Cross-Cultural Interactions in the Medical Field
In the era of globalization, interactions in health settings have become more complex due to diversity and cross-cultural issues. Different studies have shown inequalities in the provision of health services due to cultural diversity. Notably, Cultural diversity entails various factors, including an individual’s country of birth, ancestry, language spoken, parent’s country of birth, aboriginal descent, belief systems, religious affiliations, social and custom behavior[1]. Often failing to understand these dimensions results in poor quality of healthcare and health inequalities. The quality of care is determined by how medical staffs interact among themselves, as well as how they interact with patients and their family members. Literature reveals that offering care in cross-culture environments can be challenging since many practitioners are not sufficiently prepared to deal with such instances.[2] Cross-cultural interactions have become prevalent in the medical field. Cultural diversity, linguistics, and ethnicity remain challenging to medical practitioners, proving the need for cultural competence across the health sector. Hence, the reason for choosing this topic is due to the complexity attributed to cross-cultural interactions in many professional fields, and the medical field is an ideal setting for conducting a generalized study.
Effective care relies on a patient’s ability to adhere to a specific treatment plan, which depends on the level of concordance and trust established between a doctor and the patient. Culture introduces differences in values and beliefs, which might increase the emotional temperatures during instances of cross-cultural interactions.[3] Elevated emotional temperatures during a patient-doctor interaction may evoke trust issues that affect their relationship. While studies[4] have shown that medical practitioners exhibit different emotional responses when treating people from different cultural backgrounds, many tend to remain less empathetic when dealing with patients from unfamiliar cultural groups.[5] Thus, it is crucial to understand how cultural differences affect patient-doctor relationships.
Expectations may vary across healthcare providers regarding the level of care they should provide to patients hailing from different ethno-cultural backgrounds. Usually, communication barriers, different expression of emotions or pain, unexpected responses from relatives and families, as well as patient’s lack of knowledge regarding issues considered general, may elicit uncertainty and indifference towards a cross-cultural patient. A recent study[6] reveals that when a patient or family lacks knowledge about basic concepts, such as physiology, anatomy, self-care, and medical treatment, remains a challenge irrespective of the expectations established[7]. Another significant problem is the fact that cross-cultural patient-doctor interactions entail having to deal with diverse families.[8] Such interactions mean a practitioner being mistrusted or questioned over their professional role. For this reason, it is crucial to inform healthcare professionals on the fact that such questioning or mistrust may be a result of personal encounters of racism or perceived racist attitudes in similar health settings or in the public. Another viable reason would be a general cultural mistrust originating from racial discrimination, segregation, and feeling of inferior care for minority groups. Hence, a patient’s perception of
Cross-cultural competency is renowned for promoting effective patient care. As previously observed, cultural differences have the potential to upset the internal homeostasis in the medical field. Consequently, it results in negative emotional responses among practitioners and patients. In effect, it affects the doctor-patient interaction, which also affects the quality of services received by patients[9]. For this reason, it is crucial to nurture cultural competence among medical practitioners, which promotes acceptance of diversity.[10] Instilling cultural competence requires a behavioral change that utilizes a cognitive top-down strategy in addressing cross-cultural diversity in healthcare settings.
An important step towards understanding other people’s cultures is being aware of one’s cultural values, beliefs, practices, and attitudes. That need for being cognizant of the cultural diversity may vary from one individual to another, and clinicians should embrace it and respect the resulting differences.[11] The ability to adapt and remain sensitive to the cultural differences is dependent on a practitioner’s reflection and self-awareness, and is known to nurture great cross-cultural awareness, which resultantly leads to patient’s and family’s satisfaction with medical services.[12] By boosting individual’s awareness and appreciating cultural diversity, health professionals become more inclined towards delivering culturally sensitive individualized patient care. Moreover, healthcare providers should become cognizant of the fact that they might need different approaches since interactions vary from one patient to the other. Hence, evaluating one’s abilities to embrace culturally sensitive patient care can help build trust between medical practitioners, patients, and their families, which improves the quality of care and adherence to treatment plan.
Open and culturally sensitive communication offers an ideal avenue to embracing cultural diversity in the medical field. It entails active listening and respect for other people’s cultural practices and beliefs.[13] When a clinician listens actively and respects a patient or their family beliefs, they foster and build a healthy therapeutic relationship. To become culturally sensitive communicators, practitioners should examine the communication approach embraced by patients or their family, including paying attention to both verbal and non-verbal cues[14]. Further, they should evaluate the differences that exist in comparison to their own culture and other familiar cultures. [15] Utilizing culturally sensitive communication is also effective in creating a healthy collaborative environment between a health care provider, the patient, and the family in matters relating to patient care. While it is common for barriers, such as cultural beliefs, language barriers, and values to impede effective collaboration, which consequently leaves family members feeling helpless concerning their importance in providing appropriate care to their sick relative, medical practitioners who employ culturally sensitive communication can easily navigate beyond this barrier by demonstrating their understanding of the patient’s values, beliefs, and goals.[16] They can achieve this objective by embracing family-centered care, which is detailed below.
A family-centered care is an ideal approach to overcoming such barriers, which entails showing respect and support during interactions with patients and their family, promoting collaboration, and fostering continuity in patient care. Some of the recommended mechanisms to effective cross-cultural interactions include increasing chances of family participation in the patient care process. To achieve this goal, a clinician should pay attention to the family needs, motivating them to speak first and provide details regarding the type of patient care plan they deem ideal for their relative, even before the medical practitioner makes the decision or delivers the treatment plan[17]. Another strategy is by ensuring that the family becomes familiar with the hospital’s environment. By taking this action, a health care practitioner helps the family members to gain comprehensive knowledge that assists them in interpreting the clinical setting in culturally meaningful manner.[18] Thus, by taking these actions, medical practitioners alleviate or reduce any insecurities and fears associated with care provided to their relative.
In some instance, language barrier can become a huge obstacle in delivering appropriate cross-cultural care. Even with the effort to build trust through open and non-threating verbal and non-verbal language that indicates a practitioner’s desire to learn about a patient’s condition and help, failure to understand a patient’s needs may hamper proper care. In this case, using the services of a professional interpreter, who mediates the communication between the clinician, the patient and their family members, helps to address cultural differences and language barriers. Professional interpreters guarantee accurate and unbiased communication between these parties. Notably, accurate interpretation is essential to doctor-patient and doctor-family interactions, since it proves the respect for the other party’s input and language. In effect, it builds a trusting therapeutic relationship.
The paper was undertaken to explain and refine the concept of cross-cultural interactions, and to elucidate on how it affects quality of healthcare. By examining cross-cultural interactions intensively, one can understand the challenges it presents, its benefits, and ways of overcoming cross-cultural barriers in health care provision. By refining, explaining, and understanding the concept of cross-cultural interactions, health practitioners become more aware of the cultural diversity that exists between them, the patients, and their families. Moreover, becoming more conversant with the antecedents of the phenomenon helps clinicians to be more considerate of the space or environment in which such interactions occur. Medical practitioners can harness the defining attributes of cross-cultural interactions to prioritize and consider important factors, such as effective communication skills, in establishing the trust needed in fostering successful therapeutic relationship. When healthcare professionals are culturally sensitive, they become less emotional, which consequently reduces their physical and psychological stress. On the other hand, family members become more involved in patient care, while the patient experiences better healthcare outcomes.
Bibliography
Brooks, Laura, Elizabeth Manias and Melissa Bloomer. “Culturally Sensitive Communication in Healthcare: A Concept Analysis.” Collegian 26, no. 3 (2019): 383-391. https://doi.org/10.1016/j.colegn.2018.09.007
Guilherme Albieri, Jennifer Hue, and Sarah Gleason. “Cognitive Strategies to Improve Patient Care in Cross-Cultural Settings.” Optometric Education 43, (2017): 1-7.
Health Policy Institute. “Cultural Competence in Health Care: Is it important for people with chronic conditions?” George Town University. https://hpi.georgetown.edu/cultural/
Milberg, Anna, Sandra Torres and Pernilla Ågård. “Health Care Professionals’ Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study”. PLoS One 11, no. 11(2016). Doi: 10.1371/journal.pone.0165452
Murphy, Kathryn. “The Importance of Cultural Competence.” Nursing Made Incredibly Easy! 9, no. 2 (2011): 5. Doi: 10.1097/01.NME.0000394039.35217.12
Würth, Kristina, Wolf Langewitz, Stella Reiter-Theil and Sylvie Schuster. “Their View: Difficulties and Challenges of Patients and Physicians in Cross-Cultural Encounters and a Medical Ethics Perspective.” BMC Medical Ethics 19, no. 70 (2018).
[1] Laura Brooks, Elizabeth Manias and Melissa Bloomer. “Culturally Sensitive Communication in Healthcare: A Concept Analysis.” Collegian 26, no. 3 (2019): 383-84.
[2] Anna Milberg, Sandra Torres and Pernilla Agard. “Health Care Professionals’ Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.” PLoS ONE 11, no. 11(2016): 2.
[3] Guilherme Albieri, Jennifer Hue, and Sarah Gleason. “Cognitive Strategies to Improve Patient Care in Cross-Cultural Settings.” Optometric education 43, (2017): 1.
[4] Ibid., 2.
[5] Ibid.
[6] Anna Milberg, Sandra Torres and Pernilla Agard. “Health Care Professionals’ Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.” PLoS ONE 11, no. 11(2016): 10.
[7] Health Policy Institute. “Cultural Competence in Health Care: Is it important for people with chronic conditions?” George Town University. https://hpi.georgetown.edu/cultural/
[8] Anna Milberg, Sandra Torres and Pernilla Agard. “Health Care Professionals’ Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.” PLoS ONE 11, no. 11(2016): 10.
[9] Ibid.
[10] Ibid.
[11] Laura Brooks, Elizabeth Manias and Melissa Bloomer. “Culturally Sensitive Communication in Healthcare: A Concept Analysis.” Collegian 26, no. 3 (2019): 385.
[12] Ibid.
[13] Ibid.
[14] Murphy, Kathryn. “The Importance of Cultural Competence.” Nursing Made Incredibly Easy! 9, no. 2(2011): 5
[15] Ibid.
[16] Ibid.
[17] Kristina Würth, Wolf Langewitz, Stella Reiter-Theil and Sylvie Schuster. “Their View: Difficulties and Challenges of Patients and Physicians in Cross-Cultural Encounters and a Medical Ethics Perspective.” BMC Medical Ethics 19, no. 70 (2018): 6.
[18] Laura Brooks, Elizabeth Manias and Melissa Bloomer. “Culturally Sensitive Communication in Healthcare: A Concept Analysis.” Collegian 26, no. 3 (2019): 386.
