9/12a Culturally Sensitive Practice Flashcards
Cultural competence
being open and conscious about your surroundings and different cultures that exist around you
Culture
- learned
- dynamic
- primary: fixed
- secondary: fluid
- values
- ritual
- race/ethnicity
Primary aspects of culture
nationality, race, color, age
secondary aspects of culture
socioeconomic status, occupation, education, experiences, marital status, gender, religion
Define value
statement of principle, basis for moral decision making, social principles, goals, or standards held by an individual
Ritual
practices, services, and procedures that structured, shared, relevant, familiar, big or small, and tend to be religious
Race/Ethnicity
Race is NOT genetic, it is a social construct that society uses to define people
Cultural sensitivity
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
Provider/patient relationship
needs to have a therapeutic alliance
Cultural Continuum
cultural destructiveness cultural incapacity cultural blindness cultural pre-competence cultural proficiency
example of cultural destructiveness
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
cultural incapacity example
racial profiling
cultural blindness
melting pot after civil rights movement, bad to assume that everyone is the same thing
Cultural awareness
self examination, exploration of biases, exploration of ones own culture, acceptance and respect
cultural knowledge
process of learning about other cultural/ethnic groups
cultural skill
ability to conduct a cultural assessment
cultural encounter
continual engagement in cultural interaction
generalizing vs stereotyping***
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
cultural desire
natural inclination to engage in the cultural competence process
key components of cultural competence
- 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
cultural knowledge subcategories
- individual and nature
- science and tech
- materialism
- individualism
- collectivism
high context vs low context cultural knowledge
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
Breakdown of cultural knowledge
W - work ethic D - Decision Process T - Time sense C - Communication R - Relationships M - motivation V - View of Change
High Context Cultures
Asian, African, Arab, Greek
Low Context Cultures
Anglo/German, Scandinavian, American
Purpose of TA
- 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
What correlation was found between therapeutic relationship and chronic pain outcomes?
a strong TA may be more effective in addressing chronic musculoskeletal pain than traditional PT interventions alone
What were the 2 factors identified in multiple studies as having a positive influence on the TA
- Trust
2. Development of individualized treatment plans
What were the clinical recommendations of authors building successful TA alliance with patients with chronic musculoskeletal pain?
- Skill in facilitating patient involvement in the plan of care
- discussion of individual motivators and barriers with patients
- training in communication
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
- the strength of TA is not always equally interpretted by PT and patient
- strategies include: open communication, self reflection of provider beliefs and values, training in healthcare communication
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
- Establish TA: Sit face to face, be aware of pain, engage in personal dialogue with area of common interest
- Diagnostic Process of Mutual Inquiry: understand Sx, ID patient’s goal, learn about patient’s life at home
- Negotiate Common Ground: set mutual goals, address fears
- Intervention: educate and empower client, encourage ptnt to follow up with questions, establish POC and schedule
- Follow Up: ask about HEP, judge QOL and progress, re-eval effectiveness of program, select outcome measures
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
- Establish TA: stand with patient who is sitting on table, little eye contact, collecting data
- Diagnostic Process of Mutual Inquiry: focus on gathering data, assess joint irritability, and ID areas of primary Sx
- Negotiate Common Ground: start with appropriate joint mobs, discuss prognosis
- Intervention: proceed with joint techniques, give HEP, provide written instruction
- Follow Up: note complaints with difficulty, review HEP, repeat mobs
