To be culturally competent physical therapists need to understand their own world view and those of the patient, while avoiding stereotyping and misapplication of scientific knowledge (cross, et al. 1989). Therapists must take into account eight characteristics that involve the dimensions of diversity: age, race, gender, sexual orientation, ethnicity, mental and physical activity, religion and socioeconomic status. But before they do that, physical therapists must assess themselves as individuals. Cultural competence is obtaining cultural information and then applying that knowledge. This cultural awareness allows us to see the entire picture and improve the quality of care and health outcomes. Adapting to different cultural beliefs and practices requires flexibility and respect for others view points. Cultural competence means to really listen to the patient, to find out and learn about the patient’s beliefs of health and illness. To provide culturally appropriate care we need to know and to understand culturally influenced health behaviors. Culture also influences how people seek health care and how they behave toward health care providers.
How we care for patients and how patients respond to this care is greatly influenced by culture. Health care providers must possess the ability and knowledge to communicate and to understand health behaviors influenced by patients’ culture. Having this ability and knowledge can eliminate barriers to the delivery of health care. Cultural competency is an ongoing self evaluation, that we continually adapt and reevaluate the way things are done. For physical therapists, it is very important to demonstrate to our patients that we are not only clinically experts but we also culturally competent, that we truly care for them and their needs. A number of factors lead to discrepancies in health and health care among racial and ethnic groups, including those with low socioeconomic status, poor education and a lack of health insurance. These differences, which may influence providers’ decision-making and interactions between patients and the health care delivery system, may include: variations in patients’ ability to recognize clinical symptoms of disease and illness, thresholds for seeking care expectations of care and the ability to understand the prescribed treatment (D. L. Denboba et al., 1998).
The ultimate goal is a health care system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity or cultural background. Over the course of my clinical internship I came across an occupational therapist that refused making a hand splint to a patient that didn’t have health insurance. As a physical therapy student I couldn’t believe her words “that patient is not a priority, someone else will make a splint, and you can’t give the same quality of therapy to someone that doesn’t have insurance versus to some that does have insurance.” Unfortunately, circumstances like this leads to patient dissatisfaction, poor adherence to medical advice and poor health outcomes.
When health provides fail to take patients’ socioeconomic factors into account, this will resort in stereotyping, misapplication and poor clinical decision-making. To my opinion, respect for patients’ cultural beliefs and the effects of those beliefs on their well-being are critically important to quality of care. The biggest challenge in health care involves the trust that our patients place on us. As health care providers, we must listen to our patients carefully. The main source of problems in caring for patients from diverse cultural backgrounds is the lack of understanding and tolerance. Lastly, to improve cultural competence in the health care system we need to take into account our patients cultural background, cultural beliefs, and their values and incorporate all those factors into a higher quality of care that is delivered to that individual.
1. Cross, T., Bazron, B., Dennis, K., and Isaacs, M. Toward a Culturally Competent System of Care, Volume 1. Washington, D.C.: Georgetown University. (1989.) 2. G. Flores, “Culture and the Patient–Physician Relationship: Achieving Cultural Competency in Health Care,” Journal of Pediatrics 136 (2000): 14–23.
3. J. R. Betancourt, J. E. Carrillo, and A. R. Green, “Hypertension in Multicultural and Minority Populations: Linking Communication to Compliance,” Current Hypertension Reports 1 (1999): 482–88.
4. D. L. Denboba et al., “Reducing Health Disparities Through Cultural Competence,” Journal of Health Education 29 (1998): S47–S53.