Health Beliefs and Cross Cultural Communication

Question 1

Values

Answer 1

Values are strong beliefs and attitudes about the worth of a thought, idea, object, or course of action

Personal vs. Professional Values

Question 2

Attitudes

Answer 2

Attitudes are favorable or unfavorable emotions or sentiments toward individuals or groups that strongly predict behaviors.

Consider implicit bias and the impact of attitudes on health care outcomes and disparities

Question 3

Moral Sensitivity

Answer 3

Successful providers understand the importance of the client-provider relationship, identify their own personal beliefs and values, examine differences between their beliefs and values and those of their clients, and promote awareness of ethical issues found in practice.

Question 4

Race-

Answer 4

genetics inherited traits identifiable by physical attributes

Question 5

Ethnicity-

Answer 5

people of similar backgrounds who choose to live or socialize together, geographic origin

Question 6

Ethnocentrism-

Answer 6

evaluating a culture from your customs of your culture

Question 7

Culture-

Answer 7

pattern of beliefs, values, and behaviors. Includes language, communication, customs and views on roles and relationships, values, attitudes

Question 8

Collectivist cultures- Asian, Hispanic

Answer 8

Past or present orientation in time

Respect for elders

Fate, just being

Cooperation, human interactions dominate, harmony

Group welfare

Low eye contact

Question 9

Individualistic Cultures- US, Germany, Australia, UK, Canada

Answer 9

Future oriented

Precise time is important, plans are made

Personal control over the environment and outcomes

Doing, working, taking charge, control

Competition

Autonomy, self achievement

Independence

High eye contact

Question 10

APTA BluePrint for Cultural Competence

Answer 10

Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in crosscultural situations

Question 11

What is Cultural Sensitivity?

Answer 11

Value diversity

Have the capacity for cultural self-assessment

Be conscious of the dynamics inherent when the cultures interact

Institutionalize cultural knowledge

Develop adaptations to service delivery reflecting an understanding of diversity between and within cultures

Question 12

How to Develop Culturally Sustaining Practices?

Answer 12

Cultural Destructiveness
Cultural Incapacity
Cultural Blindness

Question 13

Cultural Competence:

Answer 13

a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. (CDC definition)

Question 14

Cultural Humility:

Answer 14

is a lifelong process, caregivers engage with their patients, colleagues and themselves. It is a dynamic, requiring mutual respect and willingness to learn from patients about their cultural experiences

Question 15

Cultural Respect in HealthCare

Answer 15

Cultural Pre-Competence
Advanced Cultural Competence
Cultural Humility

Question 16

The one activity even the busiest clinician should be able to find time to do:

Answer 16

routinely ask patients (and where appropriate, family members), what matters most to them in the experience of illness and treatment

Question 17

Universal Aspects of Health Care in All Cultures

Answer 17

Health care specialist applies a name to the problem

The qualities of the health care professional ( vs provider) are important. ( Credibility to help)

The health care professional must establish credibility through symbols and trappings that are familiar in the culture

The healthcare professional places the client’s problems in a familiar framework

The health care professional applies techniques meant to bring relief

Interactions between client and practitioner occur at a time and place

Question 18

One major problem with the idea of cultural competency:

Answer 18

it suggests culture can be reduced to a technical skill for which clinicians can be trained to develop expertise”

a.k.a. “Do and Don’ts”

Question 19

cultural competence framework

Answer 19

nonlinear, intersections concepts

defined constructs

addresses social justice

structure considers multiple perspectives
> individual
> family
> global factors

Question 20

cultural humility framework

Answer 20

addresses power imbalances between patient and provider

learn from the patient

active listening

recognition of personal biases

Question 21

Purnell framework:

Answer 21

a) consideration of the whole person

b) individual, family, community and global factors

c) caregivers should provide culturally sensitive, competent, and congruent care

d) self awareness

e) patient-centered care

Question 22

Campinha-Bacote framework:

Answer 22

a) cultural competence is an ongoing process

b) variations exist within cultural groups

c) caregiver provide patient-centered care

d) 5 constructs: cultural awareness, knowledge, skill, encounters, and culture desire

e) include sexual orientation, age, disability, gender, religion, language, political orientation, socioeconomic status and social justice

Question 23

Tervalon and Murray-Garcia framework:

Answer 23

a) addresses power imbalances between patient and provider

b) patient takes a decision-making role

c) provider reflects on behaviors and biases or stereotypical assumptions

Question 24

Fisher–Borne framework:

Answer 24

a) 3 core elements: institutional and individual accountability, lifelong learning and critical reflection, and mitigation of power imbalances

Question 25

Questioning, Immersion, Active Listening, Negotiation framework:

Answer 25

a) questioning that involves remaining curious about cultures b) immersion in culture c) active-listening d) negotiation to a create a mutually agreeable patient care plan

Question 26

The Explanatory Model

Answer 26

To open clinicians to human communication and set their expert knowledge alongside (not over and above) the patient’s own explanation and viewpoint.”

Question 27

Levanthal’s “Common-sense model”

Answer 27

Components include: ‘What is this health threat, what can I objectively do about it?” ‘How do I feel about it, what can I do to make myself feel better about it?’

Question 28

Health beliefs /common sense illness model

Answer 28

LABEL / DIAGNOSIS = What do I have? CAUSE = How did I get this illness /condition? CONSEQUENCES = How will it affect me? TREATMENT = How can I get better? What can be done? TIMELINE (Prognosis) = How long will this illness /conditions last?

Question 29

The L.E.A.R.N. Model of Cross–Cultural Communication

Answer 29

L = Listen with sympathy and understanding to 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

Question 30

The R.E.S.P.E.C.T Model of Cross–Cultural Communication

Answer 30

Rapport Seek the patient's point of view Consciously attempt to suspend judgment Recognize and avoid making assumptions Empathy Seek out and understand the patient's rationale for his or her behaviors or illness Verbally acknowledge and legitimize the patient's feelings Support Ask about and try to understand barriers to care and compliance Help the patient overcome barriers Involve family members if appropriate Reassure the patient you are and will be available to help

Question 31

How to develop culturally sustaining practice?What can you do?

Answer 31

Examine self through reflective practice Learn about the diversity dimensions that influence health outcomes, and affect the human experience both positively and negatively Recognize the need for a patient-centered approach for delivery of culturally competent physical therapy services Value effective communication between the patient and the therapist as a fundamental for delivery of culturally competent care Incorporate the National Standards for Culturally and Linguistically Appropriate Services(CLAS) in Healthcare CLAS Address the determinants of health that influence health outcomes Apply core knowledge about culture, belief systems, and traditions to enhance the patient-therapist interaction

Question 32

Questions we can ask our patients

Answer 32

To provide the best care for you, what would you like me to know about your culture or preferences? Who makes health care decisions for your family? Are there particular beliefs or practices I should be aware of? What do you do to prevent illness or stay well? (herbs, diets, rituals) How is our medical care different from what you or your family traditionally use? Do you or your family seek medical care from religious healers or others in your community?