Cultural Safety PDF

**[Culture]** -- pattern of many concepts, beliefs, values, habits, skills, instruments, and art of a given group of people in a given period of time. **[Multicultural Communication]** -- the ability to communicate effectively with individuals of other cultures while recognising one's own personal...

**[Culture]** -- pattern of many concepts, beliefs, values, habits, skills, instruments, and art of a given group of people in a given period of time. **[Multicultural Communication]** -- the ability to communicate effectively with individuals of other cultures while recognising one's own personal biases and prejudices and putting them aside. **[Barriers to Multicultural Therapeutic Communication]** Lack of knowledge Fear and distrust Racism Language Perceptions and expectations **[Barriers to Multicultural Therapeutic Communication]** **Bias**: a slant toward a particular belief. **Prejudice**: opinion or judgement formed before all facts are known. **Ethnocentrism**: belief that one's own culture and traditions are better than others' **Stereotyping**: attributing unvarying description or pattern to a person without allowance for individuality. **[Microaggressions]** Everyday verbal or behavioural interactions that send negative, harmful messages and insults toward minoritized people. *3 Ways to Stop* 1. Educate Yourself 2. Reflect 3. Act **[Low Context Communications]**: lots of detail with words, mainly language focused. **[High Context Communication]**: greater reliance on body language, references to objects in environment, culturally relevant phrases. **[Types of Medicine]** 1. **Western Medicine** - Bacterial/viral infusion - Symptoms and tests lead to diagnosis - Treatment: pharmacologic and surgical 2. **Holistic Medicine** - Personal accountability for one's health. - Body can heal itself. - Balancing mind, body, spirit with environment - E.g acupuncture, biofeedback, chiropractic. 3. **Oriental Medicine** - Balancing opposing energy states (acupuncture, meditation etc.) 4. **Folk Medicine** - Home remedies without scientific support - E.g herbalists and spiritual healers.    Sikhs may carry small ceremonial sword (kirpan) on their body, one of five articles of faith. - Remaining articles are kesh (uncut hair), khanga (comb), karra (bracelet), kachha (a pair of shorts. Some Catholics -- "Sacrament of the Anointing of the Sick (formerly known as Last Rites) **[Indigenous Peoples (Canada)]** Refers to First Nations, Métis and Inuit PEOPLES Original inhabitants of the land that is now Canada. Over 1.67 million people identify as Indigenous (4.9% of Canadian population) Ontario has the largest indigenous population in Canada, which represents 2.8% of total Ontario population. 78% of First Nation communities in Ontario are located in Northern Ontario ¼ First Nation communities in Ontario is a remote community, accessible only by air year-round or by icy road in the winter. **[State of Indigenous Health]** 1. Infant mortality rates range from 1.7-4x more than indigenous population. 2. Youth (1-19 years) death rate in Inuit homelands is 188 per 100,000 vs 35.5 per 100,000 in the rest of Canada. 3. First Nations people have almost 2x rate of diabetes than non-Indigenous population, as well as ↑ rates of cardiovascular disease, cancer, infectious diseases (TB), and mental illness. 4. First Nations people 6x more likely to have alcohol related death and 3x more likely to have drug-induced death. 5. Overall suicide rate 2x of total population (Inuit 6-11x population). **[Barriers to Health Care for Indigenous People of Canada]** 1. Accessibility - Rural, remote, ↓ population - Non-insured health benefits - Potential travel cost 2. Availability - Not available in area - Not available when needed. 3. Acceptability - Mistrust of institutions - Racism, lack of knowledge, language **[Cultural Protocols You May Encounter]** 1. Death - May not use name/image of deceased. - Referred by relationship to family. - May refuse autopsy and desire deceased return home ASAP for ceremonies. 2. Tobacco - Considered sacred medicine. - Offered when making a request of an elder or community member. - Acceptance of gift signifies agreement to fulfil request. 3. Smudging - Used to purify a person/space, clearing negative energy. - Herbs (sage, tobacco, cedar, sweetgrass or combo) are placed in abalone shell or clay bowl then lit. - Flame blown out to smoulder. - Smoke wafted over hands, eyes, ears, and heart to wash oneself. 4. Sweat Lodge - Dome shaped, made of natural materials. - Heated rocks - Putrification ceremony led by elders for praying and healing. **[Intersectionality]**: a theoretical framework that reveals and recognizes the ways in which identity categories overlap to produce unique experiences of discrimination and oppression. **[LBTQ2S+]** Lesbian, Gay, Bisexual, Trans, Queer, 2-Spirit 1. Lesbian - Woman whose enduring physical, romantic and/or emotional attraction is to other women. 2. Gay - A person whose enduring physical, romantic, spiritual, emotional and/or sexual attractions are to people of the same gender. Can refer to men or women (women may prefer lesbian). 3. Bisexual - A person who is emotionally, physically, spiritually and/or sexually attracted to people of more than one gender, though not necessarily at the same time. 4. Trans - Umbrella term referring to people with diverse gender identities and expressions that may differ from stereotypical gender norms. 5. Queer - Umbrella term that implies "not straight" more than it implies what exactly someone's sexuality might be. - Used by many as political term. 6. 2-Spirit - Cultural and spiritual identity used by some Indigenous peoples to describe having both masculine and feminine spirits. - Cn include people who are gay, lesbian, bisexual, trans or intersex. - Can describe a societal and spiritual role that people played within traditional societies, as mediators, keepers of certain ceremonies, transcending accepted roles of men and women, and filling a role as an established middle gender. 7. Non-Binary - A gender identity that embraces a wide range of expressions that move beyond the gender binary. **[Gender Identity vs Expression]** 1. Gender Identity - Each person's internal and individual experience of gender. Sense of being a woman, man, both or neither. Sense of self is separate from sex assigned at birth and not related to sexual orientation. Internal and not visible to others. 2. Gender Expression - How a person publicly presents or expresses their gender including behaviour and outward appearance such as dress, hair, make-up, body language, voice, chosen name and pronoun. **[Statistics]** 21% of trans people avoid the emergency room b/c of they were trans. 52% of those who have accessed emergency health services had negative experiences due to being trans. 20% trans Ontarians seeking hormones were denied a prescription. 77% of trans people experience disproportionately high rates of suicidal ideation and attempted suicide. **[Ways to Mitigate Negative Experiences]** 1. Introductions 2. Focus on Care 3. Disclose only what information is required to others. 4. Stay up to date and become more knowledgeable. 5. Only ask questions relating to the current situation 6. Clarify if needed. 7. Assessment findings -- language 8. Common hormone therapies 9. PrEP vs PEP 10. Patient advocacy **[Therapeutic Approaches to Different Cultures]** 1. Learn as much as possible about the culture's communication style. 2. Approach slowly and respectfully, avoid touching until you have assessed the cultural situation. 3. Respect personal space. 4. Listen for key words and utilize them in your responses. 5. Observe mannerisms respectfully. 6. Interview PT to discern any cultural barriers to medical care.