CULTURAL COMPETENCY IN HEALTHCARE - CH. 6

Cultural competence

Knowledge and understanding of another person's culture allowing one to better adapt interventions and approaches to healthcare to the specific culture of the patient, family, and social group. Which term fits the definition?

Low dental health literacy

People with low health care literacy may also experience ___ ______ ______ ________.

Cultural encounters

Process by which healthcare professional engages in face-to-face cultural interactions with patients from culturally diverse backgrounds. Which term fits the definition?

Cultural norms

_____ ______ contribute to how members of a specific group determine explanations for health expectations and illness.

Cultural beliefs and practices

________ _______ ___ _________ can influence oral health status, such as appreciation of the importance of healthy primary teeth or expectations about preventive or therapeutic interventions.

Cultural skill

Ability to conduct a cultural/physical assessment to collect data. Which term fits the definition?

Oral health professionals regularly encounter clients with different backgrounds, belief systems, cultures, values, attitudes, norms, traditions, and languages

As an RDH, why is it important to understand cultural competence?

Cultural sensitivity

Being aware that cultural differences and similarities exist that affect values, learning and behavior. Which term fits the definition?

Care that demonstrates cultural sensitivity starts with the clinician, who must be aware that cultural differences and similarities exist

How is cultural sensitivity defined? **

It is defined as a set of guidelines that one can inherit as a member of a particular group or society

How is culture defined? **

Refers to the belief that one's culture is superior to that of others - ignoring or devaluing the models and practices embedded in other cultures can be described as ethnocentrism and leads away from best practices in healthcare

How is ethnocentrism defined? **

Health inequalities - the result of complex interactions among biologic, lifestyle, environmental, social, and economic factors

Differences in health status or distribution of health determinants between different population groups. Which term fits the definition?

Assessment, diagnosis and care planning - by the assessment of the client's values and the beliefs of his or her culture, ethnic group or subculture

How is a complete evaluation of the client's condition obtained in a cross-cultural environment?

Cultural differences might be experienced in relation to various forms of nonverbal communication including gestures, handshakes, eye contact, or physical proximity - follow the client's lead and explore his or her expectations and beliefs

How is nonverbal communication related to cultural differences? **

Is the often erroneous assumption that a person possesses certain characteristics or traits simply because he or she is a member of a particular group - stereotyping fails to recognize the uniqueness of the individual and prevents an accurate perception of those who appear different. It is a biased opinion - stereotyping should not be promoted as a strategy

How is stereotyping defined? **

It is group of people who have different goals and interests from the primary culture based on occupation, sexual orientation, age, social class or religion

How is subculture defined? **

It is critical to completely and accurately record all information relevant to client care - documentation relates to all components of the dental hygiene process of care - a complete and accurate record of all information relevant to client care is critical

In a cross-cultural environment what changes are made during documentation?

The client's cultural perspective of success must be considered during this phase of care - evaluation determines whether the oral health services are meeting the client's needs - the client's cultural perspective of success is a pivotal factor during this phase of care

In a cross-cultural environment what changes are made during evaluation phase?

Dental hygiene interventions must be congruent with cultural values for optimal adherence - oral hygiene interventions should be culturally acceptable for optimal adherence

In a cross-cultural environment what changes are made during implementation phase?

Identification of culture-specific information

In a cross-cultural environment, what changes during the assessment phase?

Identify clients unmet human needs or any other factors affecting oral quality of life that can be fulfilled through dental hygiene care - employ motivational interviewing techniques

In a cross-cultural environment, what changes during the dental hygiene diagnosis and care planning phases?

- relates to all components of dental hygiene process of care - critical to record completely and accurately

In a cross-cultural environment, what changes during the documentation phase?

- gain insight into patient's perspectives of success - validation occurs via feedback

In a cross-cultural environment, what changes during the evaluation phase?

Dental hygiene interventions should be culturally acceptable

In a cross-cultural environment, what changes during the implementation phase?

Cultural knowledge

Information one knows about cultures. Which term fits the definition?

Cultural awareness - also help the healthcare provider avoid ethnocentric and stereotypical thoughts, actions, and behaviors that can interfere with providing culturally competent care

Process of self-examination and self-assessment of one's own culture and its potential influence on one's ways of thinking and behaving. Which term fits the definition?

Illness

Psychosocial experience and meaning of the perceived disease for the individual and those closely associated with the individual. Which term fits the definition?

Healthcare literacy

The ability to understand health, disease and how the healthcare system works. Which term fits the definition?

Cultural sensitivity

The awareness and sensitivity that cultural differences and similarities exist and can affect values, learning, and behavior. Which term fits the description?

Healthcare literacy

The degree to which a patient has the capacity to obtain, process, and understand health information and services needed to make appropriate health decisions in a particular language. Which term fits the description?

With the clinician - awareness of one's own cultural beliefs and practices - clinician is encouraged to ask clients about their health beliefs and their cultural backgrounds

Where does culturally sensitive care start? **

The culturally sensitive oral health professional should assess the core cultural values for each client individually rather than focusing on the group to which the client belongs

To remain culturally competent, what should happen at the first oral care visit? **

- poverty; individuals of low socioeconomic status are, on average, more intimidated by the healthcare system than individuals of higher socioeconomic status - disenfranchisement - lack of transportation - homelessness - seasonal work - low literacy The oral health professional should take the responsibility to reduce barriers to improve quality of and access to care

What are the common barriers to health disparities?

Nonverbal communication

What does proxemics stand for?

Negotiate mutually acceptable options - Explanation (How do you explain your illness?) - Treatment (What treatment have you tried?) - Healers (Have you sought any advice from alternative healers?) - Negotiate (mutually acceptable options) - Intervention (agree on intervention) - Collaboration (with patient, family, and healers)

What does the N in the ETHnic model stand for?

Recommend a treatment plan - Listen to patient's perspective - Explain and share one's own perspective - Acknowledge differences and similarities between these two perspectives - Recommend a treatment plan - Negotiate a mutually agreed-on treatment plan

What does the R in the LEARN model stand for?

Group is viewed as the fundamental unit of society - a client from a collectivist culture may feel threatened or disoriented by autonomous decision making - it is the responsibility of the clinician to identify the client's preference for shared decision making and to incorporate those preferences into the care provided

What is a collectivist culture? **

Ensuring equitable, high-quality care among diverse groups

What is a major emphasis of culturally competent care?

The motivation of the healthcare professional to "want to" engage in the process of obtaining the cultural knowledge

What is cultural desire?

Views the single person as central, with autonomy and self-determination being essential to medical and dental care

What is individualistic culture? **

Dental hygienist must understand patient's view or cultural context for making healthcare decisions - a clear understanding of both the collectivist and individualistic viewpoint is essential to negotiate a mutually acceptable care plan with the patient

What is involved in shared decision making in heathcare?

Use of an interpreter - when language is a barrier, it is most appropriate to use a medical interpreter with no relationship to the client

What is recommended to implement when language is a barrier?

Another culturally sensitive framework to communicate with patients in cross-cultural environments

What is the ETHNIC model?

Culturally sensitive framework to communicate with patients in cross-cultural environments

What is the LEARN model?

Maximize understanding between communicators - hygienists must understand the local cultures to communicate effectively and to help clients achieve optimal health

What is the goal of effective communication? **

Cultural factors

What must be considered when formulating and disseminating written materials such as informed consent, post-op instructions etc.?

Physical contact - necessary touch only - culture also determines the personal space that must be maintained between individuals during an encounter

When in doubt, which form of communication is best to be restricted?