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Transcultural Guidelines for Health Care Givers

Transcultural Guidelines for Health Care Givers. World 2005 Statistics: Christianity 33% Islam 21% Hinduism 14% Buddhism 6% Judaism 0.22% Other 25%. El Paso 2002 Statistics: Catholic 58% Other Christian 25% Islam 0.3% Judaism 0.8%

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Transcultural Guidelines for Health Care Givers

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  1. Transcultural Guidelines for Health Care Givers

  2. World 2005 Statistics: Christianity 33% Islam 21% Hinduism 14% Buddhism 6% Judaism 0.22% Other 25% El Paso 2002 Statistics: Catholic 58% Other Christian 25% Islam 0.3% Judaism 0.8% Other 16.9% World ReligionsVS. El Paso

  3. Ethnicity Definitions (Cornell University) - Describes your family “origins” e.g. • American Native or Alaskan Native • Origins in any of the original peoples of North & South America (including Central America), & who maintains tribal affiliation or community attachment

  4. Ethnicity • Asian • Far Eastern countries • Black/African American • African or Caribbean • Caucasian/White/Not of Hispanic origin • Europe, Middle East, North Africa, Australia, New Zealand • Mexican American • Of Mexican culture or origin regardless of race

  5. Ethnicity • Native Hawaiian or other Pacific Islander • Hawaii, Guam, Samoa, Pacific Islands • Puerto Rican • Puerto Rican culture or origin, regardless of race • Other Hispanic • Cuban, South or Central American, Dominican Republic, or other Spanish culture or origin, regardless of race

  6. El Paso’s Population Hispanic vs. Non-Hispanic 2006 Statistics • Approximately 81.4% Hispanic • Non-Hispanic 14.2% • What other things contribute to diversity? • If I’m Hispanic is a non-Hispanic another culture? Maybe… Reviewed October, 2008

  7. Many Things.. Including culture, religion, language, age, and gender…. HAVE CONSIDERABLE EFFECT ON HOW WE ACCESS & VIEW HEALTH CARE SERVICES

  8. Culture • Some may think culture determines certain things: • Physical attributes • hair or skin color • Diet • Language • Our religious & spiritual beliefs

  9. Ethnocentrism • Despite the fact that we understand that everyone is different, we still tend to subconsciously believe that our culture & religion is the right one. We may view other cultures or religions as bizarre, strange, inferior or unenlightened. This is called ethnocentrism.

  10. Ethnocentrism • It can cause misunderstandings and harm patients by: • Incorrect diagnosis • Failure to provide adequate pain relief • Arrest of parents for child abuse due to misunderstood cultural childrearing beliefs and practices

  11. CulturalCompetency • Understanding of own self • Knowledge of various cultural characteristics • Understanding of cultural characteristics • Application of cultural knowledge & understanding in the healthcare setting

  12. AvoidStereotyping • We must not presume that all people of a certain cultures adhere to all aspects of their culture • The healthcare provider must identify which aspects are appropriate for each patient during the admission process

  13. Do Not AssumeAnything • Be truly open-minded & respectful toward other’s beliefs, values, & practices • You can help patients feel more comfortable • Many of us belong to more than one ethnic group, cultural group, age group, and social group

  14. Language &Translation • Those whose English is limited often wish to speak their native language when possible • Feel that both their explanations & their understandings can be more accurate • It is more comfortable

  15. Lost inTranslation • Family members are not good translators • Issues of privacy and confidentiality • Interpreter errorscould be a previously unrecognized root cause of medical errors (Healthcare Risk Management (2003)

  16. Avoid Ad HocTranslators Flores, 2003 (University of Wisconsin) • Omission by interpreter 52% • Addition by interpreter 8% • Substitution by interpreter 13% • Editorialization by interpreter 10% • False fluency 16% 63% of errors were found to have potential medical consequences

  17. Policy &Procedure Translation Line Services • Find someone in your facility who knows the policy • It is important to be facility specific • Should be HIPAA & Joint Commission Compliant

  18. Face & BodyLanguage • Facial expressions, body language & tone of voice play a much greater role in many cultures.

  19. Cultural Differences Some Cultures: • May perceive a response like “maybe” or “that would be difficult” as a polite no • Some cultures prefer indirect communication and talking around the issue

  20. Gestures • Use with care – may have negative meanings in other cultures • Thumbs-up and the OK sign are obscene gestures in parts of South America & the Mediterranean • Pointing or beckoning with the index finger as “come here”, or snapping fingers are seen as rude in some cultures

  21. Touch • To touch or not to touch is only part of the question • Cultures also have different rules about who can be touched & where • Even casual touching people of the opposite gender can be offensive in some cultures

  22. In Summary • Observe the kinds of cultures you see in your patient population • Adjust your care for patients of different cultures • Look for resources available for patients of different cultures • Provide translation for a patient that doesn’t speak English

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