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Cultural Competence. . .from the Patient’s Perspective

The term cultural competence is finally starting to become common parlance in the nursing profession. Although various definitions of cultural competence exist, when minority health experts talk about “culturally sensitive care” most nurses pretty much understand what this means. But how do patients--especially patients of color--define cultural competence? What exactly does culturally competent health care mean to them, and how do they want clinicians to provide it?

To answer these questions, a research team funded in part by the Agency for Healthcare Research and Quality (AHRQ) conducted a series of 19 community focus groups with racially and ethnically diverse health care consumers. The groups included 61 black participants, 45 Latinos and 55 non-Latino whites. As reported in the Healthcare Intelligence Network’s online newsletter Healthcare Daily Data Byte, some of the study’s key findings were:

• Definitions of culture common to all three ethnic groups include value systems (25% of focus group comments), customs (17%), self-identified ethnicity (15%), nationality (11%) and--surprisingly--stereotypes (4%).

• All three groups cited the following as cultural factors that either positively or negatively influenced the quality of health care encounters: clinicians’ sensitivity to complementary/alternative medicine (17%), health insurance-based discrimination (12%), discrimination based on social class (9%), ethnic concordance of clinician and patient (8%) and age-based discrimination (4%).

• Differences between the minority and the white participants’ responses emerged in several areas. Only the black and Latino participants cited the following as important cultural factors: ethnicity-based discrimination (11%), clinicians’ acceptance of the role of spirituality (2%) and of family (2%). Additional factors specific to Latino respondents were language issues (21%) and immigration status (5%).