Cultural competence should be at the heart of Family-Centered Care. Recognizing patient/family cultural needs and beliefs is consistent with the 3 pillars of evidence-based practice (EBP): relevant research, clinical expertise and patient values.
Respect for the person with hearing loss as well as his/her family members is at the heart of Family-Centered Care. And what better way to show respect than by being aware and knowledgeable of each families’ cultural values? Understanding how a family’s culture informs their beliefs and behaviors is essential to planning and delivering family-centered care.
Diversity is the new norm
Increasingly, health care providers across disciplines are recognizing the need to provide care in the context of cultural competence. Demographic patterns are changing across the globe such that societies comprise of individuals with different ethnicities, age, gender identity and preferences, religions, cultures, races, socioeconomic status and languages.
As such, health care providers are seeing patients/families with a diverse range of health perspectives. Multicultural, multiracial and multilingual are the new norm for our patients and their families.
Cultural competence among health care providers has emerged as a critical public policy issue. It can be defined broadly as the ability to understand, appreciate and interact with people from cultures or belief systems different from one’s own.1 Cultural competence has taken on an even greater importance with the current focus on health care disparities among diverse patient populations. Cultural competence is viewed as a prerequisite to reducing these disparities.
Cultural competence in hearing health care
If audiologists are to successfully meet the needs of rapidly changing and diverse patient populations, cultural competence must be a key value in family-centered hearing health care. Indeed, a growing body of research is confirming that cultural competence results in improved communication with patients and families, improved outcomes, better patient satisfaction and adherence to recommendations and instructions.2
Conversely, poorer health outcomes are reported when socio-cultural differences between patients and providers are not acknowledged and/or reconciled.3 Positive health outcomes are associated with culturally competent practice because of the respect perceived by patients and their families. Ultimately, this can lead to increased mutual trust and even greater likelihood that recommendations will be followed.
Benefits beyond trust and compliance
Further support for culturally competent hearing health care delivery is seen in the critical role it plays in evidence-based practice (EBP). The classic ‘pillars’ of EBP include patient values, clinical expertise and relevant research.4
The accurate practice of EBP, therefore, includes an equal emphasis on patient values, not just current research and professional expertise. As such, if culturally sensitive consideration of patient values is not included in our care, then we are not truly providing EBP to our patients and their families.
There is no one protocol or path to becoming a culturally competent healthcare provider. The goal should be to provide the highest quality of care to all patients and their families regardless of their race, ethnicity, culture, language or literacy.5
An ongoing approach to learning about the characteristics and values of patients and families should be multi-pronged with the dual aims of increasing sensitivity, awareness and knowledge while incorporating tangible, family-centered practices. Providing culturally competent hearing healthcare is a win-win for all stake-holders: patients, their families, the community, society and audiologists.
1. DeAngelis, T. (2015). In search of cultural competence. Monitor on Psychology, 46, (3), p. 64.
2. Betancourt, J.R., Green, A.R., Carrillo, J.E. and Park, E.R. (2005). Cultural competence and health care disparities: Key perspectives and trends. Health Affairs, 24, (2).
3. Williams, D.R. and T. D. Rucker, T.D. (2000). Understanding and addressing racial disparities in health care. Health Care Financing Review, 21, (4), pp. 75–90.
4. Sackett, D.L., Rosenberg,W., Gray, J., Hayens, R. (1996). Evidence based medicine: what it is and what it isn’t. British Medical Journal. 312, pp.71–72.
5. Georgetown University Health Policy Institute. (2019). https://hpi.georgetown.edu/cultural/#. Accessed November 18, 2019.
For further interesting reading on this topic:
McGregor, B. Belton, A., Henry, T., Wrenn, G. and Holden, K. (2019). Improving behavioral health equity through cultural competence training of health care providers. Ethnicity & Disease. 29 (Supp 2), pp. 359-364.
Truong, M., Paradies, Y. and Priest, N. ( 2014). Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC Health Serv Research. 2014; 14: 99.
Saha, S., Beach, M.C. and Cooper, L.A.. (2008). Patient centeredness, cultural competence and healthcare quality. Journal of National Medical Association. 100(11), pp. 1275–1285.
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