{"id":1226,"date":"2017-11-07T15:46:04","date_gmt":"2017-11-07T15:46:04","guid":{"rendered":"https:\/\/blogs.bmj.com\/case-reports\/?p=1226"},"modified":"2017-11-07T15:46:04","modified_gmt":"2017-11-07T15:46:04","slug":"cultural-competence-in-global-health","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/case-reports\/2017\/11\/07\/cultural-competence-in-global-health\/","title":{"rendered":"Cultural Competence in Global Health"},"content":{"rendered":"

By Nathan Douthit<\/p>\n

[I]n the\u2026aim to produce cultural competence, one dimension to be avoided is\u2026 narrowly defining competence\u2026 in its traditional sense: an easily demonstrable mastery of a finite body of knowledge. Rather, cultural competence\u2026is best described\u2026 as a commitment and active engagement in a lifelong process that individuals enter into on an ongoing basis with patients, communities, colleagues, and with themselves.[1]<\/sup><\/a><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dunton et al describe the importance of cultural competence in taking care of patients in minority communities in \u201cNavigating care for Bedouin patients with diabetes<\/a>.\u201d They describe the case of a patient with a 30 year history of diabetes. Despite his best efforts, the doctor\u2019s success when, \u201cencouraging the patient to make lifestyle changes\u2026 proved virtually impossible.\u201d He developed End Stage Renal Disease as a result, and then suddenly passed away, likely secondary to \u201ca heart attack due to complications from chronic diabetes.\u201d<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 In light of the rise of chronic disease, specifically as demonstrated in a \u201cminority culture within a larger Western society,\u201d the training of culturally competent physicians is essential. In this case, fatalism plays a key role. The eldest son writes,<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u201cDuring my father\u2019s disease, his socioeconomic situation was good\u2026. He could go to the experts\u2026. [But] he didn\u2019t consider diabetes a major threat. He was shocked when he was told he needed dialysis. He initially refused treatment for a few weeks before we convinced him with the help of his doctor\u2026. We were sorry that he died. But in our society, we believe in God and see this as the will of God. We can\u2019t do anything about it.\u201d<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Addressing fatalism, a \u201cmain obstacle in educating and motivating patients,\u201d requires a culturally sensitive dialogue. The authors recommend focusing on quality of life rather than threat of death. Having patients \u201cconsider how changes in lifestyle will help in remaining strong and active until the prewritten day of death,\u201d may help in addressing this issue.<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 According to the authors, \u201cthe link between trust and the adherence to treatment regimens is found within many communities.\u201d Training culturally competent physicians must focus on having knowledge, skills, and respect and being able to implement these effectively in cross cultural situations.[2]<\/sup><\/a> \u201cCulturally appropriate intervention channels\u201d are key to reducing stigma and raising patient awareness of available resources.<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Cultural competence has been shown to improve many health behaviors, specifically related to nutrition, exercise and substance use habits.[3]<\/sup><\/a> Culturally competent physicians must be willing to partner with local leaders. As the authors write, \u201cif community and leaders could establish the importance of diet as something on par with the importance of vaccinations, it would contribute to changing the culture positively.\u201d<\/p>\n

BMJ Case Reports invites authors to publish cases regarding cultural competence and humility in training global health practitioners. Global health case reports can emphasize:<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 -The effects of culturally appropriate health interventions<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 -Training methods for culturally competent global health practitioners<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 -Disease spread or exacerbation as a result of cultural incompetence<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 -Innovation in culturally appropriate interventions<\/p>\n

Manuscripts may be submitted by students, physicians, nurses or other medical professionals to BMJ Case Reports. For more information, review the blog on how to write a global health case report.<\/a><\/p>\n

Read more about cultural competence and humility in the interaction of clinicians with patients at BMJ Case Reports<\/a><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 –A Rohingya refugee\u2019s journey in Australia and the barriers to accessing healthcare<\/a><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 –Ethiopian-Israeli community<\/a><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 –Analysis of the psychosocial impact of caretaking on the parents of an infant with severe congenital heart defect<\/a>.<\/p>\n

\n

Read more about cultural competence and humility from other sources<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 -Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. Journal of health care for the poor and underserved. 1998;9(2):117-25.<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 -Brach C, Fraserirector I. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review. 2000 Nov;57(1_suppl):181-217<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 -Goode TD, Dunne MC, Bronheim S. The evidence base for cultural and linguistic competency in health care. New York^ eNY NY: Commonwealth Fund; 2006 Oct.<\/p>\n

[1]<\/sup><\/a> Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. Journal of health care for the poor and underserved. 1998;9(2):117-25.<\/p>\n

[2]<\/sup><\/a> Brach C, Fraserirector I. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review. 2000 Nov;57(1_suppl):181-217.<\/p>\n

[3]<\/sup><\/a> Goode TD, Dunne MC, Bronheim S. The evidence base for cultural and linguistic competency in health care. New York^ eNY NY: Commonwealth Fund; 2006 Oct.<\/p>\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

By Nathan Douthit [I]n the\u2026aim to produce cultural competence, one dimension to be avoided is\u2026 narrowly defining competence\u2026 in its traditional sense: an easily demonstrable mastery of a finite body of knowledge. Rather, cultural competence\u2026is best described\u2026 as a commitment and active engagement in a lifelong process that individuals enter into on an ongoing basis […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":275,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[263,4477],"tags":[],"class_list":["post-1226","post","type-post","status-publish","format-standard","hentry","category-global-health","category-student-editor"],"yoast_head":"\nCultural Competence in Global Health - BMJ Case Reports blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/case-reports\/2017\/11\/07\/cultural-competence-in-global-health\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cultural Competence in Global Health - BMJ Case Reports blog\" \/>\n<meta property=\"og:description\" content=\"By Nathan Douthit [I]n the\u2026aim to produce cultural competence, one dimension to be avoided is\u2026 narrowly defining competence\u2026 in its traditional sense: an easily demonstrable mastery of a finite body of knowledge. 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