Theincrease in the popularity and adoption of the concept ofglobalization has been characterized by the increase in immigration.The movement of people has increased cultural diversity, which callsfor an improvement in cultural competence among the health careproviders. National Center for (2014) definedcultural competence as the ability of a given person to comprehendand respect attitudes, beliefs, values, and mores that vary acrosscultures and respond appropriately to the differences in planning,evaluating, and implementing health care education. This implies thatthe health care providers need to understand their personal worldviews as well as those of their clients, while avoidingmisapplication of scientific knowledge and stereotyping. Although thehealth care providers have individual responsibility of embracingcultural competence, health care facilities should train theiremployees in order to enhance their capacity to embrace culturaldiversity. Enhancing cultural competence among the health careprofessionals is among the most viable solution for improving thetherapeutic outcome in the contemporary society that is characterizedby cultural diversity.
Importanceof cultural competence
Ahigh level of cultural competence reduces health care disparities andenhances access to quality care that respects and responds to theneeds of diverse clients. The development and implementation ofcultural competence as a framework increases the capacity ofagencies, systems, and groups of professionals to understand theneeds of the diverse population seeking for health information(National Institute of Health, 2014). In addition, culturalcompetence improves the capacity of the health care providers tofunction more effectively. The National Institute of Health (NIH)acknowledges the challenge of an increase in ethnic and racialdiversity where each group has its own health challenges and culturaltraits (National Institute of Health, 2014). NIH responds to thischallenge in two ways. First, the institute conducts research withthe objective of identifying the appropriate means of reducing healthdisparities and delivering health care. Secondly, the NIH institutedevelops and distributes resources designed with differentcommunities and applies the norms of public engagement. A successfulimplementation of cultural competence enhances health outcomes andbenefits the consumers, communities, and the stakeholders. Moreover,cultural competence enhances medical accuracy by enhancing providers’comprehend different factors (including language, beliefs, behaviors,customs, and perspectives) that influence health care communication.
Movingtowards cultural competence
Thereis a growing need for the health care professionals to increase theircultural competence following an increase in the rate of immigration.Berg (2000) identified six steps that can guide the health careproviders in determining whether they are moving towards competenceor not. The first step is to involve immigrants in their personalhealth care, which means that the health care professionals shouldgive their immigrant clients an opportunity to make choices regardingtheir health. Secondly, health care providers should take time tolearn about culture, beginning with their own culture. This enhancestheir awareness of how culture can affect communication in a healthcare setting. Third, it is important that the health care providerspeaks the language of the client or use a professional interpreterto ensure that both the client and the health care providerunderstand one another (UCare, 2000). Fourth, the health careprofessionals should ask the right questions and expect correctanswers from their clients. Fifth, paying attention to the clients’financial issues can increase their perception that the health careprovider minding about their affairs, which enhances theircooperation and the treatment outcome. Lastly, finding resources andforming partnerships increase cultural competence of the health careproviders in the entire health care facility.
Needfor cultural competence
Healthcare providers attend to the needs of patients from differentcultural backgrounds that have varying beliefs, perception, andattitudes towards health care. Cultural competence among the healthcare providers enhances their capacity to understand and accept thesedifferences (Rasbridge, 2009). In addition, the high rate of increasein the diversity of the U.S. demography creates the need for healthcare providers to have a high level of cultural competence in orderto enhance their ability to address the health needs of a diversepopulation. According to United States Census Bureau (2014) thepopulation of non-Hispanic white is expected to reach 199.6 millionfrom 197.8 million, the black will increase to 61.8 million from 41.2million, and Asians will increase from 15.9 million to 34.4 millionby 2060. This indicates that the population of the United States isdiversifying racially and culturally. These changes are mainly causedby significant increases in ethnically, racially, linguistically, andculturally diverse groups as well as changes in the immigrationpatterns (Rasbridge, 2009).
Traininghealth care providers for cultural competency
Programsfor cultural competency training are designed to achieve three majorgoals. First, the training programs aim at improving self-awarenessand attitude towards individuals of different ethnic and racial group(United States Census Bureau, 2014). Secondly, the training programimproves health care outcome by enhancing providers’ knowledgeabout cultural practices and beliefs, care-seeking behavior,attitudes towards medical care, and perceived burden of differentvarious diseases in different populations. Third, the competencytraining improves different skills (such as communication) of thehealth care providers (including physicians, nurses, case managers,and assistants) and other members of staff (including billingpersonnel, management, and administrators) who come into contact withclients, thus increasing chances for better health care outcome. Thisimplies that the main objective of training health care professionalsis to close the gaps created by health care disparities in thequality and outcome of health care across ethnic racial andsocioeconomic groups.
Thecompetency training programs are divided into different modules thatare offered to professionals depending on the roles they play in thehealth care facilities. The introductory program can be offered toall members of staff in health care facilities, including those whoare not directly involved in health care provision. The introductorypart may take 2-4 hours and it focuses on basics of culturalcompetency, disparities existing in underserved groups, and impact ofculture on health communication (Cross Cultural Health Care Program,2014). Advanced training programs address specific areas (includingthe management of chronic diseases, care for end of life, immigrant,and mental health) that require cultural competency. This program mayalso help the management in establishing culturally competent teams,recruiting culturally competent employees, and enhancingcollaboration. Lastly, the training for trainers program is a 5 dayprogram that is offered to ensure that health care providers are ableto deliver linguistically and culturally appropriate services (CrossCultural Health Care Program, 2014). The skills provided in thisprogram include the ability to resolve conflicts that result fromcross cultural differences and the ability to work more effectivelywith health care interpreters.
Barrierscaused by cultural differences in the workplace
Theincrease in cultural diversity and the presence of different agegroups at places of work are some of the key challenges that healthcare institutions should deal with in twenty first century. Thesecultural and age factors cause significant barriers in four majorways that reduce productivity as well as the morale of coworkers.First, the presence of people who come from different parts of theworld in workplace causes language and verbal barriers. According toBlank (2013) regional differences in communication and informationlanguage are the major causes of misunderstandings at places of work.This is because people from different geographical locations havevarying accents that may annoy others or cause misunderstanding.Secondly, people from different cultures maintain varying degrees ofpersonal space and use different types of non-verbal communicationthat may be considered to be disrespectful of others (Blank, 2013).Third, the U.S. workforce of composed of individuals of different agegroups (including the mature workers, baby boomers, generation X, andgeneration Y) that use different approaches to work. The youngworkers often describe the senior ones as out of touch while theolder employees describe the young ones as slackers (Blank, 2013).Fourth, status and resistance is a commonplace occurrence whereworkers develop resistance towards various things, such as diverseworkforce, emphasis on seniority or adopt stereotyped opinionsindividuals of different cultural origins. All these barriers affectproductivity and efficiency of workers in negative ways.
Regulatoryimplications for cultural competence
TheFederal government has the primary role of ensuring that culturalcompetence is maintained in the health care sector given the factthat it acts both as a civil rights law enforcer and the mainpurchaser of medical care services. For many years, the governmenthas been formulating legal and policy measures to contain theescalating disparities in the health care sector. For example, theCivil Rights Act formulated in 1964 mandated that all people residingin the United States should not be discriminated on the grounds oftheir race, national origin, or color, denied benefits, orparticipation (National Center for , 2012).Although there are many regulatory measures put in place by thegovernment, health care organizations have competing responsibilitiesto adhere to these rules. Organizations that comply with thegovernment regulations acknowledge the existence of culturaldiversity and respond by training their staff on cultural competenceand employing culturally appropriate members of staff.
Financialimplications of cultural competence
Financialimplications of cultural competence can be assessed in two ways.First, the adoption of cultural competence may at times require theuse of financial incentives to motivate health care providers toembrace the principles of cultural and linguistic competence (Brach &Fraser, 2002). Although this may appear to be an expense to thehealth care facilities, the enhanced capacity of these facilities toaddress health issues of the diverse population attract more clients,which increases their financial gains (Minnesota Department of HumanServices, 2014). This implies that health care facilities that areable to attract the increasing population of the minority groups,which will increase their market share and financial benefits.However, there is a possibility that the majority of the minorityimmigrants may not have financial stability, which will force thesehealth care facilities to depend on public financing.
Expectedbenefits of cultural competence
Culturalcompetence has several benefits to patients, health careorganizations, and health care providers. It enhances mutualunderstanding and respect between health care organizations and theirclients (Rodak, 2013). In addition, cultural competence increasespatients’ trust and inclusion of members of the community.Moreover, organizations that embrace cultural competence are able tofacilitate the participation of the community and its involvement inhealth issues. Cultural competence also promotes families andclients’ capacity to take responsibilities for their health.
Evaluationof staff that completes the training
Theevaluation team should engage and consult with the work teams thatact as the focus of data being collected. This will help in thedetermination of alternative approaches in which the evaluation datacan be analyzed and findings presented as well as the considerationof the perspectives of multiple audiences (American EvaluationAssociation, 2014). The evaluation teams should use intermediaries incollecting data from participants who are limited by abilities,language, trust, or familiarity. The evaluation teams should engagethe groups being evaluated in the analysis and interpretation ofdata. While doing this, the evaluation team should note thatreporting the findings at different stages may bring in a newaudience that requires communication strategies that are culturallyappropriate. Lastly, the evaluation team should use culturallyappropriate strategies in metaevaluation process, such as feedbackfrom the target communities who will be affected by the evaluation.
Thecase study published by Rose, R. (2010) describes how an AfricanAmerican woman visited a health care facility for an MRI of thespine. The key issue is that the health care provider requested tothe woman to remove all metallic objects and her hair without givingvalid reasons. He health care provider instead excused himself bystating that he had seen other Black women with wore weaves and falsehairs held by pins. This shows that the health care provider wasinsensitive to the impact of his statement that suggests racism onthe client. An effective training on cultural competence would havehelped the health care provider in effective communication byselecting words that are not racially biased. This will attractpatients from the minority groups, patients’ cooperation, andenhance treatment outcome.
Improvingcultural competence in health care facilities is one of the keystrategies that can help in enhancing clients’ cooperation andtreatment outcome in the modern society that is characterized bycultural diversity. Cultural competence enhances the capacity ofhealth care facilities to reduce health care disparities, providequality care, and respond to the needs of their diverse patients. Theneed for training on cultural competence is created by the increasein the rate of immigration, which has increased the proportion of theminority groups that have different beliefs, perspectives, andvalues. Cultural competence in the health care sector has manyimplications, including financial and regulatory implications. Healthcare organizations should evaluate the staffs that have undergone thetraining programs to ensure that they have embraced the key conceptsof cultural competence.
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