Indian Health Service The Federal Health Program for American Indians and Alaska Natives
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Culturally Sensitive Care
"A fish only discovers its need for water when it is no longer in it. Our own culture is like water for the fish. It sustains us. We live and breathe through it." – Unknown
Cultural Awareness provides a foundation for health providers to communicate with, gain the acceptance of, and find success in the AI/AN communities that they serve. "Let’s say you’re a social worker or psychologist doing an assessment of an Indian person who talks very quietly and keeps their eyes on the ground," says R. Andrew Hunt, MSW, LICSW, a public health advisor in Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services (CMHS). "That can easily be misinterpreted as low self-esteem, depression, or some other problem, when in actuality that person is just showing respect." Captain Hunt, a team of U.S. Public Health Service officers, and American Indian professionals and community members have created a tool to give disaster responders and health professionals a head start on understanding AI/AN cultures. To access, download the culture card from SAMHSA , or to order, call SAMHSA’s Health Information Network at 1-877-SAMHSA-7. Ask for publication number SMA08-4354.
Some general tips for beginning CHRs to remember when visiting with patients are:
- The first meeting is extremely important, as it sets the basis of your relationship.
- Make the patient feel welcome. Be warm and friendly; let the patient know that you genuinely care about their wellbeing.
- Medical terminology may be confusing; use language the patient can understand. If you do not speak the patient's language, do your best to explain yourself and refer them to a CHR who does.
- With the patient's consent, involve their family (and extended family, when applicable.) The family plays a crucial role in the patient's treatment outcome, as family support will promote wellbeing and help speed recovery.
- Treat the patient the way you would like you or your family to be treated.
- Do not rush the patient.
- Advocate for what is best for the patient.
It's important for the health care provider to note that each people has their own cultural preferences for relationships and roles. Native People have their own social norms; however some of these are stereotypes.
- Silence is valued and is not necessarily a negative behavior. Sometimes the patient may require time to think about and respond to a comment.
- People may be more task-conscious as opposed to time-conscious.
- Eye contact is used in varying degrees and should be limited.
- Respect tribal healing ways and the diagnosis, and work to accommodate patient beliefs. CHRs can give their support to traditional healing by respecting the people's ways and not dismissing the beliefs of other peoples.
- Show great respect to the elderly. In many cases, elders are not accustomed to modern healthcare facilities, new atmospheres, noises, unfamiliar caregivers, and treatment types; for many of them it may be their first trip to a medical facility and it is important to ease their minds and explain procedures thoroughly.