Cultural Competence- exam1

Define L.E.A.R.N

L- listen with empathy and understanding of the patient's perception of the problem E- explain your perceptions of the problem A- acknowledge and discuss the differences and similarities. R- recommend treatment N- negotiate agreement

Differentiate between internal and external locus control as it relates to health beliefs.

Locus of control- the degree to which people believe that they have control over the outcome of events in their lives, as opposed to external forces beyond their control. Internal-the person has control external-the person does not have control

ethnocentricity

to consider the beliefs, values, customs, and viewpoints of your culture superior to other cultures.

Provide some recommendations to overcome disparities in health and improve health literacy.

(I'm not really sure if this is what she is looking for) -Conduct focus groups to get opinions and suggestions. -Have representatives from those groups look over any publications or education materials you plan to use to make sure they are meaningful and are not offensive. -ask representatives of specific groups where you can place educational materials so that your target group will see them. -recruit volunteers to make initial contacts with community organizations for outreach. (more on pg 579)

How to gain cultural competence.

-look at the health care industry through others' eyes- see the objectivity and separation of mind and body that people from other cultures see. -actively seek out communication with people from other cultures. -assess your own beliefs and prejudices about other cultures without shame, and become aware of generalizations and assumptions that you jump to.

Define health literacy and the concern with health disparity.

-the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (from healthy people 2020). ex. ability to understand prescription bottles, appointment slips, education brochures, doctor's directions, etc. It requires complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations. Concern with health disparities: people with health disparities might not understand or have health literacy.

aversive racism

Consciously knowing, and professing that all people are equal, yet subconsciously treating and judging some groups (races, genders, ethnicity) differently.

Health literacy video suggestions. Be able to pick out issues of health literacy and how some of these suggestions might be incorporated.

Create a shame free environment- make sure environment is open and helpful (video showed nurses wearing pins that read "ask me, I can help!"). Make sure environment feels safe and not hostile so pts can declare that they struggle with literacy. Offer help in the privacy of an exam room. If pts struggle with forms (how long do they have the form?), politely ask them if they need help, encourage them to open up. Engage entire staff of institute to watch for signs pts are struggling. Improve communication- slow down, and don't speak so quickly so they can understand what you are saying. Convey they most important concepts, and keep explanations basic and simple. use living-room language (layman's terms) Remember that anyone that isn't a doctor might not understand medical terms! Involve family members to help understand diagnosis and treatment. Use a lot of visual aids to help them understand what you are saying. Employ the teach-back method- ask them if their friends ask questions about what you are talking about...how would they explain it to them? How would they teach friends about their situation? Or just simply have them teach back to you what you have taught them.

Outline the cultural competence continuum giving an example of each stage.

Cultural Competence continuum- the process of gaining cultural competence is envisioned as a succession of stages (remember that not all stages happen in lockstep for all cultures, ex. someone may accept muslims, but not LGBT). Stages: Cultural destructiveness- attitudes, practices, and policies that are destructive to other cultures. Cultural incapacity (paternalistic)- paternalistic attitude toward the "unfortunates". No capacity to help. Cultural blindness (all the same)- belief that culture makes no difference. Everyone is treated the same. Approaches of the dominant culture are applicable for everyone. Cultural precompetence- weaknesses in serving culturally diverse populations are realized, and there are some attempts to make accommodations. Cultural competence- differences are accepted and respected, self-evaluations are continuous, cultural skills are acquired, and a variety of adaptations are made to better serve culturally diverse populations. Situations can be evaluated from multiple frames of reference. Cultural proficiency- engages in activities that add to the knowledge base, conducts research, develops new approaches, publishes, encourages organizational cultural competence, and works in society to improve cultural relations.

Define cultural competence and discuss why it is so important for dietitians.

Culture competency- a set of academic and personal skills that allows us to increase our understanding and appreciation of cultural differences between groups. -Cultural competence requires that organizations: 1. have a defined set of values and principles, and demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally. 2.have the capacity to a.) value diversity, b.) conduct self-assessment, c.) manage the dynamics of difference, d.) acquire and institutionalize cultural knowledge and, e.) adapt to diversity and the cultural contexts of the communities they serve. 3. incorporate the above in all aspects fo policy making, administration, practice, service deliver and involve systematically consumers, key stakeholders and communities. It's important for dietitians because developing an understanding and an appreciation of the health practices of various cultures can help health practitioners plan and implement meaningful interventions.

Define health disparity and what groups of people are most likely to experience and why. (I added common illnesses and food intake just for more info. It doesn't explain why they have a disparity (that's more socioeconomic, lack of insurance, etc.), but I thought it was good info)

Health disparities exist when a segment of the population bears a disproportionate incidence of a health condition or illness (also called health inequalities). Disparities exist because: -socioeconomic status -lack of insurance -culture (their beliefs) -access to and utilization of quality health care services. -discrimination /racism/stereotyping. -environment Groups: African Americans- lower life expectancy, higher infant mortality rates, higher heart disease, stroke, and cancer rates, high breast cancer rates among women, and higher asthma related deaths. This group: lactase deficiency -consume high amounts of fried foods -low intake of f/v -breastfeeding rates low Hispanics- tuberculosis rates high, high diabetes rates, cervical cancer high, aids rates high. This group: high intake of carbonated beverages; limited dental care among migrant workers. Native Hawaiians/Pacific Islanders- obesity, high blood pressure, cancer high. Diabetes death rates higher. This group: High salt intake, lactase deficiency common, not common to use milk Asian Americans- tuberculosis common, hepatitis B This group: High salt intake, lactase deficiency common, not common to use milk American Indians- diabetes rates high, aids high, cirrhosis deaths. This group: lack of refrigeration, intake of refined sugar, cholesterol, fat, and energy intake high, lactase deficiency and obesity are common.

cultural rlativity

principle that an individual's beliefs and activities should be understood by other in terms of that individual's own culture. a concept that cultural norms and values derive their meaning within a specific social context.

Acculturation

process of adopting the beliefs, values, and behaviors of another culture.

white privilege

societal privileges that benefit people identified as white in western countries, beyond what is commonly experienced by non-white people under the same social, political, or economic circumstances.