Cultural Health Care Beliefs and Evidence-Based Care Delivery
To answer this question, it is critical to first define cultural belief and competence in medicine and evidence-based medicine (EDM). EBM refers to the judicious, explicit, and conscientious application of current best care evidence from clinical trials in making patient-based and population-based care decisions (Hasnain-Wynia & Pierce, 2017). Its primary goal is the improvement of care quality via medical care standardization. Healthcare service delivery workers must be culturally competent in medicine by understanding the applicable cultural diversity and incorporating it into the clinical setting. They must also respect the patients’ healthcare behaviors, values, and beliefs. Thus, there has been a significant drive within the US healthcare system that care providers incorporate the knowledge of cultural beliefs when providing evidence-based and patient-based medicine. The reason is that people with different cultural heritages or backgrounds have disparate belief in medicine and Western care practices. Thus, the providers must be culturally competent on the patients’ medical beliefs to offer optimal care. The essay provides a discussion on the cultural healthcare beliefs and practices of people of Indian, Turkish, and Vietnamese heritage and how they influence the evidence-based healthcare delivery.
Arguably, every culture has healthcare belief systems that help in explaining the illnesses’ causes, treatment or cure practices, and the key items or people that needs to be involved during the process. Thus, the more a patient perceives of the patient education as containing some cultural relevance, the more they become receptive to the provided information and open to apply it in their medication process. Unfortunately, most of the Western industrialized societies perceive diseases as an outcome of natural scientific phenomena, and therefore, value the use of medicine and sophisticated technology for disease diagnosis and treatment. In contrast, people from other heritages perceive diseases as an outcome of supernatural powers and occurrences. Thus, they value the use of prayer and spiritual interventions. Furthermore, according to other researches, some societies may use the Western medicines and medical practices so long as they have an underlying comprehension of the working of body and medicine. In other words, medical and medical use’ compliance is significantly affected by culture.
Take the case of people of Indian heritage, for instance. The American Indians and Alaska Natives (AI/AN) are the original inhabitants of North America. The people highly value cooperation and are present-oriented. They also associate spiritual beliefs and family with great value. They relate health to harmonious living with nature. Thus, they associate ill-health with an imbalance between the [super]natural forces and the ill person, not as an imbalance in the individual’s physiological state (Hodgins & Hodgins, nd).
Consequently, Indians often use traditional medicines administered by religious leaders or shamans. In some Indian communities, touch is critical because several traditional medications involve rubbing and massaging by the family member or traditional healer. Therefore, Western healthcare providers are never permitted to touch AI/AN patients, except in handshake.
The Indian’s traditional cultural beliefs have a significant impact on biomedical healthcare decisions. For example, it is nearly impossible to explain the germ theory to the older people, and that asking them questions that would lead to making diagnosis fosters mistrust. The reason is that they are used to their traditional medicine men telling them everything even before they talk. Furthermore, most people find it hard to seek help and take medications for renal failure, diabetes, or high blood pressure.
Similarly, the people of Vietnamese heritage also have cultural beliefs on medicine that significantly affect evidence-based care. For instance, similar to the AI/ANs, the Vietnamese explain mental and physical illnesses through mystical or supernatural powers. They view health as an outcome of a harmonious balance between hot (duong) and cold (am) components governing the bodily functions (Mattson & Purnell, nd). The two are pervasive forces in the traditional Vietnamese medicine practice. Thus, they do not readily accept Western physical and medical healthcare practices, especially in cases where self-disclosure is likely. Consequently, one way to prevent the barrier is first to gain trust.
Furthermore, there are four types of folk and traditional providers that exist in Vietnamese societies. They include the Asian physicians, informal fork healers, various forms of spiritual healers, and the magicians or sorcerers. Although the Vietnamese greatly revere the well-educated and professional people, they significantly distrust any outside authority figure amongst them. However, since mistrust and respect are not mutually exclusive concepts amongst the Vietnamese patients who seek help from Western practitioners, another evidence-based care practice is to support and acknowledge their traditional belief systems.
The people of Turkish heritage suffer from several diseases. Secondly, healthcare providers may find it necessary to evaluate the Turkish immigrants for malaria, tuberculosis, and other related healthcare issues endemic to Turkey. Although the Turks in America are highly modernized into Western influence, their lifestyle is still significantly linked to folk and religious beliefs. Spiritual healers and leaders often assist people with several physical, emotional, and relationship problems. Secondly, and the concept of an autonomy-centered care approach is relatively new in Turkish healthcare systems.
Thus, most patients, especially the young and females, may find it hard to express their care wishes and expectations and know their diagnosis. The Turk tradition demands strict compliance with the paternalistic medical model, which requires that patients comply only with the physician’s opinions and wishes (Thobaben & Kuguoglu, nd). Furthermore, seriously ill patients are needed to conserve their minds and bodies to fight off the disease by preserving their energy. Fortunately, most of the Turks living in the US are fast adapting to the Western healthcare system. Since most American Turks are traditional Muslims, treatment and health teaching approaches should include the identification, prevention, and management of fatigue, hypoglycemia, constipation, bloating, and dehydration, especially during the Ramadan fasting periods. Additionally, healthcare providers should bot remove the Turk’s folk and religious items from the healthcare facilities to improve the patient’s comfort while in the facilities.
There are several evidence-based approaches for a practitioner to be culturally-competent when providing care in societies with people of these heritages and related cross-cultural settings. The first and primary strategy is learning the patients’ cultural traditions that may affect care practices, methods, and behavior. Secondly, it is essential to pay close attention to the patients’ anxiety expression, lack of response, and body language to determine whether they are open to explain their problems and for the medication (Oben, 2020). Third, to gain the patient’s general healthcare expectations and assumptions, it is vital to ask them and their family-members open-ended questions to obtain more information on the topics. Remaining non-judgmental throughout the sessions, and continuously soliciting the patients’ care opinions are other essential strategies.
References
Hasnain-Wynia, R., & Pierce, D. (2017). View Point: Practicing Evidence-Based and Culturally Competent Medicine: Is it Possible? Commentary 1. AMA Journal of Ethics.
Hodgins, O., & Hodgins, D. (nd). Chapter 25: American Indians and Alaska Natives. Retrieved August 10, 2020
Mattson, S., & Purnell, L. D. (nd). Chapter 38: People of Vietnamese Heritage. Retrieved August 10, 2020
Oben, N. (2020). How culture influences health beliefs. Retrieved August 10, 2020, from EuroMed Info: https://www.euromedinfo.eu/how-culture-influences-health-beliefs.html/
Thobaben, M., & Kuguoglu, S. (nd). Chapter 37: People of Turkish Heritage. Retrieved August 10, 2020