Module 6 Flashcards

Question

Why is cultural competency problematic?

Answer 1

- Focus on language barriers - Checklist of what to do/what to say for certain cultures - E.g. Here is how you should interact with a Latino pt rather than learning about the culture - need to learn their values, beliefs, and customs. Need to learn about their historical experiences and how it may influence them

Answer 2

- A broad view of a cultural group (e.g. latino) can lead to stereotypes and generalizations - May assume all latinos have the same beliefs, values, norms, etc. when this isn't the case. Many latin countries have different cultures eve though they share the same language (e.g. Spanish)

Answer 3

- Impossible to learn the values, beliefs, family dynamics and health behaviours of all cultural groups - Focus on the individual; get to know the patient themselves rather than focus on trends associated with certain groups and making assumptions off those trends - Switching the ethics of care from checklist principles to a focus on the individual pt

Answer 4

- DO NOT USE a one size fits all approach; all though appears as equitable, does not address differences across cultures - Are we actually catering to the needs of these people? - Refine services to be culturally competent (through education) to reduce disparities - Collect data on race and language, find out what barriers to healthcare are being experienced, interpreters, make flexible hours, refer to peer support networks, train staff and clinicians in cultural competence

Answer 5

- Group of doctors, hospitals, and other health-care providers that come together voluntarily to provide coordinated care to their patients - Minimize cost to pt; maintain effective care by meeting quality indicators - Benefits --> Increased quality of care, lower costs and improved population health - Cover diverse populations --> use anlaytics to predict barriers that atke into account race, socioeconomic status, education level

Answer 6

Community health workers, all with different cultural and linguistic backgrounds, will have the capacities to meet the needs of diverse communities

Answer 7

- A push for training culturally competent healthcare providers - However, in this regard, cultural competency can be reduced/simplified to a "checklist" --> an item to be checked off in training

Answer 8

- When we aspire to learn about a person's values, beliefs, family dynamics and health dynamics, we may disregard that all individuals are different - Just because someone belongs to a culture, does not mean that person has the same culture as another person - Healthcare providers cannot assume that all people within a culture are the same and have the same beliefs and values

Answer 9

- Healthcare professionals need to reflect on their own culture; including, the bio-medical culture - We need to reflect on the challanges that pts and families face in the healthcare system

Answer 10

Three dimensions a) Lifelong learning b) Recognizing and challanging power imbalance c) Institutionalized accountability

Answer 11

Learned and shared knowledge that specific groups generate their behavior and interpret their experience of the world

Answer 12

- Every group has a culture. Culture is fluid. No one has the same culture - Culture is shared and unique, fluid and transmitted

Answer 13

Cultural Safety ensures that service providers become respectful of all aspects of culture including (history, values, gender, socioeconomic status). - Spiritually, socially and emotionally safe as well as physically safe - No challenge or denial of their identity - Shared knowledge, respect and learning together – establish trust

Answer 14

Service providers should also acknowledge that their own cultural beliefs and attitudes have the potential, consciously or unconsciously, to influence the power balance with their clients and each other.

Answer 15

Cultural safety on a continuum comes after cultural competence and proficiency but it is not about a checklist or memorizing different norms based on ethnicity.

Answer 16

Cultural Shift - Shift the role of culture as checklist-based ethnicity to critical examination of power encounters in client relationships - healthcare provider has the power --> Shift that power to the pt

Answer 17

It is about understanding the person in front of you, creating trust and working together with the person so that your interactions do no harm to the individual. The major constructs to consider are historical oppressions and power in relationships.

Answer 18

Social Construction - Knowledge is created as we interact with all things in our environment. It is not static and not only what we learn in school.

Answer 19

Can have assumptions but must put them behind us. Get to know the person.

Answer 20

Using power and authority to create inequity and or unfair treatment

Answer 21

- Need to understand how history has affected cultures Example: First nations --> residential schools --. poorer health outcomes --> genrational trauma

Answer 22

Cultural Safety

Answer 23

- improving the provision of care to minorities with the goal of reducing ethnic disparities

Answer 24

Cultural Destructiveness (e.g. genocide) to cultural proficiency (agencies that hold culture in high esteem who seek to add to the knowledge of culturally competent practice by conducting research and developing new therapeutic approaches based on culture)

Answer 25

- The distribution of power

Answer 26

acknowledging the barriers to clinical effectiveness from the power imbalance - Be aware of difference, decolonizing, considering power relationships, reflective practice - WORKING WITH THE PATIENT NOT FOR THE PATIENT

Answer 27

The focus of cultural safety moves to the culture of the clinician or clinical environment rather than the culture of the pt

Answer 28

Complete paradigm shift --> A need for self reflection

Answer 29

- Inequities in access to the social determinants of health have their foundations in colonial histories and subsequent imbalances of power that have consistently benefited some over others

Answer 30

organizations and the individual

Answer 31

Four times higher - Routed in colonialism and history of residential schools

Answer 32

1. Colonialism and Social Determinants of Health 2. Health Services Organization 3. Language and Communication 4. Traditional Practices and Cultural Perspectives of Health

Answer 33

Barriers: - racism in health organizations - many noted being treated differently due to their indigenous status - Led people to not engage with the healthcare system - Difficult to apply advice from healthcare providers because of socioeconomic position (e.g. healthy eating due to food desserts) Enabler: - focus education on sensitizing providers to discrimination and racism - foster attitudes of acceptance, openness and respect - Systemic regulation for handling complaints regarding racism

Answer 34

Barriers: - ill adapted to the social organization of first nations culture (did not let family into care/sessions) - social support not facilitated within the system - Congestion of health care system Enablers: - Organizing a system that favours the involvement of family in care - Exclusive indigenous clinics ran by indigenous people - Hiring more indigenous staff and profesisonals

Answer 35

Barriers: - Unable to obtain services in their native tongue - Use of medical jargon by healthcare professionals - Lack of understanding of social/communication attitudes in the culture (e.g. not being able to look in the eyes as deemed inappropriate/disrespectful) Enablers: - Interpreter service - learning basic terms in the language

Answer 36

Barriers: - Guidelines for diabetes management not adapted to the communities food and lifestyle - Providers limited knowledge of traditional health practices and spiritual understanding of disease - providers unsure of where to start learning and how to apply that knowledge Enablers: - An adapted nutrition guide to their food and lifestyle - provide education about their culture to providers

Answer 37

- patients need to understand how to effectively and safely use their medications

Answer 38

Trust, Informed Consent, Good-decision making (need to know what pt knows and what they are willing and able to do), effective self-management of disease

Answer 39

- Communication based on "shared" patterns - Risk is higher as pt does not express actual experiences Any questions about med? No

Answer 40

- focus on providing information in a singular or one-way direction (dat dump) - activ ept participation possible, but, not encouraged ASSUMED POWER DIFFERENCE (PHARMACIST HAS THE POWER)

Answer 41

- Two way conversation - Information sent and recieved in stages by pharmacist and pt - feedback and discussion create context for further discussion

Answer 42

- difficult to establish rapport - lack of appropriate health information resulting in poor understanding of medications and potential adverse effects - over reliance on informal social networks and social media

Answer 43

- sender assumes the receiver knows very little and must be told everything - reciever expects communication to be explicit

Answer 44

the sender assumes the receiver knows the relevant situation/circumstance. the receiver quickly understands concerns and messages with minimum information from the sender --> more concerned with emotional quality than the meaning of individual words/sentences --> tend to make greater use of silence

Answer 45

Monochronic time: emphasis on creating and maintaining schedules, and being on time. Polychronic time: values involvement with others versus keeping appointments and schedules.

Answer 46

Important for the HCP to promote/support reflection and not try to fill in “gaps” in the conversation

Answer 47

Individualism: social pattern in which the person is primarily motivated by own preferences, needs, rights and desires Wants of the group are secondary Collectivism: the person gives greater priority to the needs of the group (family, work unit, community). Motivated by group norms and duties

Answer 48

In some cultures, loud or raised voices indicate tension or aggression In other cultures, indicates an exciting and enjoyable conversation among friends. Correct interpretation critical - People who speak quietly or slowly… Struggling with a second language Sign of respect and reflection

Answer 49

Expressions, touches and gestures Often convey stronger messages than verbal communication Can re-enforce or contradict the verbal message. Appropriate amount of touching based on cultural norms Such as handshakes, hugs, kisses, etc. Significant differences across cultures; also within cultures based on age or status. Changes in norms also occur over time within cultures

Answer 50

Refers to the distribution of power within a group or society Vertical: concentration of power “at the top”. Many with little or no power Tendency to be more formal with deference to those in positions of authority Hesitancy to give one’s opinion or ask questions of those seen as authorities/experts Horizontal: power more widely shared with a more egalitarian view of one another Less deference and less hesitancy to ask questions

Answer 51

L - Listen with empathy and for understanding - How does the patient view the problem E - Explain your view of the problem to the patient - After demonstrating active listening A - Acknowledge similarities AND differences - Done by both patient and provider R - Recommend appropriate treatment - “For consideration” approach vs. “Prescriptive” approach N - Negotiate with the patient over what is possible for the patient - The best solution may not be the best solution

Answer 52

- We are aware of resources and can refer people to more reliable multi-lingual information sources rather than social media or the internet - Encourage multi-lingual staff and health professionals - Use dual language label - Use pictograms to help identify what a patient is trung to communicate --> Put them on med labels - Use support of interpreters -