Patients with particular needs

1
Patients with particular needs

• Susan Gilbert Hunt
• Occupational Therapy Program Director

2

• The need for health workers to provide
  culturally appropriate and responsive services
  has emerged as important with the increasingly
  diverse population and the increase in consumer
  or client knowledge and expectation. User pay
  health systems create higher demands and
  expectations on health professionals to provide
  client responsive services.

3

• When stressing the importance of managing
  diversity the Government highlights the following
  Australian demographics-
• 43 of Australians born overseas or have at least
  one parent born overseas indicating a possible
  cultural preference and networks from their
  origins,
• over 200 languages spoken in Australia, and
• 25 of the workforce born overseas, with 15
  coming from non-English speaking countries
• (Commonwealth of Australia 2005, p 10)

4

• Such demographics focus on culture or diversity
  as being related to origin of birth and language
  used which in terms of appreciating the diversity
  of health consumers is quite narrow.
• A culturally competent/ safe health worker is
  someone who is also able to effectively work with
  all people regardless of language, age, gender,
  sexual orientation, economic status, disability,
  or lifestyle choices.
• Thus a culturally competent health worker is
  required to respond to the needs of people whose
  culture is different from the dominant culture
  and this is includes more than people from a
  different country (Cross et al, 1989).

5

• We need to develop the ability to respond to
  people in a culturally sensitive manner despite
  whether or not there are any visual cues of
  difference. In other words we need to develop an
  openness that enables us to respond to the
  unforeseen in others.

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So what are the barriers?

• Lack of knowledge regarding different cultural
  groups?
• Language issues?
• OR
• Unacknowledged values and assumptions

7
What does this picture tell you?

• What do you know about them?
• What do they know about you?
• How might you both feel or respond?

8

• What are likely scenarios for you?

9
What does the literature tell us?

• Input on cultural diversity increases student
  awareness of issues but there is a of lack of
  evidence as to how it impacts on practice1
• Whilst cultural is usually defined in the broader
  sense there is a tendency for education input to
  focus on aspects related to language and
  ethnicity2, 3
• Opportunities for emersion in a culture different
  from ones own resulted in greater skills in
  cultural competence4, 5, 6,
• Educators needs to be culturally competent and
  have skills in managing groups5, 7,8

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Literature Review References

• Beach et al. (2005). Cultural competence a
  systematic review of health care provider
  educational interventions. Med Care, 43(4),
  356-373.
• Rosen et al. (2004). A new approach to developing
  cross-cultural communication skills. Medical
  Teacher, 26(2), 126-132.
• Crossan et al. (2004). Evaluating the effect of
  cultural competency training on medical student
  attitudes. Family Medicine, 36(3), 199-203.
• Ekelman et al. (2003). Developing cultural
  competence in occupational therapy and physical
  therapy education a field emersion approach.
  Journal of Allied Health, 32(2), 131-137.
• MacAvoy, S. Lippman, DT. (2001). Teaching
  culturally competent care nursing student
  experience rural Appalachia. Journal of
  Transcultural Nursing, 12(3), 221-227.
• Caffrey et al. (2005). Improving the cultural
  competence of nursing students Results of
  integrating cultural content in the curriculum
  and an international immersion experience.
  Journal of Nursing Education, 44(5), 234-240.
• Froehlich, J. Nesbit, SG. (2004). The aware
  communicator dialogues on diversity.
  Occupational Therapy in Health Care, 18(1/2),
  171-184.
• Kleiman et al. (2004). Using an eclectic model to
  educate students about cultural influences on
  nurse-patient relationship. Nurse Education
  Perspectives, 25(5), 249-253.