Chapter 4
Learning Objectives
At the end of this chapter, students should be able to:
• Explain differing perspectives on the use of health-related technology by cultural groups.
• Discuss the relevance of recruiting diverse healthcare professionals.
• Identify cultural views regarding modern medical approaches.
• Describe the cultural competence continuum.
• Express the key elements of the Purnell model, the LEARN model, and the assumption exercise and their relevance to cultural competency and health professionals.
Different Perspective
“An analysis of ethnicity and social class membership reveals that members of the lower socioeconomic and ethnic minority groups are much more likely than upper-class majority groups to have a parochial form of social organization, and to adhere to a popular or nonscientific health orientation.”
(Suchman, 1964)
CULTURAL VIEWS REGARDING MODERN MEDICAL PRACTICES
Cultural practices may impact the seeking of health care and health behaviors.
Such cultural practices require an interdisciplinary approach.
See example of Haitian women in Little Haiti in Miami and cervical cancer (pg. 44 in e-book)
This above scenario, paints the picture of why knowledge about culture is important.
How can we as health professionals collect this type of information in a non-judgmental way?
RECRUITING DIVERSE HEALTHCARE PROFESSIONALS
Greater work-force diversity improved public health.
Diverse work force may help patients to feel comfortable.
There must be particular efforts to attract employees from diverse racial and cultural backgrounds.
Training in cultural competence is important for employees
It is inappropriate to assume because the individuals are of diverse backgrounds they are culturally competent.
Aspects of Diversity
Race
Gender
Age
physical appearance
Nationality
Cultural heritage
Life experience
Aspects of Diversity 2
Economic status
Religion
Language
Marital status
Educational level
Sexual orientation
Although cultural competency cannot be achieved without diversity, diversity alone is insufficient.
CULTURAL COMPETENCE CONTINUUM
6 components/levels
Cultural Destructiveness
Cultural Incapacity
Cultural Blindness
Cultural Precompetence
Cultural Competence
Cultural Proficiency
CULTURAL COMPETENCE FRAMEWORK
5 constructs
cultural awareness
cultural knowledge
cultural skill
cultural encounters
cultural desires
PARAMETERS THAT DIFFERENTIATE CULTURES
the view of time and space
physical space between people
the roles of men and women
PURNELL MODEL FOR CULTURAL COMPETENCE
a schematic combined with an organizing framework that is applicable to all healthcare disciplines and has been translated into French, Spanish, Flemish, and Korean (Purnell, 2002)
The 19 assumptions within the context of the model focus on:
Information
key factors that all healthcare professions share
cultural differences and similarities
changes in culture over time
19 assumptions
variations from the dominant culture
clients and coparticipants in their care
the influence of culture on interpretation of care
cultural groups of individuals and families
cultural respect
importance of cultural information for caregivers to ensure the provision of culturally competent care
importance of culturally competent skill sets
19 assumptions continued
how culture is learned
minimization of cultural biases and the need for health care to reflect understanding of values, beliefs, attitudes, life ways, and views of cultures and acculturation patterns
differences in race and culture need adaptation to standard interventions
LEARN MODEL
The LEARN model is an educational framework that enables healthcare providers to improve communication, increase their awareness of cultural issues relevant to the care of their patients, and gain better acceptance by patients of treatment plans.
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
