Cultural competence in the medical field refers to practicing health care that is sensitive to the health beliefs, behaviors and also epidemiology of different groups within the society (Green, 2003). It poses a great challenge especially for the health workers who are practicing health care in a multicultural environment. One has to recognize the multicultural frame work in such regions and be ready to meet the different cultural demands that may exist in such an environment. Issues related to cultural competence arise from the diverse populations that are there today. For example the United States has a population comprising of mixed individuals in terms of race, ethnicity and culture.
There is an influx of so many individuals from other countries who come to the US. Such changes in the population patterns require an equivalent change in the health sector to ensure that quality health care is offered to all individuals without any barriers. In the field of medicine the heath care provisions requires the physicians to provide quality care to all patients despite their cultural background. Most health care programs are designed to effectively meet the needs of diverse populations since it is very important to cater for the needs of all patients by understanding them and giving the right diagnoses and treatment.
Cultural competence demands more than being sensitive since it requires one to have skills and knowledge to diagnose and treat ailments in patients who come from the multicultural environment and besides coping with the challenges that may come in meeting the final goals of health care. Cultural competence covers a wide range of cultural differences which may include race, status of immigration, economic status, ethnicity, gender and also sexual orientations.
Health status is understood differently across the races and ethnic groups. The practice of cultural competence includes learning what one is not conversant with, learning to listen and willingness to learn from the patients. Learning cultural competence especially in the multicultural environment is such a big challenge in the medical field having one to learn all the new cultures and trying to incorporate them into the health care practice. It has been found important to incorporate the cultural competence into the case learning within the medical field. This could help the physicians be open minded in cultural knowledge and be able to practice health care with the right attitude in multicultural environments.
Cultural competence is important as it eradicates the barriers that may pose a danger in providing the appropriate health care to the patients. It helps to eliminate the cultural differences between the patient and the doctor. It acts as a way of improving the patient-physician communication. It further helps to improve the quality of health care and enables hospitals to be set up in multicultural environments. The world today has been faced with diverse changes in terms of ethics, economics and social behavior. It is therefore very important to incorporate the cultural competence since one will be mostly likely to serve in an environment that has a population comprised of different backgrounds.
Every individual requires accessing the proper medical care from their health care providers despite the challenges that may be posed by differences in culture. In most health institutions, the primary role of giving health care lies with the nurses and it is therefore very important to incorporate the studies on the cultural competence in the graduate schools curricula. The goal of such curricula would be to enhance the role of nursing in providing health care and also to incorporate advanced knowledge and practice to meet the different needs of the diverse populations.
A cultural competence model developed by Campinha-Bacote, (2002) describes cultural competence as a continuous process and not to have a specific end since changes in the society are continuous and never ending. It is therefore the duty of the health care providers to continuously strive to achieve the required abilities to effectively serve the needs of different cultures. Attaining cultural competence seeks to bring together the awareness of the different cultures, learning different cultural skills, interacting with them and a strong desire to survive within such cultural environment.
The model was referred to as a volcano and it primarily involves a deeper look into personal bias as opposed to appreciating and being sensitive to other cultures. The health care providers have to be actively involved in seeking different information on different cultures that may be present in the work environment. This helps them to understand the patients better when they seek medical attention. Getting information on the cultures should also involve the interacting with the patients to ensure that they both understand each other very well in matters related to beliefs and values besides health care provision (Goode, 1999).
The ability to incorporate all these different cultural backgrounds by the practitioners helps them to appreciate the unique cultures that they may come across every day. The desire to achieve cultural competence is linked to the spiritual context of a person which provides the foundation and the desire to strive to achieve the goals of cultural competence.
Cultural competence can be demonstrated in various ways within the health care institutions. One of the ways to demonstrate the appreciation of different cultures in the multicultural environment is to have a diversified population of workforce that is attending to the patients. The management of the health institutions should ensure that the physicians that attend to the physicians are not extremely from one cultural background.
It should be balanced to meet effectively the needs of the patients. The facilities that are available within the health institutions should be very convenient for use by the different cultures within the immediate society (Jones, 2006). If the facilities are not able to meet the needs of certain cultures, then cultural competence will not be equally demonstrated in such institutions since such a group will not get the optimum care required.
The institutions should also have ready assistance for patients who may not understand English which is commonly used in many institutions globally. An institution with such assistance programs promotes the sole understanding between the physician and the patients. Cultural competence is equally demonstrated by the continuous training of the health institution’s staff to ensure that they are offering culturally accepted services to the community. The institutions should also be involved in continuous checking of quality care to all the society races, ethnic groups and cultural subgroups. Institutions that adore cultural competence also have programs that incorporate the society in setting priorities that address the execution of health care (Hudmon, 2005).
Cultural competence in the health care providers is demonstrated by exploring whether the provider respects the patients believes, preferences, needs, values and meaning of sickness. The provider should also not have any personal bias but instead should be willing to build trust to establish a common ground of understanding the different cultures. Competence is also demonstrated by the ability of the provider to use interpreting services when they are needed to effectively understand the patient.
The provider should also have adequate knowledge of the cultures that are within the society. Such knowledge should include awareness of the crucial factors that may be affecting the provision of health care to the different groups within the society. The provider who embraces cultural competence should be able to provide health care with a positive attitude despite the cultural background of the patient (Jones, 2006).
One of the greatest challenges in the health care provision when working in a multicultural environment is the language barrier. Language barrier is one of the greatest challenges in communication since its poses a threat in understanding each other. The health care providers serving different cultures will always be faced with patients who do not speak a language the health care providers can understand.
This becomes a very big challenge for the health providers since they have to write medical information on the patients and also offer prescriptions for drugs. Issues relating to language barrier have risen from the increase in immigration where many people move to other countries which speak different languages and also the posting of the health care providers to work in regions that have different cultural backgrounds.
Getahn (2008) clearly brings out the dangers of language barrier in the practice of health care especially when treating the cancer patients. This is because cancer treatments requires a lot of drugs and therapies and the patients are required to give consent that they acknowledge and understand the risks involved. He further explains that cultural challenges may result to health care providers acting in a manner not acceptable in health care for example if such patients with language barrier cannot understand what the physicians are saying yet their health conditions may deteriorate if the physicians do not act quickly to safe life.
Institutions which face such challenges also find it very difficult to involve other employees in interpreting issues and at the same time handle their duties. A big challenge that may come has to under go an extra cost to employ interpreters who may not be having any other role within the hospital and it may not be very cost effective. The hiring of interpreters may increase the cost of operations for the health care providers although the issue should be concentrated on doing what is right for the patients in enhancing the health care services and not the cost of providing the service.
Lack of effective communication that is brought out by cultural differences may challenge the culture of proper health care in the medical field since it will delay treatment and also make it very hard to make the right diagnosis of the patient’s illness (Geiger, 2004).
Another challenge faced by health providers in multicultural environment is that the patients may not be willing to be treated by the health care providers from outside their culture. This is despite the fact that the health care provider may understand their language very well. The issue here can be racism and lack of acceptance of health care providers from outside their cultural background. (Scrimshaw, 2003) This may kill the morale of the health care providers and they may also develop an altitude towards the other cultures if they are not well trained in issues related to cultural competence.
Another challenge facing the health care providers in multicultural environments is arriving on the best approach in addressing the issues related to improving the health care facilities. It is not always clear to them which method will be successful and whether it will make a significant change in the system of providing health care. Other challenges include coping with the cultural differences that are found in different systems of different groups and also the environmental factors.
The programs of the cultural competence have not been in the field for a long time and therefore the mechanisms and strategies that may have been introduced in one region may not be present in another region. On the other hand, what may seem to be a solution in one multicultural environment may not be successful in another environment? There are also regions that do have any technical training on cultural competence and this may be very challenging for health care providers who may come from different cultural backgrounds. Some regions may also be aware of the importance of the cultural competence training but may ignore it or lack funds to facilitate the success of such projects (Rundle, 2008).
In conclusion the challenges that the medical physicians face related to the multicultural backgrounds may be addressed in different approaches. The hospitals may look for funds from donors if they are not in a position to find finances to hire interpreters who understand the patient’s dialects efficiently. It is very important for the medical team attending to the patients to have members who are fluent with the patient’s language.
International hospitals set in multicultural environments can hire some staff from the local community apart from the physicians who may have originated from their countries or international community. There is also the importance of enhancing the cultural competence in the health care provision systems. This can be done through continuous training of all members within the medical field (Gilliss, 1996).
The training curriculum should also take into consideration the developments that continually rise with the field. The challenges of providing health care in multicultural environment may be difficult to handle but the physician Goode s should be very committed to the training programs and be very understanding when working in such environments. The government should also take the initiative of providing the funds to organize training workshops for the health care providers. It should also provide basis for continuous research to access the situations in the background, evaluate the programs that are launched to cumber the challenges and come up with further developments that can give solutions to the cultural challenges (Anderson, 2007).
Training of the health care providers on cultural competence will enable them to practice health care provision with a lot of understanding and enhance the ability to communicate effectively with people across the different cultures. Cultural competence training helps the practitioners to be aware of the multicultural world, develop a positive attitude towards cultural differences and acquire knowledge and skills to enhance their services.
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