Cultural Sensitivity Flashcards
Lecture objectives
1) define cultural sensitivity in health care 2) identify impact of culturally insensitive care and provider barriers to cultural sensitivity 3) application of cultural sensitivity to optometric care
4) recognize high risk groups for and impact of low health literacy 5) identify ways to address patients with low health literacy
What is culture?
the accepted behaviors, beliefs, values, and symbols that are passed along by communication and imitation from one generation to the next
Major culture groups
race/ethnicity, religion, country of origin, and primary language
Subcultures
age, gender, political party, sexual orientation, disability, education level, socioeconomic status, occupation
T/F culture is only passed on explicitly
false, implicitly or explicitly
What is counterculture?
somewhat deviant against society; this type of subculture defies at least one aspect of the dominant culture
What is cultural sensitivity in healthcare?
the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patient’s social, cultural, and linguistic needs
T/F cultural sensitivity = cultural relativism
false, they are not equal
What does culturally insensitive care contribute to?
poor treatment adherence, inadequate diagnostic testing, racially inconsistent application of procedures, radically disparate mortality from treatable disease, incomplete screening of newly arrived immigrants
Systemic barriers to culturally sensitive care
language, time, lack of diversity in health care (~80% white), practitioner prejudices
Common practitioner prejudices
patients who do not practice healthy behaviors “don’t care about their health”, personal health is the most important priority for each family member, biomedicine is right, science is the only appropriate basis for practice, traditional beliefs should be changed rather than built upon
Common practitioner prejudices cont
everyone understands the concept of chronic illness, people should and will follow directions given by health practitioners, adherence failure is the patient’s problem, patients have autonomy– except with regard to adherence, health care is available and accessible to all
How to provide culturally sensitive care
be patient, watch body language, be careful of assumptions, focus on the message, provide materials in patient’s primary language, use medical interpreters when appropriate
T/F we are contractually obligated to provide free interpreter services for some patients enrolled in federal programs
true, medicare/medicaid/some vision plans
What are TEC interpretation options
bilingual SCO staff/students, telephone interpretation, lay interpreters, iPad translation
T/F ASL interpreters are federally mandated for all licensed professionals
true
How can you manage your prejudices?
identify personal biases (explicit and implicit) ex: educate yourself via Project Implicit and develop compensatory behaviors (practice patience, seek ongoing education about cultural sensitivity and your community, train your staff)
What does project implicit do?
assess conscious and unconscious preferences for over 90 topics; ex: political issues, ethnic groups, sports teams, pets
What is health literacy?
the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions and services needed to prevent or treat illness
How many people does low health literacy affect?
80 million Americans (~36% of adults)
What are activities affected by limited health literacy?
locating providers and services, filling out complex health forms, sharing medical history with providers, seeking preventative health care, knowing the connection between risky behaviors and health, managing chronic health conditions, understanding directions on medicine
Health outcomes of low health literacy
more hospitalizations, greater use of emergency care, lower receipt of mammographies and flu vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and health messages, among elderly persons, poorer overall health status and higher mortality rates
What are health literacy risk groups?
older adults, minority populations, low SES, medically underserved people (geographic areas and populations with a lack of access to primary care services)
What are health literacy risk factors?
hearing impairment, visual impairment, medication, stress, fatigue, inadequate sleep, lack of nutrition
How can you identify patients with limited health literacy?
avoid reading in office, complete forms inappropriately, unable to name medications, non-compliance with medications, ask fewer questions, unable to give coherent/sequential history, frequently missed appointments
What is the vital sign test?
3 minute test with 6 questions pertaining to a nutrition label; 1 point for each correct answer, score of 4-6 is adequate health literacy
How to address low health literacy with verbal communication
talk slower, use lay language, limit the information provided to 2-3 key points and repeat key points more than once, ask patients to repeat instructions back to you (teach-back), encourage questions, supplement instructions with video/model/pictures
How to address low health literacy with written materials
explain the purpose and limit the content, involve the reader, make it easy to read, make it look easy to read, select visuals that clarify and motivate, offer assistance in completing forms, provide materials in patients’ primary language
