Week 3 (Pg. 40-51)

Holistic Medicine

  • Holistic Medicine: is an approach to health care that considers the whole person, including physical, emotional, social, and spiritual factors, rather than just treating specific symptoms or diseases.

Cultural Competence

  • Cultural competence defined by CDC as “a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enable effective work in cross-cultural situations."

  • To be culturally competent is not to know everything about a culture, but to be able to understand yours and not judge others based on yours.

Process of Cultural Competence in Delivery of Health Care Services

  1. Cultural awareness → Process of conducting a self-examination of one’s own biases toward other cultures and an in-depth exploration of one’s cultural and professional background.

  2. Cultural knowledge → Process in which healthcare providers gain information about different cultures and their health-related beliefs, practices, and values, enhancing their ability to deliver effective care.

  3. Cultural skill → Ability to collect relevant cultural data regarding client’s presenting problem as well as accurately conducting a culturally based physical assessment.

  4. Cultural encounter → Process that encourages health care professional to engage in direct cultural interactions to help prevent possible stereotyping.

  5. Cultural desire → Motivation is to want to and not have to engage in being cultural aware.

Purnell Model for Cultural Competence

  • Model s a circle in which an outlying rim represents society, second is community, third is family and fourth innermost is you.

  • Global society → World communication and politics

  • Community → Group of people who have a common interest or identity, and living in a specified locality.

  • Family → Two or more people who are emotionally involved with each other.

  • Person → biophyschosocialcultural human being who is constantly adapting.

Sunrise Model

  • Outer Cultural & Social structure dimension ring.

  • Semi-middle environmental context, language and ethnohistory.

  • Middle influences care expressions, patterns & patterns.

  • Inner holistic health

Promoting Cultural Competence

  • Involve community representatives in the organization’s planning and quality.

  • Establish a cultural competence board to help guide the implementation of culturally sensitive prevention and treatment efforts.

  • Provide ongoing training to staff members.

  • Develop health materials for the target population written at appropriate literacy level.

  • Make on-site interpretation services available when possible.

  • Access customer satisfaction and clinical outcomes regularly.

  • Consider the health disparities that exist in your community when planning outreach efforts.

Culture

  • Culture plays a vital role in determining the level of health of individuals, the family and the community.

  • “Culture is the foundation upon which health behavior is expressed - and through which health must be defined and understood.”

Western Medicine and Culture

  • Western medicine (and Western culture) postulates that health is a-cultural.

Socio-ecological Model & Pen 3

  • Socio-ecological Model: Individual → Relationship → Community → Societal

  • PEN 3 → Health behavioral/communication theory which includes culture in each of its domains

    • Relationships and expectations

      • Personal actions are examined as functions of broader social contexts.

      • Perceptions → Knowledge, values, and beliefs.

      • Enablers → Resources and institutional factors that enable that behavior.

      • Nurturers → Influence of family, friends, community and discouraging influencings.

    • Cultural empowerment → Domain of culture exists on a continuum from:

      • The term is “an affirmation of the possibilities of culture”

      • Continuum from: good, indifferent and bad.

        • Positive → values and relationships that promote healthful behavior.

        • Existential → Values and relationships which promote neutral behavior.

        • Negative → Values and relationships that prohibit the healthful behavior of interest

    • Cultural identity → In western culture, identity is the almost always used to describe problems. Cultural identity serves as point of entries for intervention.

      • Person → Individuals make decisions that are appropriate for their roles in society (seniority, gender and duality).

      • Extended family → Programs serve to see individuals within the context of their families. Who influences who?

      • Neighborhood → Larger community influences the behaviors of those in the community. The community supports the healthful behaviors.

        • Community capacity for intervention, geographic area, ethnic group and more.