Cultural Competence and

Patient-Centered Care

Horblit Health Sciences Library

 Why Learn About Cultural
Competence?
• Patients bring many varied and cultural backgrounds,
beliefs, practices, and languages, requiring culturally
competent communication to maximize the quality
of care they receive.
• Providers also bring their own cultural backgrounds,
values and beliefs, and biases to health care
encounters. Culturally competent providers take into
account how their own cultural orientation and
background influence their perceptions and
behaviors.
 What is Cultural Competence?
• Developing an awareness of one’s own thoughts,
attitudes, and environment without letting it
influence those from other backgrounds.
• Demonstrating understanding of a client’s culture.
Understand the cause and control of specific
diseases and the effectiveness of treatments in
different populations.
• Accepting and respecting cultural differences.
• Adapting care to accommodate the client’s culture.
HRSA
 What is Cultural Competence?
The ability to acquire and use knowledge of the health-
related beliefs, attitudes, practices, and
communication of patients and their families to
improve services, strengthen programs, increase
community participation, and close the gaps in
health status among diverse population groups.
 What is Cultural Competence?
• It begins with an honest desire not to allow biases to
keep us from treating every individual with respect.
• Learning to evaluate our own level of cultural
competence must be part of our ongoing effort to
provide better health care.
 What is Cultural Competence?
Culturally competent providers consistently and
systematically:
•Understand and respect their patients’ values, beliefs,
and expectations
•Understand the cause and control of specific diseases
and the effectiveness of treatments in different
population groups
•Adapt the way they deliver care to each patient’s
 Why Provide Culturally Competent
Care?
• Every patient-provider encounter is a cross-cultural
encounter.
• Even patients with appearance and background
similar to yours can be culturally different due to life
experiences, personalities, interests, careers, etc.
Benefits of Culturally Competent Care
• Reduced health care disparities
• Improved health communication and health
outcomes
• Providing culturally competent care allows you to
develop trust and create partnerships with your
patients, and helps to ensure effective,
understandable, and respectful care for all patients.
 Cultural Factors Influencing Patient-
Provider Communication

There are several cultural factors that can influence the

quality of patient-provider communication, including:
•Personal biases

•Nonverbal communication

•Patients’ families and dynamics

•Cultural values and beliefs

 What can culture influence?
• Health, healing and wellness belief systems
• How patient and consumer perceive illness, disease,
and their causes
• Patients’ behaviors seeking health care and their
attitudes to healthcare providers
• The delivery of services by the provider who looks at
the world through his or her values
• Compliance to medication and treatment plan
HRSA
 The Asian American Patient
• Diverse population – Chinese, Filipino, Vietnamese,
Korean, Japanese
• Traditional definition of causes of illness is based on
harmony: balance of hot and cold states or elements
• Modesty highly valued
• May be too polite to disagree
• Communication based on respect; familiarity is
unacceptable
• Eldest male is head of family and may take the lead
in health decision making
 Hispanic Health Beliefs and Practices
• Preventative care may not be practiced.
• Illness is God’s will and recovery is in His hands.
• Hot and Cold Principles apply.
• Expressiveness of pain is culturally acceptable.
• Obesity may be seen as a sign of good health and
well being.
• Diet is high in salt, sugar, starches and fat.
• High respect for authority and the elderly.
• Provide same sex caregivers if at all possible.
 Cultural Groups
• Anglo American
• Native American
– Direct eye contact
– Anecdotes/metaphors
– Informed about details
– Avoid eye contact
– Aggressive approach
– Don’t speak to loudly
– Killing germs
– Traditional healing very
– Antibiotics even when important
unnecessary
– Never touch or casually
– Belief in technology admire a ritual object.
 No Stereotyping
• Culture is expressed through the individual
• Not all members of a cultural group will believe the
same thing
• Variation within cultural groups.
Tips for Communicating
 Basic Strategies
• Speak clearly and slowly without raising your voice,
avoid slang, jargon, humor, idioms.
• Use Mrs., Miss, Mr. Avoid first names which may be
considered discourteous in some cultures.
• Avoid gestures – they may have a negative
connotation.
• Many carry or wear religious symbols – Sacred
threads worn by Hindus, native Americans-medicine
bundles. DO not touch them.
 Culturally Competent Care
• Treat people uniquely • Know your comfort
• Listen respectfully level
• Gender sensitivity
• Establish trust
• Educate yourself
• Be aware of different
cultures
 Benefits of Cultural Competence
• Greater patient compliance
• Fewer harmful drug interactions
• More appropriate testing and
• screenings
Increased likelihood that minorities will seek health
• care
More successful patient education
 Developing Cultural Competence
Attitude/skill-centered approach
• Recognize your own biases; understand how race,
ethnicity, gender, etc. play a role in healthcare
delivery and perception of health care.
https://implicit.harvard.edu/implicit/
•
Acquire and apply culturally competent skills.
 Developing Cultural Competence
Fact-centered approach
• Learn specific information, such as an ethnic groups’
history, their concepts of illness and disease, their
health-seeking behavior, disease patterns, etc.
 Developing Cultural Competence
Organizational
• Build a foundation
• Collect and use data to improve services
• Accommodate the needs of special populations
• Establish internal and external collaborations