Culturally Competent

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• Culturally Competent
• Health Care
• for Refugee Children

Terri Morse, MS, RN-BC, FNP-C Susan Mahar, MS,
RN, PNP-BC
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Objectives

• Identify tools available to use during a cultural
  assessment
• Demonstrate knowledge of the health care
  practices of local cultural groups
• Create a health care plan to meet your patients
  cultural needs

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Upstate New YorkRefugee Arrivals 2012
BRIA FFY 2012
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Top 5 Upstate Counties with Refugee Arrivals in
2012
BRIA FFY 2012
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Jean Watson

• To care for someone, I must know who I am.
• To care for someone, I must know who the other
  is.
• To care for someone, I must be able to bridge the
  gap between myself and the other.

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Stereotype vs. Generalization
A Stereotype is an ending, no attempt is made to
learn whether the individual in question fits the
statement. A Generalization is a beginning
point, it indicates common trends but further
information is needed to ascertain whether the
statement is appropriate to a particular
individual. Galanti, G.A. (1991)
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The Culture of Western Medicine

• Meliorism make it better
• Dominance over nature take control
• Activism do something
• Timeliness sooner than later
• Therapeutic aggressiveness stronger better
• Future orientation plan, newer better
• Standardization treat similar the same

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Kleinmans Explanatory Model

• The following questions elicit the patients
  perception of their illness
• What caused the illness?
• Why did it start when it did?
• What does the illness do to you?
• How severe is the illness?
• What problems has the illness caused you?
• What do you fear most about the illness?
• What treatments do you think you need?
• How will you benefit from the treatment?

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B U R M E S E
B H U T A N E S E
SOMALI
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Cultural Diversity in Health Care

• Make It Better
• Control Over Nature
• Do Something
• Intervene Now
• Strong Measures
• Plan Ahead Recent is Best
• Standardized Treat Everyone the Same

• Accept with Grace
• Balance /Harmony with Nature
• Wait See
• Cautious Deliberation
• Gentle Approach
• Take Life as it Comes Time Honored
• Individualize Recognize Differences
• Cultural Competence

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LEARN Model

• Listen with sympathy and understanding to the
  patients perception of the problem (Utilize
  Kleinmans Model)
• Explain your perceptions of the problem
• Acknowledge and discuss differences and
  similarities
• Recommend treatment
• Negotiate agreement

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E
D
K
S
A
Knowledge
Skill
Awareness
Encounters
Desire
Campinha-Bacote (1991)
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Our Future