Dealing+with+Multiculturalism+within+Health+Care!

The artefact that I will be using for my wiki presentation is a clip from an episode of Grey’s Anatomy that aired in the U.S on the 23rd of October, 2005. It highlights a problem that can occur within the health industry due to different cultural views of medical treatment. It depicts the decisions made by doctors and the corresponding decisions by people within the Hmong culture. This clip is edited and shows only the main scene within the episode when the conflict occurs. This is the link to my cultural pain artefact.  [] There are a few public health issued raised by this video and I will be focusing on different cultural treatments being respected within our health care system. The video also depicts problems such as such as the need for a good good doctor/patient relationship and also mentions the age of consent being valued over family decision. I am focusing on the respect of cultural treatments because I believe this is becoming more apparent due to our increasing multicultural society. Incorporating systems and procedures into our health care field that takes into consideration other peoples cultures, beliefs and traditions is an important issue. The issue that is presented within this artefact is not only a problem within the U.S but a problem all over the world, especially for countries that have many cultures within their population. Over the many scholarly articles that I have read to educate myself on the topic, it is clear there is a common idea that more needs to be done to improve the cultural competence of health care workers around the world. Charles, C and others suggests that the role of culture in influencing physician and patient treatment decision-making is a topic that needs more research attention (Charles, C, Gafni, A., Whelan, T, & O'Brien, M. A. (2006) Cultural influences on the physician-patient encounter: The case of shared treatment decision-making.). With this is mind one of the aspects that can be focussed on to improve the issue is the important relationship between the patient and their carer, be this a nurse, doctor or assistant. Jeon states that nurses must pay attention to their interpersonal relationships and develop respect for the patient’s value systems, in order to protect their rights and avoid the tendency to stereotype cultures. They even go on to suggest that the expertise of qualified nurses from different cultures can greatly assist this process (Jeon, Y-H. Cultural competency and nursing care: an Australian perspective ). Doctors and nurses within the westernised health care system assume that the process of shared decision-making will operate in the same way in different cultural and clinical contexts. However this is now known not to be true but is something being done about it. Within Australia the government is attempting to change this trend, and has put legislation into place to improve the situation. One of these policies states that it is in the mandate to provide culturally sensitive/congruent health care through health policies and planning mechanisms (Jeon, Y-H). Within the U.S there is similar legislation within the Civil Rights Act of 1964 that prohibits discrimination on the basis of race, colour, or national origin. This Civil Right is then assisted further by emphasizing the need to improve access for persons with limited English proficiency (Chun, Maria B J(01/09/2009) . "Cultural Competency Compliance Issues in Health Care"). Although these laws are not specific to the health care system when it comes to the U.S, they are still very important when it comes to dealing with different cultures within a health setting. Another problem that presents itself within our multicultural society is not just the communication between health care provider and client, but also the communication of important information and knowledge within the health care system. This could be as simple as not understanding a leaflet or form given out when in hospital, or it could be something as important as rehabilitation information. To try and prevent any misunderstanding, within Australia the health system is attempting to develop new practical educational materials in accessible and usable form to encourage their use in clinics whenever a non-Anglo-Australian patient presented (Manderson, L(2002) . "Addressing cultural diversity in Australian health services"). Aids to assist this form of communication have been, and are being developed to help patients in several ways: (1) to provide patients with relevant information about their diagnosis and the available treatment options and their potential risks and benefits, (2) to help structure the decision-making process, and (3) to help patients participate in the process of decision-making, if they so wish (Charles, C et al). Yet another reason for the issue in difficulty communicating with other cultures derives from the health care provider themselves. It is very important for these trained individuals to not only diagnose correctly, but also be knowledgeable in regards to cross cultural communication. Manderson suggest that an additional measure to improve the quality of care, which is often neglected, is the practice of practitioners conveying an interest in cultural issues to the patient without presuming knowledge of what the patient thought or believed (Manderson, L. 2002). With all this in mind it is clear that it is possible to achieve a culturally sensitive health care system, but it will take time, financial investment and a change in education systems for these things to happen. Jeon stated that “given the wide range of cultural diversity occurring internationally, these goals can only be achieved through culturally sensitive administration, policies and procedures, training and professional development, workplace standards, and the inclusion of health consumers’ voices in all these domains”.
 * __Jonathan Mills n8090327__**
 * __Katie Page (Fri 10-11am)__**
 * __The Artefact__**
 * __Public Issue__**
 * __Literature Review__**

With culture being the main focus of this artefact, it is important to understand what culture is, and how different cultures are affected. It is important to know who would be affected by the issues raised and how these issues can be made aware to not only the individuals of different cultures but the public and most importantly health practitioners. When addressing this national and global health issue it is crucial to assess how society and cultures are affected. Historically, within Australian it has become accepted for people to assimilate into the dominant Anglo-Australian culture (Manderson, L). However this is changing due to a fast rise in the number of people from other cultures within our population. Eagleton defines culture as: “… the set of learned values, beliefs, customs and behaviours that are shared by a group of interacting individuals.”(Charles, C).With many cultures within Australia it is clear that health care systems will have to change to accommodate and support people from other backgrounds. Many cultures prefer traditional methods of healing or health care, many cultures insist on traditional methods, and some cultures are happy to follow procedure that western medicine decides. In some cultures, multiple family members may have as much or more influence on the decision than the patient, and in other cultures there may be only one culturally prescribed approach which is considered acceptable rather than several options. So the big question is, how do we know which individual wants what form of treatment or assistance? Well to start with we must understand that cultural expectations will influence the nature of the encounter and how it proceeds. For example a woman from an Arabic background must have her husband or closest male family member by her side when important decisions are being made. In regards to a client’s treatment, although it is reasonable for a client to prefer an alternate treatment because of that client's culture, it is not reasonable to withhold information or options because of something the clinician perceives in the client's culture (Charles, C). It is fairly obvious as to what part of the population would be influenced by the issue. Clearly anyone from a non-English speaking family has the opportunity to be most affected as the tougher communication barriers make it hard to relay information. Also families who although may speak English may still hold tradition and culture at high levels of importance, and can refer to traditional healing methods over conventional western methods. And although some people may be able to speak English, this does not necessarily mean they can read and understand English. With all the factors in mind it is clear that this issue will and does affect many people within Australia and globally. To help combat this obvious problem there are certainly things that can be done to achieve a culturally competent health system. These things include legislation within the health care system that promotes education of the issue. This education can start early within schools and universities, so that the knowledge is learnt over a long period of time for maximum affect. An introduction of culturally sensitive practitioners and nurses within our hospitals and practices would only improve the situation. And simply practitioners need to consider a client's culture when communicating and offering opportunities for a client to participate in his or her care (Charles, C). The artefact that I chose represents the importance of cross cultural communication within the health care system. It also represents how important it is for doctors to be culturally competent, and be able to deal with situation when they arise. It shows a strong importance for a good doctor/patient relationship as well as a need for more education based learning on the issues that could become apparent within the health industry. The artefact is a strong ‘case in point’ as it clearly highlights the realistic possibilities within the health care system. These scenarios may not happen very often but when they do, doctors must be prepared to handle the situation with care and sensitivity towards other cultures. This episode helped highlight the problem and would have been seen by many westernised countries around the world, with viewing figures in the millions. Although Grey’s Anatomy is a television drama it still highlights a realistic problem, and I personally believe this is of great importance. When I find myself in the health care industry in a few years time, I can look back at the research and knowledge that I gained from this. My learning and my new understanding of how important cross culture communication and education is can provide me with sufficient information of how to deal with certain situations. I can head into scenarios with a clear understanding of procedure and provide appropriate responses depending on my client or patient.
 * __Cultural & Social Analysis__**
 * __Analysis & own Learning Reflections__**

References

Charles, C, Gafni, A., Whelan, T, & O'Brien, M. A. (2006, November). Cultural influences on the physician-patient encounter: The case of shared treatment decision-making. Patient Education & Counselling, 63(3), 262-267. Chun, Maria B J(01/09/2009). "Cultural Competency Compliance Issues in Health Care". Journal of health care compliance(1520-8303), 11(5) ,  p.27. Jeon, Y-H(01/03/2006). "Cultural competency and nursing care: an Australian perspective". International nursing review(0020-8132), 53(1) ,  p.34 <span style="font-family: 'Times New Roman','serif';">Koepke, L. A., &Hare, J. (2000). Spiritual beliefs across generations: The impact of immigration upon Hmong families. Unpublished manuscript. University of Wisconsin-Stout at Menomonie. <span style="color: #333333; font-family: 'times new roman','serif'; font-size: 15px;">Manderson, L(01/01/2002). <span style="color: #333333; font-family: 'times new roman','serif'; font-size: 15px;">"Addressing cultural diversity in Australian health services". Health promotion journal of Australia(1036-1073), <span style="color: #333333; font-family: 'times new roman','serif'; font-size: 15px;">13(2) , <span style="color: #333333; font-family: 'times new roman','serif'; font-size: 15px;"> p.29. Notgarnie, Howard M (01/08/2007). "Cultural Congruence". RDH (0279-7720), p. 40. S.T. Parson, The social system, Free Press, New York (1951). <span style="font-family: 'times new roman','serif';">Tatman, AW(31/10/2004). "Hmong History, Culture, and Acculturation: Implications for Counselling the Hmong". Journal of multicultural counselling and development(0883-8534), 32(4), p.222. T. Eagleton, The idea of culture, Blackwell, Oxford, England (2000), p. 1.