An African American woman approaches a pharmacist at the local drugstore near the hospital where she was given a prescription for chest congestion. She asks the pharmacis

Chapter 3 Lecture notes

Learning objectives

•   Discuss political correctness and whether it is a necessary concept for health professionals to consider.

•   Understand and identify specific reasons why there is a need to consider cultural competency within all healthcare settings.

•   Explain the concept of cultural nuance and its relevance to touching patients, family dynamics, time perception, locus of control, appropriate terminology, and so on.

•   Differentiate between interpretation and translation.

•   Define visual affirmation and its relevance in the healthcare setting.

•   List why it is important to have a diversified health professions workforce.

•   Describe why it is important to establish trust with patients in terms of their culture and the provision of services to them.

Key terms

Cultural competence- cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. Per the cultural competence continuum: involves ensuring that the needs of diverse patients/clients/customers are met by health service and public health organizations based on the acquisition of specific skill sets, valuing diversity, and taking concrete steps to ensure efficacy in serving minority populations.

Diversity- the makeup of the workforce of a given healthcare organization. This includes ethnic and racial backgrounds, age, physical and cognitive abilities, family status, sexual orientation, socioeconomic status, religious and spiritual values, geographic location, and includes all of the dimensions and all of the differences between people.

Interpretation – refers to the spoken word

Linguistic competence- the capacity of an organization and its personnel to communicate effectively and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, and individuals with disabilities and the ability to communicate effectively and accurately with individuals whose primary language is other than English.

Political correctness- the notion of not offending individuals or groups by using terms that may be considered inappropriate.

Translation- refers to the written word

Visual Affirmation- the physical surroundings of healthcare organizations, such as artwork and images, that reflect the customers/patients/clients served.

Introduction

Health professionals serve a diverse population.

Political correctness, diversity, interpretation and translation are important.

Political Correctness.

For example, think about the terms we call different people. The example given in our text is “Oriental” to describe Asian people. What is the politically correct term? Turns out, they preferred to be called Asians.

If health professionals are open to the different worldviews that may exist among their patients of various cultures, in terms of health, and have some insight into various cultures, perhaps mutual trust and communication between the health professional and the patient would result in ensuring the provision of culturally competent care.

Considering cultural competency in health care.

The projections are set for the percentage of minoritized groups to increase by the year 2050. So logically this would mean that “an understanding of the history, religion, health practices and beliefs, and role of cultural influences on motivation are necessary to overcome physical challenges, illness, and the process of recovery for any group.” (Larrieux, Randolph & Blissett, 2003, p. 9)

DIFFERENCE BETWEEN INTERPRETATION AND TRANSLATION

There is a distinct difference between the two terms.

Interpretation refers to the spoken word, whereas translation refers to the written word.

Therefore, if a client who is not proficient in English enters a healthcare facility and needs to communicate verbally, the health service facility must be prepared to communicate with that person. The first instinct may be to turn to a family member, if the person is accompanied by such a person, or to find a staff person who speaks the language of the person. Although intuitively this may seem like an accurate approach, this is not appropriate due to confidentiality concerns, problems with interpretation due to dialect, or other concerns pertaining to the language spoken by the patient.

Translation, on the other hand, is a matter of ensuring that all important documents and written signage are translated so patients are able to understand words they encounter during the provision of services.

One approach is to use what is known as universal signage, such as female or male caricatures for the bathrooms and arrows for directions throughout the facility. Other documents such as healthcare brochures and documents, such as the Patient Bill of Rights and other important patient information, should also be translated by individuals who are proficient and trained in the process of translating such documents, including medical terminology, through the use of medical translations services.

Translators must be trained in the medical field in terms of providing these services for facilities relative to the provision of services by healthcare professionals.

Visual Affirmation

Health care environment should be welcoming.

For example, a display of various cultures in the form of pictures or décor, magazines, brochures.

Vaneta Masson, RN, (2005, p. 95) stated that part of the process of serving individuals in a healthcare setting is to “get to know the patient, his or her family, his or her living situation and the community over time and to allow yourself to be known.”

Health service professionals must ensure that the areas where their patients are waiting and are being treated affirm the notion of true concern and value for the person, not just as a patient/customer but as a whole person (including his or her culture). This provides the patient with a sense of feeling comfortable and serves as a precipitating factor for his or her to return to the facility for care in the future.

Diversifying the health care workforce.

Diversity refers to the makeup of the workforce in a given healthcare organization. This includes ethnic and racial backgrounds, age, physical and cognitive abilities, family status, sexual orientation, socioeconomic status, religious and spiritual values and geographic location (Betancourt, Green, & Carillo, 2002).

Diversity and culturally competency are distinctly different.

Trust

Remember that each culture has their beliefs, customs and practices when it comes to their health.

As healthcare practitioners, we must be aware of this- hence the importance of cultural competency in health care.

Kleinman et al. (1978) established the following questions healthcare professionals should ask their patients:

1.   What do you believe caused your problem?

2.   Why do you believe it started when it did?

3.   What do you believe your illness does to you?

4.   How severe is your illness?

5.   What are the chief problems your illness has caused you?

6.   What do you fear most about your illness?

7.   What kind of treatment do you believe you should receive?

8.   What are the most important results you hope to receive?

Please take a look at tables 3-1, 3-2, 3-3 and 3-4. Really informative with regards to different cultures.

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