Cultural Competence

Introduction

The demographic profile of the population of the United States (U.S.) has been changing over the last several decades, creating a greater racial and ethnic diversity. The challenge to provide culturally reasonable care is not constrained by broad boundaries. All health care providers must demonstrate a sensitivity to and understanding of a variety of cultures in order to provide high quality health care. All health care providers must understand the intricate relationship between cultural and ethnic beliefs and values and the ways in which these concepts impact the context of health services both delivered (by providers) and received (by those in need of care). Further, all health care providers must appreciate the overarching influence of the social determinants of health that also influence health inequities and disparities.

Cultural Competence: Concept Analysis

Consciousness about the issue of cultural competence has emerged within the fields of health care education and practice over the last several decades. A similar consciousness raised about the need for clarification and definition of the concept and of the domains that comprise its essence. Nursing has paid particular attention to the theoretical basis and applications of the concept in its academic and clinical literature (Tuohy and Graham 2008, 164).

The literature sets forth a broad variety of definitions, but most share a common view of cultural competency as an overarching concept that involves dimensions of the affective, cognitive and skills domains. These include the willingness of a health care practitioner to explore personal views about similarities and differences among cultures (cultural awareness), to appreciate and to value the cultural uniqueness and/or differences associated with a client's cultural identity (cultural sensitivity), a degree of knowledge about various cultural beliefs and practices (cultural knowledge), being open to understanding the ways in which culture shapes the views of others (cultural understanding), the ability to modify approaches to client care that resonate with that uniqueness (cultural skill), and the ability to communicate effectively within the cultural milieu (cultural interaction) (Starr and Wallace, 48). "Cultural proficiency" emerges as the health care practitioner incorporates all of these concepts into a personal world-view and the way of practice.

Cultural Competence In The Health Care

Commitment to the preparation of a culturally competent workforce necessarily requires congruence between what taught and what is practiced. The literature offers a number of models for assessment of the health service delivery environments (the infrastructure). It also offers models for assessment of provider performance, viewed through the lens of cultural competence, on the part of providers themselves, and of the recipients of care offers a summative model that posits that culturally competent practitioners, working within a health care system that values the community and client view can have a direct influence on the promotion of positive health outcomes (Rosemarie, 135).

The four components that constitute Papadopoulos, Tilki and Taylor model for developing cultural competence detailed in the following figure.

Figure 1 The Papadopoulos, Tilki and Taylor model for developing Cultural Competence. (Papadopoulos, 18)

In the above model, cultural competence viewed as “the process one goes through in ...