Cultural Competence in Healthcare

Importance

• Cultural competence is vital in healthcare and nursing, especially in multi-ethnic communities like Southern California.
• Nurses will encounter patients from diverse cultures, sometimes previously unknown ones.
• Integrating culturally congruent care is necessary for holistic patient treatment.
• Developing curiosity about different cultures enhances patient relationships and personal growth.

Objectives

Bias Impact

• Unconscious or Implicit Bias:
  • The latest edition of the textbook includes coverage of implicit bias.
  • Unconscious bias is influenced by background and can lead to stereotyping.
  • Implicit bias is recognized and must be addressed for improved patient care.

Definitions and Concepts

Culture

• Defined by shared beliefs, values, norms, and traditions guiding behaviors and decisions.
• Culture can unite or divide groups, serving as a context for interpreting human experiences.
• Visible and Invisible Aspects: Some cultural elements are observable, others require inquiry.

Key Terms

• Subcultures: Groups with distinct characteristics within the dominant culture.
• Enculturation: Being socialized into a primary culture from birth.
• Acculturation and Assimilation: Adapting to a new culture and integrating some of its values.
• Multicultural: Identifying with more than one culture.

Biases

• Unconscious Bias: Bias outside personal awareness.
• Implicit Bias: Recognized biases impacting behavior and decisions.

Worldview and Perspective

• Worldview: Shaped by cultural and personal surroundings.
• Emic and Etic:
  • Emic: Insider perspective (Me-centric).
  • Etic: Outsider perspective.
• Conflict arises when interpreting behaviors through personal worldview.
• Stereotypes harm individual treatment.

Health Disparities

• Defined as health differences linked to social determinants of health (economic, environmental disadvantages).
• Healthy People 2030 aims to reduce disparities and achieve health equity.
• Minority groups often have poorer health outcomes and access.

Social Determinants and Marginalized Groups

• Marginalized groups experience worse outcomes due to systemic factors.
• Examples include LGBTQ, people of color, and those with mental challenges.

Intersectionality

• Individuals often belong to multiple intersecting social categories (privilege and oppression).
• Iceberg Analogy: Visible behaviors versus hidden beliefs and experiences.

Cultural Competence Model

• Cultural Awareness, Knowledge, Skill, Encounter, and Desire:
  • Ongoing learning and self-assessment.
  • Cultural Desire: A genuine willingness to learn about other cultures.

Interaction with Patients

• Recognize patients' cultural self-identification in ethnicity and race.
• Patient Encounters are learning opportunities.
• Cultural Competence involves bridging gaps and providing supportive care.

Healthcare Standards

• Core Measures: Quality indicators for uniform care across demographics (e.g., beta-blockers for heart failure).

Language and Communication

• Providing language assistance is essential for non-English speakers.
• Use of interpreters, iPad apps, and translation tools in healthcare settings.

Patient Education

• Use plain language and verify understanding through teach-back methods.

Organizational Culture

• Each healthcare facility has its unique culture impacting patient and staff experiences.

Summary

• Cultural competence is a journey of learning and adapting to provide equitable patient care.
• Engage with diverse cultures to enrich healthcare experiences and outcomes.