Culture: the impact on health care

Cultural and ethnic issues are not examined in traditional health care professional education. Our experience in providing care for terminally ill cancer patients in their homes in a multicultural metropolitan area has demonstrated repeatedly the importance of these issues. They can help us to understand how illness is perceived, who provides care, how it is provided, and how health care professionals are accepted. In order to sensitize health professionals to important health/cultural values, a multicultural resource center in our city invites lecturers to speak on health related issues, ranging from nutritional attitudes to religious taboos. Workshops geared toward specific disciplines are available at another resource center. Inservice education on palliative care, offered one hour a week, is one method of highlighting cultural issues for the staff. General nursing rounds, presented once a month for the hospital, is another, as is the hospital nursing journal, which has a column for multicultural contributions. A complete cultural assessment is anthropologically oriented, but a shortened version, dealing with the family hierarchy of power, a cultural/medical assessment, and an awareness of general behavioural differences can help bridge the cultural gap. This paper will present a practical model of cultural assessment that can be used by health professionals. It will suggest simple interventions that can be incorporated in a health care plan.