Cultural competent health care

Describe the main countries of birth in this municipality, demographic composition,
languages spoken and organisations and services available to this community.
Choose a prominent cultural community in this region and using the ‘Community Profile’
tool describe the cultural characteristics and cultural values of this group you have chosen.
Compare and Contrast this with the cultural values of the Australian culture or your
personal cultural background. Reflect on the many ways in which culture influences you
including social norms, sanctions, values, way of life, beliefs, communication, major life
transitions (birth, death) and how you respond to authority, how you parent etc.
Using the literature, describe the characteristics of a culturally competent health care
workforce and health care system.

Cultural Competence in Practice

Using the CultureMate tool, the Victoria State was chosen with a main focus on the City
of Greater Dandenong. This area partners clinically with Monash. This is also the area where the
degree’s clinical placement will be undertaken. When interacting with community members to
offer care to them, there is a great need to ensure that one is culturally competent. This goes a
long way in ensuring that the exact needs of the patients are identified. In turn, the most
competent and appropriate care is offered. There are theories that can guide healthcare
professionals in the provision of the most appropriate care. Applying these, together with
adhering to professional codes of practice and code of ethics can guide professionals in the
provision of transculturally competent care. The aim of this paper is discussing cultural

CULTURAL COMPETENCE IN PRACTICE 2

competence care, after an analysis using the CultureMate tool with a focus on Victoria, City of
Greater Dandenong.

Main countries of birth

The main countries of birth as identified from the communication plan were India, United
Kingdom, Italy, New Zealand, Cambodia, Bosnia, and China excluding Taiwan and SARs. There
was an analysis of the percentage of people from these regions in 2011 and 2006. A comparison
was done consequently (Jeffreys, 2016).
At the same time, there were emerging communities that were slowly taking over Greater
Dandenong. An analysis by the country made it evident that these included countries like
Colombia, Liberia, Bulgaria, Zimbabwe, Saudi Arabia, Japan, Taiwan, United Arabs Emirates,
Korea, and Nepal.

Demographic composition

The main demographic composition in the City of Greater Dandenong is the indian-born
resident, Afghans, Vietnamese, and Sri Lankans. Therefore, the city has dynamic religious faiths
including the Islam- 11%, Buddhism- 18%, Christianity- 50%, and Hinduism- 4%. Almost 64%
of the residents in the city use other languages but English (Westera, 2016).

Languages spoken

The languages used in the city by most of the people are different from English. They
include Sinhalese, Punjabi, Greek, Chinese, Khmer, and Vietnamese.
Organizations and services available in this community

This community has several services and organizations. The 3CR (Community Radio) is
a community and dynamic hub that offers radio services for those lacking access to mass media,
and more so the indigenous people, women, and working class. The 21 st Century Chinese News

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is basically for the Chinese people, and airs weekly on Wednesdays. ‘Australian Mosaic’-
Federation of Ethnic Communities Councils of Australia represents Australians from
linguistically and culturally diverse backgrounds. Its role is lobbying, advocating, and promoting
issues on the behalf of the business, government and the broader community (Govere & Govere,
2016). 3ZZZ Ethnic Public Broadcasting Association of Victoria is a radio station that is
community-based and the biggest ethnic community station. Its aim is fostering and preserving
the culture and languages of the ethnic community. There is also the Australian Chinese
Community Association and Indian Television Broadcasting Association. These are some of the
services that the people in this community use, among others (Westera, 2016).

Prominent cultural community

The prominent cultural community in City of Greater Dandenong is the Indians. The
population of the Indians in this place over 6000.
Cultural characteristics and cultural values- community profile
There are some languages among the Indians that are not recognized as official. Hindi is
recognized as the official language by the central government. The caste system’s traditions and
Hinduism influences have enhanced a culture which focuses on the established hierarchial
relationships a lot. The Indians are ever conscious about the social order as well as their status as
far as the strangers, friends, and family are concerned (Pérez & Luquis, 2008). Regardless of the
kind of relationship, hierarchy is always involved. The Indians typically define themselves based
on the groups they associate with as opposed to the individual status. Therefore, people are
normally affiliated to the specific religion, career path, family, city, region, and specific state.
Close ties are maintained with families.

CULTURAL COMPETENCE IN PRACTICE 4

They do not have a tendency to say no to anything. On the contrary, they offer an
affirmative answer but are deliberately vague on the specific details. The social class, education,
and religion influence greetings Muecke, Lenthall & Lindeman, 2011). The most senior or eldest
person is greeted first. When leaving some group, everyone should be bid goodbye individually.
There is a belief that gifts ease the transition to next life. Red, green, and yellow are the lucky
colors, and therefore, used for gift wrapping. They are also good at entertaining in their homes.
There are some foods that the Indians never take including beef, alcohol, and pork (Rundle,
Carvalho & Robinson, 1999). Business transactions are mostly with those they are familiar with.
Those with the highest authority make most decisions. Successful negotiations are normally
celebrated over meals.

Comparison of the cultural community to the Australian cultural values
There are many differences between the Australian and Indian cultural lifestyles. These
are based on the relationships, time, gender, age, fate, belonging, and face among others. The
Australians are highly individualistic, where they place more focus on the self and cherish
independence over the group likes and preferences. High value is given to self-serving practices
and goal, and there is personal control over choices. They take credit and accept blame readily.
On the other hand, the Indians have a very high regard for the groups and family. There is a high
influence from the group thoughts. Allegiance is normally pledged to the group. People are
respected for the status (Ray, 2016).
The Australians have the low context communication where language is relied on to
mean the exact thing. They never beat about the bush. On the other hand, the Indians’ messages
are highly subtle as well as heavy with implications. They save face and aim at avoiding
humiliation. The Indians regard the class system with a lot of regard, as noted earlier. The

CULTURAL COMPETENCE IN PRACTICE 5

Australians think that people are equally good as the other, and based on this, there are no
difference in education, work, and social issues. This simply shows that when dealing with
people from these two backgrounds, there should be a keen differentiation and everyone should
be treated differently (Olaussen & Renzaho, 2016).
How culture influences a person- major life transitions, communication, beliefs, way of life,

values, sanctions, social norm, response to authority, parenting
There is no doubt that culture has a very huge effect on every person. This is the reason
why healthcare professionals are normally advised to consider the cultural backgrounds of their
patients. This aims at understanding the practices and reasoning of the patient. The major life
transitions such as death are carried out based on the cultural background of a person. For
example, after giving birth, there is a particular way in which a woman should be care for
depending on the culture. At the same time, breastfeeding practices and naming depend on the
culture. After death of a person, there are several practices depending on the culture (Maville &
Huerta, 2008).
Communication, both non-verbal and verbal, is dependent on the culture. Understanding
the non-verbal communication cues is very important, and more so when dealing with patients.
This enhances a detailed understanding and, therefore, efficient and competent care. Depending
on the beliefs that a patient has, the treatment practices should be adjusted accordingly Muecke,
Lenthall & Lindeman, 2011). While holding a deep regard for them is essential, the provider
should also be keen to correct those that are inappropriate. People lead their lives based on where
they come from or the requirements of their culture. The kind of foods taken and dressing are
highly dependent on the culture. This also applies to parenting where some parents are very
authoritative, and more so the dads, since such cultures are paternal. In these cultures, the

CULTURAL COMPETENCE IN PRACTICE 6

children mostly have more respect for their dads compared to the mothers (Cowen & Moorhead,
2011).
How people respond to the authorities, even at the workplace, depends on the way they
were brought up. For example, a man may be abusive to the women at the workplace if he grew
up knowing that the females are inferior. There is no doubt that the social norms and sanctions
everyone employs are highly dependent on the place where a person comes from. In this case,
there is a great need to ensure that healthcare professionals have the tools to assist them with
cultural assessment. Essentially, this is the basis for culturally competent care in that if the needs
and pressures the patient is facing are not identified from the start, then the whole healthcare
process would be useless.
Characteristics of a culturally competent healthcare workforce and healthcare system
Workforce
Healthcare professionals that are culturally competent focus a lot on interpersonal
interactions. This is aimed at knowing the patient more so as to identify the exact needs, after
which the most appropriate care is offered. The preparedness and ability of the healthcare
provider to promote effective interactions with the patients is highly dependent on the provider’s
behaviors, skills, attitudes, and knowledge. Therefore, professionals that are culturally competent
ensure that their values and aspects are for the good of the patients (Chang & Daly, 2015).
These professionals are always able to view the patient as someone who is totally unique.
At the same time, he or she can maintain unconditional positive approach when approaching
everyone he or she deals with. Moreover, the professional can build effective rapport, explore
patient beliefs, use bio-psychosocial model and various models and theories in articulating the
needs of the patients, establish a common ground as far as the treatment plans are concerned, and

CULTURAL COMPETENCE IN PRACTICE 7

knows the meaning of illness and values. Through this dynamism, the healthcare professional is
able to know the exact needs of every patient, which is very important in ensuring that the
treatment being given is proper (Raingruber, 2016). Cultural competence is the another feature
of these professionals, in that they are aware of different cultural backgrounds and apply the
respective one depending on the patient receiving care. Moreover, there is patient centeredness
where the professional focuses more on the patient with the intent of offering the most
appropriate care. This entails the use of patient-centered models that have detailed sets of skills
and knowledge that the providers need to portray and possess so as to manage offering
competent care. When the professional realizes that there as some things making the patient to be
uncomfortable, they should be approached well and addressed (Moss, 2016).
The culturally competent providers are always able to deal with ethnic and racial
disparities. The decisions that a provider should never be biased based on the race or ethnic
group of the patient. Increasing patient’s involvement is a very good way of ensuring that any
disparities are reduced. The respect, empathy, and warmth involved in a care environment should
never wane based on the patient receiving care (Farnbach, Eades & Hackett, 2015). The
providers are also very intent on recognizing the non-verbal cues being used by the patients, and
these are normally dependent on the cultural background of a patient (Muecke, Lenthall &
Lindeman, 2011). Hence, quality relationships between the provider and patient can help
differentiate between professionals that are culturally competent and those are not.
These providers are also able to understand the importance and meaning of culture.
Moreover, interpreter services are used effectively whenever possible. This is more so in the case
where the healthcare provider has not even a single idea about the patient’s cultural background.
The professionals also communicate effectively to all patients regardless of their color.

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System
Healthcare systems that are culturally competent are normally very intent at ensuring that
there are interpreters from different cultural backgrounds. These assist whenever there is a need
to offer care to patients from minority backgrounds. As such, the patient’s exact needs are
identified and dealt with. As such, there are no instances of errors or re-hospitalizations.
Moreover, patient satisfaction also increases, and this ensures that the patients are loyal clients to
the institution. Alternatively, the institution employs workers from diverse backgrounds. As
such, there is no discrimination during recruitment on the basis of race or ethnicity. In the
presence of such employees, there would be no challenges offering care to the diverse patients as
they can be called in to assist. Their presence would matter most during the healthcare
assessments (Stanley, 2016).
Healthcare systems that are culturally competent and patient centered include of
processes and structures aimed at improving the patient-centered outcomes as well as promoting
equity. The general services are also fashioned based on the preferences and needs of the
patients. Moreover, the healthcare institution releases educational materials regularly, which are
always tailored to the needs of patients, preferred language, and health literacy. There is a
cultural competence and awareness program that is followed strictly (University of
Michigan—Flint, 2011). Regular trainings are offered so that the healthcare professionals are
always in a position to offer the most appropriate and competent care. Those who go against the
cultural competence required are punished accordingly for failing to consider the patient as a
unique and special person.

Conclusion

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From the foregoing discussion, it has been established that cultural competence and
awareness are very vital aspects in the provision of care. Culturally competent healthcare
professionals are always armed with the skills of offering the most appropriate care. They
communicate effectively depending on the cultural background of the patient, and aim at
identifying the non-verbal cues. This should be done during the assessment stage. Healthcare
systems and institutions also need to embrace the approaches to cultural competence considering
that the world has gradually become globalized, and interactions with people from different
backgrounds have increased.

References

Chang, E., & Daly, J. (2015). Transitions in Nursing: Preparing for Professional Practice.
Elsevier Health Sciences APAC.
Cowen, P. S., & Moorhead, S. (2011). Current issues in nursing. St. Louis, Mo: Mosby Elsevier.
Jeffreys, M. R. (2016). Teaching cultural competence in nursing and health care: Inquiry,
action, and innovation. San Francisco, CA: Jossey-Bass.

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Maville, J. A., & Huerta, C. G. (2008). Health promotion in nursing. Clifton Park, NY: Thomson
Delmar Learning.
Moss, M. P. (2016). American Indian health and nursing. Clifton Park, NY: Thomson Delmar
Learning.
Pérez, M. A., & Luquis, R. R. (2008). Cultural competence in health education and health
promotion. San Francisco, CA: Jossey-Bass.
Raingruber, B. (2016). Contemporary Health Promotion In Nursing Practice. Sudbury: Jones &
Bartlett Learning.
Ray, M. A. (2016). Transcultural caring dynamics in nursing and health care. Philadelphia: F.A.
Davis Company.
Rundle, A. K., Carvalho, M., & Robinson, M. (1999). Cultural competence in health care: A
practice guide. San Francisco, Calif: Jossey-Bass.
Stanley, D. (2016). Clinical Leadership in Nursing and Healthcare: Values into Action. Newark:
Wiley.
University of Michigan–Flint. (2011). Online journal of cultural competence in nursing and
healthcare. Flint, Mich: University of Michigan – Flint, Dept. of Nursing.
Westera, D. A. D. R. N. M. N. M. E. (2016). Spirituality in Nursing Practice: The Basics and
Beyond. New York: Springer Publishing Company.

Olaussen, S. J., & Renzaho, A. M. (2016). Establishing components of cultural competence
healthcare models to better cater for the needs of migrants with disability: a systematic
review. Australian Journal of Primary Health, 22, 2, 100-12.

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Govere, L., & Govere, E. M. (2016). How Effective is Cultural Competence Training of
Healthcare Providers on Improving Patient Satisfaction of Minority Groups? A
Systematic Review of Literature. Worldviews on Evidence-Based Nursing, 13, 6, 402-
410.
Farnbach, S., Eades, A. M., & Hackett, M. L. (2015). Australian Aboriginal and Torres Strait
Islander-focused primary healthcare social and emotional wellbeing research: a
systematic review protocol. Systematic Reviews, 4.
Muecke, A., Lenthall, S., & Lindeman, M. (2011). Culture shock and healthcare workers in
remote Indigenous communities of Australia: what do we know and how can we measure
it?. Rural and Remote Health, 11, 2.)

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