Cultural competence Flashcards
What is the range statement from the pharmacy council? (9 types)
culture includes, but is not restricted to:
1) religion,
2) age,
3) impairments,
4) ethnicity,
5) gender,
6) socioeconomic status
7) sexual orientation,
8) race,
9) organisational culture.
Under domain M1: professionalism in pharmacy, what are pharmacists expected to demonstrate? (6 points)
- compassion, integrity & respect for others
- responsiveness to Px needs that supersedes self-interest
- Respect for Px privacy and autonomy
- Accountability to Px, society and profession
- Commitment to excellence
- Sensitivity and responsiveness to a diverse population incl (but not limited to) diversity in gender, age, culture, race, religion, disabilities and sexual orientation.
What is competence standard M1.4?
practice pharmacy within NZ’s culturally diverse environment
What is cultural competence? (2 points)
- goes beyond an awareness/sensitivity to another culture: includes ability to use that knowledge in cross-cultural situations
- Includes the development & implementation of processes, procedures and practices that support the delivery of culturally appropriate services
What are the expected behaviours of a pharmacist under M1.4? (6 points)
- undertake regular self-reflection to ID own cultural values
- Understand nd explain impact that own ID, cultural values has on one’s practice as a Phx
- IDs and values cultural diversity of own area of practice
- Respects others individually and collectively
- Understands & explains impact of culture on health status and maintenance
- IDs and works towards reducing factors that contribute to inequities in health outcomes.
Why are the expected behaviours in cultural competence important? (6 points)
- culture changes so needs reg. evaluation
- culture influences your practice as a Phx (decisions, recommendations etc.)
- increasing cultural awareness provides effective services.
- treating other cultures with respect increases trust and effective therapeutic relationships
- allows us to consider implications culture has on an individual’s health and tailor services
- obtaining stats about health inequities helps us to reflect and identify areas to address.
Why is it bad to assume? (2 points)
- we can see appearance and behaviours
- but can’t see values, beliefs or experiences shaping the behaviours so shouldn’t assume what is hidden beneath the surface
What does it mean to be culturally competent? (4 points)
- see beyond boundaries of own cultural interpretations
- maintain objectivity when facing persons from cultures different to ours
- interpret and understand behaviours and intentions of people from other cultures non-judgementally
- interact effectively and respectfully with people of different cultures
Can cultural competence be completed?
no. it is an evolving and developmental process
What are the categories along the spectrum of cultural competence? (8 points)
- culturally insensitive
- denial
- defensive
- minimisation
- acceptance
- adaptation
- integration
- culturally sensitive
what does defensive mean? (3 points)
- your culture is the only good culture
- cultural differences exist but are threatening,
- you stereotype to defend yourself
What does minimisation mean? (2 points)
- you experience elements of your culture as universal
2. you minimise differences between cultures and believe that human similarities outwiegh any differenes
What does adaptation mean? (2 points)
- you experience other cultures by yielding to perceptions and behaviours acceptable to that culture
- you change your behaviour to communicate more effectively with different cultures
What does integration mean? (2 points)
- you value a variety of cultures & continuously define your own identity in contrast and in conjunction with a number of cultures.
- you move easily in and out of varying worldviews.
How can Phx help with Px in poverty? (3 points)
- assisting with adherence to prescribed therapies by reducing the non-collection of prescriptions due to cost
- providing advice and assistance with minor health conditions
- acting as primary point of access to the health care system
What are the benefits of practicing pharmacy in a culturally competent manner? (5 points)
- enhances Phx-Px relationship
- encourages collaborative management of Px illness
- potential to improve Px outcomes
- Potential to save health care $
- potential to reduce disparities in health
What are the attributes of a culturally competent Phx? (3 points)
- understand health-related values, perspectives and behavioural patterns of diverse populations
- has the ability to avoid cook book approach to all persons associated with a population or diverse group
- has the ability to use, send and interpret a variety of communication skills to facilitate patient interaction
What are the three main components of cultural competence? (3 points)
- awareness of own culture and attitudes towards cultural differences
- being knowledgeable and sensitive of diff cultural practices
- ability to use cross-cultural skills to provide care to diverse populations
What is phatic conversation?
speech to promote human warmth
How can Phx demonstrate respect? (4 points)
- think before speaking and avoid what may be perceived as disrespect
- if unsure of correct way to pronounce names and other words, ask
- think about issues around empowerment and autonomy
- ahere to privacy.
What are some general communication strategies? (8 points)
- listen to what is being said
- use reflective techniques and to check understanding
- be aware of diff ways of communicating and barriers
- recognise cultural differences in spoken and non-spoken communication and concepts
- be flexible in communication
- avoid culturally insensitive language and behaviours
- be open minded
- avoid stereotyping
What is health literacy?
-degree to which individuals have the capacity to obtain, process and understand basic health info and services needed to make appropriate decisions
What is health literacy determined by? (2 points)
- literacy skills, and knowledge of health consumer
2. complexity of literacy demands that the consumer faces
What are examples of literacy skills/knowledge of health consumer? (5 points)
- reading, writing, speaking etc.
- familiarity with health topic and health system
- stress they are experiencing
- time and resources available
- confidence, attitudes, values, beliefs
What are examples of the literacy demands of a consumer? (5 points)
- design of health system
- health organisations’ processes and funding systems
- complexity of health issue/topic
- communication skills of health workforce
- complexity of resources given to consumer and media messages.
What are the consequences of poor health literacy? (4 points)
- non-adherence to medication Tx plans
- increased ED costs
- reduced ability to self-manage conditions
- reduced engagement with care plan/health care system
Why do Phx have a responsibility to poor health literacy px?
-legal requirement and professional obligation for Phx to communicate verbal & written info fit for the receiver
How can Phx help Px with poor health literacy? (2 points)
- have an awareness of difficulties faced by ppl with low health literacy and help them navigate the NZ health care system
- Use universal precautions approach to communication - structrue Px interactions to minimise risk of misunderstanding
How should educational materials be used when communicating to the Px? (4 points)
- do not assume Px read materials given to them
- use them together with written instruction
- use to facilitate a discussion, not replace it
- personalise them by highlighting important info, discuss how it relates to px care
What are the 3 steps to better health literacy?
- find out what ppl want to know
- build literacy skills & knowledge
- check you were clear (repeat)
What are the requirements for health education resources? (4 points)
- be easily understood by main intended audience
- encourage improved health outcomes for MIA
- provide right info @ right time, in right place using right format for MIA
- build health literacy of the MIA
What is the universal precautions approach? (8 points)
- Plain language
- Limit info (3-5 key points
- be specific and concrete, not general
- demonstrate, draw pics, use models
- repeat/summarise
- encourage questions (AskMe3)
- Use teach back to confirm understanding
- be positive and empowering
What is the teach back technique? (2 points)
- way of confirming your explanation was effective as Px understanding is confirmed when they teach it back to you
- can be used with verbal and written material
How can Phx overcome language barriers? (2 points)
- language line offers interpreting services mon-fri and are used by health related agencies (DHBs)
- Primary health care interpreting service free by ADHB for GPs and their clients for Px eligible for publicly funded health care in NZ.
What are the communication frameworks? (3 points)
- Kleinman’s questions
- ETHNIC model
- LEARN model
What are the Kleinman Qs? (8 points)
- why do you think it happened when it did?
- what do you think caused the problem?
- what do you think your sickness does to you, how does it work?
- How severe is your sickness? will it have a short course?
- What kind of Tx do you think you should receive?
- What are the most important results you hope to receive from this Tx?
- What are the chief problems your sickness has caused you?
- What do you fear most about your sickness?
What is the ETHNIC model? (6 points)
- explanation
- treatment
- healers
- negotiate
- intervention
- collaboration
What is the LEARN model? (5 points)
- listen to Px perspective
- explain and share own perspective
- acknowledge differences and similarites
- recommend tx plan
- negotiate an agreed plan
What are some resources to build up cultural knowledge? (3 points)
- cultural factors in medicine taking
- essentials of cultural competence in pharmacy practice
- ethnomed.org/culture
What are some good sources on CAMs and herbals? (5 points)
- martindale monographs
- BNF interactions
- MIMS s21 and s22
- medsafe data sheets
- NZF interactions
What are the expected behaviours for competency standard 1.5: understanding Hauora Maori? (4 points)
- understands and describes relevance of te tiriti o waitangi
- understands maori perspectives of health
- recognises differing health status of maori and non-maori and incorporates strategies in own practice to address these
- pronounces te reo maori correctly, understands common/relevant words
