Cultural Responsiveness

VCH PATIENT EDUCATION AND

WELLNESS COMMITTEE

AMY DINH
MICHELLE NGUYEN
NANCY DINH
NHAN NGUYEN
What is Cultural → The interaction of
Responsiveness? two different cultures
may produce
miscommunication.
→ Cultural
responsiveness can
help bridge that gap.
EAST WEST

Meets
 Eastern
● Inductive method (observations)
● Holistic and natural
● Concept of ‘meridians’ and
channeling energy through the
human body
● Increasing overall well-being + health
● Scientifically unproven, yet effective
● In 2015, ~60% worldwide used some
form of Eastern Medicine
Western
● Deductive method (hypothesis)
● Driven by science methods and
Modern medical technology
● Medicines, lab tests, operations
● Quick effectiveness - ideal for
urgent care
Acupuncture Herbal and dietary therapy
● What: Placing needles through ● What: using plants as ● What: Choosing foods
skin at certain points remedies that alleviates illness
● Why: ● Why: & avoid foods that
○ Flow of lymphatic fluids - ○ Migraines worsens
delivering immunity ○ Arthritis
● Why:
○ Headaches ○ PMS/ Cramps
○ High Cholesterol
○ Chronic musculoskeletal issues
○ Blood Pressure
○ Osteoarthritis
○ Common colds

Cupping
● What: Placing cups on skin to put
suction pressure
● Why:
○ Blood flow healing
○ Channeling Qi Energy
○ Cell repair/ rejuvenation
Yoga
● What: Mind-Body exercise utilizing breathing,
stretching and meditations
● Why:
○ Back pain
○ Grey Matter Volume
○ Psychological/ Physical health promotions
Drawbacks from both
Eastern:
● Limited Scientific Research
● “Natural” is not “Safe”
● Placebo Effect
Western:
● Many medications have sides
effects - discomfort + pain
● Treats people as organs -
health isn’t all about the
disease, but also wellness
● Asian/Vietnamese Americans
are very skeptical of the
complexity of scientific
methods
Cultural and Systematic Disparities
Among the Minority Population
MINORITY DISPARITIES

● Poor knowledge about ● Lack of translator services

insurance ● Uncomfortable
● Low income provider-patient relationship
● Little access to healthcare ● Cultural display rules (Asian)
services ○ Show less expressions of
● Superstition and Skepticism of pain in public
Western Medicine
Case Files
Case Study #1: Eastern vs. Western Medicine
- Talk in a calm and understanding
Patient A wants to use manner
- “Sometimes [Eastern medicine]
acupuncture/coin doesn’t always work. This method
rubbing/Eagle oil to treat seems to work for others and I think
it will help you too.”
her illness. How would you - Do not force to fully accept Western
handle the situation? medicine. Just keep it as an open
option.
- Ask what types of home treatment
they administer to themselves.
- If alternative treatment not harmful,
why not both?
Case Study # 2: Miscommunication
Patient B has a rather ill, but is
smiling and nodding his head as you
explain his illness and his treatment
options. Every so often, he’d say “Yes”
to whatever you say. You notice that
he communicates in English fairly
well despite that it is obviously his
second language.
What can you infer is the problem and
how can you fix it?
- Nodding head + “yes” ≠ Understands or
agrees
- Only acknowledges that he heard you
- Ask if and make sure he does
understand!
- Try to eliminate language barrier if possible
- Explain complex words or concepts. Do not
assume they understand everything you’re
talking about.
- Pay attention to nonverbal cues.
- Slow down! You miss cues that your patient
gives and he’ll be better able to process what
you said. It also seems rude to rush.
HOW TO BE MORE CULTURALLY RESPONSIVE

● Pick up tiny signs of discomfort/distress

○ Many Asian cultures tend to hide
negative emotions
● Be professional, not overly friendly or
informal
○ Expectation of and respect for
professionalism
● Let patient set personal space distance
○ Some have larger boundaries than in
West
● Lack of eye-contact from patient ok
○ Does not mean disengaged, direct
eye-contact may feel rude
Insurance

● Huge barrier to getting ● Culmination of many

the healthcare that factors
patients need ● Cannot afford private
● Can be confusing insurance
● Doesn’t cover the ● Don’t qualify for
procedures that are Medicaid
needed
Insurance Statistics

● 1 out of 5 Asian Americans

● Two million Asian Americans
have no regular place for
don’t have insurance in the
health care
U.S.
● Half of these uninsured
● 1 out of 5 Asian Americans
minorities have little to no
between the ages of 18-64
choice in source of care
report having no health
● In 2012-13, 64% of VCH
insurance or being uninsured
patients were uninsured
at some point in the past year ● In 2016-17, 19.3% were
uninsured
Overall Effects

Skepticism of
Lack of Poor Knowledge
Western Less Expressive
Translators / No Insurance
Medicine

Long-Term Little Access to

Untreated Health Healthcare
Problems Services

HIGHER COST OF TREATMENT AND CARE

 References

A. (2005). Profiles | Demographics | Model Minority Myth | Socioeconomic Status/Insurance Status Cultural Language
Barriers/Access to Health Care | Health Disparities. Retrieved January 29, 2019, from
http://www.aahiinfo.org/english/asianAmericans.php

P. (2002, March 01). 2001 Health Care Quality Survey. Retrieved January 29, 2019, from
https://www.commonwealthfund.org/publications/surveys/2002/mar/2001-health-care-quality-survey

P. (2007, June 27). The Commonwealth Fund 2006 Health Care Quality Survey. Retrieved January 29, 2019, from
https://www.commonwealthfund.org/publications/surveys/2007/jun/commonwealth-fund-2006-health-care-quality-survey