Cultural competence in healthcare
[1][2] This process includes consideration of the individual social, cultural, and psychological needs of patients for effective cross-cultural communication with their health care providers.
[1] By definition, diversity includes differences in race, ethnicity, age, gender, size, religion, sexual orientation, and physical and mental ability.
Multicultural competency is a more encompassing term that includes the ability to function effectively in cross-cultural interactions with a wide range of different cultural groups.
[11] According to the American Sociological Association, culture itself is understood as the languages, customs, beliefs, rules, arts, knowledge, collective identities, and memories shared by members of a social group that form the foundations of motives or actions.
[14] The Diversity Training University International (DTUI) included an attitude component that is delineated from the other factors increasing the analysis of general biases and beliefs as a scheme in one's daily life.
[15] Social psychologist Patricia Devine and her colleges conducted research that found that low-scorers on a cultural familiarity test tended to exemplify more discriminatory actions or speech in cross-cultural interactions.
[16] Knowledge of culture also includes awareness of the structural, social, and environmental barriers that give meaning to certain actions in patients' lives.
[1] As more and more immigrants are coming to America, healthcare professionals with good cultural competence can use the knowledge and sensitivity that they obtain in order to provide holistic care for clients from other countries, who speak foreign languages.
The challenges include but are not limited to the following:[1][21] In response to a rapid growth of the population of minority groups in the United States, healthcare organizations have responded by providing new services and undergoing health reforms in terms of diversity in leadership and workforce.
[24] Subconscious discrimination occurs regardless of the advancement of disease prevention in the United States, as shown by the significantly high mortality rates of the groups mentioned earlier in the paragraph.
[24] This discrimination is shaped by attitudes of healthcare professionals, who often differ in effort and type of treatment based on the race and physical appearance of a patient.
A program called Minnesota Immunization Networking Initiative (MINI) was started “in 2006 to reduce vaccination barriers of underserved populations” like African-Americans, Hispanic-Americans, etc.
Other research studies have also recommended that providers build trust with clients by making efforts to establish relationships with patients and “keeping in mind unique cultural profiles.
"[28] In response to the increasingly diverse population, several states (WA, CA, CT, NJ, NM) have passed legislation requiring or strongly recommending cultural competency training for physicians.
[35] Occupational therapists are a valued member of healthcare among the allied health professions and can offer a unique contribution to the improvement of cultural competence.
Occupational therapists develop an individualized effective intervention plan based on understanding the client's values and beliefs of health and illness.
In 1994, the National Institutes of Health established policy (Public Law 103-43) for the inclusion of women, children, and members of minority groups and their subpopulations in biomedical and behavioral clinical studies.
They should try their best to communicate their concerns relating to their beliefs, values and other cultural factors that might affect care and treatment to their physicians and other healthcare providers.
[48] Examples: In March 2022, Houston Health Department (HHD) [49] announced minority-owned, Houston-based media and creative business firm 9thWonder Agency [50] as its partner to help reduce vaccine hesitancy.
The core functions of a nurse rely on conversation and communication, which is directly impacted by the ability to speak or understand the language and culture of the patient.
The authors recommend that each health care service plan and implement processes and systems to give nurses the tools, training, or resources they need to effectively carry out their job, specifically when communicating with patients who do not speak the same first language as them.
With cultural and linguistic barriers, it is not surprising that it is hard to achieve effective communication between the health care providers and the LEP patients.
[56] The three themes of the fifteen CLAS standards areGovernance, Leadership, and workforce; Communication and Language Assistance; and Engagement, Continuous Improvement, and Accountability.
The standards clearly emphasized that the top levels of an organizational leadership hold the responsibility for CLAS implementation, and that language assistance should be provided when needed, and quality improvement, community engagement, and evaluation are importance.
[58] The high demand but low value for this position generates interpreters who may be ill-fit for the responsibility, consistently running late and not having the adequate training to perfectly translate the patient's needs or the doctors orders.
It is shown from these studies that professional translation and interpreter services, coupled with language education, are not enough to overcome these cultural and linguistic hurdles.
[61] For example, in studies, Community Navigators at Federally Qualified Health Clinics helped improve the cancer diagnosis and screening process and timeline among underserved, vulnerable populations.
[61] One factor that impinges on delivery culturally competent care is the degree in which the leadership and workforce of the physician population reflect the rates of minority groups in the United States.
[18] On a study conducted on a cohort of 147,815 primary care physicians, the Black, Hispanic, and Native American groups together constituted 13.4 percent of the population as compared.
[28] Thomson writes that direct provider-patient communication increases the chances of the patient's customs and beliefs being understood and taken into account during treatment, leading to better care.
