Scully / Wilson Culturally Sensitive Oral Healthcare

1. Auflage 2019
ISBN: 978-1-85097-336-2
Verlag: Quintessenz Verlag
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, Band 35, 190 Seiten

Reihe: QuintEssentials of Dental Practice

We work in a multicultural society and modern healthcare delivery demands that the religious, cultural and ethical beliefs of patients be considered as a part of their treatment. There is therefore an increasing need to understand other cultures. We have attempted to address this need by developing this book to provide members of the dental team with a reference source to culturally sensitive care in everyday clinical practice. This is not a text about technical dentistry. Neither is this book intended to cover the orofacial problems that can affect people of various cultures and lifestyles, although they are mentioned where relevant. This book is about patient care. The knowledge base to be culturally sensitive is enormous. Lists of cultural traits and religious customs and beliefs can help, but inevitably give a very false impression of uniformity. Thus, in making reference to such lists, it is crucial to remember that there is considerable variation within every cultural and religious group and to avoid stereotyping. The information given applies only to certain patients. It is not a recipe for all solutions: we simply provide guidelines as a starting point for individualising dental healthcare. Individuals' views, practices, needs and wishes vary widely and can be influenced by religion, ethnicity, educational, socioeconomic, acculturational and other factors. This book is presented in three sections. The first section covers the many aspects of culturally sensitive healthcare, the second section outlines features of various religions and faiths and the third discusses cultural groups. In the second and third sections, topics have been arranged alphabetically for convenience. We do not attempt to be comprehensive. Cross-referencing has been essential. Although we are based in the United Kingdom, we hope that our efforts will help improve culturally sensitive oral healthcare worldwide.

Autoren/Hrsg.

Scully, Crispian

Wilson, Nairn H. F.

Leseproben

Section 1
Diversity, Cultural Considerations and Definitions
Aim
The aim of this section is to offer an overview of aspects of culturally sensitive healthcare, with an emphasis on culturally sensitive oral healthcare provision. Outcome
Having read this section, readers should be more aware of the immediate steps needed to make their patient management more culturally sensitive, before exploring the religious, cultural and other aspects of healthcare dealt with in more depth in subsequent sections. Introduction
Many areas of the world are short of resources, and this applies especially to the tropics, and areas fraught by natural and man-made disasters. Difficult environments, inadequate nutrition and insufficient healthcare are common in resource-poor areas, leading to enumerable health and other problems. The fact that there are disparities in health between different ethnic, cultural or other groups is not new. Cultures and Cultural Considerations
Culture (Latin colere; to inhabit, to cultivate, or to honour) is a term that refers to patterns of human activity and the symbolic structures that give such activity significance. Culture can be seen as consisting of three elements: Values – comprise ideas about what seems important and guides the rest of the culture. Norms – consist of expectations of how people should behave in different situations. Each culture has different methods, sanctions, of enforcing its norms, which vary with their importance. Norms that a society enforces formally have the status of laws. Artifacts – things, or material culture, which derive from the culture’s values and norms. Cultures can differ in a number of ways. Cultural differences are based on combinations of values, norms and artifacts. This has many implications for healthcare. Cultures are often based on some sort of religion or faith, or similar basis developed for inculcating and preserving established or ‘correct’ cultural behaviour. Groups of immigrants, exiles or minorities often form cultural associations or clubs to preserve their own cultural roots in the face of a surrounding (generally more locally-dominant) culture. On a broader scale, many countries market their cultural heritage internationally, both in the promotion of tourism and in cultural development abroad. Cultural changes can and do occur – in particular in response to the environment (including education and socioeconomic status), to inventions (and other internal influences), and to contact with other cultures. When this affects an individual or groups of people, it is often termed ‘acculturation’. Multicultural societies are now common in many parts of the world, with increasing numbers of immigrants and their families seeking local access to culturally sensitive routine oral healthcare provision (Fig 1-1). Fig 1-1 London: a multicultural society. In addition, the healthcare professions have become much more multicultural, given increasing numbers graduates from different cultures and backgrounds, with many being more aware of religious and cultural issues than some older members of the professions. It is clear that healthcare professionals in a multicultural society must function across cultural divides. The health manifestations of culture are significant and determine patient behaviours. Immigration is not a new phenomenon and is unlikely to cease. Migrants from diverse social, economic and educational backgrounds arrive in other countries for a variety of reasons. Many are refugees fleeing war, political upheaval, persecution, natural disasters or deprivation in their home countries. Some are joining families from which they have been separated for years. Yet others come seeking education or financial advantage, or to provide or seek work. Evidence suggests that the desire or need to emigrate from various places around the world is unlikely to diminish (Fig 1-2). Fig 1-2 Plaque commemorating migration to the UK in part centuries. Many immigrants arrive with inadequate economical support and language skills and tend to suffer social exclusion and inequality of healthcare provision. In many countries there is inequality of healthcare provision to a minority of the population who are the most deprived and socially excluded: this minority is often related to ethnic or cultural differences. Cultural considerations in oral healthcare are increasingly important. As in healthcare in general, dentists and dental care professionals (DCPs) are increasingly expected to be familiar with ethnic, cultural and religious issues that impact on healthcare provision, and to be willing and able to treat patients belonging to different religious and ethnic groups in ways that will not cause embarrassment, let alone distress through breaches of religious and ethnic groups’ taboos. Dentists and DCPs may work in countries foreign to them, or provide care to patients who have immigrated into their country of work. In either case, it is important for the dentist and DCP to understand and recognise the culture of patients. Most members of the dental team work in their home countries and will have experienced interactions with new immigrants, those who have acculturated, and individuals who are descendants of people who may have immigrated some time ago. In many societies, it is suggested that the need for culturally sensitive oral healthcare provision has traditionally tended to be relatively limited or ignored, with relatively small numbers of patients in religious and ethnic minority groups having tended to seek dental and related oral healthcare from HCPs within their group. This may have involved a number of barriers such as cost, fear, mistrust, the need to travel long distances at inconvenient times, or the absence of dental HCPs able and willing to accommodate specific cultural and ethnic needs. The exception is hospital-based and salaried dental services, which individuals of all religious and ethnic groups tend to access for emergency and possibly specialist care. Culturally sensitive healthcare is a phrase used to describe a healthcare system that, in addition to being accessible, respects the beliefs, attitudes and cultural lifestyles both of the patient and, as a consequence, is sensitive to issues including culture, race, gender, sexual orientation, social class and economic situation. At the most simple level, it is easy to offend by asking for a ‘Christian’ name (from someone who may not be Christian) rather than a ‘personal’ (‘first’) name. Cultural competency is the understanding that we all have different values that affect the way we view our health and healthcare, and how we view the world. It implies the ability to successfully navigate through other cultures while understanding, appreciating, making comparisons to, and moving beyond stereotypes, while remaining sensitive to one’s own cultural elements and those of other persons. The goal is to provide the best care possible to each individual patient. Culturally competent care requires more than simply a knowledge of other cultures; it involves attitudes and skills as well. Once attuned to the cultural beliefs of the patient, the healthcare professional can become a more effective HCP, and a more positive health advocate. Thus healthcare is offered in a way that respects and recognises different religions and cultural needs. Families
In Anglo-American cultures there is a high proportion of nuclear families and, increasingly, lone-parent families and families in which parents live together but are not married, including some single-sex families. Independence is a characteristic of these cultures. The family structure is a significant feature of cultures where the extended family is more common than the nuclear family. In extended families, the elders act as role models, are in control, and are respected. Often the family decides where to seek healthcare, whether this be from a HCP, a traditional healer, or even a neighbour. They also may decide whether to comply with appointments and accept medication and other treatments. The perceived advantages and disadvantages of different family systems are highlighted in Table 1-1. Table 1-1 Some perceived advantages and disadvantages of extended and nuclear families Perceptions Extended families Nuclear families Features Strong family, higher social...