What Is Cultural Competence?
Cultural competence is "understanding the importance of social and cultural influences on patients' health beliefs and behaviors" (Ananeh-Firempong, Betancourt, Carrillo, & Green, 2003).
Intercultural competence can be gained by identifying and understanding the needs and help-seeking behaviors of individuals and families. To be interculturally competent is to be sensitive and self-conscious-to understand various cultures' modes of thinking and their desire to be understood and respected. It is a balance between knowledge, empathy, and self-confidence.
Why Is Cultural Competence Important?
Failing to acknowledge cultural differences among diverse patient populations can cause problems for providers and patients, thus making it difficult to achieve appropriate healthcare outcomes. Many times in the medical community, the impact of these differences are not realized.
- Lack of knowledge can result in the inability to recognize cultural differences.
- Self-protection or denial can result in the attitude that these differences are not important.
- Some people may be intimidated by the new or unknown. They may find it difficult to understand things that don't fit into their own view.
- The pressure of time constraints can make healthcare providers feel rushed and prohibit them from taking the time to listen to each individual patient's needs.
Terminology Related to Cultural Competence
Derived from the members of the Expert Panel on Cultural Competence of the American Academy of Nursing (AAN)
Cultural Diversity-Refers to diversity in race, color, ethnicity, national origin, religion, age, gender, sexual orientation, ability/disability, social and economic status or class, education, occupation, religious orientation, marital and parentalstatus, and other related attributes of groups of people in society.
Cultural Sensitivity- Cultural sensitivity is experienced when neutral language, both verbal and nonverbal, is used in a way thatreflects sensitivity and appreciation for the diversity of another. Cultural sensitivity is conveyed when words,phrases, categorizations, etc. are intentionally avoided, especially when referring to any individual that may beinterpreted as impolite or offensive.
Cultural Awareness- Cultural awareness is being knowledgeable about one’s own thoughts, feelings, and sensations and having anappreciation of the diversity of others in terms of the objective (material) culture such as the arts, clothing,foods, and other external signs of diversity.
Cultural Relativism- The belief that behaviors and practices of people should bejudged only in the context of their cultural system. Proponents argue that issues such as abortion, euthanasia,female circumcision, and physical punishment in childrearing should be accepted as cultural values withoutjudgment from the outside world. Opponents argue that cultural relativisms may undermine condemnation of humanrights violations and that family violence cannot be justified or excused on a cultural basis.
Health Disparity- Health disparity is defined as differences in the incidence, prevalence, mortality, and burden of diseasesand other adverse health conditions that exist among specific population groups in the United States.
Healthcare Disparity-A healthcare disparity exists when persons of different races, ethnic groups, and cultures do not receive equalhealth care, and illness occurs disproportionately from one group to the other.
Cultural Competence Self-Test
Self-assessment can help medical staff identify areas of bias, stereotypes, and comfort level when interacting with diverse populations. This process can be further evaluated by taking a cultural competence test. The Diversity Champion Tool Kit includes an example [hyperlink to the word doc] of such a test. It was originally published in Cultural Competence in Cancer Care: A Health Care Professional's Passport (Matthews-Juarez & Weinberg, 2004) and was directed toward physicians; however, its purpose is served throughout a range of healthcare professions, including nursing. While taking this test, please answer each question with honesty and sincerity. Your score will reflect how culturally aware you are and indicate areas in which you need to improve when providing care to racial and ethnic minorities.
How Do We Become Culturally Competent?
- Self awareness: Allow examination of your own beliefs and values.
- Institute cultural knowledge: Take time to learn the culture, language, and values of minority populations.
- Value diversity: Consider different backgrounds and viewpoints as strengths.
- Be conscious of cultural dynamics: Diversity can cause feelings of uneasiness and conflict when different cultures interact. Such issues can be resolved through empathy.
- Adapt healthcare delivery: Meet the needs of diverse patients by making adequate changes that reflect cultural understanding.
L-E-A-R-N Model
- Listen with sympathy and understanding to the patient's problem.
- Explain your understanding of the patient's problem.
- Acknowledge and discuss differences and similarities.
- Recommend a treatment plan or therapy.
- Negotiate and obtain patient consent regarding treatment plan.
Online Resources for Cultural Competency Assessment Tests
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