1. Cultural Responsiveness: Healthcare

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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
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

9. 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

10. 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?

11. 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

12. 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

13. 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?