it has only recently become a topic of conversation to men in America (Plowden, 2009). African-American men are affected by prostate cancer at a disproportionate level over all other men. They are diagnosed up to 65% more frequently and the mortality rate is twice that of their Caucasian counterparts (Emerson, 2009). So why is the African-American male less likely to take advantage of prostate cancer screenings even when it is free (Oliver, 2007)?

Current state of the science

Today, prostate cancer is usually detected through screening, and there are two methods for early detection. The prostate-specific antigen test (PSA) is used, but there are many factors that can influence the outcome of the PSA test. Medications such as antihistamines, physical exertion or recent ejaculation can raise a PSA level (Gray, 2009). The test itself was intended for staging the presence of known prostate cancer and is less reliable when used alone (Oliver, 2007).

Another test for early detection of prostate cancer has been the digital rectal exam (DRE). Although DRE is a better method for early detection, it is also a hindrance among men, particularly African-American men, to screening and early detection (Plowden, 2009). According to American Cancer Society (ACS) and American Urological Association (AUA), the PSA and DRE should be offered annually for all men beginning at age 50 (Gray, 2009). However, they also recommend that African-American men with a family history of prostate cancer should begin testing by age 45 (Plowden, 2009). However, due to the cultural barriers to prostate screening such as lack of understanding, traditions, mist...

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...efits of early detection versus late discovery; provide easy access to screening and the follow-up phase of the intervention; and maintain confidentiality. Peer group discussions with professionals have shown to aid in getting better compliance (Plowden, 2009).

Conclusion

The African-American males’ decision making process when considering prostate cancer screening is influenced greatly by cultural mores and beliefs. These cultural beliefs often lead to a lower rate of compliance to free screening versus all other races i.e. Caucasians, etc. Leisiniger’s cultural diversity theory can be used to effectively educate and increase compliance by teaching practitioners ways to overcome these cultural barriers. By following the concepts of care, caring, and understanding feelings of self, as well as the feelings of others, it is possible to overcome cultural barriers.

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