Diversity in Healthcare: Intercultural Care

The Provision of Culturally Competent Care in Nursing

1.0 Defining Intercultural Care

The emergence of intercultural care has been linked to interactions among persons from varying socio-cultural and economic backgrounds, with these variations affirmed to prompt different approaches to care provision; as improved patient outcomes are associated with content- and context-specificity in nursing (Epner, & Baile, 2012). The implication is that, with increasing diversity among nations, challenges and opportunities face policy makers, health care systems, and health care providers to establish and deliver services perceived to be culturally competent. According to Koh, Gracia and Alvarez (2014), intercultural care refers to the ability of organisations and providers to effectively offer health care services deemed to meet linguistic, cultural, and social needs of patient groups. In a related study, Clancy, Brach and Abrams (2012) documented that culturally competent health care systems are those that aid in improving the quality of care and health outcomes by contributing to the elimination of ethnic and racial health disparities. As such, it can be inferred that the central objective of intercultural care lies in the need to promote equity in access to services. Specific strategies seeking to foster intercultural care include the creation of policies responsible for the reduction of linguistic and administrative barriers to patient care, and the provision of training on cross-cultural issues and cultural competence to health professionals (Vidaeff, Kerrigan & Monga, 2015).

2.0 Background: On Intercultural Care

The impact posed by limited language proficiency, ethnicity, race, and socio-cultural factors on clinical care is increasingly significant; with quality health care delivery on focus (Epner, & Baile, 2012). For example, the nature of socio-cultural backgrounds has been observed to influence the behaviours, beliefs, values, and perspectives of patients regarding wellbeing and health. Specifically, these factors are documented to yield variations in adherence to preventive medications and measures, expectations of care (such as preferences against or for therapeutic and diagnostic procedures), comprehension of management strategies, thresholds for seeking care, and the recognition of symptoms (Koh, Gracia and Alvarez, 2014). In addition, socio-cultural differences between providers and patients influence clinical decision-making and communication. For example, a study by Clancy, Brach and Abrams (2012) found that there is a direct relationship (or positive correlation) between clinician-patient communication and patient health outcomes, adherence, and satisfaction. From this observation, the clinicians’ failure to recognise and understand socio-cultural differences existing between the patient groups and themselves are likely to be characterised by the provision of lower-quality care (Vidaeff, Kerrigan & Monga, 2015).

A related observation by Epner and Baile (2012) indicated that intercultural care focuses on the capacity to provide quality health care and communicate effectively with patients from socio-cultural backgrounds that are perceived to be diverse. Indeed, evidence suggests that the decision to educate health care clinicians about intercultural care leads to improved skill, attitudes, and knowledge (Koh, Gracia and Alvarez, 2014). It is further notable that the concept of intercultural care has been informed by the disproportionate burden of chronic illnesses facing ethnic and racial minorities. According to Clancy, Brach and Abrams (2012), ethnic and racial minorities exhibit higher mortalities and morbidities from chronic diseases; with consequences ranging from higher activity limitations to greater financial burdens. These burdens have also been found to be exacerbated by communication and language barriers that continually lead to lower quality of care, poor comprehension, and patient dissatisfaction (Vidaeff, Kerrigan & Monga, 2015). Therefore, intercultural care is important because the type of interpretation service that patients receive forms a critical factor determining levels of satisfaction. This paper discusses the importance of intercultural care in the context of nursing. Other issues that will be examined include key concepts guided by an appropriate model, a case analysis of an individual relevant to practice, and opportunities and challenges facing the strategy of intercultural care. In so doing, it is projected that the outcomes will give a further insight into the relationship between intercultural care and patient satisfaction; upon which stakeholder groups might be prompted to engage in facilitation processes while working on potential challenges facing the practice – by converting them into opportunities for improvement.

References

• Clancy, C., Brach, C. & Abrams, M. (2012). Assessing patient experiences of providers' cultural competence and health literacy practices: CAHPS Item Sets. Med Care, 50
• Epner, D. E. & Baile, W. F. (2012). Patient-centered care: the key to cultural competence. Ann Oncol, 23(3), 33
• Koh, H. K., Gracia, J. N. & Alvarez, M. E. (2014). Culturally and Linguistically Appropriate Services--advancing health with CLAS. N Engl J Med, 371, 198
• Vidaeff, A. C., Kerrigan, A. J. & Monga, M. (2015). Cross-cultural barriers to health care. South Med J, 108

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