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  1. #1
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    Default Inter-cultural Awareness/Inter-cultural Exchange

    This is something we've been talking about in one of my classes, about how to provide healthcare to a diverse group of people who might have different values.

    What do you think of this idea, that different cultures have some different values (on a general scale, obviously there is variation within the culture)? Do you feel like that is true in your experience, or do you think most of us just want the same thing deep down?

    Have you encountered many cultural conflicts in your daily life?

    Do you do anything to better try to understand other cultures (outside your own)? What do you do?
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    I haven't really encountered many cultural conflicts in my daily life.

    I feel like everyone I know is either American or has immigrated here and at least likes the country enough to want to live here, so there's a friendly cultural exchange there.

    As for cultural differences, I probably notice cultural differences most strongly when I was in a minority culturally. Like this summer, spending time in Armenia. A much more guest-centered and hospitable culture, and much more physically affectionate, like even men hugging and kissing each other.

    And also maybe a lesser value on physical activity than I'm used to (which surprised me, weirdly, what, not everybody wants to get super sweaty and uncomfortable and exert unnecessary physical effort without accomplishing anything?!!) I was trying to imagine practicing PT there, and I think I could see some different priorities coming into play with how my interactions with patients could go.
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    Seems like this is a lot harder if you are in the 'majority' culture too.
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    Post Human Post Qlip's Avatar
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    This reminds me of my nurse friends who work in a pretty ghetto hospital and end up treating low-income people who come in for bullet wounds, alcohol poisoning, extreme diabetes symptoms. Working in that sort of environment definitely takes a toll on them, where they're treating emergency situations in people that just make bad choices. It's hard to elicit compassion.

    Growing up I was a Jehovah's Witness, and we kind of represented one of the most typical depicted religious dilemmas in health care, we refused blood transfusions. I can't imagine how frustrating it would be to try to help somebody for whom it's in their best interests to have one (saline was always given as an alternative).
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    Quote Originally Posted by gromit View Post

    What do you think of this idea, that different cultures have some different values (on a general scale, obviously there is variation within the culture)? Do you feel like that is true in your experience, or do you think most of us just want the same thing deep down?
    Not really a contradiction there. Basic needs are probably universal in that they have a biological basis. But I always thought it was kind of obvious and a given that culture and upbringing shapes your values and how you see the world.

    As a translator and interpreter I get to see first hand how people with different ways of dealing with things or looking at things meet and interact. Also, having friends from different (even though not so remote) cultures helps see the small details. It doesn't have to be major clash-of-civilization style conflict of values, you shouldn't underestimate the smaller shades of difference, say even within the countries of the EU. And when you compare, for example, Americans and Japanese or Chinese the different value systems should be highly visible.
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  6. #6
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    We can become aware of another culture by learning the language and by learning the comparative history.

    And as far as I know comparative history is not taught in high school and rarely in university.

    And I do know that the study of foreign languages is falling in my country.

    The fact is we prefer to be parochial. We seek to avoid the reality of other cultures, even when we invade their countries. We prefer the comfort of fantasy enforced by power.
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    @Red Herring (and anyone else) how would you draw a distinction between cultural patterns and stereotypes?
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    I do come across a lot at the hospital I work at. We had an interesting presentation in our orientation about this subject.

    Not a lot of cultural conflicts but big differences being a person of color. It's not so bad for me--I've got a public/private split screen that helps but I've seen it in my family and in others. Hmm...examples...seeing how shocked doctors/HCPs are when medical decisions for an individual are a "family decision". Decisions are made slowly if it's possible. Someone taking care of the elderly...kin often moving into their home instead of going to a nursing home or at the very least, coming over during the day to care for them. Very often fatalistic attitudes when older concerning health problems...thinking of getting the "sugars" as normal.

    Even when pretty ill, going to the doctor may be put off...there can be a lot of mistrust in "What will they do to me? Will they listen and take me seriously? Can I trust this person?" kind of concerns that play into this...also a kinda 'heal thyself' or 'suffer in silence' attitude. It can take time to develop a relationship, so even if it's a knowledgeable doctor, a person might not feel they are able to develop a relationship with them.

    The use of herbal medicine, belief in prayers, superstitions, susto...these things are very important.

    I admit that I share some of those beliefs and yet others, I find ridiculous. There's nothing normal about getting diabetes!
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  9. #9
    Senior Member Qre:us's Avatar
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    Quote Originally Posted by gromit View Post
    This is something we've been talking about in one of my classes, about how to provide healthcare to a diverse group of people who might have different values.
    Yes, aiming for health equity, not just equality. The difference:

    https://www.pinterest.com/pin/426153183462422288/


    As someone who plans and manages the delivery of primary healthcare, and given the model of care/framework we use, this is of utmost importance. I can't count the number of conferences I've attended around health equity and I still have so much to learn about incorporating it in terms of best practices.

    One thing is a change in terminology. They are not our patients, they are our clients. It's not just about what the client wants to be called, but it is to remind the healthcare providers about the relationship they have with them, and in turn, the care they offer. Meaning that delivery of care is not uni-directional. The aim is for clients to be empowered to contribute to their own health and well-being. Only then are we moving towards a model of health and well-being rather than simply managing sickness.

    Our model ensures that the social determinants of health are considered in the delivery of healthcare.

    Something as simple as a FOBT test becomes highly challenging when administering to a homeless or transient client. You need to keep the stool overnight, for which you need a fridge. So, if the primary care provider is not aware of, and does not take into consideration, such health equity indicators, then they didn't help the client, wasted money in the delivery of healthcare, etc, etc. So, an alternate that is simple, manageable and still cost-effective must be thought of.

    Within our model, we have centres that provide healthcare to First Nations, Metis and Inuit populations. The design and delivery of healthcare is very much based on traditional practices, where appropriate. It must be evidence-based and client-centered.

    For example, tackling diabetes. Aboriginals have 3-5 higher rates of diabetes than the rest of the Canadian population. To say that one shoe fits all is to set the intervention up for failure. So, when planning the coordinated delivery of healthcare for diabetes within that population, for the prevention piece, you cannot just simply take a diabetes prevention program from somewhere else and transplant it there. It will fail. Evidence has shown that it will fail.

    So, there are teaching circles, sharing circles, with Traditional Healers, Elders, as part of the team of coordinated care, on top of the regular MD, NP, RN, Chiropodists, Dietitians, Social Workers, Occupational Therapists, Physiotherapists, etc, and even then, making sure the Dietitians are aware of the dietary habits of traditional Aboriginal food, OTs/PTs are aware of lifestyle practices, and how to incorporate that in the care plan, without creating issues of access.

    Anyway, I could go on and on, about the importance of this, as this is not just what I do, but what I believe in, firmly and deeply.


    What do you think of this idea, that different cultures have some different values (on a general scale, obviously there is variation within the culture)? Do you feel like that is true in your experience, or do you think most of us just want the same thing deep down?

    Have you encountered many cultural conflicts in your daily life?

    Do you do anything to better try to understand other cultures (outside your own)? What do you do?
    Awareness and a willingness to learn. And understanding that ignoring something as significant as cultural attitudes, will and does, affect the interaction.

    We do have core, universal needs, but the way we expect and express those needs to be met are very much so coloured by our own culture. To ignore that is to ignore the need, even if your aim was to understand it.
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  10. #10
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    Quote Originally Posted by gromit View Post
    @Red Herring (and anyone else) how would you draw a distinction between cultural patterns and stereotypes?
    Stereotypes are PC (politically correct) and make us feel morally superior.

    So anyone who rails against stereotypes yet fails to learn a foreign language and study comparative history is merely meretricious.

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