Culturaldiversity in healthcare
Healthcare providers require advanced skills in communication for theircare to be efficient and safe. Having knowledge about interpersonalinteraction and being skilled at cross-cultural communication arefundamental professional skills that providers should possess. Theinterethnic standard of communication for healthcare providersrequires that they use both verbal and nonverbal skills ofcommunication to identify what the beliefs, unique healthcare needs,perceptions and practices of their patients are.
Thispaper addresses the role played by cultural practices to improvecommunication in a hospital setting. It provides a brief descriptionof culture and discusses the concept of diversity in the currentworld. It then provides a detailed analysis of the practices thataffect communication between a healthcare worker and a patient suchas religious and dietary practices. It also discusses possiblecultural barriers to good patient care. Recognizing the differencesbetween people from different cultures and learning to deal with themmaturely encourages adequate cultural based care.
Culturaldiversity, multicultural health care, ethnic disparities, culture,and religion, health communication.
Thestyle of communication can impact therapeutic relationship eitherdirectly or indirectly. By establishing a therapeutic relationshipwith an individual who is culturally diverse, care providers cannegotiate culturally-appropriate, patient-centered, andevidence-based policies of treatments with the patient. Culture playsa significant role in augmenting effective communication andintervention as a feature related to health and health behaviors.
Theimportance of cultural concern goes hand in hand with the need to getrid of the existing disparities between various culturally definedsubgroups on a broad ray of outcomes related to health includingconditions that have an effect on health (Pöchhacker &Shlesinger, 2013). It is an overall belief that comprehension ofcultural practices of the different subgroups communication will bemade better between the patients and care providers.
Cultureand diversity in healthcare
Cultureis a widely popular concept in healthcare and typically, it isconflated with ethnicity and race. Culture is used as a lifestylelabel presumed to group people according to certain socioeconomictraits (poverty culture) and into groups that engage in behaviorsconsidered marginal or undesirable socially such as drug and gangculture. Culture also delineates national identity. Such factors,however, much popular, they limit the conception of culture to afixed and simple instead of an intricate, active and adaptive system.The traits of any particular group culturally are either directly orindirectly linked to health-related decisions, priorities, andbehaviors and with adoption and acceptance of health communicationmessages and health education programs.
Thechanging economics and demographics of our rapidly developingmulticultural world and the time-honored incongruences in the healthstatus of individuals from backgrounds that are culturally diversehave posed a challenge to organizations and providers of health careto make cultural diversity a precedence. Health care providers must,however, recognize that addressing the issue is far much outstretchedthan just knowing the values, practices, beliefs and customs ofAsians, African Americans, Pacific Islanders, Alaskan Natives/NativeAmericans, and Latinos/Hispanics. Adding onto classification by raceor national origin, many other facades of cultural diversity exist.Religious affiliation, language, sexual orientation, politicalorientation, dietary practices and geographical location are some ofthe expressions of cultural diversity.
Culturalpractices that affect the interaction/communication betweenhealthcare workers and patients
Aprovider can demonstrate competence in multiethnic communication bygetting comfortable with asking fundamental questions such thathe/she can discover the broader context within which the patient isoperating. The background includes the cultural-religious beliefs ofthe patient which tremendously impact his or her health behavior.That mainly points to the patient’s expectations about what helpsin restoring them to health which is a very powerful tool inproviding culturally responsive care.
Communicatingwith Spiritual leaders
Forpatients who are buried in religion and religious practices, it isimperative that they are allowed to interact with those they considerspiritual leaders. During a health crisis, such influential figurescan help construe what is going on a spiritual level to both thepatients and their families. In the Catholic faith, for instance, thepatient can gain inordinate peace and strength by receiving thesacrament of the sick from a priest. In Judaism, it is imperative tobe aware of the discrepancies in practice among Conservative,Orthodox, and Reformed customs. Religious leaders can elucidate thebeliefs that cut across their faith in circumstances that involvelife support or birth control. The Muslim faith prohibits discussionabout death with a patient. It is a taboo to mention it directly tothe patient, and that’s where a spiritual leader steps in as acrucial arbitrator while holding conversations between thedoctors-in-charge and second-degree male kinsfolks in determiningwhether and how to inform the immediate family about the prevailingsituation of a terminal illness. Spiritual leaders’ help peoplemake connections between their inner spirit and their social,communal and ethnic motives for getting involved in a certainpractice. When health care providers collaborate and communicate withleaders of a community of believers, strong positive results for thepatient and the family are experienced.
Patientshardly control the kind of food they are served in a hospital settingmaking dietary concerns a crucial matter of discussion. All careproviders are required to comprehend food taboos for various culturesor religions. In private clinics and practice, it is a requirementfor doctors to understand the effects dietary restrictions have onpatient compliance (Christopher, 2012). Care providers must learn toask whenever they have doubts about the dietary taboos of any givenculture. For instance, for a Hindu patient, they should find outwhether or not they are vegetarian. Some Hindus eat meat but don’teat beef or pork, whereas others are total vegetarians. Eggs may notbe an option in a Hindu diet. Strict fasting comes for both Muslimsand Hindus and should be acknowledged by care providers as well. ForMormons, their dietary code forbids caffeinated drinks such ascoffee, tea, and cola drinks. Understanding something about thedriving force behind each belief and practice is more important thantrying to memorize specific dietary rules. For instance, it’simportant to understand that where fasting is involved, the beliefbehind it is that physical cleansing directly relates to spiritualcleansing. Communicating with the patient about preference in dieteffectively enhances the care for better results.
Culturalbeliefs dictate a great deal about the various ways of how peopleconceive time. Health workers must know and respect sacred time asmuch as they do “fluid” time. Providers must not interfere withtime set aside for sacred practice, and this comes by asking oneselfwhat day, according to the beliefs of the patients, do they considera day of rest? It is Sunday for Christians, Friday for Muslims, andfor Seventh-day Adventists and Jews, their sacred time is betweenFridays at sunset to Saturday at sunset. There should be calendars ininstitutions that note all the observed holidays for patients ofvarious cultures. On sacred days, appointments to office visits andmeetings with families should be cleared. The clergy is relied uponto determine such dates for holidays like Ramadan which change yearto year. When the patient feels respected, communication becomessmooth and hence become automatically responsive to care.
Culturalpractices and beliefs that can be a barrier to good patient care
Sincemost ideas in health are defined by culture, it follows that in caseswhere two or more cultures merge in a setting of healthcare, a crashof prospects often occurs. In the United States, therefore, culturaldiversity is viewed as a barrier to adequate care by healthpractitioners (Christopher, 2012). With the different beliefs aboutcauses of illnesses and treatment from the western methods, patientsdepend on their traditional modes of healing first and seek help fromwestern doctors when the symptoms show significant deterioration.
Delayeddiagnosis can result in cases where patients fail to air theirmisperceptions about western medicine and hence poor outcomes aftertreatment. Oral birth control is misunderstood by most cultures, andit often faces rejection. Some cultures forbid sterilization. Jews,in some circumstances, try to find rabbinical consultation beforesettling on the method of birth control. Other cultures still usenatural means of birth control. Such differences may lead tomisunderstandings between healthcare providers and patients hencepoor patient care.
Manycultures perceive chronic illnesses wrongly (Christopher, 2012). Whensuch people decide to seek medical attention for their conditionswithout the concept of asymptomatic chronic diseases, they end up notfollowing doctor’s orders and hence become troublesome. Forinstance, when put on a continuous dose, they tend to discontinuemedication when they feel better even when instructed not to. Thisbecomes an area of conflict as healthcare providers tend to give upon the disobedient patient. Male circumcision is a healthy practiceaccording to medical practitioners. Some communities do it thetraditional way despite having the option of surgically removing theforeskin at a hospital. Most of those people end up visitinghospitals with dire effects of the unhygienic practice causingconflict between providers and culture. In some cultures, patientsresist methods such as blood transfusion, organ donation and surgeryonly ending up dead.
Providersmay show discomfort while discussing culturally related healthbehaviors and beliefs with their patients. The article identifiesareas that may cause barriers to effective communication and howcommunication can be enhanced between providers and those who arekeen on culture. Care providers should do all it takes to createrapport before bringing up an issue of discussion. Understandingcultural differences that come with the increasing diversity andbeing empathetic is the key to a harmonious existence at a healthinstitution (Sadri & Flammia, 2011). Health workers, therefore,need to build tact in communication and advice patients politely onpractices they consider unreasonable.
Pöchhacker,F., & Shlesinger, M. (2013). Healthcareinterpreting: Discourse and interaction.Amsterdam: J. Benjamins
Christopher,E. M. (2012). Communicationacross cultures.Houndmills, Basingstoke, Hampshire: Palgrave Macmillan
Sadri,H. A., & Flammia, M. (2011). Interculturalcommunication: A new approach to international relations and globalchallenges.New York: Continuum International Pub. Group Inc.