The Need for Cultural Competence in Hearing Healthcare. Patricia McCarthy, Ph.D. Professor & AuD Program Director Rush University Chicago, IL USA

Transcription

1 The Need for Cultural Competence in Hearing Healthcare Patricia McCarthy, Ph.D. Professor & AuD Program Director Rush University Chicago, IL USA

2 Chicago: A City with Diversity

3 Diversity in a Large Urban Medical Center

4 Cultural Competence in Hearing Healthcare Purpose of Presentation: Present argument for audiology to embrace cultural competence as a key value of the profession Consider cultural competence as a skill - A Building Block for the Future

5 Global Diversity in the 21 st Century Many challenges posed by diversity Affects every sector of society Corporations have embraced the demographic reality Proactive approach seen as an opportunity Training & education Marketing Recruiting Managing diversity in the workplace Commercials!

6 BAA Theme: Building for the Future Cultural Competence as a 21 st Century Building Block for the audiologists: WHAT is cultural competence? Why is there a NEED for cultural competence? What is the ROLE of cultural competence in 21 st Century hearing healthcare?

7 Cultural Awareness: One Component of Cultural Awareness: Cultural Competence Understanding of how a person's culture may inform their values, behavior, beliefs and basic assumptions ( Catchall phrase used to describe multifaceted process Cultural Competence: Includes multiple constructs: Cultural Awareness Knowledge Skills Encounter Desires (Campinha-Bacote, 2002). 7

8 Global Perspectives: Cultural Competence: What is it? the ability of systems to provide care to patients with diverse values and behaviors, including tailoring delivery to meet patient s social, cultural and linguistic needs. (Peninsula Medical School, UK) Culturally competent physicians are able to provide patient-centered care by adjusting their attitudes and behaviors to account for the impact of emotional, cultural, social and psychological issues (American Medical Association) Goal of cultural competence in health care: work effectively within cultural context of patient, his/her family and community (Campinha-Bacote, 2002).

9 The Need for Cultural Competence Worldwide cultural shift due to global factors Immigration patterns Economic changes Communication technology Rapid growth in diversity in USA & Europe over past 20 years outpaced all predictions Manifested in: Politics (i.e., elections) Elementary and Secondary School Higher Education Employment/Work Force Health Care 9

10 The Need for Cultural Competence Demographic projections in the USA for the next years: Decrease in current white majority to minority Corresponding increases among Hispanic and Asian American Groups (Pew Research Center, 2008) For audiologists burgeoning growth of cultural diversity in the USA mirrored in: Patient populations Pediatric Geriatric Student body seen in Audiology Programs 10

11 Patient Population Projections: More Racially and Ethnically Diverse Minority Groups as proportion of the U.S. Population (Administration on Aging, 2001) 1970: 16% 1998: 27% 2050: 50%

12 Patient Population Projections: More Racially and Ethnically Diverse (USA) 12

13 The Need for Cultural Competence Minority Population in the UK: Current and Projections In million residents were foreign-born = 13% of UK population (2011 Census Office for National Statistics, 2012) Increase from 4.6 million people in 2001 Ethnic minority populations will increase: 28 percent by percent by 2056 About half the 0 4 age group in 2056 (Coleman, 2010)

14 Global Perspective (The Migration Observatory at The University of Oxford, Coleman, 2013)

15 The Role of Cultural Competence in Healthcare What role can cultural competence play in audiology practice in the 21 st Century? Look to other healthcare professions Increasing body of research re: improved: Communication with patients and families Outcomes Interprofessionalism

16 The Role of Cultural Competence in Healthcare: Improved Communication Health care providers increasingly seeing patients/families with a broad range of health perspectives Present communication challenges( history, counseling) re: Differing social or cultural backgrounds Symptoms quite different than textbook Limited English proficiency Different thresholds for seeking care or expectations about care Unfamiliar beliefs that might influence follow-up re: care and recommendations (Betancourt et al., 2005) 19

17 The Role of Cultural Competence in Healthcare: Improved Communication Cultural competence can: Promote more effective discussions among patients & health care providers Cultural differences don t hinder process but enhance it (Office of Minority Health, 2005) Helps establish rapport (Papadopoulos et al., 2004) Appropriate communication is nonthreatening to patients and family 20

18 The Role of Cultural Competence in Healthcare: Communication and Outcomes Culturally competent provider-patient communication is linked to: Patient satisfaction Adherence to medical instructions Improved health outcomes (Betancourt et al., 2005) Conversely - poorer health outcomes: When sociocultural differences between patients and providers not reconciled (Williams and Rucker, 2000) 21

19 The Role of Cultural Competence in Healthcare: Communication & Outcomes Why positive health outcomes reported with culturally competent practice? Result of respect and responsiveness to individuals Leads to trust Improved health beliefs, practices (Office of Minority Health, 2005) Competent providers increase likelihood that minority patients will seek medical care ( 22

20 The Role of Cultural Competence in Audiology: Interprofessionalism Cultural Competence and Interprofessional Training: Other health professions ahead of the curve Signature Topic in the education of medical and public health professionals (AAMC, 2012) Joint Expert Panel of the Association of American Medical Colleges and the Association of Schools of Public Health Developed join curricula with proposed a set of knowledge, skills re: cultural competence, team approach via interprofessional training 23

21 The Role of Cultural Competence in Healthcare: Interprofessionalism Aim to ensure students acquire cultural competencies to prepare them for future: Successful practice and delivery of 21 st Century appropriate healthcare Develop and function as part of multicultural health care teams Appropriate for increasingly diverse U. S. population 24

22 The Role of Cultural Competence in Audiology: Educating for the Future Universities must prepare students who will be culturally competent 21 st Century health care providers: learn about cultures embrace pluralism advance proactive accommodations in diagnosis and treatment (Paasche-Orlow, 2004) Incorporating cultural differences into health education/treatment models will benefit: Patients Students Health professionals 25

23 Resources National Center for Cultural Competence, Georgetown University (USA) Office of Multicultural Interests (Australia) Think Cultural Health, US Dept of Health and Human Services (USA) A Manager s Guide to Cultural Competence Education for Healthcare Professionals (UK) eral/managerguide.pdf

24 Building for the Future & Cultural Competence Take-Away Points: Societies and economies are becoming more global Multicultural, multiracial, and multilingual are the new NOW Audiology as part of health care and must be relevant and current in 21 st Century healthcare Growing awareness that culturally competent teams result in improved health care outcomes Audiologists need to be part of these teams Audiology training programs must play a critical role in developing cultural competence as part of the Culture of Audiology!

25 Cultural Competence in 21 st Century Audiology If audiologists are to successfully meet the hearing health needs of a rapidly changing and diverse patient population, cultural competence must be a key value in patient care and the training of students. Providing culturally competent hearing health care is win-win for all: patients, families, community, providers, society