Essays on Culture Competence

One of the modern health services priorities is meeting the needs of culturally diverse patients. The reason is that the demographics of patients are rapidly changing. Like a deck of cards where each card is different yet contributes significantly to the whole, our country is becoming a beautiful tapestry of diversity. Within large metropolitan communities, as many as 27-45% of the residents are foreign born.

Hospitals, churches, schools, public health departments, and law enforcement agencies have had to adapt to a growing number of people unable to speak English and unable to understand Western healthcare practices.
Cultural competence: definitions and basic information

The term “cultural competence” related to Healthcare was first described by Leininger in 1978, and was proposed as a means of addressing culturally-specific health needs, for example, reducing health disparities and their burden, and optimizing an individual’s care and health outcomes. (Jeffreys, 2006)

Today, and in the foreseeable future, medical practitioners, organizations, and systems need to be culturally competent.

Culture’ encompasses learned patterns of thought and behavior, including language, values, actions, religion, and rules of conduct, which distinguish a particular social group from others. By extension, cultural competence has been defined as an ongoing process in which healthcare providers strive to function effectively within the cultural contexts of clients. (Capell, Veenstra & Dean, 2007)

Cultural competence acknowledges and incorporates – at all levels – the importance of culture, the assessment of cross-cultural relations, vigilance towards the dynamics that result from cultural differences, the expansion of cultural knowledge, and the adaptation of services to meet culturally unique needs.

Various definitions of cultural competence include “sensitivity to issues related to culture, race, gender, and sexual orientation”, “the process in which the healthcare provider continuously strives to achieve the ability to effectively work within the cultural context of a client”, and “an ongoing process with the goal of achieving ability to work effectively with culturally diverse groups and communities with a detailed awareness, specific knowledge, refined skills, and personal and professional respect for cultural attributes, both similarities and differences”. (Jeffreys, 2006)
Culturally competent care refers to professionally delivered healthcare that represents a “continuous process of cultural awareness, knowledge, skill, interaction, and sensitivity among caregivers and the services they provide. Principles of theory, research, and practice guide nurses as they identify healthcare needs of clients, provide care, and evaluate care with quantitative and qualitative measures. Cultural competence requires the continuous seeking of skills, practices, and attitudes that enable nurses to transform interventions into positive health outcomes such as improved client morbidity and mortality, and client and professional levels of satisfaction,” (Capell, Veenstra & Dean, 2007)

Culturally competent health care professional’s skills include the following:

Has the capacity for cultural self-assessment. Practitioners must recognize the immense influence of culture and be able to assess the effect it has on their own and other people’s life views and actions. It is not merely the “other” who has a unique culture, but each one of us. Understanding our own values, attitudes, beliefs and behaviors is a prerequisite to successful interventions.

Values diversity, with an awareness, acceptance, and even celebration of differences in life view, health systems, communication styles, and other life-sustaining elements. Individuals share common basic needs and cultural universals such as a family unit, parental roles, educational system, health care system, forms of work, and forms of self-expression. Yet they have different ways of going about meeting those needs: values, attitudes and behaviors are variable and unique to each individual. Not only is there great inter-cultural diversity in the world, but also within cultures there is a wide range of intra-cultural diversity. Patients and their families, as well as health professionals within a particular group, each exemplify a range of health beliefs and behaviors and are again influenced by a huge array of cultural variables.

Is conscious of the dynamics of difference. With cultural interaction comes the possibility of misjudging the other’s intentions and actions. Each party to an interaction brings to the encounter a specific set of experiences and styles. One must be vigilant to minimize misperception, misinterpretation, and misjudgment.