What Does 'Patient-Centered Care' Demand in Serious Cultural Conflict? (original) (raw)
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Abstract: Times of globalization bring with themselves a considerably high amount of migrationa fact which, again, causes an increasing degree of such cultural diversity. Since literally every individual in his or her life is likely to somehow depend upon medical care, ...
Cultural Health Capital and the Interactional Dynamics of Patient-Centered Care
As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu’s concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients’ and providers’ cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care.
Canadian Medical Education Journal , 2019
For many years, social scientists have been stressing the important role culture plays in the work of healthcare providers in their clinical settings. This idea now saturates official statements and guidelines published by professional medical associations. In an article outlining the duties and responsibilities of physicians in Canada, for instance, the Canadian Medical Protective Association describes the importance of “provid[ing] culturally competent and culturally safe care.”3 Detailing the abilities and roles of a “competent” physician, the Royal College of Physicians and Surgeons of Canada CanMEDS framework similarly focuses on the delivery of patient-centered care, which involves understanding a patient’s values, beliefs, biases, and family dynamics.
Cultural Sensitiveness in Health Care Delivery of Jimma University Specialized and Teaching Hospital
Quality in Primary Care, 2017
Background: Globally the increasing diversity in the population has led to concerns over disparities in health status between diverse patient populations. Language and cultural issues can have a significant impact on health disparities when not addressed by health care organizations. Even though disparity in health care increase very few studies have provided the opportunity for researchers to explore the issue of culturally and linguistically appropriate health care in a broad and organized fashion throughout the worldwide and none of them done across the country. Objective: To explore cultural sensitiveness in health care delivery of Jimma university specialized and teaching hospital. Methods: Institution based qualitative study was employed in JUSTH among 10 key informants (administrative and health workers) purposively selected from different service areas and 10 patients selected through purposive random sampling from different backgrounds. Data were collected using unstructured questionnaire through In-depth interview and analyzed by using ATLAS.ti7.1. Open Coding was carried out line-by-line. Following the coding process, family coding, themes and theoretical constructs were developed from both the field notes and the interview transcripts. Results: One of the most prominent challenges identified by this study is the image of cultural and linguistic sensitive diverse patients need care does not come to hospital plan image, which often results in a lack of financial and other resources for culture and language service. Developing supportive infrastructure, work force, data collecting and using, community engagement, organizational relationship, integrating cultural need into organizational planning, accommodating the specific need of patients and helping patients to manage their care are the major activities expected from the hospital as the study participants to deliver cultural sensitive/appropriate care for diverse patient populations. Conclusion: Without cultural appropriate health care services it is difficult for the hospital to deliver patient centered non disparity quality health service. For health care organizations to deliver patient centered non-disparity health service there must be conceptual framework guide the health care organization to develop a cohesive message about meeting the needs of diverse patient populations and better communicate this vision to staff, clients and the public. Thus framework must develop based on the culture of the clients/community served at the health care organization and medical indication of the patient cases. ABSTRACT Introduction
Delivering cultural-sensitive health services
2019
Cultural competence consists in attitudes, skills, behaviors and strategies allowing organizations and individuals to behave in situations of cultural diversity. Health systems are requested to assist an increasingly varied population, composed also of migrants (in Italy, they represent approximately 10% of the overall population). Since 2011, CCM has been organizing a Course in Global Health for health professionals. The course includes a module specifically meant to enhance participants' cultural skills, providing them with knowledge and competences helpful to deal with migrant patients. All health workers committed to offer high quality assistance to each patient should attain "cultural competence".
CULTURAL COMPETENCY AND QUALITY OF CARE: OBTAINING THE PATIENT'S PERSPECTIVE
Provision of "culturally competent" medical care is one of the strategies advocated for reducing or eliminating racial and ethnic health disparities. This report identifies five domains of culturally competent care that can best be assessed through patients' perspectives: 1) patient-provider communication; 2) respect for patient preferences and shared decision-making; 3) experiences leading to trust or distrust; 4) experiences of discrimination; and 5) linguistic competency. The authors review the literature focusing on these domains, summarize the salient issues and current knowledge, and discuss the policy and research implications. Incorporating patients' perspectives on culturally and linguistically appropriate services into current measures of quality will provide important data and create opportunities for providers and health plans to make improvements.
JAMA Psychiatry, 2017
Today's clinicians must develop therapeutic alliances with patients of diverse customs, values, and experiences. This can be especially challenging, as most clinicians must make decisions quickly, opening the door to systematic attributional errors and untested assumptions about patients without confirming that their expectations are correct. In one study, white therapists were more likely than Chinese therapists to describe Chinese patients as depressed with interpersonal skill deficits; Chinese therapists judged white patients as demonstrating more severe pathology than did white therapists. 1 In light of these findings, it is not surprising that members of racial and ethnic minority groups experience disparities along the entire continuum of behavioral healthcare. Current policy shifts, including efforts to reduce insurance coverage for vulnerable groups and to target large numbers of undocumented immigrants for deportation, are likely to exacerbate these disparities by reducing opportunities to access care and increasing mistrust of institutions. We offer here some background showing the enormity of this issue and ways to address it.