Health Maintenance Guidelines > Cultural Diversity and Sensitivity
Each office visit is an opportunity to gain more knowledge about a client’s health beliefs and practices. Cultural sensitivity is the responsibility of all healthcare providers. Inadequate awareness of the client’s health beliefs and practices influenced by culture may lead to mistrust. This may result in barriers including inappropriate delivery of care, increased cost, noncompliance, and seeking care elsewhere. Thus, this may eventually lead to even more barriers to healthcare access, resulting in unfavorable healthcare outcomes. Title
VI of the Civil Rights Act is very specific about providing services that are less than the existing standard of care to anyone based on race, age, sex, or financial status. According to this document, “No person in the United States shall, on the grounds of race, color or national origin be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financing assistance” (U.S. Department of Justice [USDJ ], 2021).Culture is more than nationality or race. Culture influences a person’s reasoning, decisions, and actions. It is the accumulation of learned beliefs, values, habits, and practices. Culture influences decision-making, thoughts, what is approved or disapproved, and what is normal or not, which are all acquired from close personal relations (family/members of society) over time.
Cultural diversity exists when groups from different cultures must coexist within an environmental area (family, neighborhood, township, city, or country). Knowing that there are differences in cultures and not assigning values among different cultures reflect cultural sensitivity. However, significant differences may exist in the way healthcare is perceived and practiced due to the differing values and beliefs regarding health and illness inherent among people of varying cultural backgrounds.
FACTORS CONTRIBUTING TO CULTURAL DIVERSITY
Fewer White non-Hispanic children.
Increase in immigration.
Efficiency in transportation and travel.
Increase in the homeless and poor populations.
Increase in divorce rate.
Increase in single parenting.
Grandparents raising grandchildren.
Substance abuse.
Violence.
Transgender sex changes.
Homosexual acceptance.
Information explosion/high technology.
Illiteracy.
Increase in non-English-proficient healthcare providers.
Federal regulations.
THOUGHTFUL CONSIDERATIONS
Providing care without being sensitive to the cultural needs of a client may suggest that the healthcare provider’s values and beliefs are superior to those of the client and may lead to disparity of care. The limited client involvement in care may result in noncompliance, placing clients at greater risk of health-related complications. The delay in provision of healthcare can result in life-threatening complications.
Numerous cultural resources are available throughout the literature and the internet. Preference as to which educational/assessment tools to use is the healthcare provider’s prerogative.
The following are guidelines for promoting cultural sensitivity in the clinical setting:
Provide a cultural diversity self-assessment/practice organization.
Consult online internet self-assessment tools, for example on the Centers for Disease Control and Prevention (
CDC , 2015) website at www.cdc.gov/asthma/program_eval/cultural_competence_guide.pdf.Download self-assessment tools from public sites. Resettlement Assistance Program, Cultural Competence provides a validated tool (rapworkers.com/resources/cultural-competence).
Use existing self-assessment tools and make necessary changes to fit the need of your community.
Identify the needs of the population served.
Understand the community and its health status.
Evaluate the resources, attitudes, and barriers inside the community and the practice location.
Access to resources.
Notification of assistance.
Range of assistance options:
Transportation.
Communication; consider an interpreter (personal vs. automated):
Identify bilingual staff.
Use family members or personal acquaintances as interpreters (adults only).
Provide multilingual written materials.
Education (meaningful/multilingual):
User-friendly.
Friendly technology.
Educate staff to cultural diversities.
Assessments should include the client’s health values and beliefs.
Communication should be meaningful.
Be precise and clear.
Maintain eye contact when speaking.
Use plain language.
Observe facial expressions and body language.
Use short sentences to explain lengthy information.
Avoid medical jargon.
Use repetition for emphasis.
Ask questions to confirm understanding.
Schedule longer appointments if needed.
Healthcare providers should clarify the limitations of a healthcare provider’s role (Spector, 2017; Andrews & Boyle, 2015; Douglas, et al., 2014).
BIBLIOGRAPHY
- Andrews, M. M., & Boyle, J. S. (2015). Transcultural concepts in nursing care (7th ed.). Lippincott Williams & Wilkins.
- Centers for Disease Control and Prevention. (2021). (September 10). Cultural competence. https://npin.cdc.gov/pages/cultural-competence
- Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M., Lauderdale, J., Milstead, J., Nardi, D., & Purnell, L. (2014). Guidelines for implementing culturally competent nursing care. Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society/Transcultural Nursing Society, 25(2),109–121. https://doi.org/10.1177/1043659614520998
- Ontario Council of Agencies Serving Immigrants (OCASI). (2019). Cultural competence. https://rapworkers.com/resources/cultural-competence
- Spector, R. E. (2017). Cultural diversity in health and illness (9th ed.). Prentice-Hall.