Health disparities ch 18

Question 1

cultural competence

Answer 1

• set of values, principles, behaviors, attitudes, and plocies enabling effective cross culture work. Originated in 1960s-70s in response to civil rights movements and racial/ethnic inequalities

evolution
- initially focused on “ethnic competence” in social work
- modern approaches include a broader range of intersecting identities
- emphasizes the role of healthcare systems administration, social determinants of health, and structural prejudice

healthcare perspective
- understanding how social and cultural factors influence patients health beliefs and behaviors
- devising interventions that consider these factors to ensure quality healthcare delivery

Question 2

cultural humility

Answer 2

• the ability to adopt an open, other oriented stance towards aspects of cultural identity

key characteristics
- lifelong process : focuses on continuous self reflection and self evaluation

• less emphasis on knowledge - more on maintaining openness and sensitivity
• addressing power imbalances - recognizes and mitigates power dynamics in interactions
• learning from differences - encourages supportive interaction and being open to learning from others

Question 3

Importance of cultural competence

Answer 3

institute of medicine (IOM) report - highlighted that healthcare inequities are often due to bias and stereotyping by providers, not just lack of insurance or access

training - cultural competence training is essential for addressing healthcare disparities

Question 4

model for cultural competence - Micro level model

Answer 4

• focus on strategies for effective communication in cross cultural healthcare interactions

ex -
BELIEF MODEL - focuses on understanding the patients beliefs about their problem

LEARN Model - involves listening to, explaining, acknowledging, recommending, and negotiating with patients

Question 5

model for cultural competence - macro level models

Answer 5

• provide a holistic understanding of cultural dynamics across various levels (individual, family, society)

ex
purnell’s model:
- conceptualizes cultural competence as a progression from unconscious incompetence to unconscious competence
- consists of 12 domains, such as communication, family roles, nutrition, and spirituality
- encourages an ongoing, reflective process to understand cultural differences and avoid judgemental attitudes

Question 6

model for cultural competence - meso level

Answer 6

• bridge micro and macro levels, focusing on both individual and systemic perspectives

ex:
developmental model of intercultural sensitivity (DIMS) :
- describes a progression from ethnocentrism (viewing one’s own culture as central) to ethnorelativism (accepting cultural diversity)

stages :
- ethnocentric - denial, defense and minimization
- ethnorelative - acceptance,
adaptation and integration

Question 7

Process of cultural competence in healthcare services

Answer 7

5 key constructs

1. cultural awareness - self exploration of biases and assumptions
2. cultural knowledge - understanding diverse cultural beliefs and practices
3. cultural skill - ability to gather cultural data and perform culturally sensitive assessments
4. cultural encounters - engaging in interactions with diverse patients to improve understanding
5. cultural desire - genuine motivation to learn from others and engage in cultural competence

Question 8

key terms

Answer 8

culture - an integrated pattern of learned beliefs and behaviors shared among groups, including communication styles values and customs

bias - tendency to make decisions based on cognitive shortcuts rather than evidence, which can interfere with impartial decision making

stereotype - generalized image or attitude about a group, often leading to preconceived notion about individuals based on group membership