Health Beliefs and Cross Cultural Communication Flashcards
Values
Values are strong beliefs and attitudes about the worth of a thought, idea, object, or course of action
Personal vs. Professional Values
Attitudes
Attitudes are favorable or unfavorable emotions or sentiments toward individuals or groups that strongly predict behaviors.
Consider implicit bias and the impact of attitudes on health care outcomes and disparities
Moral Sensitivity
Successful providers understand the importance of the client-provider relationship, identify their own personal beliefs and values, examine differences between their beliefs and values and those of their clients, and promote awareness of ethical issues found in practice.
Race-
genetics inherited traits identifiable by physical attributes
Ethnicity-
people of similar backgrounds who choose to live or socialize together, geographic origin
Ethnocentrism-
evaluating a culture from your customs of your culture
Culture-
pattern of beliefs, values, and behaviors. Includes language, communication, customs and views on roles and relationships, values, attitudes
Collectivist cultures- Asian, Hispanic
Past or present orientation in time
Respect for elders
Fate, just being
Cooperation, human interactions dominate, harmony
Group welfare
Low eye contact
Individualistic Cultures- US, Germany, Australia, UK, Canada
Future oriented
Precise time is important, plans are made
Personal control over the environment and outcomes
Doing, working, taking charge, control
Competition
Autonomy, self achievement
Independence
High eye contact
APTA BluePrint for Cultural Competence
Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in crosscultural situations
What is Cultural Sensitivity?
Value diversity
Have the capacity for cultural self-assessment
Be conscious of the dynamics inherent when the cultures interact
Institutionalize cultural knowledge
Develop adaptations to service delivery reflecting an understanding of diversity between and within cultures
How to Develop Culturally Sustaining Practices?
Cultural Destructiveness
Cultural Incapacity
Cultural Blindness
Cultural Competence:
a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. (CDC definition)
Cultural Humility:
is a lifelong process, caregivers engage with their patients, colleagues and themselves. It is a dynamic, requiring mutual respect and willingness to learn from patients about their cultural experiences
Cultural Respect in HealthCare
Cultural Pre-Competence
Advanced Cultural Competence
Cultural Humility
The one activity even the busiest clinician should be able to find time to do:
routinely ask patients (and where appropriate, family members), what matters most to them in the experience of illness and treatment
Universal Aspects of Health Care in All Cultures
Health care specialist applies a name to the problem
The qualities of the health care professional ( vs provider) are important. ( Credibility to help)
The health care professional must establish credibility through symbols and trappings that are familiar in the culture
The healthcare professional places the client’s problems in a familiar framework
The health care professional applies techniques meant to bring relief
Interactions between client and practitioner occur at a time and place
One major problem with the idea of cultural competency:
it suggests culture can be reduced to a technical skill for which clinicians can be trained to develop expertise”
a.k.a. “Do and Don’ts”
cultural competence framework
nonlinear, intersections concepts
defined constructs
addresses social justice
structure considers multiple perspectives
> individual
> family
> global factors
cultural humility framework
addresses power imbalances between patient and provider
learn from the patient
active listening
recognition of personal biases
Purnell framework:
a) consideration of the whole person
b) individual, family, community and global factors
c) caregivers should provide culturally sensitive, competent, and congruent care
d) self awareness
e) patient-centered care
Campinha-Bacote framework:
a) cultural competence is an ongoing process
b) variations exist within cultural groups
c) caregiver provide patient-centered care
d) 5 constructs: cultural awareness, knowledge, skill, encounters, and culture desire
e) include sexual orientation, age, disability, gender, religion, language, political orientation, socioeconomic status and social justice
Tervalon and Murray-Garcia framework:
a) addresses power imbalances between patient and provider
b) patient takes a decision-making role
c) provider reflects on behaviors and biases or stereotypical assumptions
Fisher–Borne framework:
a) 3 core elements: institutional and individual accountability, lifelong learning and critical reflection, and mitigation of power imbalances
Questioning, Immersion, Active Listening, Negotiation framework:
a) questioning that involves remaining curious about cultures
b) immersion in culture
c) active-listening
d) negotiation to a create a mutually agreeable patient care plan
The Explanatory Model
To open clinicians to human communication and set their expert
knowledge alongside (not over and above) the patient’s own explanation
and viewpoint.”
Levanthal’s “Common-sense model”
Components include:
‘What is this health threat, what can I objectively do about it?”
‘How do I feel about it, what can I do to make myself feel better about it?’
Health beliefs /common sense illness model
LABEL / DIAGNOSIS = What do I have?
CAUSE = How did I get this illness /condition?
CONSEQUENCES = How will it affect me?
TREATMENT = How can I get better? What can be done?
TIMELINE (Prognosis) = How long will this illness /conditions last?
The L.E.A.R.N. Model of Cross–Cultural Communication
L = Listen with sympathy and understanding to the patient’s perception of the problem
E = Explain your perceptions of the problem
A = Acknowledge and discuss the differences and similarities
R = Recommend treatment
N = Negotiate agreement
The R.E.S.P.E.C.T Model of Cross–Cultural Communication
Rapport
Seek the patient’s point of view
Consciously attempt to suspend judgment
Recognize and avoid making assumptions
Empathy
Seek out and understand the patient’s rationale for his or her behaviors or illness
Verbally acknowledge and legitimize the patient’s feelings
Support
Ask about and try to understand 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
How to develop culturally sustaining practice?What can you do?
Examine self through reflective practice
Learn about the diversity dimensions that influence health outcomes, and affect the human experience both positively and negatively
Recognize the need for a patient-centered approach for delivery of culturally competent physical therapy services
Value effective communication between the patient and the therapist as a fundamental for delivery of culturally competent care
Incorporate the National Standards for Culturally and Linguistically Appropriate Services(CLAS) in Healthcare CLAS
Address the determinants of health that influence health outcomes
Apply core knowledge about culture, belief systems, and traditions to enhance the patient-therapist interaction
Questions we can ask our patients
To provide the best care for you, what would you like me to know about your culture or preferences?
Who makes health care decisions for your family?
Are there particular beliefs or practices I should be aware of?
What do you do to prevent illness or stay well? (herbs, diets, rituals)
How is our medical care different from what you or your family traditionally use?
Do you or your family seek medical care from religious healers or others in your community?
