FALL 2011: WEEK 7 , LECTURE 1

PTHA 1301: The Profession of Physical

Therapy

Today’s Theme Song

Taylor Swift :)

Goals for Today: Diversity Part 2 & Disability/Chronic Conditions

Discuss multicultural perspectives and cultural competence as they relate to physical therapy care

Explain the effect of patient diversity on physical therapy care

Summarize the importance of communication on physical therapy care

Describe family needs, roles, & responsibilities on patient care

Practice Generic Abilities (Interpersonal Skills, Communication Skills, and Professionalism)

Bias and Prejudice

Unjustified negative attitude based on a person’s group membership

May become part of a normative pattern of thinking

Often exists even when we are not aware

Exists even if we believe we feel otherwise

May result in actions that are discriminatory

Becoming Unbiased, EmpathicHealth Professionals

Understand yourself

Acknowledge presence of prejudice and bias

Respect differences

Shed unhelpful bias

Discussion Questions

Where do you think that your unintended biases come from?

What are the effects on patient care?

What are the effects on the members of your health care team?

What do you think you could do to make changes for yourself or others?

Culture

Definition: the customary beliefs, social forms, and material traits of a racial, religious, or social group; also : the characteristic features of everyday existence (as diversions or a way of life} shared by people in a place or time <popular culture> <southern culture>

Acquired set of beliefs, values, behaviors, practices

Impact on daily experiences and choicesSubcultures (example: High School)

Cultural Competence

What is Cultural Competence? APTA states that “acquiring cultural competence as a

PT/PTA is a process that is cultivated within the individual through acquisition of knowledge, attitudes, and behaviors specific to culture, language, and communication”.

Cross model: “Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations”.

Campinha-Bacote model: “the process in which the healthcare professional continually strives to achieve the ability and availability to effectively work within the cultural context of the client – family, individual, or community”.

Why is Cultural Competence Important?

Society is changing and so are the faces of our clients

Critical core component of professional practice in PT

Considered part of “best practice” in providing PT care

Cultural competence will affect our clinical outcomes. How???

5 Essential Elements : Cultural Competence (from Cross, et al)

Value diversityHave the capacity for cultural self-assessmentBe conscious of the dynamics inherent when

the cultures interactInstitutionalize cultural knowledgeDevelop adaptations to service delivery

reflecting an understanding of diversity between and within cultures.

Continuum of Cultural Competence

Cultural destructivenessCultural incapacityCultural blindnessCultural pre-competenceCultural competencyCultural proficiency

L.E.A.R.N. Model

A model for culturally effective communication proposed by EA Berlin and WC Fowkes in “Teaching framework for cross-cultural Care: Application in Family Practice”

Listen – Identify and greet patient & othersElicit patient’s health beliefsAssess – Potential attributes/problems in patientRecommend – A plan of action Negotiate – with the patient after you have

made your recommendations

Elements of Culture

NationalityLanguage spokenClassReligion/

spiritualityEducationIncomeAgeRaceEthnicity

Key Concepts

Assimilation Definition: the process of receiving new facts or of

responding to new situations in conformity with what is already available to consciousness

Acculturation Definition: cultural modification of an individual, group,

or people by adapting to or borrowing traits from another culture; also : a merging of cultures as a result of prolonged contact

Bicultural Definition: of, relating to, or including two distinct

cultures

More Key Concepts

Ethnocentrism Definition: characterized by or based on the attitude

that one's own group is superior

Importance as a barrier Impact on interactions with others

Specific Cultural Perspectives

Native American There is often distrust and suspicion of non-native providers Harmony of mind-body-spirit is important Harmony with the natural world is important for health Healing is closely tied to religion and sacred religious

narratives and rituals Illness, disability and death are not discussed

Specific Cultural Perspectives

Asian Culture Harmony in body and spirit is the foundation for good health

and well-being Disruption will lead to illness Loyalty and harmony within the family lead to harmony with

the environment and within the self Hierarchy and respect for elders are an essential part of

harmony Traditional healing practices are valued and widely used

Specific Cultural Perspectives

Latino/Hispanic Good health is a gift from God Poor health is a result of fate

There is no way to overcome this Illness and disability may come as punishment for bad deeds Respeto and personalismo are essential traits for health care

providers

Specific Cultural Perspectives

Black Americans Distrust of medical providers caused by legacy of slavery and

other historical factors Reluctance to pursue care unless the illness is extreme Strong faith in God and letting His will be done Prayer is a valuable healing tool Many folk practices and reliance of family and community

Solutions

The key to eliminating fear and distrust by people of other cultures is to develop knowledge about, and respect for, other traditions and practices Develop cultural competence Be flexible and open-minded DO NOT stereotype Learn a new language and/or use interpreters

Develop knowledge and skill about communication with clients from different backgrounds

Develop skill interviewing clients from different cultural backgrounds

More Solutions

ASK the client what they would like from the medical encounter What kind of care would they like to receive?

Do not treat all patients the same Care must be individualized and congruent with cultural beliefs

and practices

IMAGINE YOU ARE 5 YEARS OLD AND YOUR SIBLING HAS JUST BEEN BORN WITH A DISABILITY.

• WHAT EFFECTS MIGHT THIS HAVE ON YOUR FAMILY?

• HOW MIGHT THE RELATIONSHIPS CHANGE?• WHAT ADDITIONAL ROLES AND

RESPONSIBILITIES MIGHT YOU NEED TO ASSUME?

• HOW MIGHT THIS HAVE CHANGED YOUR LIFE AS A 10 YEAR OLD? 15 YEAR OLD?

Disability Discussion #1

CONSIDER HAVING A SUDDEN-ONSET CONDITION VERSUS A PROGRESSIVE DISORDER.

• WHICH DO YOU THINK WOULD PRESENT A MORE CHALLENGING ADJUSTMENT FOR YOU?

• WHAT TYPES OF COPING STRATEGIES MIGHT YOU EMPLOY?

Disability Discussion #2

Andrew Ruiz, MBA, BBASPC Registrar

Guest Speaker

Graduate of Muleshoe High School, Class of 1998

Received a BBA from Angelo State University

Received a MBA from Angelo State University

Has worked at SPC as the registrar for 3.5 years!

Upcoming Assignments

Outline of Research Paper due NEXT TUESDAY 10/18/11, 11am via Blackboard

PAHC page 259,#2 - Assignment NOT due PAHC page 136, #1 - Assignment NOT due Show Elaine 5 additional notecards PER source (50 total

notecards) TODAY before you leave class!!!Watch Darius Goes West video on Blackboard, before

2:30pm next Tuesday 10/18/11 – QUIZ!!!Complete the MBTI, score it, and do calculations (this will

be in your PTA mailbox on Thursday 10/13/11. MBTI assignment will be due AT THE BEGINNING of class next Tuesday, 10/18/11.

Test #2 – Friday, 10/21/11 – Review Information will be given to you next Tuesday, 10/18/11.