Delivering Appropriate Care to Diverse Communities

Question 1

What is the problem with understanding culture?

Answer 1

There are many definitions of culture

Question 2

What does the concept of culture, cultural identity, or belonging to a cultural group involve?

Answer 2

Active engagement,not something just described

Question 3

What is it probelmatic to assign cultural categories to?

Answer 3

Single characteristics

Question 4

What is the relationship between identity and culture?

Answer 4

Identity is drawn from culture,not simply formed from it

Question 5

How does the Association of Medical Colleges (AAMC) define culture?

Answer 5

As the relationship to group or groups with whom he or she identifies

Question 6

What may an individuals identity be based on?

Answer 6

Heritage, as well as an individuals circumstances and personal choice

Question 7

What factors may affect someones culture?

Answer 7

Race Ethnicity Age Language Country of origin Acculturation Sexual orientation Gender Socioeconomic status Religious or spiritual beliefs Physical ability Occupation Others

Question 8

What behaviours may a persons culture influence?

Answer 8

Communication styles Diet preferances Health beliefs Family roles Lifestyle Rituals Decision-making processes

Question 9

What can the behaviours impacted by a persons culture influence?

Answer 9

How patients and health care professionals perceive health and illness How they interact with one another

Question 10

Why is the AAMC definition of culture used?

Answer 10

Patient/individual centred Clinically applicable Through interplay of external and internal meanings, construct a sense of identity and unique cultures Patients define which aspect of their cultural belonging is relevant at any particular point, and it can differ in different contexts Dynamic definition allowing for change Patients and professionals are acknowledged to have culture

Question 11

When may someones culture and cultural identity change?

Answer 11

In clinical context At different life stages On clinical presentation

Question 12

What is the problem with the term diversity?

Answer 12

Imprecise and inconsistent use

Question 13

What may diversity mean?

Answer 13

Diversity of ethnicity

Question 14

What is the problem with the term diversity just referring to diversity of ethnicity?

Answer 14

Much broader range of differences relating to individual characteristics beyond ethnicity

Question 15

Why is diversity important to healthcare?

Answer 15

Increasing diversity of populations,both patients and workforce
Increasing,albeit limited,evidence that taking a patient-centred approach improves outcomes Huge disparities in care accessed Disparities beyond the point of access Differential outcomes Legislative frameworks

Question 16

Why are there huge disparities in care access, related to diversity?

Answer 16

Doctors make decisions on who to give care to, may be subconsciously affected by ideas they have

Question 17

Give an example of where a doctors subconscious ideas may lead to disparities in care accessed

Answer 17

May not give black women aggressive treatment, because they don’t think they can take it, or don’t think that they’re worth the resources

Question 18

What is the result of legislative frameworks, with regards to diversity and healthcare?

Answer 18

Equal care must be given irrespective of patient factors

Question 19

When do problems arise, regarding diversity and healthcare?

Answer 19

Lack of knowledge Self protection/denial Fear of the unknown/new Feeling of pressure due to time constraints

Question 20

What does a lack of knowledge lead to in healthcare and diversity?

Answer 20

Inability to recognise differences

Question 21

What is the problem with an inability to recognise differences in healthcare?

Answer 21

Treating patients the same is not always the same as equal care, as each patient has their own needs

Question 22

What does self-protection/denial lead to when thinking about diversity and healthcare?

Answer 22

An attitude that these differences are not significant, or that our common humanity transcends our differences

Question 23

What leads to a fear of the unknown/new when thinking about diversity and healthcare?

Answer 23

Because its challenging, and perhaps intimidating, to understand something new that doesn’t fit into world view

Question 24

What is the problem with fear of the unknown/new in healthcare?

Answer 24

Decisions shouldn’t be based on perception

Question 25

What can feelings of pressure due to time constraints lead to? 

Answer 25

Feeling rushed and unable to look in depth at an individual patients needs

Question 26

What may problems relating to diversity and healthcare lead to? 

Answer 26

Patient-provider relationship affected when understanidng of each others expectations are missing  Miscommuncation  Non-compliance and not understanding patients perspective Rejection of healthcare provider Conflict or isolation within staff groups   

Question 27

Why may problems with understanding diversity in healthcare lead to non-compliance? 

Answer 27

If they don't believe what you're saying, they won't follow the treatment 

Question 28

When may conflict or isoaltion within staff groups due to diversity be exacerbated? 

Answer 28

If staff don't fit into global perspective

Question 29

How is service presentation influenced by culture? 

Answer 29

The way they think about mental health and mental health problems  The way they make sense of certain symptoms and behaviours Their view of potential services, and the services they choose to accept The treatment and management strategies they find acceptable They way in which those who have mental health problems are percieved  Issues of access  

Question 30

Give an example of how culture may affect how a patient accesses services

Answer 30

In mental health issues, some people go to religious leaders in the first instance, which doesn't help in severe cases 

Question 31

What issues of access may people of some cultures experience? 

Answer 31

Experience of service Visibility of services 

Question 32

What problems related to culture may young people experience? 

Answer 32

Pressures to conform to practice their families religion, or other practices that do not sit comfortably with them Pressure to conform to expected gender roles Pressure to conform to social norms  Pressure to conform to family expectations that differ from what the young person wants  Sexual orientation Impending forced marriages Difficulty in reconciling the culture in private and public domains   

Question 33

Why may young people have problems with pressures to conform to practice their families religion? 

Answer 33

As developing, a person develops an own view of self, and gain a wider world view, and therefore other factors start influencing what you believe

Question 34

What does the pressure to conform to the social norms depend on? 

Answer 34

The social norms of their culture/subculture 

Question 35

What actions relating to culture should all clinicians take? 

Answer 35

Providing a sensitive and respectful service, acknowledging cultural need and belief  Respecting cultural individuality whilst maintaining patient-centered curiosity  Plan care without making assumptions or falling back on stereotypes  

Question 36

What is meant by maintaing patient-centered curiosity? 

Answer 36

Can't not explore things based on what cultural view is 

Question 37

Give an example of where a clinician can't not explore something based on what the cultural view is

Answer 37

Can't accept something that is wrong because its in their culture, e.g. hitting kids