Culture and Diversity

And communication in
Healthcare
 Multiculture Health

• “Multicultural health is the phrase used to reflect the need to provide health care
services in a sensitive, knowledgeable and non-judgemental manner with respect
for people’s health beliefs and practices when they are different than your own”

• Cultural and language barriers to healthcare Impact on healthcare system

• Clients diverse backgrounds

 Ct…

• Due to various cultures, healthcare workers need to be able to

effectively communicate with patients

• Certain cultures have certain practices or stigmas related to

discussing medical conditions. An example is mental illnesses – some
cultures believe it is not a medical condition but rather traditional
imbalance with the ancestors

• Some patients from rural areas may not understand what it means
to ‘take your medicine three times a day’ but rather ‘when the sun
rises, when the sun is at its brightest and when the sun is gone’.
 Cultural Differences in Concepts of Health and Medicine

• Cultural differences in attributions of illness/health

• Acculturation

• Informed consent

• Cultural differences of people/clients- Which member of the family is

sick?
 Recognizing Cultural Diversity in Health
Beliefs
• Effectively communicating with patients from diverse cultural backgrounds

• Barriers to providing culturally sensitive health care

• Cultural competence- Key

• Culture imposition- forcing your values unto others

• Ethnocentricism- Considering your cultural values more important that those of others
 Cultural Competence
• A set of congruent behaviors, attitudes, and policies that come together in a system, agency or
professional and enables that system, agency or professional to work effectively in cross-cultural
situations

• The understanding of diverse attitudes, beliefs, behaviors, practices, and communication

patterns
attributable to a variety of factors with the population we serve

• These factors are: race, ethnicity, religion, historical and social context, physical or mental
ability, age, gender, sexual orientation, generational acculturation status

• Cultural and language barriers to healthcare Impact on healthcare system

• Clients diverse backgrounds

 Cultural Competence includes

• Self-awareness
• Cultural understanding
• Multiple perspectives
• Intercultural communication
• Relationship building
• Flexibility/adaptability
• Intercultural facilitation/conflict resolution skills
• Multicultural organizational development skills
 • Cognitive: Oblivious
Culturally • Affective: Apathetic
Incompetent • Psychomotor: Unskilled

• Cognitive: Aware
Culturally • Affective: Sympathetic
Sensitive • Psychomotor: Developing
skills

• Cognitive: Knowledgeable
Culturally • Affective: Committed to
Competent change / learning
• Psychomotor: Highly skilled

8
 Developing Cultural Competence

Cultural awareness

Cultural knowledge

Cultural skill(s)

Cultural encounter(s)

Cultural desire
9
Cultural Competence

http://www.getceusnow.com/portal/file/crisis-intervention-ceus-bbs_clip_image001.jpg
 Cultural Destructiveness

• Cultural Destructiveness - The dehumanization of specific cultures or individuals

signifying an underlying bias toward the superiority of the dominant or majority
group

• There is an intention to ignore issues affecting minorities and promote policies and
standards that have an adverse impact on them.
 Cultural Incapacity

• Cultural Incapacity - The inability to work with diverse populations

• There is not an intention to ignore issues or promote policies and standards

that have an adverse impact on minorities; instead, their practices are based
on a lack of understanding and ignorance
 Cultural Blindness

• Cultural Blindness - Approaches used by and for the

majority are perceived as relevant for all others.
Practices are adopted for "the greater good”, which
is generally the majority perspective.
• This level is characterized by inability to examine or
even recognize existing biases in approaches to
practices, education, and research that perpetuates
the continued existence and development of models
that support stereotypes of diverse populations and
thus further promotes prejudice.
 Cultural Pre-Competence

• Cultural Pre-Competence - Recognition of potential

weaknesses and biases within practices and a decision to take
action to address the problem.
• Although this phase is a positive movement, false "comfort"
may set in after making only minimal efforts to be responsive
to diverse populations. The efforts may only be peripheral and
not sufficient to truly address cultural issues.
 Cultural Competence

• Cultural Competence - A demonstrated commitment to diverse

populations in all aspects of the structure and functions of the organization

• The commitment is characterized by a sustained, systematic integration

and evaluation at all levels of significant collaboration from diverse
populations into the infrastructure of the organization
 Barriers to Cultural Competence
17
Cultural
Conflict
Cu
Im ltura judic
po l Pr e a n d
on siti e ism
c
Ra

Eth
ot
r e ntr noce
Ste ping ism
y

Cultural
Shock
 Defining Cultural Quotient (CQ)

• It is one’s ability to function effectively in a variety of cultural contexts.

• In addition to understanding different cultures, it focuses on problem
solving and effective adaptations for various cultural settings.
• It is an overall capability you can take with you anywhere.
 CQ Knowledge

• The extent to which you understand the role of culture in how people think
and behave and your level of familiarity with how cultures are similar and
different.
 Why CQ?

• There is widespread globalization― People of different cultures

today live together everywhere in the world.
• There are more opportunities to interact with foreigners in
many aspects (e.g., domestically, business, and work).
• One would need to know the customs of other cultures,
especially the taboos or risk offending people.
• People with higher CQ would be able to interact with people
from other cultures easily and more effectively.
 Spirituality, Culture, and Health

• Associations among spirituality, culture, and health

• Religion and psychological/physical health outcomes
• Religion and social support
• Contemporary vs Alternative medicine
• Masculine and feminine orientations
• Food and dietary practices
• Birthing and End of life care
 Social Implications of Illness

• Stigma and disease

• HIV/AIDS
• Cancer
• Alcoholism
• Mental illness
Changing Social Perceptions of Health Issues
through Communication

• Language usage
• Use of narrative
• Advocacy
• Demonstrate cultural competence
 Provider Diversity

• Culture also applies to health care providers

• Specialization and unique provider cultures
• Socialization processes and provider diversity
 Ethics in healthcare communication
• Informed consent
• Pts rights
• Disclosure policy
• Privacy and confidentiality
• Respect- as individuals, their culture

• Read and make notes on this