Goals for Today: Diversity Part 2 & Disability/Chronic Conditions<br />Discuss multicultural perspectives and cultural competence as they relate to physical therapy care<br />Explain the effect of patient diversity on physical therapy care<br />Summarize the importance of communication on physical therapy care<br />Describe family needs, roles, & responsibilities on patient care<br />Practice Generic Abilities (Interpersonal Skills, Communication Skills, and Professionalism)<br />
Bias and Prejudice<br />Unjustified negative attitude based on a person’s group membership<br />May become part of a normative pattern of thinking<br />Often exists even when we are not aware<br />Exists even if we believe we feel otherwise<br />May result in actions that are discriminatory<br />
Becoming Unbiased, EmpathicHealth Professionals<br />Understand yourself<br />Acknowledge presence of prejudice and bias<br />Respect differences<br />Shed unhelpful bias<br />
Discussion Questions<br />Where do you think that your unintended biases come from?<br />What are the effects on patient care?<br />What are the effects on the members of your health care team?<br />What do you think you could do to make changes for yourself or others?<br />
Culture<br />Definition: the customary beliefs, social forms, and material traits of a racial, religious, or social group; also: the characteristic features of everyday existence (as diversions or a way of life} shared by people in a place or time <popular culture> <southern culture><br />Acquired set of beliefs, values, behaviors, practices<br />Impact on daily experiences and choices<br />Subcultures (example: High School)<br />
Cultural Competence<br />What is Cultural Competence? <br />APTA states that “acquiring cultural competence as a PT/PTA is a process that is cultivated within the individual through acquisition of knowledge, attitudes, and behaviors specific to culture, language, and communication”.<br />Cross model: “Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations”. <br />Campinha-Bacote model: “the process in which the healthcare professional continually strives to achieve the ability and availability to effectively work within the cultural context of the client – family, individual, or community”. <br />
Why is Cultural Competence Important?<br />Society is changing and so are the faces of our clients<br />Critical core component of professional practice in PT <br />Considered part of “best practice” in providing PT care<br />Cultural competence will affect our clinical outcomes. How???<br />
5 Essential Elements : Cultural Competence (from Cross, et al)<br />Value diversity<br />Have the capacity for cultural self-assessment<br />Be conscious of the dynamics inherent when the cultures interact<br />Institutionalize cultural knowledge<br />Develop adaptations to service delivery reflecting an understanding of diversity between and within cultures.<br />
Continuum of Cultural Competence<br />Cultural destructiveness<br />Cultural incapacity<br />Cultural blindness<br />Cultural pre-competence<br />Cultural competency<br />Cultural proficiency<br />
L.E.A.R.N. Model<br />A model for culturally effective communication proposed by EA Berlin and WC Fowkes in “Teaching framework for cross-cultural Care: Application in Family Practice”<br />Listen – Identify and greet patient & others<br />Elicit patient’s health beliefs<br />Assess – Potential attributes/problems in patient<br />Recommend – A plan of action <br />Negotiate – with the patient after you have made your recommendations<br />
Elements of Culture<br />Nationality<br />Language spoken<br />Class<br />Religion/spirituality<br />Education<br />Income<br />Age<br />Race<br />Ethnicity<br />
Key Concepts<br />Assimilation<br />Definition: the process of receiving new facts or of responding to new situations in conformity with what is already available to consciousness <br />Acculturation<br />Definition: cultural modification of an individual, group, or people by adapting to or borrowing traits from another culture; also: a merging of cultures as a result of prolonged contact <br />Bicultural<br />Definition: of, relating to, or including two distinct cultures <br />
More Key Concepts<br />Ethnocentrism<br />Definition: characterized by or based on the attitude that one's own group is superior <br />Importance as a barrier<br />Impact on interactions with others<br />
Specific Cultural Perspectives<br />Native American<br />There is often distrust and suspicion of non-native providers<br />Harmony of mind-body-spirit is important<br />Harmony with the natural world is important for health<br />Healing is closely tied to religion and sacred religious narratives and rituals <br />Illness, disability and death are not discussed<br />
Specific Cultural Perspectives<br />Asian Culture<br />Harmony in body and spirit is the foundation for good health and well-being<br />Disruption will lead to illness <br />Loyalty and harmony within the family lead to harmony with the environment and within the self<br />Hierarchy and respect for elders are an essential part of harmony<br />Traditional healing practices are valued and widely used <br />
Specific Cultural Perspectives<br />Latino/Hispanic<br />Good health is a gift from God<br />Poor health is a result of fate<br />There is no way to overcome this<br />Illness and disability may come as punishment for bad deeds<br />Respetoand personalismoare essential traits for health care providers<br />
Specific Cultural Perspectives<br />Black Americans<br />Distrust of medical providers caused by legacy of slavery and other historical factors<br />Reluctance to pursue care unless the illness is extreme<br />Strong faith in God and letting His will be done<br />Prayer is a valuable healing tool<br />Many folk practices and reliance of family and community<br />
Solutions<br />The key to eliminating fear and distrust by people of other cultures is to develop knowledge about, and respect for, other traditions and practices<br />Develop cultural competence<br />Be flexible and open-minded<br />DO NOT stereotype<br />Learn a new language and/or use interpreters<br />Develop knowledge and skill about communication with clients from different backgrounds<br />Develop skill interviewing clients from different cultural backgrounds<br />
More Solutions<br />ASK the client what they would like from the medical encounter<br />What kind of care would they like to receive?<br />Do not treat all patients the same<br />Care must be individualized and congruent with cultural beliefs and practices<br />
Imagine you are 5 years old and your sibling has just been born with a disability. <br /><ul><li>What effects might this have on your family?
Has worked at SPC as the registrar for 3.5 years!</li></ul>GuestSpeaker<br />
Upcoming Assignments<br />Outline of Research Paper due NEXT TUESDAY 10/18/11, 11am via Blackboard <br />PAHC page 259,#2 - Assignment NOT due <br />PAHC page 136, #1 - Assignment NOT due <br />Show Elaine 5 additional notecards PER source (50 total notecards) TODAY before you leave class!!!<br />Watch Darius Goes West video on Blackboard, before 2:30pm next Tuesday 10/18/11 – QUIZ!!!<br />Complete the MBTI, score it, and do calculations (this will be in your PTA mailbox on Thursday 10/13/11. MBTI assignment will be due AT THE BEGINNING of class next Tuesday, 10/18/11.<br />Test #2 – Friday, 10/21/11 – Review Information will be given to you next Tuesday, 10/18/11. <br />
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