Transcript powerpoint presentation

What is Culture?
• Culture is shared values, norms, traditions, customs,
history, and beliefs of a group of people.
• Culture has a multitude of aspects
• Cultural factors include geography, age,
socioeconomic status, religion, gender, education,
language, politics, sexual orientation, and not just
race, language and ethnicity.
• Culture shapes how people experience their world,
make decisions about quality of life, work and how
people relate to others.
• It’s dynamic. One of the most important aspects of
culture is what is not seen, that which controls values
and thought patterns.
CC Definitions
“To be culturally competent doesn’t mean you are an
authority in the values and beliefs of every culture.
What it means is that you hold a deep respect for
cultural differences and are eager to learn, and willing
to accept, that there are many ways of viewing the
world”
--Okokon O. Udo
CC Definitions
“The process in which the [service or program]
provider continuously strives to achieve the ability to
effectively offer services within the cultural context of
a client (individual, family or community)”.
Campinha-Bacote 1998
Cultural Humility
• a lifelong process of self-reflection and self-critique
• does not require mastery of lists of "different" or
peculiar beliefs and behaviors supposedly pertaining
to certain groups of patients
• the provider is encouraged to develop a respectful
partnership with each [client] through client-focused
interviewing, exploring similarities and differences
between their own and each client's priorities, goals,
and capacities
• the most serious barrier to culturally appropriate care
is not a lack of knowledge of the details of any given
cultural orientation, but the providers' failure to
develop self-awareness and a respectful attitude
toward diverse points of view.
Melanie Tervalon and Jann Murray-Garcia, 2001
Cultural Competency and Humility
 Cultural Awareness: A deliberate action of becoming sensitive to the
values, beliefs, lifestyle and practices of the client’s culture.
Appreciating the client’s problem solving strategies.
 Cultural Knowledge: Obtaining information about the world views of
other cultures. The way individuals or groups of people view the world
to form values about their lives
 Cultural Skill: The ability to gather relevant data concerning a client’s
health history and problems and being able to use that knowledge to
conduct a cultural assessment and culturally based physical
assessments.
 Cultural Encounters: Face to face; the process of engaging in crosscultural interactions with clients from culturally diverse backgrounds.
 Cultural Desire: Is the “wanting to” process of cultural competency.
Genuine caring and desire to work with clients that are diverse.
Campinha-Bacote, 1998
Five Elements of Cultural
Competence
Individual
Organizational
• Awareness and acceptance
of difference
• Valuing diversity
• Awareness of own cultural
values
• Cultural self assessment
• Understanding the dynamics
of difference
• Managing for the dynamics
of difference
• Development of cultural
knowledge
• Institutionalization of cultural
knowledge
• Ability to adapt practice to the
cultural context of the client
• Adaptation to diversitypolicies, structure, values,
services
Kleinman-Explanatory Model
• What do you call your situation? Do you have a name
for it?
• What do you think has caused your situation?
• Why do you think it started when it did?
• What does your situation do to you? How does it
work?
• How severe is your disability? Will it have a long or a
short course?
• What kind of program options do you think would be
helpful?
• What are the most important results you hope to
receive from the program?
• What do you fear most about your situation?
• What are the chief problems your situation has
caused you?
“LEARN” Model
• L Listen with empathy to the client’s
perception of the problem
• E Explain your perceptions of the problem
• A Acknowledge and discuss the differences
and similarities
• R Recommend treatment
• N Negotiate agreement
Altered Data Gathering
•
•
•
•
•
•
•
Family History
Life/Community Events
Dreaming and Difficulties with Sleep
Indirect Interviewing Style
Depersonalization
Story Telling
Special Events
Citations for Models
• Kleinman: Kleinman AK, Eisenberg, Good B: Culture
Illness and Care; Clinical Lessons from Anthropologic
and Cross-cultural Research. Ann Int. Med
1978;88:251-258
• LEARN: Berlin E.A. and Fowkes W.C.: A Teaching
Framework for Cross-Cultural Health Care. WJMed
1983; 139: 934-938.
• Altered Data Gathering: Cross Cultural Health Care
Program, 2000
Being Culturally Appropriate
with Clients
• Seek information (country of origin, reason for
migration, length of time in this country, number of
generations in this country, languages spoken, family
and kinship network, religious beliefs, beliefs about
causality and fate, child rearing practices, sex roles,
kind of community, life space, overt and covert
reasons for seeking help, help seeking behavior,
education, occupation, experiences with
discrimination, degree of acculturation, degree of
cultural conflicts)
The Culturalogic Interview by Gloria Johnson-Powell