Transcultural
Guidelines for Health
Care Givers
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Reviewed 10/2014
Ethnicity
Definitions (Cornell University) - Describes your
family “origins” e.g.
American Native or Alaskan Native
Origins in any of the original peoples of North &
South America (including Central America), &
who maintain tribal affiliation or community
attachment
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Ethnicity
Asian
Far Eastern countries
Black/African American
African or Caribbean
Caucasian/White/Not of Hispanic origin
Europe, Middle East, North Africa, Australia, New
Zealand
Mexican American
Mexican culture or origin regardless of race
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Ethnicity
Native Hawaiian or other Pacific Islander
Hawaii, Guam, Samoa, Pacific Islands
Puerto Rican
Puerto Rican culture or origin, regardless of race
Other Hispanic
Cuban, South or Central American, Dominican
Republic, or other Spanish culture or origin, regardless
of race
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El Paso’s
Population
Hispanic vs. Non-Hispanic 2010 Statistics
Approximately 84.13% Hispanic
Non-Hispanic 15.87%
What other things contribute to diversity?
If I’m Hispanic is a non-Hispanic another
culture? Maybe…
Reviewed October, 2008
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Many Things..
Including culture, religion, language, age,
and gender have an effect on how we
access and view health care services.
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Culture
Some may think culture determines
certain things:
• Physical attributes
• hair or skin color
• Diet
• Language
• Our religious & spiritual beliefs
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Ethnocentrism
• Despite the fact that we understand that
everyone is different, we still tend to
subconsciously believe that our culture &
religion is the right one. We may view other
cultures or religions as bizarre, strange,
inferior or unenlightened. This is called
ethnocentrism.
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Ethnocentrism
• It can cause misunderstandings and harm
patients by:
– Incorrect diagnosis
– Failure to provide adequate pain relief
– Arrest of parents for child abuse due to
misunderstood cultural childrearing beliefs
and practices
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Cultural
Competency
Understanding of own self
Knowledge of various cultural
characteristics
Understanding of cultural characteristics
Application of cultural knowledge &
understanding in the healthcare setting
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Avoid
Stereotyping
We must not presume that all people of a
certain cultures adhere to all aspects of
their culture
The healthcare provider must identify which
aspects are appropriate for each patient
during the admission process
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Do Not Assume
Anything
Be truly open-minded & respectful toward
other’s beliefs, values, & practices
You can help patients feel more
comfortable
Many of us belong to more than one ethnic
group, cultural group, age group, and social
group
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Lost in
Translation
Family members are not good
translators
Issues of privacy and confidentiality
Interpreter errors could be a previously
unrecognized root cause of medical
errors (Healthcare Risk Management)
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Language &
Translation
Those whose English is limited often wish
to speak their native language when
possible
Feel that both their explanations & their
understandings can be more accurate
It is more comfortable
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Policy &
Procedure
Facility approved Translation Services
should be used
• Find someone in your facility who knows
the policy
• It is important to be facility specific
• Should be HIPAA & The Joint
Commission Compliant
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Face & Body
Language
• Facial expressions, body language &
tone of voice play a much greater
role in many cultures.
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Cultural
Differences
Some Cultures:
• May perceive a response like “maybe” or
“that would be difficult” as a polite no
• Some cultures prefer indirect
communication and talking around the
issue
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Gestures
Use with care – may have negative
meanings in other cultures
Thumbs-up and the OK sign are obscene
gestures in parts of South America & the
Mediterranean
Pointing or beckoning with the index
finger as “come here”, or snapping fingers
are seen as rude in some cultures
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Touch
To touch or not to touch is only part of
the question
Cultures also have different rules about
who can be touched & where
Even casual touching people of the
opposite gender can be offensive in
some cultures
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(CLAS)
The National Standards for Culturally
and Linguistically Appropriate Services
(CLAS) in Health and Health Care.
CLAS Standard 1-15
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Overview
Medical care is complex and confusing, and many
people struggle with understanding medications, self
care instructions and follow up plans because of cultural
differences. Not having a cultural awareness of our
patients and an understanding of their health literacy can
create significant problems that go beyond the walls of
the hospital and into our community.
Significance for
Culturally Competent Health Care
• Responding to demographic changes
• Eliminating disparities in the health status of people of
diverse racial, ethnic and cultural backgrounds
• Improving the quality of services and outcomes
CLAS Standards 1-15
The National CLAS Standards are intended to advance
health equity, improve quality, and help eliminate health
care disparities by establishing a blueprint for health and
health care organizations
CLAS Standards 1-15
• Principal Standard: (Standard 1)
• Governance, Leadership and Workforce: (Standard 2-4)
• Communication and Language Assistance: (Standard 5 – 8)
• Engagement, Continuous Improvement,
and Accountability: (Standards 9-15)
In Summary
•
•
•
•
Observe the kinds of cultures you see in
your patient population
Adjust your care for patients of different
cultures
Look for resources available for patients
of different cultures
Provide translation for a patient that
doesn’t speak English
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