Lecture 3 Flashcards
What is intercultural communication?
“Language and the context in which words are interpreted, including gestures, postures, spatial relationships, concepts of time, the status and hierarchy of persons, the role of the individual within a group, and the setting
What is the cultural iceberg?
- Comes into play how we act an treat others
- Most visible can be debated too
Representation of apparent personal characteristics of a person versus unseen characteristics that may influence a person’s communication
What are the visible characteristics of the ice burg?
Race
Age
Gender
What are the least visible characteristics of the iceberg?
Degree of acculturation or assimilations SES (rich people dress down and vie versa) Health (mental health not visible) Religion (sometimes clothes) Sexual orientation Political affiliation Education
what do people assume about the bottom of the iceberg?
Areas below the iceberg typically assumed
-Incorrect assumptions can lead to distrust of health care professional
Below play a more important role than those visibla too people
What is communication related too?
An action chain
One phrase or action > reciprocated action
“Thank you” > “You’re welcome”
What do reciprocated and unreciprocated actions lead to with communication?
Reciprocated actions = potential for successful relationship
Unreciprocated actions = potential for communication breakdown
Why do we use cultural norms?
When comply with cultural norms is positive outcomes
What do we do when we meet someone for the first time in terms of cultural norms?
Meeting a person for the first time
- Automatic assumption to comply with cultural norms
- Prediction of communication pathway
- Communication breakdown with unanticipated response
What re the concepts for intercultural communication?
Communication uses codes to represent objects, ideas, or behaviours
-These are decoded to language and non verbal communication
Thoughts, emotions, attitudes > decoded into language and non-verbal communication
What are the components of marriage?
Content
Relationship between speaker and receiver
What type of communication is best for delivering and conveying info?
Verbal communication is best for delivering content
Non-verbal communication convey relationship information
What makes or breaks a conversation with someone?
Communication can only be correctly interpreted within context
What is verbal communication explained by?
Low- and High-Context Cultures
Individuals and Groups
Uncertainty Avoidance
Power, Authority, and Status
Time Perception
What is the different between low and high-contact cultures?
Affective and physical cues a speaker uses to indicate meaning
Tone of voice
Facial Expression
Gestures
Posture
What are characteristics of low contacts cultures?
Ideas presented in a logical, linear sequence
Use of precise, objective wording
May overuse medical jargon
“To the point”
little reading between the lines
E.g., Swiss, Germans, Scandinavians, Americans, Canadians
What are characteristics of high context cultures?
Meaning of the message is found in the context, not in the words
“Read between the lines”
Wording may be vague or incomplete
Word choice focused on the individual person, rather than objectively
-Varies depending on relationship
Attitudes and feelings more prominent than thought
Use different languge wuth each person based on your relatipnship with them
E.g., Asians, Middle Easterners, Indigenous people
What is relationship of the individual to the group determined by?
low vs high-context cultures
What are low context culture groups like?
Individuality, self-realization, and self-esteem predominate
Gain acceptance from a group through communication of one’s self
Canada, Great Britain, US, Australia, Netherlands, etc.
What are high context culture groups like?
Individual is defined by group association
Desire for “oneness” within a group
Affiliation with a group tells outsiders all that is needed about that person
Denmark, Ghana, El Salvador, Indonesia, Nigeria, Taiwan, Thailand, etc.
how tolerant are high uncertainty avoidance cultures?
Exhibit great discomfort with the unknown and things that are different
Typically have a history of central rule and laws that regulate individual action
Argentina, Belgium, Chile, Colombia, Egypt, France, Greece, Israel, Japan, Korea, Mexico, Turkey, etc.
how tolerant are low uncertainty avoidance cultures?
Curious about the unknown and things that are different
Willing to accept dissent within a group, open to change
Canada, Denmark, Great Britain, Hong Kong, India, Jamaica, Netherlands, Philippines, Sweden, US, etc.
What is the perception of power and its influence on communication like in low context/individualistic cultures?
Power or status usually in the role/job a person fulfills
Power distance remains small due to equality focus
Questioning accepted > Focus on understanding why before a task can take place
What is the perception of power and its influence on communication like in high context/group cultures?
Superiors are different from subordinates
Large power distance
Belief that the higher-ranked person’s opinion dominates
Limited participation in selecting treatment or outcomes
How do low context cultures (monochronistic) view time ?
Respect for a person’s time
Sticking to a schedule
Punctuality
How do high context cultures (polychronistic) view time ?
Personal relationships are more important than time
Deadlines are only met if relationships are not impacted
Can be late if they are valuing another relationship
What can non verbal communication reveal?
Can reveal more about a person’s thoughts and feelings than verbal communication
Can be more importan becaue protrays truly how someone if feeling
What are examples of non verbal communication?
Touching Gestures Eye contact Spatial relationships Sighing
How do touching norms vary from culture?
Touching Unexpected:
Canada, US, Great Britain, Scandinavia, Japan, Korea, Germany, the Balkans, etc.
Touching Expected:
Middle East, Greece, Latin America, Spain, Italy, Mexico, Columbia, Russia, Portugal, etc.
Somewhere in the middle:
France, China, Ireland, India, countries in Africa, Southeast Asia, Pacific Islands
What are gestures?
Waving, standing when an important person enters, nodding in acknowledgement, middle finger, etc.
-Varies depending on the country
What are facial expressions?
Deliberate looks of attention or questioning and unintentional wincing or grimacing, smiling, frowning, etc.
What is posture?
Sign of respect, confidence, “power stand”
What does eye contact very with?
Vary according to SES, gender, distance from a person
- Usually a sign of honesty and openness to Canadians, but staring is considered rude
- Germans consider it a sign of attentiveness
- Indigenous people may find eye contact rude
- Asians and Latinos may look away as a sign of respect
- Middle Easterners see the motions of the eyes and pupils as an indicator of a person’s reaction
How can someone violate spatial relationships?
Each person has their own “bubble”, an area reserved for the individual
Depending on the circumference determined by a person, it can be offensive to step within this boundary
Considered insulting by some cultures to step back
What is the role of communication?
HCP study for a long time
However, all of this is meaningless if communication is unsuccessful
Communication allows for mutual understanding of health beliefs, personal preferences, culture, etc.
-Ignorance of this can leave a patient unwilling to pursue treatment
What are the 5 misunderstandings that occur between client and HCP?
Health professional can never fully know thoughts, attitudes, and emotions of client
A client’s verbal and nonverbal communication may be ambiguous
Meaning may be lost due to cultural context (e.g., mine vs yours)
Provider’s state of mind may induce bias
Provider’s interpretation of a client’s signals or behaviours may be inaccurate
What is a large result of the 5 misunderstandings?
Noncompliance
Rejection of treatment
Skipping appointments
Terminating health care relationship
What can poor client HCP relationships lead to?
Poor relatoionship can lead to extra//unecessary pain and death sometimes
What are the responsibilities of the health care provider in terms of communication?
Communication requires a two-way participation between the client and provider
Provider assumes superordinate position
- Obligation to understand what is said by client and provide necessary information for treatment
- Knowledge of cultural norms and observance of personal cues
- Demonstration of caring can lead to better outcomes
What are the 4 stages of intercultural communication a awareness?
Unconscious incompetence
Conscious incompetence
Conscious competence
Unconscious competence
What is successful intercultural communication?
Begins with the provider being aware of their own communication behaviours and consciously aware of their own biases
Limiting assumptions or bias and understanding the patient is truly the expert
What is the Mnemonic to remember components of cultural competency?
C – consider Culture in all patient-practitioner interactions
R – show Respect and avoid gratuitous familiarity and affection
A – Assess/Affirm intracultural differences
S – be Sensitive to issues that may be offensive
H – demonstrate Humility. Apologize quickly and accept responsibility for communication missteps
What doe successful face to face interaction need?
Require understanding of cultural communication expectations
Being aware of the distinctive style of the client
Understanding that each client may or may not abide by stereotypical behaviour of their culture
Every client will be different and communicae in their own different way
When meeting a client for the first time what do you ask them?
How they want to be addressed
What is appropriate language include?
Avoid ambiguous language; especially with those who are not proficient in English
Avoid words with multiple meanings (e.g., that’s cool)
Avoid vague verbs
Avoid slang/idioms
Avoid jargon
Avoid asking questions that can be answered with yes or no
What kind of interpreter is the best?
Limit non-professional interpreters (e.g., spouse, family member)
- Embarrassed to discuss issues in front of certain people
- Unfamiliarity with medical terms/translation
- Ethical issues
When interpreter present, speak to the person not the interpreter
What is involved with intercultural counselling?
Practitioner attitude = most important element of successful intercultural counseling
Open mindedness is impossible when objectives and outcomes are planned before appointment
Engaging in give-and-take exchange can reveal key issues of a client, medical and social history, etc.
What are the basic competencies needed for pre counselling preparation?
Information transfer
Relationship development and maintenance
Compliance gaining
What is important in terms of communication for the in depth interview?
Important to determine many iceberg issues that may effect communication, treatment, and outcomes
Some questions may be viewed as invasive and unnecessary
-Only ask questions that are of necessity
Open-ended questions can be effective to initiate conversation
What has intercultural nutrition assessment shows?
Research has shown standardized assessment tools can introduce systematic bias or provide misleading information when used with different cultural groups
Food recalls
- Use of food groups may be unfamiliar to other cultures
- Meals vs snacks
- Different meaning of foods (e.g., tea = hot drink? -Evening meal? Afternoon snack?)
- Mixed dishes can lead to omission of nutrient sources
- Portion sizes
With intercultural nutrition communication, how do you deliver that info to the client?
Biomedical paradigm emphasizes behaviour change through 1-1 counseling
Other cultural groups may prefer group setting with family or friends
What is the phase of process for How to establish and succeed with communication?
motivaitonL first phase, influenced by different things (above)
When they are motivated they can move to attending or non participation. Cultural influence can contradict messages being recived.
Can provide welcoming eenvironet then they move onto learning. Need to deliver message to actually help them and thern in a way the suits them.
Can leanr then they move to behaviour change.
Blue box: reps opporunitiy to bring them back up, if they don’t work thtas wheen the engative actions star to happen
How do you make a culturally relevant program?
Take time to understand your audience and their views of health
Collect demographics
Involve members of the target audience in program planning
How do you set goal and objectives for the culturally relevant program?
Define clear and realistic goals and objectives
Overly ambitious goals are main cause of failure
Focus on behaviour changes (e.g., portion control) rather than elimination of culturally important foods (e.g., rice is a staple food for many Asian and Hispanic countries)
-Noncompliance associated with fear of losing cultural identity
How do you develop the mesage for the culturally relevant program?
Relevancy to a group’s survival, safety, or social needs is key
Messages should be as direct and explicit as allowed in cultural norms
- Writing should be brief
- Use of pictures can be very useful
Personal messages are more effective than objective messages
- Emotional context is just as important as the content
- Storytelling can be very effective to resonate with the audience
How should the implementation strategies be implemented for the culturally relevant program?
Should include:
- Analysis of cultural influence channels and media preferences
- Development of an effective marketing mix
- Program evaluation
Even the most exciting, culturally appropriate messages fail if they never reach the target audience
What are the implementation strategies?
Influence channels
- TV, internet, social media, radio newsletters, etc.
- Understanding this can better reach your audience
Marketing Mix: 4 P’s
What are the 4 Ps?
Product
Price
Place
Promotion
How do you evaluate the culturally relevant program?
Keep track of progress throughout the program (successes, barriers, etc.)
Assess program results through surveys, interviews, etc.
Publication of results can help other organizations
