Cultural Diversity ELDER Project Fairfield University School of Nursing Session 4 – Cultural Competence Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Cultural Competence Objectives: Upon completion of this session, the participants will be able to …. define and discuss components associated with cultural competence. explore the LEARN Model and how it relates to providing culturally competent care. apply the concepts of the LEARN Model to selected case studies. identify care taker responsibilities associated with providing culturally competent care. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Cultural Competence “The ability of systems to provide care to patients with diverse values, beliefs and behaviors including tailoring delivery of care to meet patients’ social, cultural and linguistic needs. The ultimate goal is a health care system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background or English proficiency.” The Commonwealth Fund, New York, NY, Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Cultural Competence Cultural competence requires expansion of the ability to provide services effectively to people of all cultures, races, ethnic backgrounds and religions in a way that respects the worth of the individual and protects and preserves their dignity. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Cultural Competence Components: diverse values, beliefs, behaviors and delivery of care It is unrealistic to think that we can gain in-depth knowledge about health-affecting beliefs and practices of every ethnic or cultural group you are likely to encounter. It is valuable for us to have some understanding of common basic conceptions of health and illness held by various cultures. There is a strong need to enhance communication and promote the integration of patients’ and providers’ perceptions of needs and solutions into the therapeutic process. The LEARN Model is a communication framework that can be used to help healthcare providers improve communication, heighten awareness of cultural issues in medical care and obtain better patient acceptance of care. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Cultural Competence Challenges to culturally competent practice: Cultural competence is an approach, not a technique, in which each patient is seen as an individual. No two people embrace or practice their culture the same way – the importance lies in gaining their perspective. Be willing to ask the patient questions about their cultural beliefs and preferences. View each encounter as an opportunity to add to your culturally competent still set. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Cultural Competence Cultural competence starts with awareness grows with knowledge is enhanced with specific skills and is polished through cross-cultural encounters. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

The LEARN Model A communication framework that can be used by healthcare providers to overcome communication and cultural barriers to delivering quality patient care. It is composed of five steps. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

The LEARN Model LISTEN: Listen with empathy and understanding to your patient’s perception of the problem Encourage your patient to discuss their understanding of the cause and effects of their illness and to describe the treatment and resources they feel will help them get well. Questions that can be used to get this information can include: “What do you feel may be causing your problem?” “What do you feel might help or hinder your recovery?” “How do you feel the illness is affecting you?” Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

The LEARN Model EXPLAIN: Explain your perceptions of your patient’s illness, the recommended plan of care and management of self-care. Explain what you have in mind in terms the patient can understand. Take into consideration literacy level, cultural beliefs and past experiences, which may affect understanding and acceptance of any suggestions you give. Try to link your explanation to something the patient already knows. Do not ask if they understand or have any questions, rather talk about a particular point to which the new information can be applied. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

The Learn Model ACKNOWLEDGE: Acknowledge your patient’s feedback and understanding of the illness and plan of care. Talk about the differences and similarities with your observations to help promote patient involvement. Areas of differences should be recognized and differences resolved. Whenever possible, integrate your patient’s suggestions into the care approach. This will give them a sense of control and commitment. If the patient’s suggestions appear harmful, explain the consequences. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

The LEARN Model RECOMMEND: Recommend a plan of care that fits within the patient’s parameters. The more involved your patient is in the development of the plan of care, the more interested they will be in its outcome. Listen to the patient’s concerns and agree on solutions that will enhance commitment. NEGOTIATE: Negotiate a mutually agreed upon treatment plan. Form a partnership in the decision-making process. This is a key step and can lead to a variety of patient-specific approaches that will increase the chance of a successful recovery and healthier life. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Caretaker’s Responsibilities Cultural interaction is created in verbal and nonverbal behaviors such as: Spoken word Eye gaze/Eye Contact Head movements Facial gestures Touch Body posture/postural orientation Interactional space Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Caretaker’s Responsibilities Seven lessons to learn about cross cultural communication: Don’t assume sameness What we think of as normal behavior may only be cultural Familiar behaviors may have different meanings Don’t assume what we meant is what was understood Don’t assume what we understood is what was meant We don’t have to like or accept different behaviors, but making an effort to understand where it comes from is important Most people do behave rationally – discovering the rational is important Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Caretaker’s Responsibilities Caretaker responsibilities: Learn to use a few phrases of greeting and introduction in the patient’s native language. It conveys respect and demonstrates your willingness to learn about their culture. Reinforce verbal interaction with visual aids and materials written in the patient’s language. Repeat important information more than once. Always give reasons or the purpose for a treatment or prescription. Make sure the patient understands by having them explain it themselves. Avoid saying “you must” - rather, teach patients their options and let them decide, i.e. “Some people in this situation would…” Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Cultural Competence CONCLUSION: Effective communication enhances: patient satisfaction health outcomes adherence to treatment and job satisfaction. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Reference American Medical Student Association. Cultural Competency in Medicine. Retrieved October 6, 2010 from mpetency_in_medicine.doc. mpetency_in_medicine.doc Galanti, G. Cultural Diversity in Healthcare. Retrieved July 13, 2010 from Yeo, G. (2010). Culture Med Ethnogeriatrics Overview Assessment. Retrieved October 6, 2010 from ment. ment Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Power Point Presentation Created by: Joyce Cunneen, MSN, RN Fairfield University School of Nursing ELDER Project Education Coordinator Monica Starr, BSN, RN Fairfield University School of Nursing ELDER Project Program Coordinator Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858