Cultural Responsiveness: Healthcare

Cultural Responsiveness & Health Care Culture determines… How health and illness are defined Beliefs about what causes disease What diseases are stigmatized and why Types of health promotion activities engaged in by individuals and families The experience and expression of illness and pain Who one seeks advice and/or help from regarding health and illness The experience individuals have with healthcare providers How treatment options are understood and followed The perception of rehabilitation services of chronic disease condition Culture influences health, illness and health care seeking in many ways. Culture determines: How health and illness are defined Beliefs about what causes disease What disease are stigmatized and why Types of health promotion activities engaged in by individuals and families The experience and expression of illness and pain Who one seeks advice and/or help from regarding health and illness The experience individuals have on healthcare providers How treatment options are understood and followed The perception of rehabilitation services of chronic disease condition

Why does cultural responsiveness matter to healthcare professionals? Caring is often called the key attribute of being nurse and is not limited to interactions with clients. Developing cultural responsiveness means that the health professional becomes aware of one’s own cultural attributes and biases, and their impact on others. Understanding one’s own worldview and that of the “other”, avoids stereotyping and the misapplication of scientific knowledge. — RNA of Ontario, 2007

Why does cultural responsiveness matter to healthcare professionals? To care for someone, I must know who I am. To care for someone, I must know who the other is. To care for someone, I must be able to bridge the gap between myself and the other. — RNA of Ontario, 2007

Cultural Responsiveness & Health Care: “Western Medicine” The Culture of “Western” Medicine Meliorism – make it better Dominance over nature – take control Activism – do something Timeliness – sooner than later Therapeutic aggressiveness – stronger=better Future orientation – plan, newer=better Standardization – treat similar the same

Cultural Responsiveness & Health Care Individualist “Western” Collectivist “Asian/African/Indigenous” Make it Better Accept with grace Control Over Nature Balance/Harmony with Nature Strong Measures Gentle approach Do Something Wait and see Intervene Now Cautious deliberation Plan Ahead – Recent is Best Ours is more for western culture and western medicine where others is more for traditional medicines and other cultures that use and believe in traditional medication. Majority of countries around the world will fall in to the category of others. Sickness is seen as imbalance in our system and it will get better with some traditional medicine to balance those imbalances and sometime it will get better just over time. Take life as it comes – Time honoured Standardize – Treat Everyone the Same Individualize – Recognize differences

Cultural Responsiveness & Health Care: What it “looks like” Obvious Manifestations: Religion Ethnicity (Race?) National Origin (language) Gender Less Obvious Manifestations: Age Education Educational Status Mobility (including handicaps) Previous experience with Healthcare system Cultural norms (gender, roles, child rearing, medicine, wellness) We all have cultural diversity in every aspects of life particularly around health care. Everything in our live is interconnected and it impacts our decision making everything including how we look after our health and

CHALLENGES FOR THE NEWCOMER Language barrier Conflicting values at home Conflicting understanding of healthcare system Social cues and relationships to doctors and nurses may be different Culture shock and transition stress causes behavioural issues Challenges of learning a new language and culture Parents have strict rules regarding healthcare, wellness and medicine Poverty - lack of funds for proper nutrition, medicines or knowledge of them Refugees may have more difficulties, or ones that surface again once demands increase. It is very hard for kids to listen, to learn normally when they do not understand the language used in preschool facilities, ex. Daycare, preschool. Even toys are different. The child might be confused about how to act between 2 different cultures. Parents have strict rules and expectations regarding socializing, offer limited freedom http://72.10.50.165/wordpress/wp-content/uploads/2011/05/CI127.jpg According to Gopalkrishnan, immigrants generally go through different stages as they settle in Canada. Four phases have been identified: The honeymoon stage. Everything appears new and fantastic. 2. The frustration phase. Individuals come face to face with the daily problems of living. 3. The coping phase. The person can operate in the new society within its cultural and behavioral norms, although they may not be comfortable with them. 4. The adjustment phase. The person is comfortable with their environment, and is able to deal with the society around them

CHALLENGES FOR NURSES Limited access to knowledge of cross-cultural awareness/ communication Difficulty in building relationships and trust with children and parents Different expectations from parents regarding healthcare, hospitalization, medicines, parent roles Approach medicine and healthcare from own perspective Might unwittingly make assumptions or use stereotypes Limited access to use of translators

Knowing the Cultural Characteristics of Your Patient Population What cultures are predominantly represented in your program? What are the values, beliefs, traditional concepts particular to these groups? Who are the “gatekeepers” of health within these groups? What is the group’s perception of health and illness?

The mindset of culturally responsive healthcare professionals Socio-cultural consciousness High expectations Desire to make a difference Constructivist approach Deep knowledge of their patients Culturally Responsive Nursing Practices

Cultural responsiveness and healthcare: Summary Culture is a very complex concept made up of many factors. The “Culture Iceberg”: “Visible” and “Invisible” Cultures can be broadly grouped into “Individualist” (Western) and “Collectivist” (Asian/African/Native) groupings which present different approaches to healthcare Cultural Responsiveness and Healthcare has both “obvious” and “less obvious” manifestations Cultural Responsiveness and Healthcare takes into account culture, language, country of origin, collectivist/individualist societies Really emphasize that culture runs deep, beyond dress and food Where are you from: many people use this question to capture cultural information, should go beyond this basic question

Cultural Responsiveness and Healthcare: Questions/Comments What have you learned about cultural responsiveness and healthcare? What is the biggest surprise? What difference will understanding cultural responsiveness and healthcare make in your relationships with people? What difference will understanding cultural responsiveness and healthcare make in your professional practice?