PACIFIC CULTURAL COMPETENCIES

1
PACIFIC CULTURAL COMPETENCIES

• Presentation to the 7th International Conference
  on Medical Regulation
• 12th November 2006

2
Constraints

• Lack of research on the issue so that statements
  made can be evidence based
• As yet incomplete work by Ministry of Health on
  policy framework for Pacific cultural competency
  in healthcare
• District Health Boards in Auckland are
  undertaking Pacific cultural competency training
  for hospital staff but limited and not
  evaluated
• Waitemata DHB has developed a Pacific Cultural
  Competencies Framework still in draft.

3
Medical Councils Statement on Cultural Competence

• The purpose of the Councils statement is to
• outline the attitudes, knowledge and skills
  expected of doctors in their dealings with all
  patients. (Medical Council of New Zealand August
  06).

4
A View about Competence and Culture

• competence is a process of becoming, not a
  state of being (Campinha-Bacote 2002)
• Culture remains as process not fixed, not
  predetermined constructed by individuals,
  expressive of interplay between individual
  subjectivities and collective objectivities
  (Airini 1997)

5
Rationale for Presentation

• If staff at the coal face do not or cant see
  how cultural competence is going to improve their
  work with Pacific patients, they will not have
  time for it
• So start with the most immediate, ie the
  interface between the doctor and the patient and
  work outwards
• Pose a few questions and attempt to answer them
  and be practical
• The answers will reflect the norm but the
  norm maybe changing quite rapidly between
  immigrant and NZ born Pacific people.

6
Doctor Interaction with Patients
7
What should you know about Pacific people and
Pacific patients then?

• the attitude that we bring to the encounter with
  you the doctor
• our attitude towards health in general
• how these attitudes were acquired
• how can you influence these attitudes to effect
  good communication between yourself and the
  patient.

8
The doctor-patient interaction
9
The doctor-patient interaction
10
The doctor-patient interaction
11
The doctor-patient interaction
12
The doctor-patient interaction
13
The doctor-patient interaction
14
The doctor-patient interaction
15
Attitudes

• Traditional interventions can be broadly
  categorised from a western perspective as
  psycho-therapy and physiotherapy
• The use of traditional healing is common
• If a problem can be positively influenced by
  faith, psychotherapy will help if not massage
  may give some degree of physical comfort
  otherwise you will get progressively worse and
  die
• The understanding of the underlying premise for
  medical science is limited to those who have a
  certain level of western education
• The response is logical in the context in which
  people live/lived.

16
The doctor-patient interaction
17
(No Transcript)
18
The doctor-patient interaction
19
Organisational Competency

• Organisational competency is the ability of an
  organisation to effectively deploy and manage its
  resources in order to produce a desired outcome.
  The outcome in this case is Pacific cultural
  competency
• Cultural competency can be a capacity that a
  health organisation or a team has or that a team
  has access to a doctors skill in that context
  is an assessment skill that cultural competency
  is required.

20
Can Cultural Competence be Learned?

• Yes but requires
• - a desire on the part of the doctor to learn
• - a learning programme that is directly
  relevant and responds to the realities of the
  coal face in terms of the needs of both
  patient and doctor, that is based on research
  of Pacific patients needs and takes into
  account the constraints of the doctors time and
  the other demands on that time.