Medicine in a Multi-cultural Society Flashcards
Define culture
Keesing (1981) “systems of shared ideas, systems of shared concepts and rules and meanings that underlie and are expressed in ways that humans live”
Define race
Differences in physical characteristics that are of no importance to health.
Not a biological given.
More genetic variation within races than between.
Define ethnicity
Social, psychological and cultural characteristics.
Patterns health in terms of disease prevalence, outcome, illness beliefs and treatment, presentation patterns, healthcare use and consultation communication.
Describe how ethnicity affects disease prevalence
Rates of diabetes over 5x higher in Pakinstani and Bangladeshi women than the general population
All male ethnic minority groups except Chinese men have higher rates of heart attacks.
Black Caribbean men are at higher risk of stroke
Describe how ethnicity affects disease outcomes
Lung cancer survial death rates higher in black men than white men
Women from ethnic minorities with breast cancer have power survival rates than white women even when care access is similar.
Racial disparities in use of joint replacement for knee osteoarthritis not explained by prevalence.
Describe how ethnicity affects attitudes to treatment
South Asian patients diagnosed with asthma had less confidence in their GP and were less confident at controlling asthma.
Ethnic minority groups did not benefit equally in terms of specialist nurse intervention.
Describe how ethnicity influences disease presentation
Schizophrenic delusions are more likely related to technology in the West and religious beliefs in Africa and India.
Describe the three types of non-verbal communication
Physical: body language (posture, position, tough), facial expression and gesture
Accent
Paraverbal: linguistic connection (info structure, yes and no, politeness)
: (tone of voice, stress, pauses, pace of speech)
Give an example of how non-verbal communication can vary between cultures
In some Asian cultures, eye contact can be considered disrespectful while it is considered respectful in Western cultures.
Give some key facts on culture and communication
6-8 different languages are spoken in each GP surgery
31% showed clear misunderstandings
73% occurred where patients had limited English
List barriers to trans-cultural communication
Lack of knowledge about NHS Fear and distrust Bias and ethnocentricism Stereotyping Language barriers Differences in perceptions and expectations Racism Gender differences Lack of knowledge or differences in opinion about common health conditions Examination taboos Presence of third party e.g. translator, relative Religious beliefs Difficulty using language line Patient not entitled to NHS care
List strategies to provide culturally competent care and improve trans-cultural communication
Communicating clearly
Facilitating communication
Taking an active interest in other cultures and groups
Research other cultures and groups to gain an understanding
Identify barriers to healthcare
Address barriers to healthcare
