Cultural competence in palliative care delivery and health outcomes

Cultural Diversity

Healthcare providers deal with people and family during stressful and difficult situations. Professionals delivering palliative care must understand how culture and religious background affect this interaction. The provision of a favorable healing environment is possible via the understanding of culture and religion.

How cultural diversity affects the quality of services and health outcomes

Regardless of the similarities, fundamental variations among people arise from nationality, culture, ethnicity, as well as from personal experience and family background. These variations affect the health behaviors and beliefs of both providers and patients have of each other. The provision of high-quality palliative care that is accessible, effective, affordable and requires medical care practitioners to exhibit an in-depth understanding of the socio-cultural backgrounds of a patient, their families, and the environments in which they live. Culturally competent palliative care facilitates clinical experiences with more favorable outcomes, support the possibility for an extremely rewarding patient experience, and increase the satisfaction of the person receiving the service (Andrews & Boyle, 2008). Critical factors to consider in delivering culturally competent palliative care services include understanding of the:

Values, beliefs, practices and traditions of a culture

Health-related, culturally defined needs of families and communities

Cultural Considerations in Treatment and Therapy

One element of health care relates to how a culture plans the health system, regarding private and public access to palliative care. In some nations, access to palliative care is mediated by socioeconomic components, implying only the wealthy get quality care. In other nations, palliative care is widely accessible by all, despite the income level or insurance position. Many cultural aspects can affect effective and successful intervention approaches among them social support networks, religion and spirituality, beliefs and attitudes about treatments and causes, socioeconomic position, and language barriers. There is no single perfect program, which is culturally competent for all involved. However, approaching healing and treatment from a culturally conscious perspective must be paramount. There is an obvious need for culturally-oriented palliative care services in order to fulfill the health needs of an ever diverse, pluralistic world, eradicate existing health disparities among minorities, fix a fragmented system of care where some get better services than others get, and meet the required social proficiency standards of accreditation bodies within medical training. Within medicine, the notion of social proficiency originated from medical anthropology with emphasis on the universality disease and distress (Bomar, 2004).

Medicine is defined as a social system, which requires careful cultural research to determine illness and disease. Traditionally, most health care projects in cultural understanding have highlighted immigration and refugees with limited prominent language expertise and "buy-in" to foreign norms. This approach became somewhat challenging because stereotyping was common and the unique encounters and viewpoints of the various refugee and immigrant groups were not recognized. Cultural problems have progressively become integrated into health care, as there has been greater identification of the intimate link between health belief and cultural beliefs. Views of good and bad health and the causes of sickness are established in a cultural context -- what is appropriate in one culture is not for the other (Srivastava, 2007). For example, obesity is considered as appropriate in some cultures. Sometimes it can even be believed to be a sign of health and prosperity. Many health care organizations and community sites have integrated language expertise in their services besides employing experienced interpreters to foster language diversity in the workplace. Nevertheless, being linguistically competent is comparable to being culturally competent. For example, although a website may have interpreters available for patients, the website may still encourage a foreign value-based health care and the environment. They include certain feeding methods and dietary requirements, lack of spiritual accommodation like non-denominational areas for prayer, some grieving expectations, and non-recognition of close relatives or "tribal" relationships as immediate family members.

Cultural Considerations in Medical Education

A culturally diverse patient population requires that healthcare teachers to reform their teaching and educating techniques and concepts and appreciate the cultural health attributions, practices and values of patients who healthcare students will face. This variety requires healthcare teachers to teach health care students how to approach and manage illness in patients with different background scenes from their own. In order to highlight the importance of the role that cultural attributions, beliefs, practices and values play in healing and health, health care education programs require a teaching curriculum and philosophy that integrates techniques, treatments and models into practice (Coward & Ratanakul, 2009). Training in healthcare education and learning must integrate globalization, the changing demographics, and technology as socio-cultural conditions that shape the current learning needs. Although diversity and changes bring new possibilities for global interaction and developing learning methods, they also may have a "splintering" and "fragmenting" effect on the community. The unprivileged and marginalized people may have less access to educational resources and may experience oppression from the prominent groups. Social change education and critical theory provide vital insights for healthcare learning and education concerning the political world, including socio-cultural issues, oppression, globalization, and power within the community.

This connection in the healthcare setting is complicated and needs shared knowledge about each other. This shared knowledge needs effective give-and-take connections, concern, and time to create so that each party is comfortable with the other so the doctor can provide the most appropriate care and advice. Shared knowledge is the key to developing believe in, which research has shown to be an important aspect in medical care adherence. When there are significant variations between doctor and patient, this procedure takes more understanding and more work. Variations in culture in its largest sense are present in almost all communications and these variations must be recognized and considered as medical care choices are made. This procedure is a learned procedure and a key part for the medical care instructor to teach (Daniels, 2014).

The increasing number of multicultural communities has pushed the nursing staff to be culturally competent. Religious practices and beliefs significantly influence sickness and health. Leininger's transcultural theory concentrates on culture as an essential component of wellness. Clearly palliative care staff without preparation in transcultural nursing would be significantly incapable when working with people of different culture. The main ideas of Leininger's concept are cultural values, culture, cultural congruence, cultural diverse and ethnocentrism. Transcultural concept is also essential for self-assessment and follows cultural elements between co-workers to continue good interpersonal relationship. Transcultural concept is versatile. It can be globally used in any medical configurations to provide maximum, natural, and culturally-based palliative care.