5+-+Cross-cultural+communication

__Cultural Competence__
As healthcare professionals, every day we interact with clients of different cultural backgrounds. Cultural competence is a concept described since the 1960s, that includes respect, knowledge and skills, and the ability to use these effectively in cross-cultural situations.


 * So, what is cultural competence?**
 * It does not mean knowing everything about every culture or needing to abandon your own cultural identity
 * It means a respect for differences and a willingness to accept the idea that there are many ways of viewing the world
 * It is a lifelong process

Srivastava, R.H. (2007). Culture Care Framework I: Overview and Cultural Sensitivity. In //The Healthcare Professional's Guide to Clinical Cultural Competence//. (pp. 55) Toronto: Elsevier. **Here is a video with client and provider perspectives on cultural competence:** (A bit long, but gives a good background) media type="youtube" key="dNLtAj0wy6I?fs=1" height="307" width="384" align="center"
 * Key points to think about:**
 * Culture influences every aspect of our lives, yet rarely intrudes into conscious thought
 * Culture is both individual and shared. It is universal in the human experience, yet each local, regional or individual manifestation of it is unique.
 * Individuals may belong to many cultures
 * We all approach a situation from our own individual and cultural bias
 * Cultural differences are not about right or wrong - just differences
 * Self-awareness is the first and most critical step for developing cultural competence


 * Immigrant and Refugee Perspectives** - Dr. Kevin Pottie

"Consider the ramifications of speaking a different language and interpreting the world with a different educational or cultural background. Imagine not knowing whether to shake the doctor’s hand, where to sit, or how quickly to attend to the problem at hand. Picture being suspicious of the privacy of the medical record and distrustful of physicians in general. Imagine scanning for signs of competence, authority, humanity- elements of a trusting relationship that would alleviate anxiety.

Consider the burden of fears created by illness or the feeling the doctor will never speak directly of bad news such as a diagnosis of cancer. Imagine having experienced previous encounters that did not go well: too fast, too technical, humiliating, or physically harmful. Your family has been your sole support for having lived in an unstable society they were the only ones you could trust. Imagine having suffered, your human rights repeatedly abused and the doctor does not even ask about your family. Picture a society where few people trust a doctor’s opinion and so their only way to feel safe in the care they receive is to obtain ten opinions and then to select the one that sounds the best, costs the least, or is suggested most frequently.

Imagine the clinical encounter as the starting point in the process of building a connection to a new society. Migration involves the adaptation to new social and culture realities, a process that may produce considerable stress, anxiety and isolation. Such stressful events place an individual at risk for a multitude of problems ranging from family violence to tuberculosis. This stress of migration overlaps into the context of clinical encounters, so physicians must put forth a significant amount of effort to help overcome these barriers and stresses to build a respective therapeutic relationship. Building trust takes time so listen attentively and respectfully to a newcomer’s stories."

media type="youtube" key="Py3vfCs-TcY?fs=1" height="268" width="336"
 * Here's a video that attempts to give you a sense of what this might feel like:**

__Cross-cultural communication__
Communication is one of the most obvious challenges in providing culturally competent care.
 * Some tips to help improve communication:**
 * Speak slowly, not loudly. (A loud voice implies anger)
 * Face the person and use non-verbal communication. (Gestures, pictures, and facial expressions)
 * Watch the person's face, eyes and other non-veral communications carefully. When these don't agree with their words, ask further. Don't assume the non-verbal communication used in your culture is the same as in their culture.
 * Avoid difficult and uncommon words
 * Watch out for frequently misunderstood words and those that describe a sensation. (eg. "anxiety," "depression," "dizziness," "pins & needles")
 * Keep it simple: no unnecessary words or information
 * Organize what you say for easy access - short simple sentences with the most important info at the beginning & end
 * Repeat when are not been understood. Use the same sentence again first as changing words may confuse things
 * Rephrase and summarize often
 * Don't ask questions that can be answered with a "Yes" or "No". Use phases like "tell me about" instead.
 * If possible, greet the client in the client's own language to establish a rapport

Srivastava, R.H. (2007). Cross-Cultural Communication. In //The Healthcare Professional's Guide to Clinical Cultural Competence//. (pp. 117) Toronto: Elsevier.


 * This video helps give you a sense of some possible differences you could encounter in both verbal and non-verbalcommunication with different cultures:**

media type="youtube" key="XF8yZRgcSkg?fs=1" height="307" width="384"

For an excellent Canadian resource on community interpretation, refer to the website at: [|http://www.criticallink.org]