9/12a Culturally Sensitive Practice

Question 1

Cultural competence

Answer 1

being open and conscious about your surroundings and different cultures that exist around you

Question 2

Culture

Answer 2

• learned
• dynamic
• primary: fixed
• secondary: fluid
• values
• ritual
• race/ethnicity

Question 3

Primary aspects of culture

Answer 3

nationality, race, color, age

Question 4

secondary aspects of culture

Answer 4

socioeconomic status, occupation, education, experiences, marital status, gender, religion

Question 5

Define value

Answer 5

statement of principle, basis for moral decision making, social principles, goals, or standards held by an individual

Question 6

Ritual

Answer 6

practices, services, and procedures that structured, shared, relevant, familiar, big or small, and tend to be religious

Question 7

Race/Ethnicity

Answer 7

Race is NOT genetic, it is a social construct that society uses to define people

Question 8

Cultural sensitivity

Answer 8

a dynamic, fluid, continuous process whereby an individual system or health care agency finds meaningful and useful health care delivery strategies based on knowledge and competency of other cultures

Question 9

Provider/patient relationship

Answer 9

needs to have a therapeutic alliance

Question 10

Cultural Continuum

Answer 10

cultural destructiveness
cultural incapacity
cultural blindness
cultural pre-competence
cultural proficiency

Question 11

example of cultural destructiveness

Answer 11

tuskegee syphillis experiment - african american males in the 1970s were told that they were going to get treatment, but they never got any even when they attended the doc office and the doc said they were

Question 12

cultural incapacity example

Answer 12

racial profiling

Question 13

cultural blindness

Answer 13

melting pot after civil rights movement, bad to assume that everyone is the same thing

Question 14

Cultural awareness

Answer 14

self examination, exploration of biases, exploration of ones own culture, acceptance and respect

Question 15

cultural knowledge

Answer 15

process of learning about other cultural/ethnic groups

Question 16

cultural skill

Answer 16

ability to conduct a cultural assessment

Question 17

cultural encounter

Answer 17

continual engagement in cultural interaction

Question 18

generalizing vs stereotyping***

Answer 18

generalizing - based on data or previous experience
stereotyping - no attempt to learn whether an individual is outside of a common trend, automatically typecasting a person without any additional facts

Question 19

cultural desire

Answer 19

natural inclination to engage in the cultural competence process

Question 20

key components of cultural competence

Answer 20

• valuing diversity
• capacity of self-assessment
• raising awareness of dynamics inherent when cultures interact
• organizational processes to institutionalize cultural knowledge
• striving to develop individual and organizational adaptations to diversity

Question 21

cultural knowledge subcategories

Answer 21

• individual and nature
• science and tech
• materialism
• individualism
• collectivism

Question 22

high context vs low context cultural knowledge

Answer 22

high context - relationship oriented, intuitive, deep respect for past, non-verbal>verbal, fewer and tighter relationships, team achievement, tradition over change
low context - task oriented/individualistic, rule-oriented, present/future oriented, verbal communication, many loose relationships, individual achievement, change over tradition

Question 23

Breakdown of cultural knowledge

Answer 23

W - work ethic
D - Decision Process
T - Time sense
C - Communication
R - Relationships
M - motivation
V - View of Change

Question 24

High Context Cultures

Answer 24

Asian, African, Arab, Greek

Question 25

Low Context Cultures

Answer 25

Anglo/German, Scandinavian, American

Question 26

Purpose of TA

Answer 26

• Systematic review
• Impact of TA combined with PT on chronic musculoskeletal pain: improved results because patient trusts PT
• Elements that strengthen TA: collaboration, communication, therapist empathy, mutual respect

Question 27

What correlation was found between therapeutic relationship and chronic pain outcomes?

Answer 27

a strong TA may be more effective in addressing chronic musculoskeletal pain than traditional PT interventions alone

Question 28

What were the 2 factors identified in multiple studies as having a positive influence on the TA

Answer 28

1. Trust

2. Development of individualized treatment plans

Question 29

What were the clinical recommendations of authors building successful TA alliance with patients with chronic musculoskeletal pain?

Answer 29

1. Skill in facilitating patient involvement in the plan of care
2. discussion of individual motivators and barriers with patients
3. training in communication

Question 30

describe discrepancy between therapist and client that was reported in one of the included studies (Burns et al 1999). Define 3-4 brief but specific ways to minimize this inconsistency of experience between client and provider

Answer 30

1. the strength of TA is not always equally interpretted by PT and patient
2. strategies include: open communication, self reflection of provider beliefs and values, training in healthcare communication

Question 31

Case: 86 year old patient with thoracic pain, newly diagnosed with osteoperosis. Referral: evaluate and treat.
What do you do with the patient/practitioner collaborative model? PATIENT CENTERED

Answer 31

1. Establish TA: Sit face to face, be aware of pain, engage in personal dialogue with area of common interest
2. Diagnostic Process of Mutual Inquiry: understand Sx, ID patient’s goal, learn about patient’s life at home
3. Negotiate Common Ground: set mutual goals, address fears
4. Intervention: educate and empower client, encourage ptnt to follow up with questions, establish POC and schedule
5. Follow Up: ask about HEP, judge QOL and progress, re-eval effectiveness of program, select outcome measures

Question 32

Case: 86 year old patient with thoracic pain, newly diagnosed with osteoperosis. Referral: evaluate and treat.
What do you do with the patient/practitioner collaborative model? PROVIDER CENTERED

Answer 32

1. Establish TA: stand with patient who is sitting on table, little eye contact, collecting data
2. Diagnostic Process of Mutual Inquiry: focus on gathering data, assess joint irritability, and ID areas of primary Sx
3. Negotiate Common Ground: start with appropriate joint mobs, discuss prognosis
4. Intervention: proceed with joint techniques, give HEP, provide written instruction
5. Follow Up: note complaints with difficulty, review HEP, repeat mobs