A culture-sensitive healthcare system, often referred to as cultural competence in health care services, encompasses approaches designed to deliver health care in a manner that respects and integrates the cultural sensibilities of diverse stakeholders and communities. The profound connection between culture and health gained international recognition in 2015 when the World Health Organization formally acknowledged its significance.
The WHO integrated a cultural dimension into its 2030 Agenda for Sustainable Development specially integrated a cultural dimension into its 2030 Agenda for Sustainable Development to underscore the he critical importance of cultural contexts in shaping new models of care that considers factors beyond biology and medicine. This strategic inclusion highlights a global shift towards a more holistic understanding of health and well-being.
Importance of Cultural Competence in Healthcare: Cultural Dimensions and Specific Cultural Factors Influencing the Effective Delivery of Health Care Services
Effective healthcare delivery is profoundly influenced by various cultural dimensions and specific cultural factors. Recognizing and addressing these factors are paramount for healthcare professionals aiming to provide equitable, effective, and patient-centered care. A deep understanding of these elements allows providers to tailor interventions, build trust, and ultimately improve health outcomes for all populations. This comprehensive approach ensures that healthcare is not a one-size-fits-all solution but rather a nuanced interaction that respects individual and community values.
1. Language and Communication
Language serves as a fundamental conduit for human interaction, and within healthcare, it can act as both a significant barrier and a powerful enabler of effective healthcare delivery. Researchers R. F. I. Meuter et al. emphasized that proper communication between healthcare workers and public health officials is indispensable not only for delivering appropriate services but also for raising awareness and educating patients and the broader public.
Beyond mere translation, cultural nuances in communication, such as directness, non-verbal cues, and the role of family in decision-making, also play a critical role. Understanding these subtle aspects of communication is essential for building rapport and ensuring that health information is accurately conveyed and understood.
Language barriers, as a collective example of how culture impacts healthcare, can have life-threatening consequences. Miscommunications stemming from linguistic differences between care providers and patients can lead to improper diagnoses, the failure to fulfill essential service requirements, and the alienation of all parties involved.
The increasing global mobility of populations, evidenced by migrant patients from diverse linguistic backgrounds and the influx of foreign-trained healthcare workers, such as the arrival of nurses from countries like the Philippines to countries like the United Staes, further accentuates the urgency of addressing these communication impediments. Bridging these gaps is essential for ensuring patient safety and fostering a trusting therapeutic relationship.
2. Socio-Cultural Preferences
Socio-cultural preferences, particularly those leaning towards traditional medicine or unscientific practices, can significantly influence both the perception toward healthcare professionals and acceptance of modern medical interventions. J. Bussey-Jones and I. Genao observed that certain individuals or groups may prioritize seeking assistance from folk healers or depend on food supplements with unproven therapeutic claims.
Deeply ingrained beliefs often stem from generations of cultural practice and community trust. This makes cultural competency crucial for modern healthcare providers. It allows them to approach some practices with respect and understanding. Dismissing traditional beliefs without proper engagement can lead to distrust and non-adherence to prescribed treatments.
Their specific case study vividly illustrates how language barriers combined with socio-cultural preferences for traditional medicine can threaten the quality of service delivery and the interest of patients. One instance involved a Mexican immigrant who faced repeated misdiagnoses across several hospitals due to the absence of multilingual providers.
Another instance was when the condition of a patient worsened after he opted to supplement his prescribed medical treatment for an accident with herbal medicines. These examples underscore the critical need for healthcare providers to understand and navigate the existing health beliefs and practices of patients, seeking to integrate traditional approaches safely where possible, or provide effective and sensitive patient education about potential risks.
3. Religion and Beliefs
Religious and spiritual beliefs constitute another powerful cultural dimension that profoundly impacts healthcare decisions because they often provide a framework for understanding life, illness, suffering, and death. Researcher C. M. Puchalski highlighted that the spiritual and religious convictions of individual patients can directly influence their health-related choices, specific treatment options, and overall perception toward certain medical interventions.
These beliefs can shape views on life, death, suffering, and healing, often guiding decisions about medical procedures, end-of-life care, and even diet. Respecting these deeply personal convictions provides both ethical alignment and practical benefits. These are fundamental to providing not only effective but also compassionate and patient-centered care.
Religious inclinations often predetermine individual preferences. Some patients may refuse medical procedures that conflict with their deeply held religious tenets. Others might opt for faith healing over science-based medicine. It can be challenging for healthcare professionals to deal with patients with what seems to be an unbendable inclination.
It is still important to note that the absence of sensitivity from care providers regarding the religious beliefs of patients can lead to feelings of alienation from modern medical systems. A prime example is a Western nutritionist recommending increased animal-based protein intake to an undernourished Hindu patient. It is crucial to note that a significant proportion of Hindus are vegetarian. This is the reason why cultural awareness should be ingrained in healthcare.
4. Educational Attainment
Education is also another crucial cultural factor influencing both healthcare access and the effective delivery of services. It also defines the competency of healthcare professionals. L. D. Gruppen, R. S. Mangrulkar, and J. C. Kolars noted that the level of educational attainment, the quality of training received, and the extent of skills and knowledge imparted to healthcare providers collectively define their capabilities and impact different patient outcomes.
It is important to underscore the fact that educational background and other learning experiences can have far-reaching positive impacts on global healthcare because it can foster a workforce equipped to handle diverse patient needs and complex medical challenges. Continuous professional development and culturally informed training are key to enhancing this competency.
Patient education and health literacy are as vital as the capabilities or skills and knowledge of care providers. A study by Fereidouni et al. on patient education in Iran revealed that poor patient education remains a significant obstacle to quality healthcare. A substantial number of Iranians struggled to grasp scientific and medical concepts.
The level of the educational attainment of the population can make or break not only healthcare at the individual level but the overall public health. The same is true for the capabilities of healthcare providers and public health authorities both in delivering care and raising awareness or promoting patient education. These highlights the fact that health education goes both ways. It involves not only healthcare practitioners but also the public.
5. Lifestyle or Way of Life
The lifestyle or prevailing way of life within an individual and their community represents another critical cultural dimension relevant to understanding cultural competence in healthcare. A review by D. Fardhud indicated that approximately 60 percent of factors related to individual health and quality of life are correlated with lifestyle choices. These choices are often deeply embedded in cultural norms, community practices, and socio-economic conditions.
Effective interventions must consider and adapt to these ingrained patterns. The dominant way of life in a community encompasses socio-cultural norms and customs concerning food choices, work setups and behaviors, common activities and prevalent habits, community involvement and other dimensions of social relationships, and overall attitudes about health and well-being.
Lifestyle diseases are common in communities with rampant unhealthy eating habits and poor lifestyle choices like prevalent alcohol and tobacco use tend to have. This can be observed in high-pressure working environments, dense populations, and busy urban settings. These areas often experience a greater incidence of physically and mentally unwell citizens.
Remember that lifestyle is a risk factor in several diseases. Understanding different lifestyle factors is essential for developing targeted and effective public health interventions that resonate with local customs and promote sustainable healthy behaviors. This tailored approach fosters greater acceptance and long-term adherence. Such can ultimately result in more impactful health improvements and better public trust in the healthcare system.
Summary and Takeaways: Reiterating the Importance of Cultural-Driven Health Care Services Delivery and Cultural Competence in the Healthcare System
The World Health Organization recognizes the need for health care workers to be culturally aware. This means that effective healthcare delivery requires an understanding of the diverse cultural contexts that shape how services are approached, developed, and implemented. This understanding also necessitates the cultivation of cultural competence to enable healthcare professionals to be not only culturally aware but also culturally responsive.
Specific competencies include, but are not limited to, learning a secondary language, developing acute cultural and religious sensibilities, and mastering effective public health communication strategies. The five cultural factors discussed above collectively represent both significant opportunities and formidable challenges in ensuring access to quality healthcare.
Note that different cultural factors can either be a barrier or an enabler. Language, for example, could either promote or obstruct communications between patients and care providers, while lifestyle could either serve as an entry point or endpoint for promoting public health and patient education. This is why it is essential to equip the health care workers with specific capabilities aimed at turning these cultural dimensions and factors into their advantage.
The aforementioned also aligns perfectly with the concepts of patient-centric and population-centric healthcare service delivery. Adherents of these philosophies believe that quality healthcare hinges on a strong, trusting relationship between patients and their providers, coupled with a focused effort on addressing the specific healthcare needs of individuals and their communities.
An awareness of cultural contexts translates into patient-centeredness and people-centeredness. This facilitates the provision of precision and personalized medicine in modern healthcare. Cultural competence empowers healthcare providers to metaphorically step into the shoes of their patients, thereby enabling them to deliver services that are culturally sensitive, considerate, appreciative, and ultimately, appropriate for each unique individual.
FURTHER READINGS AND REFERENCES
- Bussy-Jones, J. and Genao, I. 2003. “Impact of Culture on Health Care.” Journal of the National Medical Association.95(8): 732-735
- Farhud, D. D. 2015. “Impact of Lifestyle on Health.” Iranian Journal of Public Health. 44(11): 1442-1444
- Fereidouni, Z., Sarvestani, R. S., Hariri, G., Kuhpaye, S. A., Amirkhani, M., and Kalyani, M. 2019. “Moving Into Action: The Master Key to Patient Education.” The Journal of Nursing Research. 27(1): 1-8. DOI: 1097/jnr.0000000000000280
- Gruppen, L. D., Mangrulkar, R. S., and Kolars, J. C. 2012. “The Promise of Competency-Based Education in the Health Professions for Improving Global Health. Human Resource for Health. 10(43): DOI: 1186/1478-4491-10-43
- Meuter, R. F. I., Gallois, C., Segalowitz, N. S., Ryder, A. G., and Hocking, J. 2015. “Overcoming Language Barriers in Healthcare: A Protocol for Investigating Safe and Effective Communication When Patients or Clinicians Use a Second Language.” BMC Health Services Research. 15(1). DOI: 1186/s12913-015-1024-8
- Puchalski, C. M. 2001. “The Role of Spirituality in Health Care.” Baylor University Medical Center Proceedings. 14(4): 352-357. DOI: 1080/08998280.2001.11927788
- The World Health Organization. 2017. Culture Matters: Using a Cultural Contexts of Health Approach to Enhance Policy-Making. The World Health Organization