PSYCHOLOGY

Multicultural Perspectives

Introduction:

Regardless of race, culture and beliefs, everyone needs medical care when he or she unwell. Most communities are multicultural and diverse and America is no exception. It has citizens from different backgrounds all living together in one society. Though they live as one, their differences must be recognized in order for their special needs to be catered for. Communities living in the United States include Asian Americans, Hispanics and Latino Americans, Middle Eastern Americans, conservative Christians and the gay and lesbian community. Due to differences in culture and diversity among populations, healthcare has to be dynamic enough to accommodate these differences (Ekmam and Emami, 2007). Health care givers should develop awareness of different cultures to avoid forcing their beliefs on others. In present times, provision of health care suited to the culture in question has become one of the basic human rights. In addition, failure to provide this has led to numerous lawsuits. There are many ways of dealing with mental or physical health delivery services in a clinic in relation to three groups of people namely Asian Americans, conservative Christian individuals and the gay and lesbian community.

Discussion:

Asian Americans are in dire need of mental health. The stress of having to leave their homes and adapt to a new environment, learn English and find stable jobs challenge their mental welfare. In an attempt to mitigate these effects, such individuals may end up in drug addiction, alcoholism, or worse yet, suicide. Among the Asian American community, HIV/AIDS is not openly discussed. Those affected or infected by it would rather keep silent than seek medical and psychological help. This is attributed to their background marred with ignorance of the disease and stigma against those infected by the disease.

            Asian Americans may also be denied access to health care based on race (Shevrin, Shilpi and Rey, 2009). Racism is a prevalent vice in our society and is used as an excuse to discriminate against those who are not of the same race as others (Gee, 2008). Among Asians, women have always been considered part of men’s property. Even when they migrate to the United States, they still carry this belief with them. The women are then subjected to battering, eventually leading to broken homes. Family counseling becomes an integral part of Asian American families in a bid to salvage the family as a unit.

Among the Asian American community, smoking is one of the leading causes of diseases, imbalance in blood pressure and death. Findings show that a greater proportion of tobacco advertising in America is in Asian populated areas, and less in white dominated areas. As explained above, this habit may have its roots in depression in searching for jobs and settling into the new environment. In the same manner, counseling against the abuse of tobacco should be targeted to the Asian American community.

When it comes to Conservative Christians, they hold strong opinions on methods of family planning. To them, it is equivalent to interfering with the natural process of fertility, and hence abortion. This belief is commonly known as the Quiverfull movement, advocates that one should have as many children as possible as they are a sign of blessing. Instead of health care providers looking down on conservative Christians as uncivilized, they should spread awareness on how family planning works and its importance. Conservative Christians should have the knowledge that family planning methods prevent fertilization rather than killing an already forming zygote (Ashcroft, Dawson and Draper, 2007, p.104).

The gay and lesbian fraternity faces intolerance in the society because of their sexual orientation. They are not considered as normal human beings, in turn being denied access to human rights such as equal opportunities to employment and basic health care services. Reasons for this could be homophobia, or just plain discrimination (Clarke, Ellis, Peel and Riggs, 2010). It is the duty of health care givers to provide services to every individual regardless of their sexual orientation, as they too are part of society.

Guidelines for providing health care in a culturally diverse society

• Awareness- Health caregivers are most likely to assume that everyone else is like them in terms of belief systems and culture. A white physician is likely to treat an Asian American in the same way he will treat a white patient. He will treat a Conservative Christian the same way he handles a patient of liberal views, and will treat a homosexual as though s/he were heterosexual. Physicians should be made aware of the disparities among the population before handling their patients.
• Individuals should be treated as such rather than be generalized to be like every other person. A method that worked on one individual will not necessarily work on another, negating the application of a blanket solution. For example, pre-marital and family counseling for the gay/lesbian community will greatly differ from that given to heterosexual couples. This category is unable to have children by themselves and one of the options available to them is adoption.
• Language barriers should be bridged. This is particularly so when dealing with the Asian American community. This group has limited knowledge of the English language. While talking to them, it is important for the health care giver to try as much as possible to understand the patient’s problem in order to prescribe the correct treatment. Asian Americans are susceptible to depression arising from the stigma and racism they face in the American society. Because of this, mental care becomes a critical component for their well-being.
• Foreign accents- Health care givers should not have a negative attitude towards Asian and other foreign accents. The health specialist’s mind should be broad enough to recognize and accept different cultures as they are. Looking down on a patient solely because of how they talk will discourage them from stating their health problem and they may never return for further medical check up in future.
• Beliefs- Conservative Christians have their own beliefs when it comes to health. Some are of the opinion that medical intervention to cure ill health should not be allowed. In such cases, instead of forcing treatment on someone, the health care giver should take time to explain the gravity of the illness and the consequences of not taking up treatment. Others are against the use of contraceptives as a way of family planning, and should be understood and counseled accordingly.
• In providing health services, the concept of equality among all must be applied. Discrimination in society comes about due to differences in religious beliefs, cultural or background, and sexual orientation, among others (Blustein, 2008). More often than not, homosexuals are denied access to health acre, yet they may be the one needing the service the most. Research findings show that gay men are more pre-disposed to contracting the AIDS virus compared to their heterosexual counterparts. They are the ones in great need of counsel on how to avoid contracting the disease, or ways of managing the disease if they already have it.

Another perspective in regards to equality is having all health care centers catering to everyone as opposed to having different centers for the different groups of people (McIntyre and Mooney, 2007).

• Assumptions- In many cases, health care giver givers draw conclusions on what a patient needs without getting a comprehensive explanation from the patient himself. The physician may end up with a misdiagnosis by relying purely on his own judgment. This can occur particularly with the Asian American community where language may be a barrier. A way to solve this problem is by having a translator to act as a bridge between the patient and the caregiver. His work will be to convey the patients’ problems and treatment preferences to the caregiver and relay the caregiver’s recommendations to the patients.
• Respect- It is part of human nature to judge those who hold different beliefs and cultural practices. Health care givers however must resist this tendency and attempt to respect diversity in culture. They need not necessarily agree with the different views but should demonstrate tolerance for divergent ideologies. For instance, among the Asian American community, it is not recommended for a female patient to be treated by a male physician and vice versa. As a sign of respect, female caregivers should tend to female patients, and likewise, male care givers to male patients.
• Understanding- It is imperative that the health care provider understands his patient’s rationale for saying what he is saying. This goes hand-in-hand with respecting the patient’s vies without having to agree with them. Before the two parties can reach an understanding, the physician must understand the basis of his patient’s argument and then advise him from there. A good example is when a Conservative Christian is against the use of contraception, claiming it to be a form of abortion. The health care provider’s task will be to enlighten the patient on the pros (and cons) contraception.
• Homophobia- A physician, though afraid of homosexuals, should be able to put his phobia aside and look into the well-being of his gay or lesbian patients. Failure to do this might cost the health care giver his operating license. This is tied to tolerance and the principle of equality. With this in mind, homosexuals can be accorded the right to health care. If a caregiver cannot overcome this fear, he should hand over the patient to another physician rather than turning him away completely.
• Choice of health care- Before patients visit a health care giver, they usually already have a preferred choice of health care ranging from mode of administration of treatment to whether or not they should be admitted in the hospital. The health care provider should as much as possible be willing to accommodate the patients’ wishes and beliefs while giving the required medical attention.
• Provision of alternative modes of treatment- In the event that the patient is completely against the mode of treatment to be administered by the health care giver, it is the physician’s obligation to inform his patient on other existing forms of treatment. In this way, the patient is not forced to go through an undesirable experience but will still recover to good health.

Conclusion

If not properly looked into, cultural disparities are likely to lead to misunderstandings among people from diverse cultures. A caregiver, in providing health services to a patient, may be conflicting with his patient’s beliefs. Cross-cultural understanding will ensure that the physician properly grasps the needs of his patient, who in turn will be more willing to stick to the treatment plan prescribed. Ultimately, more people will be health and there will be a reduction in the number of legal suits involving health issues.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References:

Ashcroft, R.E., Draper, H. and Dawson, A. (2007). Principles of Health Care Ethics. New Jersey: John Wiley and Sons.

Blustein, J. (2008). Who is Accountable for Racial Equity in Health Care? The Journal for the American Medical Association. Retrieved from http://jama.ama-assn.org/content/299/7/814.extract

Byrd, W.M. (2010). Race, biology, and health care: reassessing a relationship. Journal of Health Care for the Poor and Underserved, 1(3), 278-296.

Clarke, V., Ellis S.J., Peel, E. and Riggs, D.W., (2010). Lesbian, Gay, Bisexual and Queer Psychology: An Introduction. London, UK: Cambridge University Press.

Ekman, S.L., and Emami, A. (2007). Cultural diversity in health care. Scandinavian  Journal of Caring Servives, 21(4), 417-418.

Gee G.C., (2008). A multilevel analysis of the relationship between institutional and individual racial discrimination and health status. American Journal of Public Health. 98, S48-S56). Retrieved from http://ajph.aphapublications.org/cgi/content/abstract/98/Supplement_1/S48

Leiyu, S. and Singh, D.A. (2008). Delivering health care in America: A systems approach. MA: Jones & Bartlett Learning.

Marcias E.P. (2010). Journal of Health Care for the Poor and Underserved, 12(1), 77-87.

McIntyre, D. and Mooney, G. (2007). The Economics of Health Equity. London, UK: Cambridge University Press.

Shevrin, C.T., Islam, N.S. and Rey, M.J. (2009).Asian American Communities and Health: Context, Research, Policy and Action. New Jersey: John Wiley & Sons.