2. Healthcare Leadership Course: Patient and Family Centered Care PowerPoint CULTURE AND BELIEFS BY KEVIN BLACKMAN RN BSCN

3. Highlights 1.Describe the specific behaviors providers should practice to respect their patients’ culture and belief systems. 2.Describe the specific behaviors to deal with patients and families who speak a language other than the primary language spoken in your setting. 3.Analyze a variety of clinical situations to assess how well providers are – or are not – respecting their patients’ cultural and religious beliefs and practices. 4.Analyze a variety of clinical situations to assess how well providers are – or are not – meeting the needs of patients and families who speak a language other than the primary language spoken in your setting.

4. Section 1: Introduction Much has been written about the importance of respecting the culture and belief systems of patients and their families. For many patients and their families, encountering the health care system can create many challenges due to factors often involving culture and belief related concerns.

5. Understanding and Respecting Culture Culture is defined as the attitudes and behavior that are characteristics of a particular social group or organization. Merriam-Webster Learning Dictionary (2014) describes culture as a set of values, beliefs, traditions, habits, behaviors, and language that are held by a specific group of people and handed down from generation to generation. (Merriam-Webster Learning Dictionary, 2014)

6. HOW TO HANDLE CULTURALLY SENSTATIVE SITUATIONS It’s not always easy to perceive all the ways that your daily routine as a caregiver can make certain patients feel uncomfortable or alienated – particularly when those patients’ culture and belief systems are different from your own. Furthermore, there is a tension between the desire to avoid making assumptions about patients and the desire to offer them choices based on what you think their needs and preferences might be. It is therefore important to ask patients about their preferences directly. Here are some basic things that you can do to show respect for the culture and belief systems of patients and families: 1) Avoid assumptions about a patient’s or family’s culture or beliefs. 2) Learn by asking patients and families about their culture and preferences. 3) Ask patients and families how you can help make them more comfortable. 4) Allow the patient and family members to define their needs. Acknowledge that patients and families are the experts on their needs and their family’s culture. 5) Keep in mind that some patients and families may be reserved about expressing their needs, and that this may be cultural as well. 6) Refrain from placing judgment on beliefs and preferences that are different from you own.

7. SECTION 2: Respecting Language Differences If you hear a family speaking to each other in a language other than the primary language spoken in your setting, should you speak to them in their language – or in the primary language? If you are speaking to a patient using an interpreter, should you look at the patient when you speak – or at the interpreter? Your patients and their families speak a variety of languages, have a variety of belief systems, and represent a variety of cultures. Because of this fact, one of the most obvious ways in which a patient and family can experience difficulty is when they speak a language different from the language spoken in the health care setting they encounter – whether it’s an emergency room, hospital, or office practice. Thus, it important that health professionals incorporate various strategies and behaviors to better treat all patients requiring cultural considerations.

8. Respecting Language Differences (Cont.) In addition to the strategies identified by IHI, we should also consider a few others: 6) How cultural groups understand life processes. 7) How cultural groups define health and illness. 8) What cultural groups do to maintain wellness. 9) What cultural groups believe to be the causes of illness. 10) How healers cure and care for members of cultural groups (Americas Nurses Association, 2010) Here are some basic things to consider when caring for a patients and their family whose primary language is not the language spoken in your setting: 1) For patients and families with limited English proficiency (or whatever the primary language spoken in your setting), ask them which language they prefer and offer the assistance of an interpreter, if available. 2) Before the conversation with the patient or family member begins, speak briefly with the interpreter to tell him or her what you hope to accomplish with the discussion, and give the interpreter a brief description of the patient’s situation. Position the interpreter to the side and slightly behind the patient or family member. 3) Introduce the interpreter to the patient and family members. 4) Look at the patient or family, not at the interpreter, when you speak so you can gauge their reaction to what you’re saying. 5) Use short sentences and avoid jargon. (Institute of Healthcare Improvement, 2014)

9. Respecting Language Differences (Cont.) Access and use the different kinds of support your organization may offer for them (ie. Assessment Tools: “The Hope Approach to Spiritual Assessment” Tool

10. Section 4: Meeting The Cultural and Spiritual Needs of Patients and Families WATCH VIDEO: QUALIFIED INTERPRETING FOR QUALIT Y HEALTH CARE VIDEO LINK - http://vimeo.com/16029243 http://vimeo.com/16029243 Health Care Interpreter Network. Qualified Interpreting for Quality Health Care [Video]. United States: Casa Madre Films, 2009.

11. References American Nurses Association (1991). Council on Cultural Diversity in Nursing Practice, Congress of Nursing. - http://nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and- Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/prtetcldv14444.html http://nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and- Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/prtetcldv14444.html Fadiman A. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: Farrar, Straus, and Giroux; 1997. Health Care Interpreter Network (2009). Qualified Interpreting for Quality Health Care [Video]. United States: Casa Madre Films, 2009. Available online at http://vimeo.com/16029243. http://vimeo.com/16029243 Institute of Healthcare Improvement. (2014). Retrieved From: http://app.ihi.org/lms/lessondetailview.aspx?LessonGUID=5a12d97d-5409-46b7-a3e3- 3689d77970ee&CourseGUID=8eb52137-21d7-4b30-afcd-fd781de6d6d5&CatalogGUID=4cc435f0-d43b-4381-84b8- 899b35082938 http://app.ihi.org/lms/lessondetailview.aspx?LessonGUID=5a12d97d-5409-46b7-a3e3- 3689d77970ee&CourseGUID=8eb52137-21d7-4b30-afcd-fd781de6d6d5&CatalogGUID=4cc435f0-d43b-4381-84b8- 899b35082938 Merriam-Webster Learning Dictionary. (2014). Culture. Retrieved from http:// http://www.webster- dictionary.org/definition/culture)