Culturally appropriate

Good Attendant care is culturally appropriate

Culture

All of us are cultural beings. All of us have culture. Our culture shapes how we see the world and make sense of it. Culture influences all of our behaviours and interactions.

Culture is acquired - we learn about culture from others in our community, including our parents.

Culture is shared - culture does not exist in a vacuum, it is shared amongst a group of people.

Culture defines core values - because we have been taught our culture and share it with our cultural group, we tend to form the same core values.

Cultures resist change but are not static - culture does and can change, but change is usually slow and gradual.

Good attendant care will be culturally appropriate.

For attendant care to be culturally appropriate the service providers and the workers must be culturally competent.

Cultural competence is not just knowing about other cultures, being culturally aware or being sensitive to other cultures. 

Cultural competence is the knowledge, behaviours, attitudes, policies and systems that enable service providers and workers to work effectively in cross-cultural situations and respond to the needs of a culturally diverse population.

Cultural competence is required by organisations and individuals.

Culturally competent  service provider:

Culturally competent  service providers:

• Value diversity by accepting that the people they serve are from different cultural backgrounds and will make different choices based on culture
• Acknowledge and accept that cultural differences exist and have an impact on service delivery
• Believe that diversity within cultures is as important as diversity between cultures
• Respect the unique, culturally defined needs of various client populations
• Recognize that concepts such as "family" and "community" are different for various cultures and even for subgroups within cultures
• Incorporate cultural knowledge into all levels of service planning, delivery and evaluation
• Understand that people from different racial and ethnic groups and other cultural subgroups are usually best served by persons who are a part of or in tune with their culture

Culturally competent workers

Culturally competent workers:

• Understanding the concept of culture and how culture influences behaviours and the meaning of behaviours
• Show an openness and willingness to become aware of and explore their own cultural values, beliefs and attitudes
• Show an openness and willingness to explore the same things from the perspective of people from other cultural backgrounds  
• Show they can identify useful and culturally appropriate strategies for working with people from diverse cultural backgrounds

Knowledge of particular cultures

To be culturally competent in working with a particular client does require some knowledge of their culture and beliefs.
Service providers and workers can ask clients and the family members about their culture and beliefs.
There are also community profiles available that service providers and workers can use to help gain the specific knowledge they need to best work with particular clients.

Good attendant care in practice

The worker

• Asking about the client and their family’s culture and beliefs.
• Cooking culturally appropriate meals when helping with meal preparation.
• Being aware of and taking into account the cultural significance of
  • gender roles
  • religious belief

The person receiving attendant care and/or their family

• Describing for the worker and the service provider your culture and beliefs.
• Understanding the role of the worker and the limits to their work.

 

Generalising versus Stereotyping

In order to understand culture and compare cultures, we need to generalise but not stereotype.

Generalising

Generalising is grouping elements to form categories to make sense of a complex world.

We cannot respond to all of the isolated and disparate things we encounter or observe in our interactions with different groups and types of people so we group information into categories.

When observing different cultures we can make general observations based on our knowledge and experience. For example, we can generalise that:

• '‘Western’ societies tend to be individualistic
• Germans tend to value efficiency and formality
• U.S. Americans readily praise personal achievement
• Japanese society values discretion and politeness.

Stereotyping

But when we take these categorisations of general observation and apply them to whole groups of people, ignoring individual differences, we stereotype everyone in those groups. The stereotypical views of the above generalisations could be:

• Australians are selfish
• Germans are uptight
• Americans are show-offs
• Japanese never say what they really think.

Generalisations & Stereotypes

The key differences between generalising and stereotyping are:

Generalisations	Stereotypes
Retained consciously Descriptive, not judgmental Modified by subsequent experience	Retained unconsciously Judgmental, not descriptive Not modified by experience

 

Generalising can be a useful starting point for understanding - and then being open to modify our perceptions as new information about groups comes to us.

Stereotyping is not a useful starting point for understanding others or working with them.

Adapted from Culture from the Inside Out, Alan Cornes (1998)

 

 

Cultural differences across nations

Layers of culture

Every group of people carries a set of common mental programs that constitute its culture.

Almost everyone belongs to a number of different groups at the same time, so we have several layers of culture within ourselves, corresponding to the different levels of culture.  In particular each of us has a layer of culture at:

• A national level – according to ones country (or countries for people who migrated during their lifetime).
• A regional and/or ethnic and/or religious and/or linguistic affiliations as most nations are composed of culturally different regional and/or ethnic and/or religious and/or language groups
• A gender level, according to whether a person was born as a girl or as a boy
• A generation level, separating grandparents from parents from children
• A social class level, associated with educational opportunities and with a person’s occupation or profession
• For those employed, organisational, departmental and/or corporate levels, according to the way employees have been socialised by their work organisations.

The national level

We can use the national level as an example.

National cultures are different from one to the next.

To help us make sense of the diversity of national cultures it is useful to consider five dimensions of culture:

1. Social inequality, including the relationship with authority: More equal than others

   For example in some societies children are more likely to treat parents and older relatives as equals and in other societies it is more likely that respect for parents and older relatives is a basic lifelong virtue. Sweeden is an example of the former and Russia of the latter.

2. The relationship between the individual and the group: I, we they

   For example in some societies it is more likely that resources should be shared with relatives and in other societies it is more likely that there is individual ownership of resources, even for children. Indonesia is an example of the former and the United States is an example of the latter.

3. Concepts of masculinity and femininity: He, She and (S)he

   For example in some societies it is more likely that both boys and girls are allowed to cry but neither should fight and in other societies it is more likely that girls cry, boys don't; boys should fight back, girls shouldn't fight at all. Ireland is an example of the former and Denmark is an example of the latter.

4. Ways of dealing with uncertainty and ambiguity: What is different is dangerous

   For example in some societies it is more likely that people are comfortable in ambiguous situations and with unfamiliar risks and in other societies it is more likely that there is acceptance of familiar risks and fear of ambiguous situations and of unfamiliar risks China is an example of the former and Japan of the latter.

5. Fostering of virtues oriented towards future rewards or oriented to past and present rewards: Yesterday, now or later.

   For example in some societies it is more likely that people have concern with social and status obligations and in other societies it is more likely that people have a willingness to subordinate oneself for a purpose Pakistan is an example of the former and China is an example of the latter.

Below is a more detailed description of each of these five dimensions, and lots more examples.

Questions

• What is your culture like?
• Where is your culture on each of these five dimensions?
• What is your worker’s culture like?
• Where is your worker's culture on each of these five dimensions?
• What are the similarities and differences and their implications?
• Are you talking about your respective cultures and how to understand each other better?

The examples below are about the national layer. There are of course all the other layers as well.

The key point is having conversations about what’s important – and recognising that the way people communicate from one culture to another is also different.

See also cross cultural communication on the next Tab.

 

 

 

 

Cross cultural communication

Cross-cultural communication is complex, but four elements are usually present, though one or two may stand out.

1. Verbal behaviour: What we say and how we say it.

This includes accents, tone of voice, volume, rate of speech and slang.

2. Non-verbal behaviour: What we say when we’re not talking.

This includes ‘body language’ such as eye contact and ways of showing respect, ‘object language’ such as dress codes and ornaments and ‘environmental language’ such as house and office design.

3. Communication style: How we prefer to express ourselves.

This includes ways of getting our point across, assumptions about ways of
speaking and interacting with each other.

4. Values, attitudes and prejudices: What we believe is right.

This element is the most complex and includes our deep beliefs and feelings about our own identity, about the world and how we judge other people.

Questions

• What are some of the characteristics of your culture's communication style?
• What are some of the characteristics of your worker’s culture's communication style?
• What are the similarities and differences and their implications?
• Are you talking about your respective cultures and how to best communicate with each other?

 

 

Knowledge of particular cultures

Diversicare have published a range of profiles to provide an overview of various cultures which support service providers in delivering culturally sensitive care.

Austrian Profile
Bhutanese Profile
Chinese Profile
Croatian Profile
Dutch Profile
Fijian Profile
Finnish Profile
German Profile
Greek Profile
Indonesian Profile
Lao Profile
Papua New Guinean Profile
Philippino Profile
Polish Profile
Russian Profile
Samoan Profile
Swiss Profile
Tokelauan Profile
Vietnamese Profile

If the cultural profile you are looking for is not listed above do a web search for the particular cultural profile. There are many cultural profiles available on the Internet.

 

Definitions

Cultural Knowledge

Cultural Knowledge is familiarization with selected cultural characteristics, history, values, belief systems, and behaviours of the members of another ethnic group (Adams, 1995)

Cultural Awareness

Cultural Awareness is developing sensitivity and understanding of another ethnic group. Awareness extends to special foods, manners of dress, language, religious preferences and observances, and differences in communication styles. As an example, in some cultures it is impolite to make eye contact, especially with someone you do not know well. Cultural Awareness also involves changes in attitudes and values and reflects an openness and flexibility in working with others of another culture.

Cultural Sensitivity

Cultural Sensitivity is recognizing and knowing that both cultural differences as well as similarities exist, and not making value judgments of good or bad, better or worse, right or wrong (Texas Department of Health, National Maternal and Child Health Resource Center on Cultural Competency, 1997). It is important to be familiar with and sensitive to special events, activities, meaning of holidays, and other ethnic celebrations and the special foods that are served at these times.

Cultural Competence

Cultural Competence is a set of congruent behaviours, attitudes, and policies that come together in a system, agency, or among professionals that enables that system, agency, or those professionals to work effectively in cross-cultural situations (Cross, Bazron, Dennis, and Isaacs, 1989). Cultural competence also refers to a set of academic and interpersonal skills that allow individuals to increase their understanding and appreciation of cultural differences and similarities within, among, and between groups. This requires a willingness and ability to draw on community-based values, traditions, and customs and to work with knowledgeable persons of and from the community in developing targeted interventions, communications, and other supports.