Delivering Culturally Competent Healthcare

Healthcare providers nationwide are having to make do with fewer resources and staff, while serving an increasingly diverse clientele. It is the culturally competent organization that will have a competitive edge in the healthcare market and a decreased likelihood of liability/malpractice claims.

Culturally Competent Care
Healthcare providers at all levels benefit from cross cultural training. Providers must examine their own cultures as well as their patients’ to understand the customs, beliefs and practices regarding the patient/provider relationship, and concepts of wellness and illness. Organizations must look at their policies and procedures and see if they facilitate or hinder culturally sensitive service delivery.

Providers must be attentive to nonverbal communication, show empathy, and respect patient’s perspectives, even if they disagree. The provider should ask the patient questions, not only about symptoms, but about individual's perception of the illness and why he or she became ill. This approach provides good cultural insight into the patient's view of illness, which can be useful when recommending treatment. The culturally competent provider acknowledges and discusses viewpoint differences and similarities with the patient, so they can offer services that are compatible with the patient's health beliefs and practices.

Language can be a huge barrier to health care delivery. Even people who are fairly fluent in English may not have the specialized vocabulary to discuss symptoms, testing, and treatments. Organizations should have a strategic plan to incorporate culturally and linguistically appropriate services and provide appropriate language assistance at all points of contact. This may includes bilingual staff, interpreters and written materials in commonly used client languages. Never use a family child as an interpreter.

Below are a few basic beliefs and practices for various cultures.

1. Personal relationship and trust between provider and patient is extremely important.
2. Belief in fatalism or God’s will. This can affect whether or not they seek care and adhere to treatment.
3. Medical decisions often involve the whole family.
4. May use traditional or folk healers and medicines.
5. Since Latin culture is hierarchical, patients often view the doctor as an authority figure and may not express disagreement or lack of understanding.

1. Asian culture views health in a more holistic light than in Western culture. Health is not only physical, but spiritual, social and environmental.
2. Balance and harmony of opposing forces leads to good health. (e.g. yin and yang; Ayurveda (Indian) medicine).
3. Fatalism affects views of illness. This can include punishment or curses from spirits for wrong doings in this or past lives.
4. Traditional healing includes herbal medicines, as well as acupuncture to restore flow of chi (the life force in everything)
5. Since Asian culture is hierarchical, the eldest male may be the primary decision maker. Additionally, Asians may not express disagreement or lack of understanding.

African American
1. Faith and prayer are an important part of the healing process.
2. African American culture has a history of a strong mistrust of the healthcare system. 3. Belief in fatalism or God’s will.
4. Extended family and friends play an important role in successful treatment and healing.
5. Tradition of herbal remedies. Health care providers should ask about these to avoid potential drug interactions.

On Lauren's what problems these healthcare providers encountered with patients from other cultures.