Cultural Competence Flashcards
Attitudes, behaviors and policies that enable us to provide care to patients in cross-cultural situations = ?
Cultural Competence
Cultural competence:
- Attitudes, behaviors and policies that enable us to provide care to patients in cross-cultural situations.
- Includes tailoring of healthcare delivery to meet patients’ diverse needs.
- (E.g.) race, ethnicity, language, age, religion, education, ability, gender identification
Three stages of developing cultural competence = ?
Cultural Competence
Three stages of developing cultural competence:
Stage #1:
- Develop knowledge of self, self-awareness and how one’s self is influenced by one’s culture and beliefs.
Stage #2:
- Develop awareness of people who have their own values and a willingness to treat others as they wish to be treated.
Stage #3:
- Develop the ability to empathize with and to respect individuals having a different world view.
Encompasses the various characteristics that make one individual or group different from another = ?
Cultural Competence
Diversity:
(a) Includes all of the ways in which individuals differ.
(b) Encompasses the various characteristics that make one individual or group different from another.
(c) These differences are shaped by:
- Family
- Friends
- Life experiences
Includes elimination of barriers and upliftment of marginalized groups to produce fair access, opportunity and treatment for all = ?
Cultural Competence
Equity:
(a) Goes beyond equality (equal treatment of all people).
(b) Includes elimination of barriers and upliftment of marginalized groups to produce fair access, opportunity and treatment for all
(c) When applied to health care is termed “health equity”:
- The attainment of the highest level of health for all people.
- Everyone has a fair and just opportunity to attain their optimal health.
- Regardless of race, ethnicity, language, socioeconomic status, disability, gender identity, sexual orientation, geography….
Includes seeking contribution and participation of all people = ?
Cultural Competence
Inclusion:
- The quality of valuing, welcoming, respecting, and providing opportunities for full participation for all individuals and groups.
- Includes seeking contribution and participation of all people.
- Creates a culture of belonging.
Generalized beliefs about an individual or group of people = ?
Cultural Competence
Barriers to diversity, equity and inclusion:
(a) Stereotypes: Generalized beliefs about an individual or group of people.
- An expectation that people might have about every person of a particular group.
- “cognitive bias”
Preconceived opinions or judgements about another person that isn’t based on logic or actual evidence = ?
Cultural Competence
Barriers to diversity, equity and inclusion:
(a) Prejudices: Preconceived opinions or judgements about another person that isn’t based on logic or actual evidence.
- Making a judgment based on prior history.
- “emotional bias”
Acting on feelings of prejudice to treat people unfairly, based on the group(s) or class(es) that they belong to = ?
Cultural Competence
Barriers to diversity, equity and inclusion:
(a) Discrimination: Acting on feelings of prejudice to treat people unfairly, based on the group(s) or class(es) that they belong to.
- “behavioral bias”
Any form of conscious/unconscious discrimination, prejudice or stigmatization against a group or population of people = ?
Cultural Competence
Prejudice - ‘Isms’:
(a) Any form of conscious/unconscious discrimination, prejudice or stigmatization against a group or population of people.
(b) Includes:
- Racism
- Sexism
- Ageism
- Sizeism
- Xenophobia
- Ableism
- Anti-Semitism
- Classism
- Homophobia
Biases:
- Explicit = ?
- Implicit = ?
Cultural Competence
(A) Explicit bias:
- The traditional concept of bias
- Individuals are aware of their prejudices and attitudes toward certain groups
- Includes overt racism or homophobia
(b) Implicit bias:
- Attitudes or stereotypes held toward individuals or groups without conscious knowledge.
- Many studies demonstrate that bias is unconsciously present, even in those who do not want to be biased.
- Without recognizing these unconscious biases, we can’t take the first step toward confronting them.
- Race = ?
- Ethnicity = ?
- Nationality = ?
Cultural Competence
(a) Race:
- Social construct that groups people based on shared physical traits, primarily skin tone as well as other social and biological attributes.
- E.g. White, Black, American Indian, Asian, Pacific Islander…
(b) Ethnicity:
- Of/relating to large groups of people according to common racial, national, tribal, religious, linguistic or cultural origin or background.
- Belonging to a certain social group that has common traditions, cultures, language, ancestry, music, food, dress, values…
- Based on ancestry and shared history
- E.g. German, Lebanese, Mexican, Argentinian, Nigerian, Somali, Navajo Nation, Mayan, Chinese, Vietnamese, Samoan
(c) Nationality:
- A legal relationship involving allegiance on the part of an individual and protection on the part of the state.
A belief that race is a fundamental determinant of human traits and capabilities and that racial differences produce an inherent superiority = ?
Cultural Competence
(a) Racism:
- A belief that race is a fundamental determinant of human traits and capabilities and that racial differences produce an inherent superiority of a particular race.
(b) Systemic/structural racism:
- Systemic racism is said to occur when racially unequal opportunities and outcomes are inbuilt or intrinsic to the operation of a society’s structures.
- Systemic racism createsdisparities in many area including wealth, the criminal justice system,employment,housing,health care, politics andeducation.
Discrimination against people with disabilities = ?
Cultural Competence
(a) Ableism
- Discrimination against people with disabilities.
(b) Language and behavior regarding people with disabilities are forms of prejudice.
(c) As PTs we have been at the forefront of changing society’s responses to persons with disabilities
(d) Remember:
- People are not the sum product of their medical conditions.
- Avoid using a person’s diagnosis or disability to reference the patient
- E.g.The Left hemi, “the quad”, the central chronic pain patient, the paraplegic…
- Other examples:
- Saying ‘the bad leg’ vs the involved leg or painful leg.
- “She is confined to a wheelchair” vs. “she uses a wheelchair for mobility”
1994 Americans With Disabilities Act (ADA) was important legislation covering public accommodations and employment rights of persons with disabilities
Five social determinants of health = ?
Cultural Competence
Social determinants of health:
(1) Economic Stability:
- Reduce the proportion of adolescents and young adults who aren’t working or in school
- Increase employment in working age people
- Increase proportion of children living with at least one parent who works full time
- Reduce household food insecurity and hunger
(2) Education Access and Quality:
- Increase number of children in high quality early childhood education programs
- Increase proportion of high school students who graduate
- Increase the number of families whose parents read to them at least 4 days/week
(3) Health Care Access and Quality:
- Increase the number of adolescents who had a preventative health care visit in the past year
- Increase the proportion of people with health and dental insurance
- Increase the health literacy of the population
(4) Neighborhood and Built Environment:
- Reduce the rate of minors and young adults committing violent crimes
- Increase the proportion of homes that have an entrance without steps
- Increase the proportion of smoke-free homes
(5) Social and Community Context:
- Increase the proportion of voting age citizens who vote.
- Reduce bullying of lesbian, gay or bisexual high school students.
- Reduce bullying of transgender students
- Reduce the proportion of children with a parent or guardian who has served time in jail/prison.
- Increase the proportion of adults who can talk to family/friends about their health.
