Current Status
Not Enrolled
Enroll in this module to get access
Price
Free
Get Started
Cultural Competence
Cultural Competence
Cultural Competence
Standard 1 Social Justice
- Principles of social justice guide decision related to the patient, family, community, and other healthcare professionals. Providers will develop leadership skills to advocate for socially just policies
Standard 2 Critical Reflection
- Engage in critical reflection of one’s own values, beliefs, and cultural heritage in order to have an awareness of how these qualities and issues can impact culturally congruent care
Standard 3 Transcultural knowledge
- Understand the perspectives, traditions, values, practices, and family systems of culturally diverse individuals, families, communities, and populations cared for, as well as knowledge of complexities of achieving well-being
Standard 4 Cross Cultural Practice
- Utilize cross cultural knowledge and culturally sensitive skills implementing culturally congruent care
Standard 5 Healthcare Systems and Organizations
- Provide the resources and structure to evaluate and meet cultural and language needs of diverse clients
Standard 6 Patient Advocacy and Empowerment
- Recognize the effect of healthcare policies, delivery systems, and resources on patient population and advocate and empower their patients
Standard 7 Multicultural Workforce
- Be activists for a more multicultural workforce in healthcare settings globally
Standard 8 Education and Training
- Be educationally prepared and receive ongoing continuing education in the knowledge and skills for care that is culturally congruent, that is also included in the global health care agenda
Standard 9 Cross Cultural Communication
- Use effective, competent, communication with clients that consider verbal and non-verbal language, cultural values and context, and unique healthcare needs and perceptions
Standard 10 Cross Cultural Leadership
- Be able to influence individuals, groups, and systems to achieve culturally competent outcomes for diverse populations
Standard 11 Policy Development
- Work with public/private organizations, professional associations and communities to establish policies and standards for comprehensive implementation and evaluation of culturally competent care
Standard 12 Evidence-Based Practice and Research
- Practice is based on effective interventions for culturally diverse populations. Where lack of evidence exists, researchers should test and investigate to contribute to reducing racial and ethnic inequalities in health outcomes
Culturally and Linguistically Appropriate Services (CLAS)
Ultimately, the aim of the standards is to contribute to the elimination of racial and ethnic health disparities and to improve the health of all Americans
There are 14 CLAS standards. The following standards guide all providers in their direct care roles:
Standard 5
- Healthcare organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation
Standard 6
- Healthcare organizations must provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their rights to receive language assistance services
Standard 7
- Healthcare organizations must assure the competence of language assistance provided to limited English proficient patients/consumers by interpretation services (except on request by the patient/consumer)
Evidence-Based Cultural Considerations
African American
- May discontinue medications once symptoms subside, often doubling the need for further therapy
- Touch is viewed as an essential part of healthcare; personal space may be minimal
- Heavily rely on religious rituals and a minister’s advice
- Health viewed as a gift from God
- Illness and suffering may be God’s will or evil influences
- Folk healers and fold medicine may be common
- Cod liver oil to prevent colds
- Copper or silver bracelets to protect from harm
- Allopathic healthcare often not a priority for prevention
- May believe in voodoo (especially Haitians and Africans)
Hispanics
- Often believe it is unnecessary to continue pharmacotherapy once symptoms abate
- Especially problematic for diabetes in which ongoing medication is required
- Esteem the mother or grandmother, especially from the husband, as the primary decision-maker of health related issues
- Balance of “hot and cold” is essentials
- “Hot/cold” illnesses and medications
- “Wet/Dry” concepts
- Illness is treated with the opposite type medicine: hot for cold, cold for hot
- May not take penicillin for a “hot” illness because penicillin is viewed as a “hot” medicine
- Illness may be caused by Mal de Ojo (“evil eye”)
- Healthcare workers can inadvertently give this look
- Strong religious association
- Health is a gift from God and reward for good behavior
- Illness prevention strategies: Eating proper foods, working the proper amount of time, wearing religious medals and sleeping with relics
- Use of curanderos (holistic healer) may be common
- Treat with a variety of herbs, teas, visits to shrines, medals, candles, and promises to God to change behavior
- Often concerned about the potential for addiction when taking medication for prolonged periods of time
- May expect injections as a necessary component of effective treatment for disease
- Taking oral medications may be viewed as a less effective treatment
Asians
- Vast array of herbal remedies are used: Potential for drug-drug interactions
- Eye contact may be a sign of disrespect
- Using the word “yes” is common; it usually means “I’m being polite” and maybe understanding what is being said
- Esteem elders’ views, wishes, and authority among other members of the family
- Diabetes is relatively less common in asians
- Dietary requirements may be difficult to follow given dietary traditions
- Well insured in comparison to other races
- 18% of US Asians uninsured, lowest of all groups
- Approximately only one-half of Asians over the age of 65 make as many visits to healthcare providers as caucasians
- Longer life expectancy and lower death rates from all causes than general population
- Many influenced by Shinto, a religious orientation
- Evil is caused by outside spirits (pleasing good spirits is important to health)
- Japanese
- Japanese and other asian females may be open to talking with a female healthcare provider, but not male
- Japanese esteem drug safety more than effectiveness
- May explain the usual belief an practice of using lower doses of medication and resultant fewer reported side effects
- Chinese
- Health is a result of forces that rule the world: Yin (cold and Yang (hot)
- Cold illnesses (diarrhea) are treated with hot herbs and food
- Hot illnesses (hypertension) are treated with cold herbs and foods
- Illness may be diagnosed by pulses and color and/or texture of the tongue
- Traditional Chinese medicine may pose that one can remove not only the cause of the symptoms for an underlying disorder, but permanently remove the disease state, as well
- Often use American medicine for acute illnesses and surgery and fall back to Chinese medicine to treat long-term conditions
- Health is a result of forces that rule the world: Yin (cold and Yang (hot)
- Filipinos
- Subscribe to Yin and Yang
- God’s will and supernatural forces determine illness as a punishment for violations
- Amulets and religious medals may be worn as a shield from witchcraft or as a good-luck charm
Native Americans
- The term “elder” in the Native American community denotes a position of leadership, based on experience, spirituality, and community service, rather than on chronological age
- Many tribes consider 50 years of age and older as qualifying as an “elder”
- In some tribes and/or nations, causes of illness may be considered an “imbalance” between the spiritual, mental, physical, and social interactions of the individual and his family or clan
- Must consider the spiritual aspect of an individual, since healing is considered sacred work in many Native American traditions
- Many contemporary Native Americans use “causasian man’s medicine” to treat “caucasian man’s diseases” such as diabetes, cancer, and cholelithiasis
- Use “Native American Medicine” to treat what are considered “Native American problems” such as
- Pain
- Disturbed family relationships resulting in physical symptoms
- Mental illness
- Alcoholism
Caucasians
- Generally viewed as intolerant to pain while other cultures accept pain as a part of life
- Perceive eye contact as communicating interest and honesty
- Most hold high expectations that disease will be cured and/or managed through powerful medications
- Strong family ties – historically males are viewed as the dominant force and/or decision-maker
- Strong religious ties
- Religious medals and rituals are often used to prevent illness and heal
- Increasing number of caucasians using:
- Alternative sources of healthcare
- Herbal therapies
- Most believe and expect that a prescription is a necessary component when seeking career in the doctor’s or practitioner’s office
