Cultural Competence

cultural incapacity example

"African Americans are the best Athletes"

cultural blindness example

"Everyone has the same healthcare needs" "I don't see race"

cultural destructiveness example

"patients should learn to speak English, they're in America"

what core values are involved in cultural competence?

- accountability - altruism - excellence - professional duty

benefits of cultural competence for the patient

- better outcomes - more likely to follow their care

unconditional positive regard

- committing to respectful interactions w/ all people - transcends race

3 ways CLAS seeks to achieve their goal

- culturally competent care - language access services - organizational support for cultural competency

examples of cultural impositions in healthcare

- giving a diet to a patient without regard to cultural beliefs on food - restricting family contact for a patient who believes family support is needed for recovery

cultural proficiency

- hold cultural differences in high regard & educate others - develop skills to address differences & partner w/ other cultures

how does ethnocentrism affect cultural competence?

- it could be a barrier to cultural competence - could compromise care - can lead to cultural impositions

ethnicity

- language - beliefs - ancestry - customs

cultural incapacity

- not intentional, but ignorant and lacking the ability to help minority clients - believing in superiority of dominant group

cultural competence

- respecting and accepting differences & making changes to accommodate those differences

race

- skin, hair, eye color - bone structure

cultural blindness

- thinking culture or race makes no difference - use traditional dominant culture as universal

benefits of cultural competence for the health care provider

- understanding differences - awareness of culture - improved skills of understanding verbal & nonverbal cues - increased confidence

how can culture affect your communication?

- using common idioms may confuse non-native speakers - leads to miscommunication & can affect the patient/practitioner relationship

cultural destructiveness

- viewing other cultures as problematic & seeking to destroy it -denying services/dehumanizing patients

3 stepping stones to cultural competency

1) awareness 2) knowledge 3) skills

5 traits of a culturally competent organization

1) it values diversity 2) assesses cultural climate 3) it adapts delivery of healthcare services for different groups & cultures 4) it understands interactions b/t cultures 5) it institutionalizes cultural knowledge

CLAS Mandates

Any facility that receives federal funding must: 1) give language assistance to patients w/ no cost to the patient 2) give written & verbal notification of those services 3) not use family/friends as interpreters unless patient requests 4) make sure interpreters are competent 5) make patient's materials & signage available in languages that are common in the area of service

cultural pre-competence example

Attending a continuing education course on Spanish for the Physical Therapist

CLAS stands for

Culturally and Linguistically Appropriate Services

CLAS Guidlines

For accreditation from an accrediting bodies, facilities must: 1) provide patients care w/ respect for their culture 2) promote diversity in staff 3) ensure all staff provide ongoing education 4) promote plans for culturally & linguistically appropriate services 5) perform self assessment of cultural services 6) collect info on patient's culture in their medical record 7) maintain demographic of the patient population 8) ensure conflict and grievance resolution can be used by everyone regardless of their language/culture

excellence (as it relates to cultural competence)

PT practice that uses the patient/client perspective

cultural competence example

Scheduling your patient's appointments to avoid a conflict with their religious holiday

subcultures

a group that doesn't hold all the values of the dominant cultural group

prejudice

adverse & hostile attitude b/c a person belongs to a group

why should you be aware of your own unconscious and conscious biases?

allows you to be more controlled in your interactions

culture

an integrated pattern of human behavior

stereotyping

applying false characteristics to an entire group

awareness

appreciating the importance of the issue

cross's cultural competence continuum

ascending in order from negative and least competent to positive and the most culturally competent you can be

cultural proficiency example

attending monthly in-services & lectures on culture given by experts

subcultures and experiences

can be based on shared experiences (ex: people w/ disabilities, cancer survivors, military)

organizational culture

collective personality of an organization (their attitudes, beliefs, experiences)

professional duty (as it relates to cultural competence)

committing to positively influencing the health of society

Cross's Cultural Competence (actually continuum list) from negative to positive

cultural: - destructiveness - incapacity - blindness - pre competence - competence - proficiency

minority percentage in APTA

currently 12% identify as belonging to an ethnic/racial minority group

what guidelines do organizational cultures describe for that organization

describes guidelines of appropriate behavior

organizational culture is developed by

employees and their own personalities & experiences

knowledge

factual info on cultural demographics

bias

feeling in favor or against one person or group compared to another

what is unconditional positive regard essentially?

good sandbox skills

cultural bias

interpretations that are based on culturally derived meanings

cultural imposition (or cultural imperialism)

intrusive projection of one's values onto another's

cultural competence in relation to the APTA

is a key goal of the APTA's 2020 vision b/c pt profession understands how culture shapes our ability to deliver good healthcare

cultural combination

language communications customs attitudes beliefs values

competence

meaning having the capacity to function effectively

accountability (as it relates to cultural competence)

participating in achieving the health goals of patients & society

stigmatization

people are depersonalized by negative labels

APTA Strategic Plan on Cultural Competence

plan's goal is to increase the number of PTs and PTAs from minority groups so they match the changing demographic in US

altruism (as it relates to cultural competence)

providing PT to under served/represented populations

cultural pre-competence

realizing ones weaknesses in serving others & attempting to improve

ethnocentrism

tendency of people to think that their way of thinking or acting is the only right ways to act

the iceberg analogy of culture

that things like race & gender are just the "tip of the iceberg" when it comes to what is included in culture, and there are many other subcultures like mental health or religious beliefs

organizational culture within the healthcare field is defined by

the culture of the patient, the practitioner, the organization's, and the medical field's

cultural competence as a health disparity

the lack of cultural competence within healthcare services is considered to be one of the causes of health disparities

acculturation

the process of adopting the cultural traits of another group

why were CLAS standards developed

to reduce health disparities in care and improve healthcare for all people in the US

goal of CLAS standards

to reduce overall costs of healthcare by decreasing the errors made b/c of cultural or linguistic misunderstandings

discrimination

unjust treatment based on culture alone

skills

using your awareness and knowledge in action

marginalization/oppression

victims are subjected to unfair or unequal treatment

CLAS Recommendations

would be nice if facilities provided info to the public on CLAS standards