HG1681 Course Notes 1

Unit 6 Diversity, Cultural Competence & Patient Care

Diversity Defined
Diversity is differences rooted in culture, age, experience, health status, gender, racial or ethnic identity,
mental abilities, and other aspects of sociocultural description and socioeconomic status.

Diversity and Ethical Problem solving

Recognizing, accepting, and dealing with issues of diversity will allow students and healthcare professionals
to become more skilled at providing care that protects patient autonomy, right to information, informed
consent processes, right to the truth, and confidentiality.

What is Culture?
• The behaviors’ and belief characteristic of a particular social, ethnic, or age group.
• The beliefs, values, arts, customs, social behavior, and thought characteristics of a population of
people that guide their worldview and decision making. These may be learned or transmitted by
family.

A Look at Qatar
• Approx. 100 different nationalities
• 190 languages spoken
• Will cultural competence be important for your healthcare practice?

How can we be Culturally Competent?

• Cultural awareness- appreciation of the external signs of diversity such as arts, music, dress, foods
and physical characteristics
• Cultural sensitivity- not saying something that might be offensive to someone from another culture
different than your own.
• Cultural competence- is having the knowledge, abilities and skills to deliver healthcare that fits with
a patient’s cultural beliefs and practices.

Linguistic Competence
• Providing readily available culturally appropriate oral and written language services to patients with
limited English proficiency through:
• bilingual and bicultural staff,
• trained medical interpreters and
 • qualified translators
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Interaction Patterns or “-isms”

• interaction patterns as it relates to diversity are labelled “-isms” due to their common word endings.
• -isms are prejudgments entailing a tendency to judge others according to a standard considered ideal
or presumed to be “normal.”
• Ethnocentrism- The assumption that one’s own cultural or ethnic group is superior to that of others.
• Racism - The assumption that members of one race are superior to those of another.
• Egocentrism - The assumption that oneself is superior to others. The assumption that one’s own
cultural or ethnic group is superior to that of others.
• Sexism - The assumption that members of one sex are superior to those of the other

Individualist or Collectivist?
• All cultures vary in regards to how much their culture values individualism and collectivism.
• Individualism- Cultures encourage self expression. People freely express their opinions, share
personal issues and ask personal questions of others. Direct, straight questioning is appreciated.
• Collectivism- people view themselves as members of a larger group. They are bound by expectations
of loyalty and personal and family lifetime ties. Older people are respected and usually not disagreed
with. Parent and elders have a say in career and life partner choices.

Where are you?

• Collectivism
• Individualism

Individualist or Collectivist?
• Canada
• United States
• Middle East
• India
• China

Canada’s Multiculturalism Act

• Multiculturalism reflects Canada’s cultural and racial diversity. All Canadians have the freedom to
preserve, enhance and share their cultural heritage.
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• Multiculturalism is a fundamental characteristic of Canadian heritage and identity and provides an
invaluable resource in the shaping of Canada’s future.
• Everyone has a right to full and equal participation in all aspects of Canadian society and assistance to
remove any barrier to that participation

Current state of cultural diversity in the health care profession

• According to a report released by the institute of medicine (IMO) the USA is rapidly becoming a
more diverse nation.
• Statistics show that minority populations are significantly underrepresented in all health professions
• Let’s look at the statistics of Physicians and Surgeons in the USA.
Physicians and surgeons in the US are predominantly Christian, white males who come from high
socioeconomic backgrounds.
• Almost 75% are white. About 20% are Asian. Less than 5% are black.
• Almost 65% are male.
• The majority of medical students come from affluent, higher socioeconomic status backgrounds.
• In terms of faith, medicine remains a largely Christian profession.
• 65% Christian,
• 14% Jewish,
• 7% unaffiliated,
• 5% Hindu,
• 3% Muslim.

Cultural diversity and Occupational Performance

When a homogenous workforce is tasked with caring for an extremely diverse array of patients, the quality of
care can suffer.
• Increasing racial and ethnic diversity among HCP is important.
• Evidence indicates that diversity is associated with:
• Improved access to care for racial and ethnic minority patient
• Greater patient choice and satisfaction, and
• Better educational experiances for health professions students
• It’s about providing the best possible care for a variety of patients by enlisting a variety of providers.

Domains of Culture Workforce issues

• Language
 • Multicultural
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• Gender Roles
• Communication styles
• Health care practices in home country
• Timeliness and punctuality
• Differences in training in different countries
• Generational differences

Culture and Healthcare

How might these characteristics effect health care delivery? Do different cultures have different values about
these?
• Gender (male or female)
• Age
• Ethnic origin-nationality
• Religion
• Language
• Culture

Domains of Culture - Health-care Practices

• Traditional
• ‘Magic’ religious or folk medicine beliefs
• Biomedical beliefs
• Individual responsibility for health
• Self-medicating practices
• Views toward mental illness
• Rehabilitation
• Organ transplantation and donation
• Responses to the pain and sickness role
• State of health is a gift or punishment from God
• Advanced directives
• DNR
• Immunization
Health-care Practices - Health care Providers
 • Folk healers
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• Religious healers
• Herbalists
• Biomedical health care providers
• Cultures value doctors, nurses and other health providers differently
• Biomedical health providers are more respected by educated people

Caution!
• Not all people in ANY culture want the same type of treatment
• People are individuals, do not assume they want something because of the way they look
Tips to Practice Cultural Competence
• Identify and acknowledge your own cultural biases
• Recognize assumptions that may be part of medical culture and determine how they impact patient
care
• Be aware of the cultural context from which your patients approach healthcare
• Work with your patients to understand and determine the treatment option that best suits them