Healthcare D1
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CulturalConcernsandViewpointsinHealthcare2.pptxCH4
Cultural Concerns and Viewpoints in Healthcare
The Technology Factor
Consider different cultural beliefs in terms of the use of yearly testing for various pathologies, and how this may conflict with beliefs that these diseases are there for a reason. Perhaps a better approach, when targeting high risk populations, is finding out the belief systems of the patient and then educating and providing prevention awareness so that the disease/pathology is addressed in a timely manner and in a respectful way.
Cultural Competency Continuum
This continuum is divided into six levels from cultural destructiveness to cultural proficiency. The levels are ranked from the lowest to the best case scenario.
encompasses those beliefs in the healthcare system that are destructive to a cultural group. For example forcing a patient to look you in the eye when speaking may be against their cultural beliefs and thus you are causing that patient to have a very upsetting and destructive healthcare experience. These are societal practices that are detrimental to a particular culture. In healthcare an example may be a patient’s culture prohibits spinal taps. This example is discussed in the book The Spirit Catches You and You Fall Down. Cultures have boundaries and if those boundaries are not respected by healthcare professionals then the impact can be destructive.
1) Cultural Destructiveness
2) Cultural Incapacity
This happens in healthcare when certain cultural, ethnic, or racial groups are being excluded from optimal healthcare. This may mean these groups are not offered all the services they need or that the group is set apart from the other patients because they associate themselves with a particular cultural group.
3) Cultural Blindness
The thought that all people are the same, therefore cultural differences are not acknowledged. For example; a healthcare facility may offer limited services that don’t meet the needs of the people in that community, the healthcare staff may not be very diverse, or healthcare professionals may blame the patients for not accessing healthcare when clearly the facility is not welcoming diversity.
4) Cultural Precompetence
This beginning stage of awareness in healthcare cultural competency demonstrates that efforts are being made to be culturally competent. A healthcare facility may employ a somewhat diverse group of healthcare professionals, for example. This stage needs to be encouraged to grow more toward competency by providing continuing education opportunities, mentoring from other health professionals, and exposure to culturally relevant topics within the healthcare community.
5) Cultural Competency
At this stage healthcare professionals are ensuring that cultural competency is a thread throughout a facility's practices. There are policies and procedures in place to ensure this competency and continued training to make sure it continues. There are assessments that look both cultural knowledge and cultural awareness. These assessments ensure that every patient is valued and respected, both as an individual, and a member of a cultural group.
6) Cultural Proficiency
This level assures competency within the healthcare staff by employing individuals with expertise in the area of cultural competency. Consistently providing assessments and training helps maintain this high level of cultural competency.
Cross, T., Bazron,B., Dennis, K., & Issacs, M. (1989). Towards a culturally competent system of care. (Vol.1) Washington, DC.
Stereotyping
There are stereotypes that society has generated regarding different cultures that can affect healthcare service delivery. Some examples of there were listed in your text and others can be indigenous to certain areas. As you read through these examples, think of some that are specific to your area of practice. Some of these examples are culturally relevant; but to assume that they are all encompassing is the beginnings of stereotyping, which is viewed very negatively.
Examples of stereotyping
Area specific
In Appalachia individuals often don’t show up, or are late, for their appointments. This could be true in that these individuals may have to travel long distances to access the healthcare they need, have unreliable transportation, or simply cannot afford a healthy lifestyle which may be more of the reason for these missed appointments versus simply being noncompliant.
Culturally acceptable
Some cultures, African American and Cuban were the examples cited in your text, may be late for appointments. This may be because culturally in those countries the atmosphere is more relaxed and being late is not viewed negatively. Because healthcare is so busy; when a person is late for an appointment they may not be able to get in because the provider’s schedule is full. A lot of healthcare facilities have a no show policy or late policy that clearly states what will happen if someone is late excessively, which helps put the expectation out there.
No assumptions should be made that everyone in these cultures will be late because this thought process is what can lead to stereotyping.
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Second level
Third level
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Fifth level
Personal Space
Another example of cultural differences deal with spacial orientation in regards to healthcare. One individual may not want others in their personal space or they may feel if the healthcare provider doesn’t get close they don’t care enough. This spatial factor can also be linked to sensory preferences by certain people.
Gender expectations
Anther factor to consider in terms of stereotypes is gender expectations. Some cultures may prefer only male healthcare professionals because of the views of males in that society. This also comes into consideration with who the patient consults with in their family about making healthcare decisions.
Two different models used for cultural competency
Purnell Model
The Purnell Model utilizes 19 assumptions based on various supplied information from multiple theories and research. The model emphasizes the importance of one’s culture in healthcare.
Purnell, L. (2002) the Prunell Model for Cultural Competence. Journal of Transcultural Nursing 13 (3), 193-196.
LEARN Model
This model facilitates improved communication between healthcare professionals and their patients. Listen, explain, acknowledge, recommend, and negotiate are the words behind the LEARN acronym.
The Assumption Exercise
Determining if a healthcare professional is culturally competent is challenging. The assumption exercise contains pictures of individuals from different cultures and assesses a healthcare professional’s responses to provide a better sense of their cultural competency. These pictures can elicit certain stereotypes people have formed throughout their lives and careers. This can increase awareness of possible cultural stereotypes and reinforce that one should not judge on first impressions. Appreciation of all cultures is the ultimate goals of this exercise.
