Cultural Competence in Healthcare

Cultural Competence in Healthcare is not so much about learning facts about particular cultures you might encounter. It has more to do with hospitality: cultivating an openness that communicates that you want to hear about others’ beliefs and practices. If your manner invites people to trust you, they can teach you what you need to know to be sensitive to their family’s particular needs.

Attitudes of Culturally CompetenceUnderstanding:
Acknowledging that there can be differences between our Western and other cultures' healthcare values and practices.

Empathy: Being sensitive to the feeling of being different.

Patience: Understanding the potential differences between our Western and other cultures' concept of time and immediacy.

Respect: The importance of culture as a determinant of health.The existence of other world views regarding health/illness.The adaptability and survival skills of our patients.The influence of religious beliefs on health.The role of bilingual/bicultural staff.

Ability: To laugh with oneself and others.Trust: Investment in building a relationship with patients which conveys a commitment to safeguard their well-being.

Guidelines for Communicating Across Cultural Differences

The United States is a “tossed salad” of groups from all over the world. Therefore, do not assume that an exotic-looking person is not an American. The forms of address differ among cultures; don’t assume that it is appropriate to address someone by his/her first name. In addition, the wife’s last name is not always the same as the husband’s.

Ask first.Don’t always expect direct answers to direct questions; many cultures address questions and issues in a more indirect way.Caregivers must explore the health-related beliefs and practices of each patient individually. The degree to which the information in this section may be true for each patient will be heavily influenced by social and economic factors, educational background of the patient and the patient's family, urban vs. rural origin, level of acculturation to the life and ways of the United States, length of time in the United States, and many other cultural, social, and individual factors.

The following questions may be useful in assessing culturally diverse patients and families:So that I might be aware of and respect your cultural beliefs...

Can you tell me what languages are spoken in your home and the languages that you understand and speak?

Please describe your usual diet. Also, are there times during the year when you change your diet in celebration of religious and other ethnic holidays?

Can you tell me about beliefs and practices including special events such as birth, marriage and death that you feel I should know?

Can you tell me about your experiences with health care providers in your native country?

How often each year did you see a health care provider before you arrived in the U.S.?

Have you noticed any differences between the type of care you received in your native country and the type you receive here?

If yes, could you tell me about those differences?Is there anything else you would like me to know?

Do you have any questions for me? (Encourage two-way communication)

Do you use any traditional health remedies to improve your health?

Is there someone, in addition to yourself, with whom you want us to discuss your medical condition?

Are there certain health care procedures and tests which your culture does not allow?

Are there any other cultural considerations I should know about to serve your health needs?

Websites with cultural information related to different cultural groups:

http://www.diversityresources.com/rc21d/menu_diversity_awareness.html

http://ggalanti.com/cultural_profiles.html

Web-based Self-Assessment for Health Care Practitioners
http://www11.georgetown.edu/research/gucchd/nccc/features/CCHPA.html

HRRV Library Resources
Hospice Care and Cultural Diversity, Infeld et al, 1995, Hayworth Press.

How Different Religions View Death and Afterlife, 2nd Edition, Johnson & McGee, eds., 1998, Charles Press.

Ethnic Variations in Dying, Death, and Grief: Diversity in Universality, Irish et al, eds., 1993,
Taylor & Francis.

How to Be a Perfect Stranger: The Essential Religious Etiquette Handbook, Third Edition, Matilins & Magida, eds., 2003, Skylight Paths Publishing.

Culture & Nursing Care: A Pocket Guide, Lipson et al, eds., 1996, UCSF Nursing Press.

The Education of Little Tree: A True Story, Forrest Carter, 1976, University of New Mexico Press.

For more information on accessing medical interpreter services through AT&T, available 24/7, speak to a social worker or Karen Smithson.