The Importance of Cultural Safety in Home Care
Published: 24 July 2024
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Published: 24 July 2024
The clients in your care will come from vastly different backgrounds and have varied life experiences. Having knowledge of and respecting an individual’s cultural background is crucial to being able to provide person-centred care.
Culture refers to values, customs, languages, social structures, beliefs, patterns of human activity and shared experiences - the symbolic structures that provide meaning and significance to human behaviour (Engebretson 2016; Rawson 2019).
Culture is fundamental to how we live and informs how we interact with the world (Rawson 2019).
Cultural safety involves being mindful of the similarities and differences between cultures and using this knowledge to inform your communication with members of different cultural groups (HETI 2018).
In healthcare, this means you must act in a way that recognises, respects and nurtures your client’s identity while ensuring you meet their needs, expectations and rights. Instead of working from your own perspective, it’s important to consider the cultural perspective of the person you are caring for (HETI 2018).
You can make a difference in the lives of your clients by doing your own research (see SBS's Cultural Atlas) and by incorporating cultural awareness into your care.
Individual values and beliefs is a requirement of the NDIS Practice Standards under Core Module 1: Rights and Responsibilities.
This Practice Standard aims to ensure that NDIS participants receive supports that respect their culture, diversity, values and beliefs (NDIS 2021).
NDIS providers must meet the following quality indicators:
(NDIS 2021)
Statistics from the most recent national Census in 2021 reveal how culturally diverse Australia is, with just over one-quarter (27.6%) of Australians being born overseas (ABS 2022).
In fact, over half (51.5%) of Australians were either born overseas themselves (first generation Australian) or had one or both parents born overseas (second generation Australian) (Khorana 2022).
As of 2016, there were over 300 separately identified languages spoken in Australia. More than one-fifth (21%) of Australians spoke a language other than English at home (ABS 2017).
As a health professional, you should be able to appropriately and sensitively care for clients of all backgrounds, including:
(DoH 2017)
Unfortunately, the perception of Australia’s healthcare system among people of culturally and linguistically diverse (CALD) backgrounds is far from positive.
People from diverse cultural backgrounds (including Aboriginal and Torres Strait Islander people) are also known to have difficulty accessing and using healthcare services in Australia, leading to poorer health outcomes (Khatri & Assefa 2022; White et al. 2019; AIHW 2023).
The potential for error in the absence of culturally-aware healthcare is vast. Misunderstandings, miscommunication and culturally-unsafe care by healthcare professionals are often reported (Johnstone & Kanitisaki 2006). People of a non-Anglo-Saxon background have cited feelings of powerlessness, vulnerability, loneliness and fear (Garrett et al. 2008).
Language barriers have been found to have significant adverse effects on care, including:
(Shamsi et al. 2020)
Culturally safe and sensitive practice is defined by the Medical Board of Australia (2020) as:
The following are some practical tips for providing culturally safe care:
(Centre for Cultural Diversity in Ageing 2024; Rawson 2019)
Culture-specific information allows us insight into the lives of people who share ethnicity, language, religion or other characteristics that individuals identify with, or groups that they belong to (Centre for Cultural Diversity in Ageing 2024).
While culture-specific information will inform your work with individual clients, keep in mind that within any cultural group, peoples' values, behaviour and beliefs can vary greatly (Centre for Cultural Diversity in Ageing 2024).
Learn and remember the ABCD Cultural Assessment Model developed by Kagawa-Singer & Backhall (2001). Make it part of your routine to take time to discuss the following with the clients in your care, as well as their families:
A - Attitudes |
|
B - Beliefs |
|
C - Context |
Also identify community resources that may assist healthcare professionals, clients and family members, such as translators, healthcare workers, community groups, religious leaders, and traditional healers. |
D - Decision-making style | Identify the general decision-making style of the cultural group, specifically the client and their family. Explore whether individual or family decision-making processes are used. Ask questions such as:
|
E - Environment | Determine whether there are community resources available to the client and their family. |
(Kagawa-Singer & Backhall 2001)
A - Assessment | Emphasis on the cultural aspects of a client’s lifestyle, health beliefs and health practices. |
C - Communication | Awareness of variations between verbal and non-verbal responses. |
C - Cultural negotiation and compromise | Awareness of aspects of other people’s culture as well as understanding the client’s views and how they articulate their problems. |
E - Establishing respect and rapport | Foster a therapeutic relationship that portrays genuine respect for the client’s cultural beliefs and values. |
S - Sensitivity | Provide culturally-sensitive care to a culturally diverse group. |
S - Safety | Create a space for clients to derive a sense of cultural safety, placing emphasis on the cultural aspects of a client’s lifestyle, health beliefs and health practices. |
(Narayanasamy 2002)
Although we, as healthcare professionals, constantly strive to provide sensitive, compassionate care, there is no doubt we may find ourselves in situations that challenge us. Although we don’t need to have a comprehensive understanding of every cultural and ethnic norm of all those who live in our society, we do need to make an effort to communicate with our clients and understand their needs in order to provide culturally safe care.
Respecting the dignity and human rights of each client is fundamental to providing quality care.
Question 1 of 3
Which one of the following is NOT part of the ABCD Cultural Assessment Model?