Cultural Diversity
 In Health Care
Cultural Diversity and Health Care


  We All Have It! Obvious Manifestations:
    •   Religion
    •   Ethnicity (Race)
    •   National Origin (Language)
    •   Gender
Cultural Diversity and Health Care

Less Obvious Manifestations:
     Age
     Educational Status
     Mobility (including handicaps)
     Sexual Orientation
Cultural Diversity and Health Care

What is Culture?
The values, beliefs, standards, language, thinking patterns,
  behavioral norms, communications styles, etc. shared by
  a group of people. It guides decisions and actions of a
  group through time.
We have an obligation to be respectful and sensitive to
  another's belief system. Healthcare workers must be
  culturally competent and comfortable with those they
  serve. Healthcare workers should understand how their
  own personal biases and values influence communication
  with patients, families, and co-workers.
Cultural Diversity and Health Care

  Cultural Sensitivity
  The ability to be open to learning about and
    accepting of different cultural groups.
  Multiculturalism
  The recognition and acknowledgement that
    society is pluralistic. In addition to the
    dominant cultural, there exists many other
    cultures based around ethnicity, sexual
    orientation, geography, religion, gender, and
    class.
Cultural Diversity and Health Care

CULTURAL COMPETENCE
• The understanding of diverse attitudes, beliefs, behaviors,
  practices, and communication patterns attributable to a
  variety of factors (such as race, ethnicity, religion, SES,
  historical and social context, physical or mental ability, age,
  gender, sexual orientation, or generational and acculturation
  status).
• A health care provider is culturally competent when he/she is
  able to deliver culturally appropriate and specifically tailored
  care to patients with diverse values, beliefs, and behaviors.
• Providing culturally competent care is an advocated strategy
  for reducing heath disparities.
Continuum of Cultural
Competency            Cultural
                   Proficiency                                                        implement changes
                                                                                   to improve services
                                                                                   based upon cultural
                                                     Cultural                      needs
                                                  Competence          recognize individual & cultural
                                                                      differences, seek advice from
                                      Cultural                        diverse groups, hire culturally
                                                                      unbiased staff
                               Pre-Competence
                                                        explore cultural issues, are committed,
                                                        assess needs of organization and
                           Cultural                     individuals
                         Blindness
                                           differences ignored, “treat everyone the same”,
                 Cultural                  only meet needs of dominant groups
               Incapacity
                              racism, maintain stereotypes,
                              unfair hiring practices
        Cultural
Destructiveness    forced assimilation, subjugation,
                   rights and privileges for dominant
                   groups only
                                                                                       SAMHSA
Cultural Diversity and Health Care


Acquiring Cultural Competence Reduces
  the chance of stereotyping
  •   Starts with Awareness
  •   Grows with Knowledge
  •   Enhanced with Specific Skills
  •   Polished through Cross-Cultural
      Encounters
Acquiring
Cultural Competence
Ask yourself these questions:
• Who are my patients, families and co-workers?
• How can I learn about them?
• What are my beliefs about this group?
Acquire knowledge of the cultural values,
beliefs and practices of your customers:
•   Ask questions
•   Listen
•   Account for language issues
•   Be aware of communication styles
Acquiring
Culturally Competence
Be sensitive to personal health beliefs and practices:
 Special foods, drinks, objects or clothes
 Avoidance of certain foods, people or places
 Customary rituals or people used to treat the illness
 Will the patient take medicine even when
  he/she doesn't feel sick?
 Is the patient taking other medicines or anything
  else to help him feel well?
 Who in the family makes decisions about health care?
 Are illnesses treated at home or by a community member?
Acquiring
Cultural Competence
Be sensitive to language barriers:
• Does the patient understand any English?
• Consider literacy level
• Use visual aids and demonstrate procedures
• Check understanding
• Is an interpreter necessary?
Acquiring
Cultural Competence
    Consider body language:
•    Eye contact
•    Touching
•    Personal space
•    Privacy/modesty
Other cultural factors to consider:
•    Gender
•    Wealth or social status
•    Presence of a disability
•    Sexual orientation
Acquiring
Cultural Competence
Consider Religious/Spiritual factors
Are there sensitivities/beliefs associated with:
• Birth, death
• Certain treatments, blood products
• Prayer, medication and worship
• Food preparation, clothing, special objects, and
   gender practices
Ways to Facilitate Communication
Across Cultural Boundaries
1. Recognize differences
2. Build your self-awareness
3. Describe and identify, then interpret
4. Don’t assume your interpretation is correct
5. Verbalize your own non-verbal signs
6. Share your experience honestly
7. Acknowledge any discomfort, hesitation, or
   concern
8. Practice politically correct communication
9. Give your time and attention when communicating
10.Don’t evaluate or judge
Cultural Diversity and Health Care


     It is because we are different
         that each of us is special.

Cultural Diversity and Health Care

  • 1.
  • 2.
    Cultural Diversity andHealth Care We All Have It! Obvious Manifestations: • Religion • Ethnicity (Race) • National Origin (Language) • Gender
  • 3.
    Cultural Diversity andHealth Care Less Obvious Manifestations:  Age  Educational Status  Mobility (including handicaps)  Sexual Orientation
  • 4.
    Cultural Diversity andHealth Care What is Culture? The values, beliefs, standards, language, thinking patterns, behavioral norms, communications styles, etc. shared by a group of people. It guides decisions and actions of a group through time. We have an obligation to be respectful and sensitive to another's belief system. Healthcare workers must be culturally competent and comfortable with those they serve. Healthcare workers should understand how their own personal biases and values influence communication with patients, families, and co-workers.
  • 5.
    Cultural Diversity andHealth Care Cultural Sensitivity The ability to be open to learning about and accepting of different cultural groups. Multiculturalism The recognition and acknowledgement that society is pluralistic. In addition to the dominant cultural, there exists many other cultures based around ethnicity, sexual orientation, geography, religion, gender, and class.
  • 6.
    Cultural Diversity andHealth Care CULTURAL COMPETENCE • The understanding of diverse attitudes, beliefs, behaviors, practices, and communication patterns attributable to a variety of factors (such as race, ethnicity, religion, SES, historical and social context, physical or mental ability, age, gender, sexual orientation, or generational and acculturation status). • A health care provider is culturally competent when he/she is able to deliver culturally appropriate and specifically tailored care to patients with diverse values, beliefs, and behaviors. • Providing culturally competent care is an advocated strategy for reducing heath disparities.
  • 7.
    Continuum of Cultural Competency Cultural Proficiency implement changes to improve services based upon cultural Cultural needs Competence recognize individual & cultural differences, seek advice from Cultural diverse groups, hire culturally unbiased staff Pre-Competence explore cultural issues, are committed, assess needs of organization and Cultural individuals Blindness differences ignored, “treat everyone the same”, Cultural only meet needs of dominant groups Incapacity racism, maintain stereotypes, unfair hiring practices Cultural Destructiveness forced assimilation, subjugation, rights and privileges for dominant groups only SAMHSA
  • 8.
    Cultural Diversity andHealth Care Acquiring Cultural Competence Reduces the chance of stereotyping • Starts with Awareness • Grows with Knowledge • Enhanced with Specific Skills • Polished through Cross-Cultural Encounters
  • 9.
    Acquiring Cultural Competence Ask yourselfthese questions: • Who are my patients, families and co-workers? • How can I learn about them? • What are my beliefs about this group? Acquire knowledge of the cultural values, beliefs and practices of your customers: • Ask questions • Listen • Account for language issues • Be aware of communication styles
  • 10.
    Acquiring Culturally Competence Be sensitiveto personal health beliefs and practices:  Special foods, drinks, objects or clothes  Avoidance of certain foods, people or places  Customary rituals or people used to treat the illness  Will the patient take medicine even when he/she doesn't feel sick?  Is the patient taking other medicines or anything else to help him feel well?  Who in the family makes decisions about health care?  Are illnesses treated at home or by a community member?
  • 11.
    Acquiring Cultural Competence Be sensitiveto language barriers: • Does the patient understand any English? • Consider literacy level • Use visual aids and demonstrate procedures • Check understanding • Is an interpreter necessary?
  • 12.
    Acquiring Cultural Competence Consider body language: • Eye contact • Touching • Personal space • Privacy/modesty Other cultural factors to consider: • Gender • Wealth or social status • Presence of a disability • Sexual orientation
  • 13.
    Acquiring Cultural Competence Consider Religious/Spiritualfactors Are there sensitivities/beliefs associated with: • Birth, death • Certain treatments, blood products • Prayer, medication and worship • Food preparation, clothing, special objects, and gender practices
  • 14.
    Ways to FacilitateCommunication Across Cultural Boundaries 1. Recognize differences 2. Build your self-awareness 3. Describe and identify, then interpret 4. Don’t assume your interpretation is correct 5. Verbalize your own non-verbal signs 6. Share your experience honestly 7. Acknowledge any discomfort, hesitation, or concern 8. Practice politically correct communication 9. Give your time and attention when communicating 10.Don’t evaluate or judge
  • 15.
    Cultural Diversity andHealth Care It is because we are different that each of us is special.