● Do they utilize a combination of these approaches? ● Who is the primary medical provider or conveyer of medical information, family members, elders, friends, folk healers, family doctors, or medical specialists? ● Do all family members of the family agree on approaches to medical needs? ● It is important to remember to remain nonjudgmental about differences in beliefs about the medical issue, cause, or treatment. ● Correcting a client or patient’s different beliefs about their condition may lead the person to withhold future thoughts, and may interfere with building a trusting relationship. ● Treating patients with respect and allowing them to openly discuss differences in health beliefs permits them to reveal their medical history and symptoms, so that the therapist can make an accurate plan of treatment and the client will be willing and able to adhere to the therapist’s advice. biases, and beliefs can be used to ensure that they do not negatively affect the care that is provided to patients. One example of a self-assessment tool to assess conscious preferences, beliefs, and related practices is the set of cultural competency assessment questions provided by the American Academy of Family Physicians (2016): Questions to assist with informally assessing one’s level of cultural competence ○ Am I knowledgeable about the worldviews of different cultural and ethnic groups? ○ Am I aware of my biases and prejudices towards other cultural groups, as well as racism in health care? ○ Do I seek out face-to-face and other types of encounters with individuals who are different from me? ○ How do I react when a person I encounter does not speak English? ○ What are my beliefs toward folk remedies? 2.6% Racial and ethnic minority patients tend to be more receptive to care from practitioners of their own race or ethnicity, particularly in primary care and mental health settings. Non-English speaking patients experience better relationships of trust, greater medical comprehension, and greater likelihood of keeping follow-up appointments when they see a language-concordant practitioner, particularly in mental health care. ● Native Hawaiian/Pacific-Islander ● Multiple Other Race/ Non-Hispanic 0.2 % These findings suggest that greater diversity in health professions will likely lead to improved public health by increasing access to care for underserved populations, and by increasing opportunities for minority patients to see practitioners with whom they share a common race, ethnicity, or language. Although there is no consensus about how to define cultural and linguistic competence, what is common to their definitions is the need to be respectful and responsive to cultural and linguistic needs. The National Human Genome Project has found that any two humans are approximately 99.9 percent genetically identical. The most important genetic material for human functioning is in the shared set (NIH, 2016). It is for this reason that a sociocultural definition of race is recommended.
● Personal space and conversational distance vary across cultures. Look to the family for nonverbal cues about acceptable distance. ● Nonverbal signals for yes and no vary across cultures. In some cultures, nodding signals disagreement (Greece, Turkey, Iran). ● When taking notes, explain the contents and why they are being written. ● Be sure to ask the interviewee what he or she prefers to be called. ● Do not use a medical title as a tool to enforce a power differential. ● Eye contact patterns vary by culture and should not be used to assess truthfulness. Sample questions Regarding medical care: ● What is the family’s approach to medical needs? ● Do they rely solely on Western medical services? ● Do they rely solely on holistic approaches? Health provider’s self-assessment and reflection Most health professionals harbor some assumptions about patients, based on characteristics such as race, ethnicity, culture, age, social and language skills, education or socioeconomic status, gender, sexual orientation or disability. Often unconscious, these assumptions are so deeply rooted that even when a client or patient behaves contrary to assumptions, the therapist may view this as an exception to the rule. A conscientious therapist, aware of these underlying assumptions, will work diligently to ensure that these prejudices do not interfere with designing an appropriate treatment plan. Two different types of self-assessment tools are available for massage therapists to assess conscious and unconscious preferences: beliefs and related practices. Completion of self-assessment tools should be accompanied by reflection of how this new information on personal experiences, Value importance of diversity in health care According to the Health Resources and Services Administration, racial and ethnic minorities, particularly African-Americans, Mexican-Americans, Native- Americans, mainland Puerto Ricans, and people from a socioeconomically disadvantaged background are significantly underrepresented among health professionals. The following data was provided in the January 2015 report from the U.S. Department of Health and Human Services, Health Resources and Services Administration Bureau of Health Workforce National Center for Health Workforce Analysis: Minority representation among massage therapists ● White/Non-Hispanics 83.6 % ● Black/African American /Non-Hispanic 5.2 % ● Asian/Non-Hispanic 7.9% ● American-Indian/Alaskan Native 0.5% Section summary The United States lags behind other developed countries in key health indicators. Significant differences in health and health care persist by race, ethnicity, and socioeconomic status. As the linguistic and cultural diversity of the United States population grows, health care professionals are becoming increasingly aware of the need to be both linguistically and culturally competent.
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Book Code: MMD0724
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