Cultural-Competence-Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件

DiversityandCultureRobertF.Jex,RN,MHA,FACHEDiversityandCultureRobertF.GoalsandObjectivesEstablishaclearandsharedunderstandingoftheconceptsofdiversityandcultureDefinetheconceptofculturalcompetencyanditsrelevancetohealthcareBeabletoperformaself-assessmentofindividualculturalcompetencyDevelopanawarenessoftheimpactofcultureonhumandynamicsGoalsandObjectivesEstablishCulturalCompetency “Aprocessoflearningthatleadstoanabilitytoeffectivelyrespondtothechallengesandopportunitiesposedbythepresenceofsocialculturaldiversityinadefinedsocialsystem.”CulturalCompetency “AprocessCulturalCompetency“Tobeculturallycompetentdoesn’tmeanyouareanauthorityinthevaluesandbeliefsofeveryculture.Whatitmeansisthatyouholdadeeprespectforculturaldifferencesandareeagertolearn,andwillingtoacceptthattherearemanywaysofviewingtheworld.”

OkokonO.UdoCulturalCompetency“Tobecu

TorespondtocurrentandprojecteddemographicchangesintheUnitedStatesToeliminatelong-standingdisparitiesinthehealthstatusofpeopleofdiverseracial,ethnicandculturalbackgroundsToimprovethequalityofservices.ToenhancetheworkplaceenvironmentTomeetregulatoryandaccreditingmandatesTodecreasethelikelihoodofliability/malpracticeclaims.WhyCulturalCompetency?

TorespondtocurrentandpDiversityencompassesissuesrelatedto….racecolorclassageexperienceabilitygenderethnicitylanguagereligionpoliticssexualorientationsexualidentitysocio-economicstatusresidentstatusDiversityencompassesissuesrUnderstandingCultureIndividualculture:

Ismultifacetedandencompasses-

personality,uniquestyleinternalfactors-gender,race,age,sexualorientationexternalinfluences-society,experienceswhereindividualsgrowuporlivenow,religiousaffiliationorganizationalinfluences-seniority,levelwithinorganization,worklocationUnderstandingCultureIndividuaCommunityculture: Existswithinanetworkofrelationships-betweenlanguageandtradition,traditionandhistory,historyandeconomicsOrganizationalsystems:

Operateascomplex“cultures”withspecified“l(fā)anguages”traditions,codesofconductCommunityculture:GroupExerciseExploringtheIndividual:GivenNamesandoneStoryEthnicities,Languages,ReligionsandSpiritualBeliefsCurrentRolesinLifeGroupExerciseExploringtheInAnotherwaytoviewtheworldIfwecouldshrinktheworldintoavillageof100people:52wouldbefemale:48wouldbemale33wouldbechildren6wouldbeover6558wouldbeAsian79wouldbepeopleofcolor30wouldbeChristian6wouldownhalfthevillage’swealth—all6wouldbe

AmericanAnotherwaytoviewtheworldIAnotherwaytoviewtheworld(cont’d)9wouldspeakEnglish50wouldsufferfrommalnutrition80wouldliveinsubstandardhousing66wouldnothaveaccesstoclean,safedrinkingwater1wouldhaveacollegeeducationAnotherwaytoviewtheworldChangingDemographics18%ofUSresidentsoverage5speakalanguageotherthanEnglishinthehomePersonswithphysicalandmentalimpairmentsarethelargestsingleminority(45million)21-23%oftheUSpopulationis“functionallyilliterate”=“l(fā)owliteracy.(MostareEnglishspeakingnativeborn)35millionHispanics.34.5millionBlacks.10.5millionAsianAmericans.4millionNativeAmericans.TheU.S.hasmovedbeyondBlackandWhitetobecomeacomplexmosaicofracesandethnicities.

ChangingDemographics18%ofUSChangingDemographics(cont’d)Since1970andtheendofimmigrationlimitsimposedin1924,theAsianAmericanpopulationhasgrownfrom1.5milliontonearly12millionin2000.By2030,1in4elderlypersonswillbefromaracialorethnicminoritygroupBy2030,itisprojectedthat: -theHispanicpopulation65andolderwillincrease328% -AsianandPacificIslander65andolderpopulationwillincrease285%ChangingDemographics(cont’d)Disparities

Avoidabledifferencesintheincidence,prevalence,mortality,andburdenofdiseaseandotheradversehealthconditionsthatexistamongspecificpopulationgroups.Disparities InstituteofMedicine2002ReportonDisparities“Racialandethnicminoritiestendtoreceivelowerqualityhealthcarethanwhitesdo,evenwheninsurancestatus,income,age,andseverityofconditionsarecomparable.”

-AlanNelsonM.D. CommitteeChair March20,2002InstituteofMedicine2002RepDisparitiesinHealthCareInfantmortalityforblacksistwicetherateofwhitesCancerdeathsamongblacksandLatinosarehighCervicalcanceris5timesmorelikelytostrikeVietnamesewomenaswhitewomenNativeAmericanshavehigherratesofdiabetesandheartdiseaseMinoritiesarelesslikelytobeimmunizedMinoritiesarelesslikelytohaveregularcheck-upsDisparitiesinHealthCareInfaCultural-Competence---Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件Cultural-Competence---Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件Cultural-Competence---Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件Cultural-Competence---Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件Aggravatingissues21-23%oftheUSpopulationis“functionallyilliterate”=“l(fā)owliteracy.(MostareEnglishspeakingnativeborn)60%ofMedicaidpopulationhaslowliteracy25%don’tknowdiagnosisornameofdrug50%don’tknowpurposeofdrug75%can’tdescribetheirdiseaseAggravatingissues21-23%ofthImpactoflowliteracyonhealthThosewholackbasicliteracyskillsaremuchmorelikelythanotherstosufferfrom:heartdiseasediabetescancer andtohavehealthcareexpensesasmuchassixtimeshigherthanadultswithaveragelevelsofliteracy.

Source:U.S.ProgramsDivisionofPro-LiteracyWorldwide March2003ImpactoflowliteracyonhealAssumptions“AtleasthalfoftheexerciseIgeteverydaycomesfromjumpingtoconclusions.”

BruceDexter JournalistAssumptionsAssumptionsAssumptionsExerciseDescribeatimewhenassumptionsweremadeaboutyouthatledtodiscriminationExerciseDescribeatimewhenaSuccessfulOrganizationshavetheabilityto:ValueDiversity ConductongoingselfassessmentManagethedynamicsofdifferenceAcquireandinstitutionalizeculturalknowledgeAdjusttodiversityandtheculturalcontextsofthecommunitiestheyserveSuccessfulOrganizationshaveTheElementsofCulturalCompetenceAwarenessofone’sowncultureUnderstandingthedynamicsofdifferenceAwarenessandacceptanceofdifferenceDevelopmentofculturalknowledgeCelebrationofdiversityTheElementsofCulturalCompeReflections

“Eachpersonislikelytohavehispersonalsystemofvalueswhichhebelievestobepreferabletosomeothers.Thosevaluesheprefersarelikelytobeheavilyweightedinfavorofthoseinhisownculturalbackground,whetherornotherealizesit.”

CondonandYousef,1975Reflections“EachpersonPersonalCultureonCommunicationIncorrectassumptionsabouttheotherLanguageandcommunicationstyleissuesBiasagainsttheunfamiliarPersonalvaluesconflictExpectationsthatotherswillconformtoestablishednorms(stereotypes)

AdaptedfromSelmaMyersPersonalCultureonCommunicatCommunication"Doctors(andotherhealthcareproviders)todaydevotefarmoretimeandthoughttothewordsofapathologist(wordsthatareoftennotevenheard,butreadoffacomputerscreen)thantothewordsofthemanorwomanforwhoselifetheyhavetakenresponsibility.”Source:Nuland,DoctorsandDeities:Medicine,MulticulturalismandtheDutyofPhysicians.NewRepublicOctober,13,1997,31-39.Communication"Doctors(andoth

Toofferculturallyappropriatecarerequiresbeingopentotheexpectations,perceptions,andrealitiesofvariousindividualsandcommunities.

PartingThoughts

Everyrelationshipwehaveissuccessfulbecauseweareculturallycompetentwiththatindividual. Allhateisselfhate.Itismoreimportanttoknowwhatsortofpersonthisdiseasehasthanwhatsortofdiseasethispersonhas.

WilliamOslerPartingThoughtsEveryrelaReferencesNationalCenterforCulturalCompetence

GeorgetownUniversity,BureauofPrimaryHealthCareAllianceCommunityServices,JorgeJ.Arce-LarretaCulturalCompetencyinHealthandHumanServices,CCHCPReferencesNationalCenterforDiversityandCultureRobertF.Jex,RN,MHA,FACHEDiversityandCultureRobertF.GoalsandObjectivesEstablishaclearandsharedunderstandingoftheconceptsofdiversityandcultureDefinetheconceptofculturalcompetencyanditsrelevancetohealthcareBeabletoperformaself-assessmentofindividualculturalcompetencyDevelopanawarenessoftheimpactofcultureonhumandynamicsGoalsandObjectivesEstablishCulturalCompetency “Aprocessoflearningthatleadstoanabilitytoeffectivelyrespondtothechallengesandopportunitiesposedbythepresenceofsocialculturaldiversityinadefinedsocialsystem.”CulturalCompetency “AprocessCulturalCompetency“Tobeculturallycompetentdoesn’tmeanyouareanauthorityinthevaluesandbeliefsofeveryculture.Whatitmeansisthatyouholdadeeprespectforculturaldifferencesandareeagertolearn,andwillingtoacceptthattherearemanywaysofviewingtheworld.”

OkokonO.UdoCulturalCompetency“Tobecu

TorespondtocurrentandprojecteddemographicchangesintheUnitedStatesToeliminatelong-standingdisparitiesinthehealthstatusofpeopleofdiverseracial,ethnicandculturalbackgroundsToimprovethequalityofservices.ToenhancetheworkplaceenvironmentTomeetregulatoryandaccreditingmandatesTodecreasethelikelihoodofliability/malpracticeclaims.WhyCulturalCompetency?

TorespondtocurrentandpDiversityencompassesissuesrelatedto….racecolorclassageexperienceabilitygenderethnicitylanguagereligionpoliticssexualorientationsexualidentitysocio-economicstatusresidentstatusDiversityencompassesissuesrUnderstandingCultureIndividualculture:

Ismultifacetedandencompasses-

personality,uniquestyleinternalfactors-gender,race,age,sexualorientationexternalinfluences-society,experienceswhereindividualsgrowuporlivenow,religiousaffiliationorganizationalinfluences-seniority,levelwithinorganization,worklocationUnderstandingCultureIndividuaCommunityculture: Existswithinanetworkofrelationships-betweenlanguageandtradition,traditionandhistory,historyandeconomicsOrganizationalsystems:

Operateascomplex“cultures”withspecified“l(fā)anguages”traditions,codesofconductCommunityculture:GroupExerciseExploringtheIndividual:GivenNamesandoneStoryEthnicities,Languages,ReligionsandSpiritualBeliefsCurrentRolesinLifeGroupExerciseExploringtheInAnotherwaytoviewtheworldIfwecouldshrinktheworldintoavillageof100people:52wouldbefemale:48wouldbemale33wouldbechildren6wouldbeover6558wouldbeAsian79wouldbepeopleofcolor30wouldbeChristian6wouldownhalfthevillage’swealth—all6wouldbe

AmericanAnotherwaytoviewtheworldIAnotherwaytoviewtheworld(cont’d)9wouldspeakEnglish50wouldsufferfrommalnutrition80wouldliveinsubstandardhousing66wouldnothaveaccesstoclean,safedrinkingwater1wouldhaveacollegeeducationAnotherwaytoviewtheworldChangingDemographics18%ofUSresidentsoverage5speakalanguageotherthanEnglishinthehomePersonswithphysicalandmentalimpairmentsarethelargestsingleminority(45million)21-23%oftheUSpopulationis“functionallyilliterate”=“l(fā)owliteracy.(MostareEnglishspeakingnativeborn)35millionHispanics.34.5millionBlacks.10.5millionAsianAmericans.4millionNativeAmericans.TheU.S.hasmovedbeyondBlackandWhitetobecomeacomplexmosaicofracesandethnicities.

ChangingDemographics18%ofUSChangingDemographics(cont’d)Since1970andtheendofimmigrationlimitsimposedin1924,theAsianAmericanpopulationhasgrownfrom1.5milliontonearly12millionin2000.By2030,1in4elderlypersonswillbefromaracialorethnicminoritygroupBy2030,itisprojectedthat: -theHispanicpopulation65andolderwillincrease328% -AsianandPacificIslander65andolderpopulationwillincrease285%ChangingDemographics(cont’d)Disparities

Avoidabledifferencesintheincidence,prevalence,mortality,andburdenofdiseaseandotheradversehealthconditionsthatexistamongspecificpopulationgroups.Disparities InstituteofMedicine2002ReportonDisparities“Racialandethnicminoritiestendtoreceivelowerqualityhealthcarethanwhitesdo,evenwheninsurancestatus,income,age,andseverityofconditionsarecomparable.”

-AlanNelsonM.D. CommitteeChair March20,2002InstituteofMedicine2002RepDisparitiesinHealthCareInfantmortalityforblacksistwicetherateofwhitesCancerdeathsamongblacksandLatinosarehighCervicalcanceris5timesmorelikelytostrikeVietnamesewomenaswhitewomenNativeAmericanshavehigherratesofdiabetesandheartdiseaseMinoritiesarelesslikelytobeimmunizedMinoritiesarelesslikelytohaveregularcheck-upsDisparitiesinHealthCareInfaCultural-Competence---Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件Cultural-Competence---Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件Cultural-Competence---Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件Cultural-Competence---Utah-Department-of-Health文化能力-猶他州衛(wèi)生部門課件Aggravatingissues21-23%oftheUSpopulationis“functionallyilliterate”=“l(fā)owliteracy.(MostareEnglishspeakingnativeborn)60%ofMedicaidpopulationhaslowliteracy25%don’tknowdiagnosisornameofdrug50%don’tknowpurposeofdrug75%can’tdescribetheirdiseaseAggravatingissues21-23%ofthImpactoflowliteracyonhealthThosewholackbasicliteracyskillsaremuchmorelikelythanotherstosufferfrom:heartdiseasediabetescancer andtohavehealthcareexpensesasmuchassixtimeshigherthanadultswithaveragelevelsofliteracy.

Source:U.S.ProgramsDivisionofPro-LiteracyWorldwide March2003ImpactoflowliteracyonhealAssumptions“AtleasthalfoftheexerciseIgeteverydaycomesfromjumpingtoconclusions.”

BruceDexter JournalistAssumptionsAssumptionsAssumptionsExerciseDescribeatimewhenassumptionsweremadeaboutyouthatledtodiscriminationExerciseDescribeatimewhenaSuccessfulOrganizationshavetheabilityto:ValueDiversity ConductongoingselfassessmentManagethedynamicsofdifferenceAcquireandinstitutionalizeculturalknowledgeAdjusttodiversityandtheculturalcontextsofthecommunitiestheyserveSuccessfulOrganizationshaveTheElementsofCulturalCompetenceAwarenessofone’sowncultureUnderstandingthedynamicsofdifferenceAwarenessandacceptanceofdifferenceDevelopmentofculturalknowledgeCelebrationofdiversityTheElementsofCulturalCompeReflections

“Eachpersonislikelytohavehispersonalsystemofvalues