What next?

2021 ◽  
pp. 649-650
Author(s):  
Dinesh Bhugra
Keyword(s):  
Health Care ◽  
Cultural Competence ◽  
Curriculum Development ◽  
Cultural Values ◽  
Health Professionals ◽  
Explanatory Models ◽  
Service Planning ◽  
Therapeutic Engagement ◽  
Planning Development ◽  
Culturally Appropriate Services

Migration occurs for a number of reasons and there are various stages and types of migration. These experiences are heterogenous and require different approaches. This chapter includes recommendations for service planning, development, and delivery for migrants’ health care. It is important that all health professionals are suitably trained in cultural competence. Explanatory models held by the patients, their carers, and families must be acknowledged and not denigrated. Researchers need to be culturally sensitive, whereas policymakers have legal and ethical obligations to provide adequate resources to deliver accessible and culturally appropriate services. The specific nature of migration and experiences carry with them specific challenges in therapeutic engagement for a number of reasons, which must be understood. Cultural values, nuances, and differences must be recognized and acknowledged. Specific recommendations are made for service planners, clinicians, policymakers, and researchers. Suggestions are made for curriculum development in cultural competence.

scholarly journals Cultural factors and sexual dysfunction in clinical practice

2013 ◽  
Vol 19 (2) ◽  
pp. 144-152 ◽  
Author(s):  
Vishal Bhavsar ◽  
Dinesh Bhugra
Keyword(s):  
Sexual Dysfunction ◽  
Cultural Values ◽  
Help Seeking ◽  
Epidemiological Data ◽  
Explanatory Models ◽  
Cultural Factors ◽  
Child Rearing ◽  
Sex Partners ◽  
Therapeutic Engagement

SummaryAttitudes to sex and the perceived role of sexual activity are very strongly influenced by cultural values. Culturally determined gender roles influence relationships between different-sex partners, and cultural values affect attitudes towards sexual variation. Cultures define what is deviant and from where help is sought. Through differing patterns of child-rearing, cultures also affect individuals' cognitive development, world views and explanatory models of emotional distress. It is critical that clinicians are aware of the role of culture in defining sexual dysfunction and how cultural factors can be used in initiating treatment as well as in therapeutic engagement and alliance. Although epidemiological data on prevalence of sexual dysfunction across cultures are scanty, it is likely that prevalences vary, as will pathways into care and patterns of help-seeking. In this article we discuss the potential impact of culture on sexual dysfunction, and issues that clinicians, whether in specialist or in general services, need to be aware of in assessing and treating patients who present with sexual dysfunction.

Cultural competence in clinical practice

2011 ◽  
Vol 26 (S2) ◽  
pp. 2226-2226
Author(s):  
D. Bhugra
Keyword(s):  
Clinical Practice ◽  
Cultural Competence ◽  
Cultural Values ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Good Clinical Practice ◽  
The Core ◽  
Potential Sources ◽  
Values And Beliefs ◽  
Practice Skills

With increasing globalisation it is inevitable that along with goods, people will move too. Certain psychiatric disorders are more common among some groups of migrants. It is inevitable that there may be a degree of mismatch between the cultural values and beliefs of patients in comparison with their psychiatrists. Every individual has certain cultural values and it is vital that mental health professionals are not only aware of these values but are also conscious of their own values, prejudices and both strengths and cultural weaknesses. Cultural competence is at the core of good clinical practice. Skills and knowledge about other cultures can be learnt and clinicians also need to be aware of potential sources of conflict and sources from where they can gather information and then utilise it appropriately.

EPA guidance on cultural competence training

2015 ◽  
Vol 30 (3) ◽  
pp. 431-440 ◽  
Author(s):  
Meryam Schouler-Ocak ◽  
Iris T. Graef-Calliess ◽  
Ilaria Tarricone ◽  
Adil Qureshi ◽  
Marianne C. Kastrup ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Cultural Competence ◽  
Mental Health Care ◽  
Cultural Values ◽  
Service Providers ◽  
Psychiatric Treatment ◽  
Good Clinical Practice ◽  
Care Needs ◽  
Competence Training

AbstractThe stress of migration as well as social factors and changes related to the receiving society may lead to the manifestation of psychiatric disorders in vulnerable individuals after migration. The diversity of cultures, ethnicities, races and reasons for migration poses a challenge for those seeking to understand how illness is experienced by immigrants whose backgrounds differ significantly from their clinicians. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient's own culture as well as from the perspective of the clinician's cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can improve the effectiveness of psychiatric treatment. To reach these aims, both individual and organizational competence are needed, as well as teaching competence in terms of educational leadership. The WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants list a series of recommendations for policy makers, service providers and clinicians; these are aimed at improving mental health care for immigrants. The authors of this paper would like to underline these recommendations and, focusing on cultural competency and training, believe that they will be of positive value.

Oral health diseases among the older people: a general health perspective

2020 ◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Older People ◽  
Health Professionals ◽  
General Health ◽  
Oral Health Care ◽  
Oral Diseases ◽  
Public Health Professionals ◽  
The Relationship

Background: The relationship between oral health and general health is gaining interest in geriatric research; however, a lack of studies dealing with this issue from a general perspective makes it somewhat inaccessible to non-clinical public health professionals. Purpose: The purpose of this review is to describe the relationship between oral health and general health of the elderly on the basis of literature review, and to give non-clinical medical professionals and public health professionals an overview of this discipline. Methods: This study was based on an in-depth review of the literature pertaining to the relationship between oral health and general health among the older people. The tools commonly used to evaluate dental health and the academic researches of male elderly people were also reviewed. And future research directions were summarized. Results: Dental caries, periodontal disease, edentulism, and xerostomia are common oral diseases among the older people. Dental caries and periodontal diseases are the leading causes of missing teeth and edentulism. Xerostomia, similar to dry mouth, is another common oral health disease in the older people. No clear correlation exists between the subjective feeling of dryness and an objective decrease of saliva. Rather, both conditions can be explained by changes in saliva. The General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP) are the main assessment tools used to examine oral health and quality of life in the older people. The GOHAI tends to be more sensitive to objective values pertaining to oral function. In addition, oral health studies in male elderly people are population-based cohort or cross-sectional studies, involving masticatory function, oral prevention, frailty problems, cardiovascular disease risk, and cognitive status. Conclusion: It is possible to reduce the incidence of certain oral diseases, even among individuals who take oral health care seriously. Oral health care should be based on the viewpoint of comprehensive treatment, including adequate nutrition, good life and psychology, and correct oral health care methods. In the future, researchers could combine the results of meta-analysis with the clinical experience of doctors to provide a more in-depth and broader discussion on oral health research topics concerning the older people.

Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

2019 ◽  
Author(s):  
Ignatius Bau ◽  
Robert A. Logan ◽  
Christopher Dezii ◽  
Bernard Rosof ◽  
Alicia Fernandez ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Literacy ◽  
Cultural Competence ◽  
Health Care Quality ◽  
Care Quality ◽  
National Committee ◽  
Patient Centered ◽  
Organizational System ◽  
Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study (Preprint)

2019 ◽  
Author(s):  
Amelia Hyatt ◽  
Ruby Lipson-Smith ◽  
Bryce Morkunas ◽  
Meinir Krishnasamy ◽  
Michael Jefford ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Professional ◽  
Clinical Setting ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Smartphone App ◽  
Implementation Study ◽  
Pilot Testing ◽  
Effective Implementation

BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. CLINICALTRIAL Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

A Scoping Review of Interventions Aimed at Improving Knowledge, Detection Practices and Management of Dementia among Health Professionals (Preprint)

2020 ◽  
Author(s):  
Krishna Krishna Prasad Pathak
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Health Professionals ◽  
Educational Program ◽  
Best Practice ◽  
Intervention Studies ◽  
Educational Interventions ◽  
Learning Activities ◽  
Inclusion Criteria ◽  
Improving Health Care

BACKGROUND Health professionals (HPs) play a key role in dementia management and detection. However, there is a gap in the literature as to what represents best practice with regard to educating HPs to improve their dementia detection practices and management. OBJECTIVE The objective of this scoping review is to synthesize the aggregated studies aimed at improving health care knowledge, detection practices and management of dementia among HPs. METHODS We searched electronically published relevant articles with inclusion criteria; (1) intervention studies aimed at improving HPs practices concerning dementia care and (2) educational interventions focused on nurses and doctors’ knowledge, detection practice and management of dementia. Twenty-five articles fit the inclusion criteria. RESULTS Collaborative programs of practice based workshops, interactive learning activities with community and multi-faced educational program were the most effective. CONCLUSIONS HPs should be supported to improve their knowledge, tackle behavioural problems associated with dementia, be made aware of services and be enabled to engage in more early diagnosis. CLINICALTRIAL no applicable

Sign in / Sign up

Export Citation Format

Share Document