introduction to cultural competency in health care pharmacy practice ii
Post on 19-Dec-2015
228 Views
Preview:
TRANSCRIPT
Introduction to Cultural Competency in Health Care
Pharmacy Practice II
Definitions
Culture: set of learned and shared beliefs and values that shape interactions and interpretation of experience; each of us can belong to many different cultures.
Ethnicity: self-defined groups identity that is based on religion, nationality, and cultural patterns
Race: a social and political construct having no scientific basis
US Census Data
People Quick Facts 2000 OR% US%
White, not Hispanic/Latino 83.5 69.1
Black/African Americans 1.6 12.3American Indian/Alaskan Native 1.3 0.9Asian 3.0 3.6Native Hawaiian/Pacific Islander 0.2 0.1Hispanic/Latino 8.0 12.5
US Census Data: County Examples
Multnomah County:Black/African American 5.7%
Language other than English at home 16.6%
Hood River County:Hispanic/Latino 25%
Language other than English at home 24.7%
Health Disparities
Racial or ethnic differences in the quality of healthcareDifferences result in worse clinical outcomesDifferences persist after adjusting for known factors:
Socioeconomic factorsPatient preferencesAppropriateness of intervention
Examples of Health Disparities
Cardiovascular
Cancer
Pain
Asthma
Diabetes
Prenatal Care
Potential Sources of Disparities
Patient variables: preferences, refusal, appropriateness of care
Healthcare systems
Care process: bias, stereotyping, uncertainty
Cross-cultural education
Examining your own cultural background
Review the questions provided
Consider your own bias, stereotyping, uncertainty
Cultural influences
Health Perception
Treatment Preferences
CommunicationVerbal
Nonverbal
Federal Mandate: Title VI
The US Department of Health and Human Services’ Office for Civil Rights (OCR)
mandates that medical professions receiving federal funds must ensure limited English speaking persons can “meaningfully access” services.
National Standards for Culturally & Linguistically Appropriate Services in Health Care (CLAS)
14 standardsCulturally competent care (Stds 1-3)
Language access services (Stds 4-7)
Organizational supports for cultural competence (Stds 8-14)
Varying levels of stringency (mandates, guidelines, recommendations)
National Standards for Culturally & Linguistically Appropriate Services in Health Care (CLAS)
Culturally competent careCare that is compatible with cultural health beliefs, practices, preferred language
Diverse staff and leadership
Education and training in CLAS
CLAS Standards, continued
Language Access ServicesOffer and provide language assistance services at no cost, in a timely manner
Verbal and written notice of right to receive language assistance services
Family and friends should not be used except when requested by the patient
Materials and signs in languages commonly encountered
CLAS MandatesLanguage Access Services
Based on Title VI of the Civil Rights Act of 1964 with respect to services for limited English Proficiency (LEP) individuals
Std 4: Offer and provide language assistance services at no cost and in a timely manner
Std 5: Both verbal and written notice of their right to receive language assistance services
CLAS MandatesLanguage access services
Std 6: Family and friends should not be used to provide interpretation services except when requested by the patient
Std 7: Easily available materials and signage in languages commonly encountered or represented in the service area
CLAS Standards, continued
Organizational supports for cultural competence
Strategic plansSelf-assessmentsData collectionCommunity profilePartner with communityConflict resolutionPublic information
Definitions of DiseaseNavajo
Lack of harmony in and with the universeWHO
Anything less than a complete state of physical, social, and mental well-being
FDAAny deviation from impairment or interruption of the normal structure or function of any part, organ, or system (or combination thereof) of the body that is manifested by a characteristic set of one or more signs or symptoms, including laboratory or clinical measurements that are characteristic of a disease.
Adapted from UC regents – School of pharmacy and center for the Health professions
Cultural influences
Health PerceptionTreatment PreferencesCommunication
Verbal InterpretersLanguage lineOregon Pacific AHECPay attention to your language
Nonverbal
Taking Action: Improving Cross-cultural interactions
Examine your own cultural background.
Learn about the cultures in the community you serve. Show interest.
Be aware. Don’t generalize.
Ask open-ended questions to determine health beliefs and level of understanding.
LEARN MODEL
Listen
Explain
Acknowledge
Recommend treatment
Negotiate agreement
Taking Action: Improving Cross-cultural interactions
Use a trained interpreter.“Language Line”
Be aware of and enlist culturally-based resources.
Learn the language or phrases of the predominant non-English speaking population you serve.
References and Resources
Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. National Academy of Sciences. 2003
National Standards for Culturally and Linguistically Appropriate Services in Health Care Executive Summary. U.S. Department of Health and Human Services, OPHS, Office of Minority Health. Washington, D.C. March 2001
References and ResourcesFadiman, Anne. The Spirit Catches You and You Fall Down. New York: Strauss and Giroux. 1997National Center for Complimentary and Alternative Medicine http://nccam.nih.govU.S. Department of Health and Human Services, Office of Minority Health. http://www.ohmhrc.govUS census data. http://quickfacts.census.gov Ethnic Medicine Information from Harborview Medical Center http://www.ethnomed.org University of California San Francisco Primary Care Resource Links: Cross Cultural http://medicine.ucsf.edu/resources/guidelines/culture.htmlAPhA. Handbook of Nonprescription Drugs 14th edition 2002
top related