The Importance of Cultural Sensitivity
In Australia, well-intentioned government officials, including representatives of the health min- istry, identified problems related to substandard housing among a particular aggregate of aboriginal people. To assist this community, the officials spent a great deal of time, energy, and finances plan- ning and building homes for the Aborigines. The homes were small but modern and offered many of the conveniences that officials believed would improve the quality of life for the community.
The Aborigines were appreciative of the group’s efforts and moved into their new homes. Before long, however, officials realized that one by one the community members were moving back to their
“substandard” housing. When asked about their lack of appreciation for the improved lifestyle, the group informed the officials that their watering hole was their life-line and that the houses were not only uncom- fortable to them but were too far from their watering hole. Soon, all of the aboriginal families had returned to living on the land, and the homes were part of a veritable ghost town in the middle of nowhere.
QUESTIONS
• Was the aboriginal community truly “poor,” as the officials seemed to think?
• Discuss your perception of the following issues:
Cultural imposition Cultural poverty Dignity and spirit
• If you were part of an international health team assigned to return to the community to try again to improve their quality of life, what steps would you take to ensure that previous mistakes are not repeated?
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1. Based on your own cultural background, how would you feel and what behaviors would you exhibit if you were:
a. A client sitting in a clinic waiting room in a foreign country whose language you did not know?
b. Part of a nutrition class being told to eat foods you had never heard of before?
c. Visited in your home by a nurse who told you to discipline your child in a way that contradicted everything you had been raised to believe about parenting?
2. Describe three tacit cultural rules that govern your own behavior. How might these affect your interac- tions with clients from another culture?
3. What does the term ethnocentrism mean to you?
Have you ever experienced someone else’s being ethnocentric in their attitude toward you? If so, describe that experience. Using the Cross-Cultural Sensitivity Continuum (see Fig. 5.1), explore where your own attitudes are on the continuum toward several of the cultural groups with which you regularly come in contact or from which you know people well.
4. Imagine that you are assigned to work with a Mexican American migrant population. What steps would you take to gather the appropriate informa- tion to provide culturally relevant nursing service?
What sources might provide that information?
5. A Hmong father who severely beat his 12-year-old son with a belt, leaving cuts and bruises, is charged with child abuse. “If I can’t discipline my son, how can he be a good child?” said the father. What nursing responses would show respect for this cul- tural group’s norms and values, yet be constructive in resolving the cultural conflict?
6. Find websites that elaborate on transcultural nurs- ing and cross-cultural health care concerns. Print materials of interest and develop a resource file for your professional use.
7. Interprofessional communication techniques among diverse health care disciplines are impera- tive to effective caregiving. How comfortable are you with knowing the linguistic style, practice, and research backgrounds of social workers, pharma- cists, physical therapists, educators, psychologists, and others? Seek out a colleague from a different interprofessional discipline and discuss developing a “shared language.”
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Selected Readings
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Keswick, R., & McNeil, L. (2006). Reaching out to the Arabic community. Behavioral Healthcare, 26(11), 32.
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Oppenheimer, G.M. (2001). Paradigm lost: Race, ethnicity, and the search for a new population taxonomy. American Journal of Public Health, 91(7), 1049–1055.
Pappas, G., Aktar, T., Gergen, P.J., et al. (2001). Health status of the Pakistani population: A health profile and comparison with the United States. American Journal of Public Health, 91(1), 93–98.
Parker, M.W., Bellis, J.M., Bishop, P., et al. (2002). A multidisci- plinary model of health promotion incorporating spirituality into a successful aging intervention with African American and White elderly groups. The Gerontologist, 42(3), 406–415.
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Yang, R., Mills, P., & Dodge, J. (2006). Cancer screening, repro- ductive history, socioeconomic status, and anticipated cancer- related behavior among Hmong adults. Asian Pacific Journal of Cancer Prevention, 7(1), 79–85.
Ypinazar, V., & Margolis, S. (2006). Delivering culturally sensi- tive care: The perceptions of older Arabian Gulf Arabs concerning religion, health, and disease. Qualitative Health Research, 16(6), 773–787.
Internet Resources
AltaVista’s Translator—translates any web page to one of eight languages: http://abelfish.altavista.com
American Academy of Child and Adolescent Psychiatry (AACAP), Facts for Families (available in four languages):
http://www.aacap.org/publications/factsfam/index.htm American Diabetes Association, Facts and Figures: http://www.
diabetes.org
American Immigration Resources on the Internet—general refer- ences for immigrants: http://theodora.com
Association of Asian Pacific Community Health Organizations (AAPCHO). Health education information to improve the health status of Asians and Pacific Islanders in the United States. Available in 12 languages. http://www.
aapcho.org
Cultural Competence Compendium: http://www.ama-assn.org Cultural Competence Health Practitioner Assessment:
http://www11.georgetown.edu/research/gucchd/nccc/CCHPA.html Culture and Diversity: http://www.amsa.org
Ensuring Linguistic Access in Health Care Settings: Legal Rights and Responsibilities: http://www.kff.org
Indian Health Service—an agency within the U.S. Department of Health and Human Services that provides health services and information about American Indians and Alaska Natives:
http://www.ihs.gov
Milstead, J.A. (2003). Interweaving policy and diversity. Online Journal of Issues in Nursing, 8(1), manuscript 4. Retrieved from http://www.nursingworld.org/MainMenuCategories/
ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/
Volume82003/Num1Jan31_2003/InterweavingPolicyandDiversity.
aspx.
Multicultural Health Communication Service. The goal of this Australian site is to provide quality health care information to people of non–English-speaking backgrounds. Information is offered in 36 languages, including Arabic, Chinese, Russian, and Vietnamese:
http://www.mhcs.health.nsw.gov.au/
Office of Minority Health: http://www.omhrc.gov/
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