Cultural Diversity SLP 5

Cultural Competence
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Introduction
The world is rich with cultures, stemming from across the entire globe. Some of the times, some cultures will share some fundamental beliefs and practices and sometimes these elements will be as different as night day. However there are those elements that cut across the cultural platform. Today the world is a global community, meaning that different people from different cultures are bound to interact on a regular basis. Medical professionals no longer have to deal with patients from their cultural background as they work across the globe. This also means that patients can seek medical care from across the globe (Purnell, 2005). The interaction of cultures is what makes cultural awareness and competence some of the most sought after and researched topics in the academia realm. As such cultural diversity is a reality that most health care givers have to deal on a daily basis (Korea.net, 2015). Different cultures observe different communications practices, beliefs, values and views which are generic to their social upbringing, cultural background and religion, which dictate their living styles. For health workers, understanding some of the basic elements of the different cultures could mean the difference between having a successful and satisfied patient outcome and failure. Simple issues like communications cues can easily be misinterpreted to mean that the medical practitioner is rude and arrogant (‘Handbook of Patients’ Spiritual and Cultural Values for Health Care Professionals’, 2013).
For the medical teams this could easily escalate into a standoff with patients and their family refusing to corporate. Understanding some of the aspects of a certain culture not only helps the medical teams to communicate effectively with the patient, but also comes out as respectful and caring and is greeted with a lot of corporation. Purnell model for cultural competence designed by Larry Purnell, underlines with certainty the 12 domains that medical care givers have to observe as they deal with the different cultures of their patient on a daily basis. According to the model, every person’s cultural background can be understood by looking at the three rings and the 12 domains. The three rings comprise of global society, the family unit and the person in question. The cultural background can then be reviewed under the heritage, communication, family roles and organizations, workforce issues, bicultural ecology, high risk behaviors, nutrition, pregnancy and childbearing, death rituals, spirituality, health care practices and health care practitioner domains (Warner, 2005). All these are domains that are crucial to understand the culture of focus in this paper that is the Korean culture. Like most Asian cultures, this is a very rich culture and offers intriguing insights with reference to health care.
Taking Medical Care Of a Korean Patient
Focus On Health Care
For Koreans, the focus on health care mainly relates preventive and in some of the cases curative practices that may spread from traditional practices, religious beliefs and proper nutrition. Health is an aspect that seen to be the balance between ones soul and the physical being (Culture Clues, 2007). As such, maintaining a healthy living means that one has to maintain a health spiritual practice and healthy physical being, an imbalance of which could lead to illness. The holistic aspects of the body, mind and soul are central to the health status of any patient, and thus have to be observed with a keen response. Believe in the spiritual world is thus quite fundamental to the Koreans and it is crucial for the medical practitioners to understand this element. Although they may accept the western medicine, they may tend to incorporate the complementary medical practices such as acupuncture, spiritual interventions or even herbal medicine (Purnell, 2005). The Koreans also maintain close family ties and organization. In the case of a patients may tend to consult with their family heads more than they will with the physicians. In most cases this is an elder brother, eldest son or husband (Lipson & Desantis, 2007). As such it is crucial for the medical teams to understand and respect this arrangement for the best patient outcomes. For the Koreans, diet also plays an important role, as patients are told to refrain from certain foods when sick from specific ailments and even when pregnant.
Traditional practices
Like most of the cultures across the world, the Koreans also have traditions that they hold dear. Traditionally most of the Koreans are Shinto, Christians or Buddhists. Spiritual matters play a very subtle role in the health of the Koreans thus the medical care givers need to understand and appreciate this aspect. Patients may want to seek spiritual healing and some may be seen to pray using beads. As mentioned earlier, Koreans respect family ties, roles and organizations and will tend to gain consent from the respectful authorities within the family before making a major medical decision (Culture Clues, 2007). For the medical team, this is one of the main domains that are listed under Purnell’s model. As such, the best way to help a Korean patient would be to work with the figures of authority in the family while giving them the space and time to consult. One other aspect that is a common among the Korean people is that for ages they associated ones well-being with the nutrition that they take. As such foods are easily classified as hot or cold. A woman that is pregnant is considered hot and thus cannot eat foods that are considered hot. It is important for the medical teams as such, to work with the patients and their families to determine the correct foods that the patient should eat, relative to the traditions and the nutritional needs of the patient at the time.
As highlighted earlier, spirituality plays a major role in the lives of the Koreans and thus the medical teams ought to respect the decision of the patients and their family members. Koreans tend to seek guidance from spiritual figures in an effort to determine the root cause of their demise (Purnell, 2005). As a medical care giver, one may try to explain the scientific aspects behind the diseases or the medical conditions, but they should never be forced on the patient. This is mostly due to the fact that, the Koreans also believe in fate and they may be reluctant to take any medication. The best way to deal with such a situation is shine hope on the situation while agreeing with the elements of their spirituality, this way the patient may find it easier to cooperate (Culture Clues, 2007).
Magic and religious beliefs
In the Korean society religion plays a major role and thus it is inseparable from the patients’ well-being. For most of the Koreans there are a number of religions that can be said to be crucial among them; Christianity, Buddhism, Confucianism, Islam and even traditional shamanism. Religious beliefs form part of the Korean culture, where they believe that there is always a divine power above what they able to see or feel. As such, when a patient comes to the hospital they may show signs of religious beliefs some of which may override the medical practices. It is also important to note that, white chrysanthemums can never be brought to the patient’s rooms, given that they are widely used during funerals. According to the Purnell’s model, spirituality is one of the domains that the health practitioners have to understand for them to be culturally competent. It is common for patient to practice some of the beliefs in light of disease as they seek divine intervention from their god. It is crucial for the medical practitioners to appreciate the aspect of spirituality as to the patients it gives meaning to life. Korean patients may be seen to wear religious symbols while in hospital as a sign of their faith.
For the medical teams it is crucial to respect these elements unless they are a hindrance to care, such as wearing on infected areas that could easily get worse or affect the treatment. Some of the Koreans that believe in the power good luck, happiness and protection among others, may also be seen to wear amulets as a sign that they are seeking better health (Purnell, 2005). They may use prayers, such as the Tongsung kido, as a way to connect with their god and even ancestors. When the family members are visiting, the medical teams may expect that the visitors are going to say a prayer as they seek the wellbeing of their patient. Sometimes the prayers are loud, such as the Tongsung kido and the medical team relative to the hospital setting and rules may be forced to issue out directives in light of the safety and comfort of the rest of the patients in the wards. For the patient, this is a genuine effort to get well and unless it is interfering with the health care that the givers are offering, it is important to respect their beliefs. While to the medical teams some of these beliefs may seem bizarre and even unproductive, it is important to note that to the patient they have subtle meaning and thus it is crucial that their beliefs are respected (Culture Clues, 2007). This is mostly the case with Koreans that living in the rural areas and with limited education backgrounds.
Responsibility for health
Given the tight ties that the Koreans have to their family members, the care of the patient rests on the entire family. The responsibilities that come with making crucial decisions however rest with the respected members of the family. In most cases, a family may rely on the eldest sons, husbands, fathers and even guardians for counsel. This means that the family member that is give the power to oversee all the aspects of the family affairs is also going to play a major role in the responsibility of the patient, however, the entire family take the responsibility of the patient in the guidance of the leader. This is also reflected on the need for the medical teams to understand this aspect from the family roles domain in the Purnell’s model. Consulting with the patient without the guidance of the family leader is only going to be counterproductive in some of the cases, as the decision will still have to be run through the elder before the patient or the family members can agree to go forward. For the medical teams, it is easy to see it in the light that one is just trying to look out for the patient, but to the family it may seem as the medic is rude. This can thus easily escalate into poor patient outcomes given the level of respect that is held among the Koreans. In some of the cases, when the head of the family makes a decision, it cannot be contested and thus as a medic one has to be very cautious and address the issue with a lot of calm and reason without rush, reprimand or judgment (Lipson & Desantis, 2007).
Transplantation
This is an issue that remains controversial in most of the cultures and not just the Koreans. In that light, the Koreans believe that the body should always remain intact. This means that aspects of transplanting an organ from one person to the other, is viewed as highly invasive and unnatural. As such, where a medical team may have been considering transplantation, it is likely to be met with sharp resentment. Even medical practices that can be considered invasive also meet the same criticism among most Koreans. Where patient agree to such medical practices, it is likely to be met with a lot of fear and anxiety and thus it is up to the medical team to calm the patient and explain to them that the procedure is only going to make them better (Purnell, 2005). Most of the Koreans that are educated however may not hold the same feeling and attitude towards these medical practices (Warner, 2005). It is important for the health care providers to understand these aspects and try to explain to the patient and the head of the family the need for the transplantation against the odds of the patient remaining with the disease organ. Showing that one understands and respects their position is going to be much easier than forcing the issue to which they are already resistant.
Rehabilitation/chronicity
Given the family ties and the religious believes among most of the Koreans, the issues of terminal illnesses can also be quite dicey. In most of the cases the Koreans would respect that the family members are informed of the terminal illness and the need to rehabilitate (Warner, 2005). This can then be discussed among the family members before the news and the decision are then passed on to the patient. As such, medical teams need to understand this aspect and respect the flow of information between the family members and the patient (Purnell, 2005). In case the patient is likely to die from the terminal illness, most Koreans will prefer that the patient dies at home in their care. In case the medical team is considering the option to prolong the life of the terminally ill patient, it is also crucial to consult with the patient as this is an aspect that is prohibited by religious beliefs (Warner, 2005).
Self-medication
Self-medication is one of the aspects that are quite crucial es...