Delivering Appropriate Care to Diverse Communities Flashcards
What is the problem with understanding culture?
There are many definitions of culture
What does the concept of culture, cultural identity, or belonging to a cultural group involve?
Active engagement, not something just described
What is it probelmatic to assign cultural categories to?
Single characteristics
What is the relationship between identity and culture?
Identity is drawn from culture, not simply formed from it
How does the Association of Medical Colleges (AAMC) define culture?
As the relationship to group or groups with whom he or she identifies
What may an individuals identity be based on?
Heritage, as well as an individuals circumstances and personal choice
What factors may affect someones culture?
- Race
- Ethnicity
- Age
- Language
- Country of origin
- Acculturation
- Sexual orientation
- Gender
- Socioeconomic status
- Religious or spiritual beliefs
- Physical ability
- Occupation
- Others
What behaviours may a persons culture influence?
- Communication styles
- Diet preferances
- Health beliefs
- Family roles
- Lifestyle
- Rituals
- Decision-making processes
What can the behaviours impacted by a persons culture influence?
- How patients and health care professionals perceive health and illness
- How they interact with one another
Why is the AAMC definition of culture used?
- Patient/individual centred
- Clinically applicable
- Through interplay of external and internal meanings, construct a sense of identity and unique cultures
- Patients define which aspect of their cultural belonging is relevant at any particular point, and it can differ in different contexts
- Dynamic definition allowing for change
- Patients and professionals are acknowledged to have culture
When may someones culture and cultural identity change?
- In clinical context
- At different life stages
- On clinical presentation
What is the problem with the term diversity?
Imprecise and inconsistent use
What may diversity mean?
Diversity of ethnicity
What is the problem with the term diversity just referring to diversity of ethnicity?
Much broader range of differences relating to individual characteristics beyond ethnicity
Why is diversity important to healthcare?
- Increasing diversity of populations, both patients and workforce
- Increasing, albeit limited, evidence that taking a patient-centred approach improves outcomes
- Huge disparities in care accessed
- Disparities beyond the point of access
- Differential outcomes
- Legislative frameworks
Why are there huge disparities in care access, related to diversity?
Doctors make decisions on who to give care to, may be subconsciously affected by ideas they have
Give an example of where a doctors subconscious ideas may lead to disparities in care accessed
May not give black women aggressive treatment, because they don’t think they can take it, or don’t think that they’re worth the resources
What is the result of legislative frameworks, with regards to diversity and healthcare?
Equal care must be given irrespective of patient factors
When do problems arise, regarding diversity and healthcare?
- Lack of knowledge
- Self protection/denial
- Fear of the unknown/new
- Feeling of pressure due to time constraints
What does a lack of knowledge lead to in healthcare and diversity?
Inability to recognise differences
What is the problem with an inability to recognise differences in healthcare?
Treating patients the same is not always the same as equal care, as each patient has their own needs
What does self-protection/denial lead to when thinking about diversity and healthcare?
An attitude that these differences are not significant, or that our common humanity transcends our differences
What leads to a fear of the unknown/new when thinking about diversity and healthcare?
Because its challenging, and perhaps intimidating, to understand something new that doesn’t fit into world view
What is the problem with fear of the unknown/new in healthcare?
Decisions shouldn’t be based on perception
What can feelings of pressure due to time constraints lead to?
Feeling rushed and unable to look in depth at an individual patients needs
What may problems relating to diversity and healthcare lead to?
- Patient-provider relationship affected when understanidng of each others expectations are missing
- Miscommuncation
- Non-compliance and not understanding patients perspective
- Rejection of healthcare provider
- Conflict or isolation within staff groups
Why may problems with understanding diversity in healthcare lead to non-compliance?
If they don’t believe what you’re saying, they won’t follow the treatment
When may conflict or isoaltion within staff groups due to diversity be exacerbated?
If staff don’t fit into global perspective
How is service presentation influenced by culture?
- The way they think about mental health and mental health problems
- The way they make sense of certain symptoms and behaviours
- Their view of potential services, and the services they choose to accept
- The treatment and management strategies they find acceptable
- They way in which those who have mental health problems are percieved
- Issues of access
Give an example of how culture may affect how a patient accesses services
In mental health issues, some people go to religious leaders in the first instance, which doesn’t help in severe cases
What issues of access may people of some cultures experience?
- Experience of service
- Visibility of services
What problems related to culture may young people experience?
- Pressures to conform to practice their families religion, or other practices that do not sit comfortably with them
- Pressure to conform to expected gender roles
- Pressure to conform to social norms
- Pressure to conform to family expectations that differ from what the young person wants
- Sexual orientation
- Impending forced marriages
- Difficulty in reconciling the culture in private and public domains
Why may young people have problems with pressures to conform to practice their families religion?
As developing, a person develops an own view of self, and gain a wider world view, and therefore other factors start influencing what you believe
What does the pressure to conform to the social norms depend on?
The social norms of their culture/subculture
What actions relating to culture should all clinicians take?
- Providing a sensitive and respectful service, acknowledging cultural need and belief
- Respecting cultural individuality whilst maintaining patient-centered curiosity
- Plan care without making assumptions or falling back on stereotypes
What is meant by maintaing patient-centered curiosity?
Can’t not explore things based on what cultural view is
Give an example of where a clinician can’t not explore something based on what the cultural view is
Can’t accept something that is wrong because its in their culture, e.g. hitting kids
