What does cultural competence mean in nursing?
There are numerous assessment tools available for evaluating cultural competence in clinical, training, and organizational settings. These tools are not specific to behavioral health treatment. Though more work is needed in developing empirically supported instruments to measure cultural competence, there is a wealth of multicultural counseling and healthcare assessment tools …
Who should be targeted for cultural competence?
Throughout this guide, aspects of cultural competence in evaluation are discussed within the context of CDC’s . Framework for Program Evaluation in Public Health. 2. to highlight opportunities for integrating cultural competence during each of the six steps of the evaluation process. A list of related resources and tools and an abbreviated
Is there a tool to measure cultural competence in behavioral health treatment?
have the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge and (5) adapt to diversity and the cultural contexts of the communities they serve.
Can cultural competence reduce health disparities?
What Is Cultural Competence? Cultural competence is “a set of congruent behaviors, attitudes, and policies that come together in a . system, agency, or among professionals and enables effective work in cross-cultural situations.” 1. Cultural competence is an essential and ethical obligation for all evaluators. Applying a critical cultural ...
How do you determine cultural competence in healthcare?
To develop cultural competence, healthcare professionals need to identify their beliefs and build an awareness of their culture. This gives them a basis to improve their cross-cultural awareness. Cross-cultural awareness makes healthcare providers more open to unfamiliar attitudes, practices, or behaviors.Mar 1, 2021
What factors should be considered when measuring or assessing cultural competence?
All four components awareness, attitude, knowledge, and skills work hand in glove. A cultural competence approach to diversity education offers professionals a way to consider all four components.
What are the 4 C's of cultural competence?
Healthcare providers may use the 4 Cs of culture by Slavin, Galanti, and Kuo to perform the cultural assessment. The 4 Cs of culture are call, cope, concerns, and cause.
What two or three strategies can you use to develop cultural competence?
How do I become culturally competent?Learn about yourself. Get started by exploring your own historical roots, beliefs and values, says Robert C. ... Learn about different cultures. ... Interact with diverse groups. ... Attend diversity-focused conferences. ... Lobby your department.
How do you assess cultural competence in the workplace?
Conduct surveys and gather feedback to understand how employees feel about their place within the workspace, and what their views are on the cultural competence of their co-workers and managers. Gather data about the cultural makeup of workplaces to create policies that increase diversity and cultural competence.
Can cultural competence be measured or assessed?
There are numerous assessment tools available for evaluating cultural competence in clinical, training, and organizational settings. These tools are not specific to behavioral health treatment.
How a healthcare professional can use the 4 C's of culture when evaluating a patient?
Find out the main concerns regarding their condition and treatment. Address questions such as, “How serious do you think this is?” “What potential complications do you fear?” “How does it interfere with your life, or your ability to function?” “Do you know anyone else who has tried the treatment I've recommended?
What are the five stages of cultural awareness?
AnswerStage 1. Blindness – Unconsciously Unaware. The first stage, also known as blindness, is where you're unconsciously unaware. ... Stage 2. Sensitivity – Consciously Unaware. ... Stage 3. Competence – Consciously Aware. ... Stage 4. Proficiency – Unconsciously Aware.Dec 28, 2018
What is being culturally competent?
Cultural competence is the ability of an individual to understand and respect values, attitudes, beliefs, and mores that differ across cultures, and to consider and respond appropriately to these differences in planning, implementing, and evaluating health education and promotion programs and interventions.
What interventions should be implemented to ensure cultural competence?
Here are 5 ways to help you provide culturally competent nursing care.Perform a cultural competence self-assessment. ... Obtain a certificate in cultural competence. ... Improve communication and language barriers. ... Directly engage in cross-cultural interactions with patients. ... Participate in online chats and networks.May 24, 2018
How can a teacher demonstrate cultural competence?
The National Education Association (NEA) defines cultural competence as “the ability to success- fully teach students who come from cultures other than our own.”2 Cultural competence involves interpersonal awareness, cultural knowledge, and a skill set that together promotes impactful cross-cultural teaching.
How do you demonstrate cultural competence in childcare?
Encouraging cultural competency in your early childhood settingbeing aware of one's own world view.developing positive attitudes towards cultural differences.gaining knowledge of different cultural practices and world views.developing skills for communication and interaction across cultures.
What are the disparities in healthcare?
For example, a study that looked at hospitals across the country found that patients with limited English proficiency were more likely to be harmed than their English-proficient counterparts when they experienced adverse events, and that harm was more likely to be severe. [11] These findings extend to pediatric populations, such as the study that found that hospitalized Latino children are more likely to experience an adverse event than non-Latino white children.[12]
What is cultural competence training?
Cultural competence training programs a im to increase cultural awareness, knowledge, and skills, leading to behavior change.[20] Most reviews of cultural competence training conclude that training has positive impacts on provider outcomes, but as a standalone strategy training may insufficient to improve patient outcomes without concurrent systemic and organizational changes.[21]
What is cultural broker?
Cultural brokerage is the mediation between the traditional health beliefs and practices of a patient’s culture and the healthcare system. [18],[19] Interpreters, community health workers, and patient navigators can play the role of a cultural broker by providing context and by serving as a partner for both the patient and provider.
What is cultural identity?
Culture can be defined as the “personal identification, language, thoughts, communications, actions, customs, beliefs, values, and institutions that are often specific to ethnic, racial, religious, geographic, or social groups.” [1] For both patients and providers, healthcare is defined through a cultural lens.[2]An individual’s cultural affiliations can affect where and how they seek care, how they describe symptoms, how they select treatment options, and whether they follow care recommendations. [2] Similarly, providers bring their own cultural orientations, including the culture of medicine.
What is cultural competence?
“Cultural competence is a stance taken toward culture, not a discrete status or simple mastery of particular knowledge and skills. A culturally competent evaluator is prepared to engage with diverse segments of communities to include cultural and contextual dimensions important to the evaluation. Culturally competent evaluators respect the cultures represented in the evaluation.”8
What is integrated pattern?
“The integrated pattern of thoughts, communications, actions, customs, beliefs, values, and institutions associated, wholly or partially, with racial, ethnic, or linguistic groups, as well as with religious, spiritual, biological, geographical, or sociological characteristics.”4
How did Program X evaluate asthma?
To evaluate a pilot asthma education program for young inner-city girls with asthma, Program X hired an external evaluator who had extensive experience working with schoolchildren in City H, 100 miles north of the program. With a graduate degree in evaluation, “Janice” (not her real name) and the funders assumed her extensive experience and familiarity with children would facilitate interactions during the group interviews with the girls. After reading extensively about the asthma program and familiarizing herself with the epidemiologic data (e.g., school absenteeism, hospitalization rates), Janice found herself surprised at the challenge she faced getting the girls to open up during discussions. She later learned that they had perceived her as an outsider who, although she “knew children,” had a “different way of speaking and acting.” Janice was an upper-middle-class professional. In this context, the evaluator’s social class played a more dominant, critical role than gender.
What does it mean when you talk to a man in a language he understands?
If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart.
Why is cultural competence important in evaluation?
Because culture is influenced by many characteristics (i.e., race, ethnicity, language, gender, age, religion, sexual orientation, education, and experience), it is important that we stop and reflect on our own culture before embarking on an evaluation. To conduct culturally competent evaluations, we must learn and appreciate each program’s cultural context and acknowledge that we may view and interpret the world differently from many evaluation stakeholders.
Where do we stand depends on where we sit?
As the saying goes, where we stand depends on where we sit—or are situated. To understand the impact of culture in our own lives and others’, we can look directly at how we are situated and the ways in which it might influence our perspectives and behaviors.
What is the outcome measure that indicates whether implementing training programs, policies, and culturally or linguistically appropriate standards
Institutionalize cultural competence. Improved quality of care is the outcome measure that indicates whether implementing training programs, policies, and culturally or linguistically appropriate standards makes a difference.
How to develop cultural competence?
Cultural competence requires that organizations: 1 have a defined set of values and principles, and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally. 2 have the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge and (5) adapt to diversity and the cultural contexts of the communities they serve. 3 incorporate the above in all aspects of policy making, administration, practice, service delivery, and involve systematically consumers, key stakeholders, and communities.
What are some examples of disparities in access to quality care?
For example, HIV-infected injection drug users are less likely to receive antiretroviral therapy than non-drug users are.
How can cultural competence be demonstrated?
Cultural competence must be demonstrated not only by intervention programs and staff, but also by surveillance staff, researchers (and their investigations), as well as by those delivering prevention services, care, and treatment programs to those who are HIV-infected.
What is cultural competence?
Cultural competence is the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services ; thereby producing better outcomes . ( 3) Principles of cultural competence include: ( 4) ...
What is the ASHA certification for audiology?
See ASHA's Scopes of Practice in Audiology and Speech Language Pathology as well as Audiology Certification Standards and Speech-Language Pathology Certification Standards. Clinicians are responsible for providing competent services, including cultural responsiveness to clients/patients/families during all clinical interaction. Responsiveness to the cultural and linguistic differences that affect identification, assessment, treatment, and management includes the following:
What is cultural competence?
Cultural competence involves understanding and appropriately responding to the unique combination of cultural variables and the full range of dimensions of diversity that the professional and client/patient/family bring to interactions.
What is the role of a clinician in the provision of clinically appropriate services?
Upholding ethical responsibilities during the provision of clinically appropriate services. Clinicians also have a responsibility to advocate on behalf of consumers, families, and communities at risk for or with communication disorders and differences, swallowing, and/or balance disorders.
What is the ADA?
The ADA (2009) is intended to protect—and guarantee access to and participation in society for—persons with disabilities. The statute is specifically directed at employment, public accommodations, public services (i.e., services delivered by state and local governments), transportation, and telecommunication.
What is ethnographic interviewing?
Ethnographic interviewing encourages the interviewee to provide information that they feel is relevant, rather than respond to clinician-presented questions. This style of interviewing can provide insight into the client's/patient's/family's perceptions, views, desires, and expectations.
What is cultural destructiveness?
Cultural Destructiveness —in which "attitudes, policies, and practices that are destructive to cultures and consequently to the individuals within the culture " (p. 29) are exhibited. Cultural Incapacity —in which individuals and agencies do not seek to be "culturally destructive, but lack the capacity to help . . .". (p.
Can a person discriminate on the basis of race, ethnicity, sex, gender identity, or gender
Individuals shall not discriminate in the delivery of professional services or in the conduct of research and scholarly activities on the basis of race, ethnicity, sex, gender identity/gender expression, sexual orientation, age, religion, national origin, disability, culture, language, or dialect (Principle I, Rule C).
What is cultural competence intervention?
Cultural competence intervention research by definition generally draws on defined priority populations, and very possibly specific subgroups of those priority populations. To the extent that similar interventions are tested in multiple studies across priority population groups, we will be able to suggest generalizability across those groups. Otherwise generalizability will be narrowly subscribed by the study populations. Applicability of studies will be determined according to the PICOTS framework. Study characteristics that may affect applicability include, but are not limited to, the population from which the study participants are enrolled, and patient or intervention characteristics different than those described by population studies of the priority populations or types of organizational settings. We will pay special attention to defined subgroups that are at the intersections of two or more priority populations. These applicability issues are present in the synthesis frameworks and sensitivity analyses described in more detail in the data synthesis section.
What is comparative effectiveness?
Comparative effectiveness reviews evaluate the evidence for both benefits and harms, or adverse effects, of interventions in order to provide decisionmakers with the balance of net benefits. In the case of cultural competence interventions, harms may include unintended consequences of an intervention.
What is technical expert?
Technical experts constitute a multi-disciplinary group of clinical, content, and methodological experts who provide input in defining populations, interventions, comparisons, or outcomes and identify particular studies or databases to search. They are selected to provide broad expertise and perspectives specific to the topic under development. Divergent and conflicting opinions are common and perceived as health scientific discourse that results in a thoughtful, relevant systematic review. Therefore study questions, design, and methodological approaches do not necessarily represent the views of individual technical and content experts. Technical experts provide information to the EPC to identify literature search strategies and recommend approaches to specific issues as requested by the EPC. Technical experts do not do analysis of any kind nor do they contribute to the writing of the report. They have not reviewed the report, except as given the opportunity to do so through the peer or public review mechanism.
How much must an EPC team disclose?
EPC core team members must disclose any financial conflicts of interest greater than $1,000 and any other relevant business or professional conflicts of interest. Related financial conflicts of interest that cumulatively total greater than $1,000 will usually disqualify EPC core team investigators.
What are intermediate outcomes?
Provider training and motivation outcomes, such as post-test competencies, knowledge, changes in attitudes, willingness to serve and perceived competence in service people with disabilities. Provider behavior, such as clinical decision-making, communication.
How can cultural competence be used to reduce health disparities?
healthcare system. Cultural competence is widely seen as a foundational pillar for reducing dispar ities through culturally sensitive and unbiased quality care. Culturally competent care is defined as care that respects diversity in the patient population and cultural factors that can affect health and health care, such as language, communication styles, beliefs, attitudes, and behaviors. 1 The Office of Minority Health, Department of Health and Human Services, established national standards for culturally and linguistically appropriate services in health and health care (National CLAS Standards) to provide a blueprint to implement such appropriate services to improve health care in the U.S. 2 The standards cover areas such as governance, leadership, workforce; communication and language assistance; organizational engagement, continuous improvement, and accountability.
What are the four domains of KQ2-5?
The overall strength of evidence for primary outcomes of KQ2-5 within each comparison will be evaluated based on four required domains: (1) study limitations (risk of bias); (2) directness (single, direct link between intervention and outcome); (3) consistency (similarity of effect direction and size); and (4) precision (degree of certainty around an estimate). 12 A fifth domain, reporting bias, will be assessed when SOE based upon the first four domains is moderate or high. 12 Based on study design and conduct, risk of bias will be rated as low, medium, or high. Consistency will be rated as consistent, inconsistent, or unknown/not applicable (e.g., single study) based on the direction, magnitude, and statistical significance of all studies. Directness will be rated as either direct or indirect based on the need for indirect comparisons when inference requires observations across studies. Precision will be rated as precise or imprecise based on the degree of certainty surrounding each effect estimate or qualitative finding. An imprecise estimate is one for which the confidence interval is wide enough to include clinically distinct conclusions. Other factors that may be considered in assessing strength of evidence include dose-response relationship, the presence of confounders, and strength of association. Based on these factors, the overall strength of evidence for each outcome will be rated as: 12
Why is cultural appropriateness important in HIV/AIDS?
In HIV/AIDS, where behavioral factors figure so prominently in transmission, prevention, and treatment, cultural appropriateness is crucial to providing patient education and nursing care.
Why is cultural competence important?
The importance of cultural competence in providing health care to a diverse patient population is well-recognized throughout the health professions, though there is as yet no widely accepted set of criteria for establishing and maintaining cultural competence. In HIV/AIDS, where behavioral factors figure so prominently in transmission, prevention, ...
How to develop cultural competence?
At the individual practice level, there are several things groups can do to cultivate cultural competence: 2 1 Value diversity. In other words, do not merely tolerate people of differing backgrounds and viewpoints, but consider differences as strengths. 2 Conduct a cultural self-assessment. One example of a fairly comprehensive cultural competence self-assessment tool is shown below. It was developed by Tawara D. Goode of the Georgetown University Child Development Center. 3 Be conscious of the dynamics when people from different cultures interact. Diversity can cause conflict and force individuals out of their comfort zones, but it need not cause division. 4 Institutionalize cultural knowledge. Its importance must be emphasized by those at the top of the organization, and it should be evident in the group's policies and practices. 5 Adapt service delivery to reflect an understanding of cultural diversity. In other words, move beyond theory and into practice by carrying out changes to meet the needs of your diverse patients.
Why is understanding patients' cultures important?
It is integral to eliminating health care disparities and providing high-quality patient care. Culture shapes individuals' experiences, perceptions, decisions and how they relate to others.
Why are health care organizations and individual medical practices responsible for the disparities?
Although disproportionate poverty and lack of health insurance contribute greatly to the disparities, health care organizations and individual medical practices are also responsible in that they often fail to provide culturally competent health care.
What is cultural competence?
Cultural competence: A set of congruent behaviors, attitudes and policies that come together as a system, that system, agency or those professionals to work effectively in cross-cultural situations. The word “culture” is used because it implies the integrated pattern of human thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group. The word competence is used because it implies having a capacity to function effectively. 2
How does diversity affect the organization?
Diversity can cause conflict and force individuals out of their comfort zones, but it need not cause division. Institutionalize cultural knowledge. Its importance must be emphasized by those at the top of the organization, and it should be evident in the group's policies and practices.
Background
- Culture can be defined as the “personal identification, language, thoughts, communications, actions, customs, beliefs, values, and institutions that are often specific to ethnic, racial, religious, geographic, or social groups.”For both patients and providers, healthcare is defined through a cultural lens.An individual’s cultural affiliations can a...
Cultural Competence and Patient Safety
- Disparities in healthcare extend to the patient safety arena. For example, a study that looked at hospitals across the country found that patients with limited English proficiency were more likely to be harmed than their English-proficient counterparts when they experienced adverse events, and that harm was more likely to be severe.These findings extend to pediatric populations, such …
Approaches to Improving Cultural Competence
- Provider cultural competence has the potential to decrease patient safety disparities. Language Assistance Language assistance, a strategy to overcome language barriers, can take the form of bilingual clinicians and staff and qualified foreign language and American Sign Language interpreters. Successful language assistance relies on the adequacy of the supply of interpreter …
References
- Cultural Respect. nih.gov. https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/cultural-respect. Updated February 15, 2017. Accessed December 5, 2019. Andruilis DP, Brach C. Integrating literacy, culture, and language to improve health care quality for diverse populations. Am J Health Behav.2007;31 Suppl 1:S122-3…