These include: 1. lack of awareness or confidence to address the needs of CALD families; 2. practice that is not culturally competent; 3. lack of adequate resources; 4. institutional racism; and 5. lack of awareness and partnering with CALD-focuse… Ethnic minority families are less likely to access services if they are concerned they will be typecast and will not receive the same quantity or quality of service they believe others receive. In another small-scale study of Arabic families, mental illness was considered a negative reflection on the family that may have an impact on events like the marriage of their children (Youssef & Deane, 2006). Because of differences in cultural characteristics between Anglo-Australian and ethnic minority cultures, a number of barriers to equal access and use of services may be perceived or experienced by service providers and practitioners who deliver services to CALD families. 6. Because of differences in cultural characteristics between Anglo-Australian and ethnic minority cultures, a number of barriers to equal access and use of services may be perceived or experienced by service providers and practitioners who deliver services to CALD families. 2008). model of service is culturally inappropriate; service not perceived as relevant due to lack of cultural diversity in the workforce and marketing of services; service choice perceived as limited due to lack of cultural diversity in the workforce; and. Although all Australians have the right to equitable healthcare, patients from culturally and linguistically diverse (CALD) backgrounds (including Aboriginal Peoples) may experience significant barriers to accessing and using healthcare services and suffer adverse events including medication errors, misdiagnosis and healthcare-associated infections (DoH 2019; Brach, Hall & Fitall 2019). Commitment on an organisational level that recognises and. This can produce a burden on CALD staff, both in terms of being expected to know and understand the nuances of all CALD groups, but also in terms of workload. It is a fact that effective communication is the key to success in both personal and business relationships. It is vital you adapt your practice to address the wants and reasonable expectations of the patient (Medical Board of Australia 2014). of Psychology, UCLA. People of a non-English speaking background are more likely to experience medication errors, misdiagnosis, incorrect treatment, poorer pain management and poorer outcomes in general (Ferwerda 2016). Healthcare professionals could be part of an effective solution for diminishing racial/ethnic disparities in healthcare. This is one reason why healthcare professionals are wise to avoid making assumptions and should work toward understanding a patient’s culture beyond what may seem obvious to them. The primary consequences of cultural neglect are poorer outcomes for people of diverse or marginalised backgrounds and, on a more general level, distrust for the healthcare industry (Ferwerda 2016). Language presents perhaps the most significant single cultural barrier. In essence, it is nursing that seeks to provide care that acknowledges and is congruent with a patient’s culture, values, beliefs and practices – the crux of which is good communication between the healthcare professional, the patient and their family. Such situations can burden other family members such as children, who at times may be engaged as interpreters for their parents on sensitive issues. In fact, the whole concept of a family sitting down and discussing their problems together was alien, in that parents very seldom discussed issues with children. The ongoing and fluid process in which individuals from CALD groups must balance their conflicting needs for cultural preservation and cultural adaptation is known as acculturation (Berry, 1980). Just over two years ago, the National Council for Interpreters … Although treating everyone in the same way is superficially equivalent to providing equal opportunities, it can in fact result in discrimination and "institutional racism" (discussed below). (2007) pointed out that, even among service providers and practitioners from ethnic minority groups, standardised professional training practices reduce the number of culturally tailored options for models of service delivery. Determine whether there are community resources available to the patient and their family. Only by being culturally sensitive and responsive to ethnic values will parent training be accepted within these populations. Good medical practice guided by genuine efforts to understand and meet the cultural needs and contexts of different patients to obtain good health outcomes, which requires: Having knowledge of, respect for, and sensitivity towards, the cultural needs of the community. If CALD families have had experiences of services that target chronic issues that did not meet their expectations and/or the ideology of the service differs from that of the family's or the community's, they may be reluctant to engage with services when there is a crisis and service provision is necessary. “There are many ways that race and ethnicity are connected to health. Low English proficiency can mean that families are prevented from seeking out or do not have the confidence to seek out information about services in the community from which they could benefit (Box et al., 2001). There may be situations in your job when cultural-beliefs and wishes clash with best practice. In addition, some CALD families may simply agree with service providers and practitioners so as not to disappoint them. Therefore, under-representation of the cultural diversity of the local community in the workforce can compromise effective and culturally appropriate service delivery. Print; Summary. For example, they may be concerned that they will be seen as being overly dependent on their family or not sufficiently independent, compared to their age-matched Anglo peers. anything that restricts the use of health services by making it more difficult for some individuals to access It is important for staff to respect the particular preferences of ethnic minority parents (Box et al., 2001). However, fathers from ethnic minority families are particularly challenging to engage because of traditional gender roles. For example, based on research that investigated parent training issues with Chinese families in the US, Lieh-Mak et al. As of 2016, there were over 300 separately identified languages spoken in Australian homes. Acknowledging and understanding the social, economic, cultural and behavioural factors that underpin health, both at individual and community levels. Statistics from the most recent national census reveal how truly diverse Australia is as a nation. Medical Board of Australia 2014, 'Good Medical Practice: A Code of Conduct For Doctors in Australia', Medical Board of Australia, viewed 9 July 2019. Provide culturally-sensitive care to a culturally diverse group. – Margaret Millar. ... Alexander M. Telemedicine in Australia. Differences in cultural norms and values between two individuals from the same cultural group may in fact exceed those across two individuals from different cultural groups. What illness and care mean to them and their family. There is always a tension between, on the one hand, a "colour blind" service, which treats everybody in the same way, and a culturally specific service, which assumes that each culture is different. Box 951563, Los Angeles, CA 90095-1563 (310) 825-3634 E-mail: Ltaylor@ucla.edu How they prefer to communicate about death and dying and diagnosis and prognosis. Of the 6,163,667 overseas-born persons, nearly one in five (18%) arrived since the start of 2012 (ABS 2016). Further, ethnic minority families in regional Australia may not have the social support of extensive community networks. Start an Ausmed Subscription to unlock this feature! Culture is influenced by political and economic conditions and varies with factors including age, gender, class, education and personality (Engebretson 2016). This is where culturally-safe practice is crucial. lack of knowledge or understanding of services that are available. Cultural differences can cause misunderstandings between patients and doctors. Alternatively, some CALD families may prefer to have a service provider or practitioner who is not of the same cultural background as themselves. (2007) pointed out, a service user and service provider "ostensibly belonging to the same ethnic group because of shared country of origin, may actually differ in terms of social class, religious practices, languages, and cultural beliefs about illness and recovery" (p. 8). See Educator Profile. Social Cultural Structural/systems Limited ability to pay for services restricting choice of provider Inclusion of symbols and signs (like Aboriginal artwork) Non-compliance with appointment schedules A perception (or evidence) of poor provider attitudes or understandings of Aboriginal cultures A lack of understanding of separate systems A lack of health literacy and health systems literacy Dis/comfort with the physical environment of a service Need for many services in one, central … A culturally diverse staff profile is necessary but not sufficient; it is still important to have "culturally competent" staff.6 That is, training in cultural competency for all staff, regardless of their ethnic background, will increase effective engagement with all CALD families. A lack of cultural diversity can also be problematic to family relationship service outlets because "ethnic minority staff are over-relied upon and the racialised experiences of service use are focussed on too heavily" (Page et al., 2007, p. 68). Thus, the brochures or other information should indicate that the service is available in minority languages and should point out how it can be accessed. As Bhui et al. How they and their family cope with suffering. Babacan, 2005; Page et al., 2007; Weerasinghe & Williams, 2003) has shown that this is especially so for Muslim families, with media portrayals making them targets of racism and discrimination. The framework includes measures on culturally respectful health care services; Indigenous patient experience of health care; and access to health care services. However, it also presents many challenges. Ethnic minority families who perceive that the skills, support and advice they are receiving from family relationship services reflect individualistic norms may disengage from the service because they do not consider it appropriate for their cultural needs or issues. Thus, the challenge of acculturation spills over into the second and subsequent generations of CALD families, and may underlie intergenerational conflict or tension between family members. (p. 200). full article: Introduction. Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. It is suggested that CALD families who perceive the services as being geared toward Anglo-Saxon families may be less likely to use the services. Garrett, PW, Dickson, HG, Young, L, Whelan, AK & Forero, R 2008, ‘What do non-English-speaking patients value in acute care? For example, CALD families should be informed that service providers and practitioners are required by law to breach confidentiality and disclose issues in cases involving mandatory reporting of child abuse. These can include, for example, local CALD advocacy groups, Migrant Resource Centres (MRCs), Ethnic Communities Councils (ECCs), language centres that provide interpreting and translation services, centres that specialise in meeting the needs of refugees or newly arrived migrants, and multicultural organisations. Volume 39, No.1, January/February 2010 Pages 71-73. However, Weerasinghe and Williams (2003) importantly pointed out that even among CALD families who are proficient in English, the use of professional jargon by service providers and practitioners, without accompanying explanations, can be a deterrent to their uptake of services. Such differences can either decrease empathy or understanding for the family's concerns and/or increase (pre-)judgement; CALD families may feel service providers and practitioners who are not as aware of their cultural norms and expectations will judge them less. These issues can pertain to a range of factors, such as dislocation, acculturation, identity and racism. Nevertheless, a staff profile that reflects the ethnic mix of the local population is preferable. Learn and remember the ABCD model of Kagawa-Singer & Backhall (2001), and make it part of your routine to take time to discuss the following with your patient and their family: There will be times in which you may find differing cultural practices and beliefs at odds with your practice and therefore hard to navigate. They are usually more satisfied with services when they feel they are being treated equally, feel they are receiving full and accurate information about service provision, and that the services offered are sufficient in addressing their range of needs (Chand & Thoburn, 2005; Lloyd & Rafferty, 2006). 1: The health-care system and the development of telemedicine. The National Evaluation of Sure Start in the UK (Lloyd, O'Brien, & Lewis, 2003) indicated that most family counselling services have great difficulty engaging fathers. (1984) stated that one of their cultural beliefs is that "the private shame of a family should not be made known to outsiders" (cited in Forehand & Kotchick, 1996, p. 199). There is extensive research (e.g., Bell, Bryson, Barnes, & O'Shea, 2005; Box et al., 2001; Page et al., 2007; Williams & Churchill, 2006) pointing to the importance of service providers and practitioners being sensitive to these individual variations within families; ethnic minority families are more likely to engage these services if their concern that family members will be stereotyped or misunderstood is alleviated. For example, being aware of religious diversity within CALD groups makes service providers and practitioners more likely to tailor services to meet the needs of Christian Indians compared to Hindu Indians, Lebanese Muslims compared to Lebanese Christians, and secular Turks compared to Muslim Turks. Generally, deviations are greater for CALD family members born in Australia compared to immigrants, settled migrants compared to newly arrived migrants, migrants who have chosen to live in Australia compared to those who have not (e.g., spouses who have moved because of their partner or some refugees), and for those who identify with and feel they belong to Australia compared to those who do not (Forehand & Kotchick, 1996; Ward & Kennedy, 1999; Ward & Rana-Deuba, 1999). Cultural competence in healthcare refers to the ability for healthcare professionals to demonstrate cultural competence toward patients with diverse values, beliefs, and feelings. Cultural differences clearly impact on different aspects of mental health including perceptions of health and illness, coping styles, treatment-seeking patterns, impacts of history, racism, bias and stereotyping, gender and family and stigma and discrimination. Only two thirds (67%) of the Australian population were born in Australia. It is important for service providers and practitioners to keep a regularly updated list of the main CALD-focused centres and organisations in their local community who can offer interpreting and translation services as well as support and advice. This included 50 semi-structured interviews with 25 families from a refugee background who had resided in Australia for between one and ten years, and were living in South Australia or the ACT. Awareness of and sensitivity to cultural and personal diversity is necessary for enhancing equity in services; a one-size-fits-all approach may only lead to inequity. Objective: Access barriers to health care for minority populations has been a feature of medical, health and social science literature for over a decade. The authors also suggested that service providers or practitioners may misinterpret the body language of CALD families, which can interfere with how comfortable the latter feel about expressing their issues or concerns. The simple realities of large distances and low population densities make service provision far more difficult in rural than urban areas of Victoria and Australia. How you can accommodate their spiritual and religious needs. Additionally, residents of more inaccessible areas of Australia are generally disadvantaged in their access to good and services, educational and … With increasing cultural diversity among nurses and patients in Australia, there are growing concerns relating to the potential for miscommunication, as differences in language and culture can cause misunderstandings which can have serious impacts on health outcomes and patient safety (Hamilton & Woodward-Kron, 2010). Cultural barriers may include differing languages, differing practices as related to medical procedures, and different conceptions of gender and sexuality. New migrants arrive in Australia tend to have minimal knowledge about the health-care system in Australia. Realizing how culture can influence a person’s perceptions of health and medicine can really make a difference in understanding a person’s medical needs and how to communicate with them. In a study by Katz (1996), Asian families in the UK (who in the main refer to families from India, Bangladesh and Pakistan), for example, viewed children's mental health issues as being behavioural or spiritual difficulties, and sought advice from Imams, who generally recommended increased religious observance and training (or marriage, in the case of young women) as the solution, rather than psychiatry. Barriers to good health care. Services are more thinly spread, and people have to travel longer distances to reach them. Some CALD families may prefer to have a service provider or practitioner who is of the same or similar cultural background to themselves because they might feel more comfortable or feel that they will be understood better. See section 4.1. for more information. 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