Larry 跨文化交际 PPT Lecture 10

Developing intercultural competence
1) Know your own culture
Awareness of host culture’s beliefs help practitioners to realize how they affect practice, lead to appreciation of other belief systems
1) Do not treat patient in the same manner as you want to be treated
Fundamental understanding of relationships between health care, culture, and communication necessary for health care professionals
Health care belief systems Supernatural / magico / religious
• Treatment of illness
- Chinese treatments include strict food regimens (also ingesting thousand-year-old eggs), acupuncture, moxibustion, herbal remedies, exercise - Mexican folk treatments include foods, herbs administered by curanderos, yerberos (herbalists), and sobadors (masseuses) - Categories of South African healers: destructive/evil, diagnosticians/diviners,
Diverse health care belief systems
Theories of health and disease/illness causation tied to worldviews Examples:
Chinese believe health a state of spiritual and physical harmony with nature; value health care that helps to attain this ideal African Americans frequently view folk medicine as curative
2) Gain knowledge of co-cultures
Respectfully explore patients’ beliefs within context of culture (may hold several viewpoints simultaneously
Include family in concerns/decisions where consistent with norms
• Treatment of illness
- Wellness achieved by positive association with spirits - Treatment carried out by healer-practitioners (examples: shamans, medicine men, curanderos, santeros, spirit healers) - Practices that vary culture to culture include cupping, hanyak, animal sacrifice,
- Illness attributed to spiritual forces (example: belief in power of the evil eye, i.e. projected by gazing/staring) - Five belief categories
1) sorcery 2) breaching a taboo 3) intrusion of a disease object 4) intrusion of a disease-causing spirit 5) loss of the soul
• Five attributes of intercultural competence in health care settings
1) Culturally diverse staff reflecting cultures served
2) Providers/interpreters who speak patients’ language
- Mexican and Puerto Rican cultures use amulets, charms, candles, crystals; Chinese also use amulets and jade charms
- Laotians engage in ceremonies, group prayers - American Indians avoid or counteract violations of cultural taboos
Cultural diversity in prevention of illness
• Many cultures combine supernatural, holistic, and scientific to prevent illness
In U.S., physical exams, immunizations, exercise, good nutrition combined with stress-reducers (massage, meditation), ingestion of probiotics, alternative treatments (chiropractors, acupuncturists, etc.)
• Causes ofБайду номын сангаасillness
- Assumption that a person’s health requires being in harmony with nature’s laws - Cultures possessing holistic health views: Chinese, Filipino, Korean, Japanese, Southeast Asian, Mexican, Puerto Rican, African, Haitian, Jamaican, American Indian
Communication Between Cultures
7th ed.
Larry A. Samovar
San Diego State University, Emeritus
Richard E. Porter
California State University, Long Beach, Emeritus
Clinical situation best conceptualized as negotiation
Health care communication strategies:
Do’s and don’ts to remove barriers to effective communication
• Treatment of illness
- Physicians employ surgery, medicine (e.g. antibiotics), therapies to destroy/remove causative agents
- Some co-cultures subscribe to combination of beliefs/treatments, respecting both scientific/biomedical approach together with culturally-accepted approach
• Other illness prevention examples
- Muslim Afghanis’ rely on Koran for protection: ta’ wiz (Koranic verses literally worn or ingested to ward off evil) - Latino and Asian cultures maintain hot-cold balance through therapies, remedies
Health care belief systems Scientific
• Underlying premises
- Focused on objective diagnosis and scientific explanation of disease - Disavows metaphysical, ignores holistic approaches - Can result in Western biomedical ethnocentrism
• Causes of illness
- Illness caused by breakdown in patient’s physical, chemical processes - Interested in discovering abnormalities in body’s function; deviations suggest/ indicate disease
Intercultural health care competence
• Intercultural competence defined
The knowledge, motivation, and skills to interact effectively and appropriately with members of different cultures.
3) Training for providers about patients’ language/culture 4) Signage, instructional literature in patients’ language and consistent with norms
5) Cultural skill
Chapter 10 Overview
Cultural influences on context: the health care setting
• Cultural beliefs about health care • Intercultural health care competence • Health care communication strategies • Language diversity
• Underlying premises
- Supernatural forces predominate the world - Followers hold strong beliefs about existence of sorcery, magic, evil spirits
• Causes of illness
Health care belief systems Holistic
• Underlying premises
- Based on natural law that whole is made up of interdependent, interacting parts
- More than a view about health; actually an approach to life