Transcript Culturally-Competent-Patient-Carex

Presenters: Ariel Cochrane-Brown and Erica Wallace
Source: http://www.dmu.edu/magazine/spring-2013/the-criticality-of-culturalcompetency/
1. Introduction of presenters
2. Conversation about culture
3. Cultural awareness of self
4. Cultural knowledge of others
5. Inclusive language
6. Case studies
Source: http://www.speakingandpresenting.com/presentation-ideasagendas.html
Ariel Cochrane-Brown
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B.A., Journalism and Mass
Communication, University of North
Carolina at Chapel Hill
M.Ed., Counselor Education, Clemson
University
PhD student, Educational Research and
Policy Analysis, North Carolina State
University
Erica Wallace
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B.A., Sociology, Davidson College
M.Ed, Counselor Education, Clemson
University
Coordinator for Peer Mentoring &
Engagement, University of North
Carolina at Chapel Hill
Source: http://www.juliaferguson.com/shock.html
• Culture is learned from birth through group socialization and language acquisition.
• Culture is adapted to specific conditions.
• Culture is dynamic and ever-changing.
• Culture is shared by most, if not all, of the members of that particular group.
Cultural sensitivity as it relates to health care consists of:
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the awareness and acceptance of cultural differences in patients.
the ability to conduct an honest self-assessment of one's own cultural values and beliefs regarding health and illness.
the recognition that people of different cultures have different verbal and nonverbal ways of communicating
the ability to gather and analyze knowledge of other cultures
recognize that cultural beliefs about health and illness impact a patient’s interactions with healthcare professionals,
self-treatment practices, health care outcomes and adherence to medications.
Cultural competency encompasses cultural sensitivity, but goes a step further. It also is the ability to adapt
your practice to meet the cultural needs of the patient community in which you serve. Being competent
also means that patient care may have to be adapted or negotiated to be compatible with that patient’s
culture.
More specifically cultural competence is having the ability to provide care to patients with diverse values,
beliefs and behaviors and to tailor that care to patients’ social, cultural, and linguistic needs.
Source: http://www.rcn.org.uk/development/learning/transcultural_health/foundation/sectionthree
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Source:
http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofC
ontents/Volume82003/No1Jan2003/AddressingDiversityinHealthCare.aspxThank
Cultural awareness is the self-understanding of one’s own cultural and professional background.
Cultural knowledge is the process of seeking and obtaining an educational foundation about different cultural and ethnic groups.
Cultural skill is described as the ability to collect relevant cultural data about the patient’s problem as well as perform a culturally based
physical assessment.
Cultural encounter involves the health professional engaging in cross-cultural interactions with individuals from diverse backgrounds.
This interaction is almost impossible when the patient and health provider speak different languages, the patient has a limited English
proficiency, the patient is speaking from a different perspective, or the provider has a limited proficiency in the patient’s language.
Occasionally, cultural tradition may preclude a patient speaking directly to a provider. For these reasons, an interpreter is sometimes
needed.
Cultural desire is the motivation of the health care provider to engage in the process of culturally responsive care. A culturally
competent pharmacist will consciously adapt care for the patient in a way that is consistent with the patient’s need from the context of
a cultural framework.
Source: http://ptcrn.com/post/cultural-awareness
In her book, Cultural Diversity in Health and Illness, R. Spector lists some questions to consider to better understand one’s cultural
heritage and its effects on health care perceptions. The questions below include many from Spector’s work, as well as some
more general cultural background questions.
1. What is your cultural heritage?
2. Where did your parents/grandparents/great grandparents come from?
3. What were/are some foods, celebrations, rituals, clothing, etc that were meaningful to your
family and symbolized your cultural background?
4. How do you define health?
5. How do you keep yourself healthy?
6. How do you define illness? What causes illness?
7. What would you define as a minor, or non-serious medical problem?
8. How do you know when a given health problem does not need medical attention?
9. What health problems do you self-diagnose?
10. Who do you seek for help with minor health problems? Major health problems?
11. Do you use over the counter medications? Which ones and when?”
12. Who makes health care decisions in your family?
13. What expectations are there for who is to care for an elderly relative?
Source: http://www.oliviahdzp.com/2013/08/07/what-is-cultural-knowledge-and-how-can-we-use-it
Demographics of PC Pharmacy Students
1. Current enrollment: 311
2. % Minority by class
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d.
P1 (first year) 25%
P2 21%
P3 23%
P4 21%
3. % Female by class
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b.
c.
d.
P1 60%
P2 64%
P3 73%
P4 70%
Consider the many social identities individuals possess that
are connected to different cultures.
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Gender
Sexual Orientation
Race
Ethnicity
Source: http://alexanderstreet.com/products/health-sciences/counseling-andtherapy/counseling-and-therapy-alexander-street-press
● Bias: a tendency to believe that some people, ideas,
etc., are better than others that usually results in
treating some people unfairly
When you hear a narrative, you fill in the blanks
with what you know…..that’s your bias
Source: http://studentlife.umich.edu/article/inclusive-language-campaign
Inclusive Language Definition: Inclusive language is language that does not
belittle, exclude, stereotype or trivialize people on the basis of their identity
including but not limited to race, gender, sexual orientation and ability.
(UNC-CH)
Inclusive language does not mean cumbersome, dull or vague language; it
simply means language that has been carefully constructed in ways that treat
all people with respect and impartiality.
(Guidelines for Inclusive Language, 2012, p. 2)
When using inclusive language, it is useful to keep the following generic questions in
mind:
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Is it necessary to refer to personal characteristics such as sex, religion, racial
group, disability or age at all?
Are the references to group characteristics couched in inclusive terms?
Do the references to people reflect the diversity of the intended audience?
Is the use of jargon and acronyms excluding people who may not have
specialized knowledge of a particular subject?
(Guidelines for Inclusive Language, 2012, p. 3-4)
Try to avoid being gender specific. Use words like “partner” instead of
“husband”, and “they” instead of “he” or “she.”
Use language which carries the fewest connotations about the person you
are talking to. Instead of saying, “Who is your next-of-kin?” say, “Is there
anyone you would like to give as an (emergency) contact name and telephone
number?”
Don’t force people into categories or disclosure. Instead of saying, “Are you
straight, gay or bisexual?” or “Are you male or female?” say, “How do you
describe your sexual orientation?” or, “How do you describe your gender?”
(Inclusive Language in the NHS, p. 3-4)
Use terms that are inclusive such as “first name” and “family name”, instead of
“Christian name” and ‘surname”
Avoid “racial or ethnic invisibility” like using umbrella terms such as “Asians” that
ignores multiple ethnicities within Asia. Instead, refer to people from Indonesia,
Thailand, etc.
Avoid undue emphasis on racial and ethnic differences. Only refer to the ethnic or
racial background of a person or group if it is relevant to the discussion
Avoid stereotyping. Do not make positive/negative generalizations about members of
a particular racial, ethnic or national group in ways that detract from people’s
fundamental humanity and individuality
(Guidelines for Inclusive Language, 2012, p. 4)
Source: http://www.theclinegroup.com/the-clients/case-studies/
Mr. Eduardo Montanez is a 68-year-old Latin American man originally from
Matamoros, Mexico. He moved to San Antonio, Texas, 5 years ago because his
son, daughter-in-law, and their five children wanted to take care of him. He has
limited English skills but is able to navigate his way reasonably well. His son is a
schoolteacher and has excellent health benefits. Mr. Montanez is a dependent;
therefore, he is eligible to receive the full benefit of his son’s health insurance
plan. All of his life, Mr. Montanez has been a deeply religious person. He was
raised in the Catholic Church and went to a Catholic school in Mexico. His mother
raised him to believe in the church as a spiritual basis for everything in his life. He
also has traditional Mexican beliefs about the spiritual nature of illness. Mr.
Montanez believes that any illness he develops is related to a failing or
wrongdoing on his part. He was raised with folk medicines administered by his
mother and spiritual healers.
Huong is an 8-year-old Vietnamese boy who arrived in the United States
4 years ago with his mother and father. He speaks English well; however,
his mother and father are quite limited in their command of the
language. Huong attends public school in Omaha, Nebraska. He is doing
very well with all of his subjects. His schoolteacher and a friend in his
neighborhood help him to learn his lessons because his parents are not
able to correctly interpret the assignments in English. Huong interprets
for his parents when they do life chores, such as purchasing items at the
hardware or grocery store. He is their “window” to the English-speaking
world. His parents frequent a shop that sells Chinese medicines.
Mr. Samuel Robinson is a 76-year-old African American male who has resided in Biloxi,
Mississippi, since he was 12 years old. He and his wife, Georgia, were married for 40 years.
Georgia died 1 year ago. He is having a difficult time keeping his life in order now that he
lives alone. He has always been a self-sufficient man. However, Mr. Robinson had a deep
love and interdependency with Georgia, as did she with him. She would prepare remedies
when he did not feel well, exchanging and discussing several of the traditional comfort
remedies with her friends. These remedies were not written down anywhere, and Mr.
Robinson cannot help himself with it. He finds this discomforting. Georgia frequented a
pharmacist in town regularly. She took care of her husband’s needs with the pharmacist as
far as he was concerned. Now he is forgetful and often distracted. Mr. Robinson attended a
Baptist church with his wife. He has only gone to church twice since she died—at her
funeral and at the 6-month anniversary of her death. Mr. Robinson is on Medicare, his only
form of health insurance coverage. He retired from being a farm worker 9 years ago with a
very small pension and no supplementary health coverage.
Questions
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Rogowski, A.C. The pharmacy technician’s guide to understanding cultural diversity.
https://www.cedrugstorenews.com/userapp/lessons/page_view_ui.cfm?lessonuid=&pageid=1B04088130882D5944B21736
06285525
Zweber, A. (2002). Cultural competence in pharmacy practice. American Journal of Pharmaceutical Education, 66(2), 172176. http://pharmacy304.pbworks.com/f/Cultural+Competence+in+Pharmacy+Practice.pdf
American Society of Health-System Pharmacists. Chapter 1: The patient.
http://www.ashp.org/DocLibrary/Bookstore/P2524/Chapter-1.aspx
Clark, K. J. Achieving cultural competency and its role in pharmacy.
http://www.scrx.org/assets/journalce/culturalcompetencynoanswersnocomments.pdf
American Pharmacists Association. Cross-cultural communication.
http://www.pharmacist.com/sites/default/files/files/Chapter19InstructionalMaterials--Halbur.ppt
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Social identity wheel
https://awnastas.expressions.syr.edu/wp-content/uploads/2011/12/Social-Identity-Wheel.pdf
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Cultural Competence Health Practitioner Assessment (CCHPA)
http://nccc.georgetown.edu/features/CCHPA.html
Quality of Culture Quiz
http://academicdepartments.musc.edu/gme/pdfs/Quality%20and%20Culture%20Quiz.pdf
Cultural Assessment Mnemonic Tools
http://www.geneticcounselingtoolkit.com/pdf_files/Cultural%20and%20Spiritual%20Mnemonic%20Tools
%2011.06.09.pdf
Fadiman, A. (1997). The spirit catches you and you fall down: A Hmong child, her American doctors, and
the collision of two cultures. Macmillan.
Spector, R. E., & Spector, R. E. (2004). Cultural diversity in health and illness(pp. 256-268). Upper Saddle
River, NJ: Pearson Prentice Hall.
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Ariel Cochrane-Brown, M.Ed.
PhD Student, Educational Research & Policy Analysis
Graduate Assistant, Office of Graduate Student Support Services
Department of Leadership, Policy, and Adult and Higher Education
North Carolina State University
[email protected]
Erica Wallace, M.Ed.
Coordinator for Peer Mentoring & Engagement
Center for Student Success and Academic Counseling
University of North Carolina at Chapel Hill
[email protected]
Source: https://www.knowthegoodshepherd.org/contact