Chapter 2: Cultural Competence Flashcards
Cultural Competence
Achieving cultural competence is a learning process that requires:
Self-awareness
Reflective practice
Knowledge of core cultural issues
Cultural competence:
Involves recognizing one’s own culture, values and biases, and using patient-centered communication skills
Requires adaptation to the unique needs of patients of backgrounds and cultures that differ from one’s own
Culturally competent care requires healthcare providers be sensitive to patients’ heritage, sexual orientation, socioeconomic situation, ethnicity, and cultural background.
A Definition of Culture
Culture in the broadest sense reflects the whole of human behavior, including:
Ideas and attitudes
Ways of relating to each other
Manners of speaking
Material products of physical effort, ingenuity, and imagination
“Culture” includes:
Language
Beliefs
Etiquette
Law
Morals
Entertainment
Education
Sets of dynamically evolving shared traits
An individual may belong to more than one cultural group or subgroup.
It is inappropriate to use physical characteristics to distinguish a cultural group.
Cultural Humility
Recognition of one’s limitations in knowledge and cultural perspectives; being open to new perspectives
Involves:
Viewing patients as individuals
Self-reflection and self-critique
Meeting patients “where they are”
Impact of Culture
Influences the way patients seek medical care and the way clinicians provide care include:
Age
Gender
Race
Ethnic group
Cultural attitudes
Regional differences
Socioeconomic status
Blurring of Cultural Distinctions
Cultural differences are malleable in a way that physical characteristics may not be.
Modern technology and economics may eventually lead to universality in language, but we can begin by acknowledging and overcoming our individual biases and cultural stereotypes.
Use of medical interpreters has a positive impact on health care.
Primacy of the Individual in Health Care
Predicting an individual patient’s character merely on the basis of common cultural traits or stereotypes is not appropriate.
Cultural attitudes may constrain professional behavior and confuse the context in which the patient is served.
Each individual is unique.
Impact of Culture on Illness
Disease is shaped by illness, and illness is shaped by the totality of the patient’s experience.
Cancers are diseases―the patient dealing with, reacting to, and trying to live with a disease is having an illness.
Healthcare providers must consider the substance of illness―the biologic, emotional, and cultural aspects―or else fail to offer complete care.
Modes of Communication
The use of speech, eye contact, touch, and silence
Cultural variation in communication suggests a variety of behaviors within groups.
The cultural and physical characteristics of both patient and practitioner may significantly influence communication.
Health Beliefs and Practices
Patient view of health, illness, and approach to cure are shaped by culture and faith belief.
Imbalance can result in illness.
Faith-based or naturalistic beliefs can conflict with treatment options.
Herbs, rituals, religious artifacts
Family Relationships
Family structure and the social organizations to which a patient belongs are among many imprinting and constraining cultural forces in a person’s life.
One type of already known behavior may predict another type of behavior.
A patient may belong to many groups, and the attitudes and behaviors of one group can modify and impact the cultural values of the other groups to which the person belongs.
Diet and Nutritional Practices
Beliefs and practices related to food, as well as the social significance of food, play a vital role in everyday life.
Some of these beliefs of cultural and/or faith-based significance may have an impact on the care you provide:
Orthodox Jew
Muslim
Chinese
Herbal, home, and natural therapies
Complementary and alternative therapies
respect model
rapport: connect on social level, see the pt POV, consciously suspend judgement, recognize and avoid making assumptions.
empathy: remember the pt has come to you for help, seek out and understand the pt rationale for his/her behaviors and illnesses, verbally acknowledge and legitimize the pt feelings.
support: ask about and understand the barriers to care and compliance, help the patient overcome barriers; involve family members if appropriate, reassure the patient you are and will be available to help.
partnership: be flexible, negotiate roles when needed, stress that you are working together to address health problems.
explanations: check often for understanding and use verbal clarification techniques.
cultural competence: respect the pt cultural beliefs, understand that the patients view of you may be defined by ethic and cultural stereotypes, be aware of own cultural bias and preconceptions, know your limitations in addressing health issues across cultures, understand your personal style ad recognize when it may not be working with a given patient.
trust: recognize that self-disclosure may be difficult for some patients; consciously work to establish trust.
Cultural humility involves:
Improving language barriers
Providing holistic care
Meeting patients where they are
Teaching patients about alternative medicine
ANS: C
Rationale: Cultural humility involves recognizing and meeting patients where they are.
Culture includes which factor?
Travel
Entertainment
Job position
Family tree
ANS: B
Rationale: Culture encompasses many factors, including entertainment. How people spend their free time and engage in entertainment varies by culture.
