Cultural competence in Occupational Therapy - Essay Example

Mini Literature Review

Why is cultural competence important in OT practice when working with Aboriginal and Torres Strait Islander (ATIS) people?

Introduction

Cultural competence proves an essential element in the delivery of Occupational Therapy (OT). Its occurrence in research that focuses on OT prompts the need to understand its application in a practice. It influences an understanding of the ethical implications cultural competence has on the delivery of services to patients such as Gerald. The study further reveals culture is living and OT occurs as a culture on its own. Gerald as a Torres Strait Islander provides an example of an Aboriginal person that is sensitive to their culture. The management of a patient as Gerald requires that the therapist has a high level of cultural competence which includes being aware of their cultural needs and understanding the approaches to implement in addressing challenges arising in practice as it prepares the personnel for diversity. In this part of the literature review, the research focuses on examining the literature on cultural competences and its contribution to OT practice when handling Aboriginal and Torres Strait Islander people such as Gerald.

Results and Implications

According to Matteliano & Stone, (2014), cultural competence refers to that framework that involves “being, doing and knowing” those cultures, customs and beliefs of those people that one serves as in this case the Aboriginal Torress and Strait Islanders as pictured in figure 1. It involves the presence of authenticity and awareness with relation to the values of the people the OT personnel serve.

In the above figure, cultural competence or cultural capability is explained with knowing focused on the understanding of the different cultures, beliefs, and customs of the people. Being covers the element of awareness, openness, and authenticity which also involves the examination of the values and beliefs of the OT practitioners Australian Government, (2015). Lastly, doing focuses on the actions considered culturally appropriate.

According to the Royal Australian College of General Practitioners, (2012), the cultural diversity of the ATIS has constantly resulted in an effect in the management of their health. It further affirms that the improvement of the health of the ATIS remains one of the top priorities of the Australian government despite continued difficulties arising from the cultural elements of this group of people. The journal provides an understanding of the cultural diversity of the ATIS people hence providing a contribution to the subject by improving the understanding of OT personnel on the approaches to employ in handling this group of Aboriginals which provides cultural competence. In addition to the above, affirms that the aboriginal people including the ATIS have developed a cultural diversity over the years that have contributed to the existing differences in their health determinants and the health systems they believe in or tolerate. The authors focused on identifying those elements considered determinants of health for the Aboriginal people to provide a comparison to the non-Aboriginals. details that diversity has over the years increasingly become the hallmark of OT and hence emphasizing the essence of embracing it in practice to improve the delivery of healthcare services to the culturally diverse communities. The works of these authors contribute to an understanding of the health needs of the ATIS people which further improve the cultural competence of the practitioners involved ultimately improving OT.

Numerous approaches may provide support to a work environment of OT in understanding and implementing approaches that promote an understanding of cultural diversity. identify clinical reasoning as one of the contributors of complications in OT. In their study, they involved twelve different practitioners working in fields that dealt with mental and physical dysfunctions of their patients in which they identified three essential clinical reasoning issues that affect healthcare. These included the beliefs of the clients they handle, the values and beliefs of the therapist, and the attitude that the society has on disability. The contribution of these to OT is similar to that identified in the case of disability. The belief of Gerald was instrumental in determining their response to OT. The beliefs and values of the practitioners also were central to the relationship between Gerald and the practitioner while the societal beliefs also contributed to the environment and the belief that the Aboriginal people have constantly employed in handling their health situations. on the other hand, emphasizes cultural competency in the OT by advocating for an understanding of the illness experiences that the patient carries and integrating them into the therapy process. In addressing challenges arising in practice and professional education for Occupational Therapist requires the creation of cultural competence in the work environment which will promote cultural competency.

Why is client centredness important in OT practice (e.g working in a hospital setting)?

Introduction

In the development of practitioners to work in the field of OT, the focus has been emphasized on the collaborative component of the practice that the OT practitioners need to have. The shift from this approach to a more client-centered collaborative approach has been advocated for by numerous scholars to improve OT practice. Working in a hospital setting in handling a situation as that of Gerald requires that one employs an approach that is centered on the client to deliver quality care that provides positive results. The literature review below focuses on examining the importance of client-centered approaches in a hospital setting in the delivery of OT.

Results and Implications

Dominant ideologies

In a study conducted by , critical thinking was revealed as an essential contributor to understanding the different ideologies of patients to eliminate the application of dominant ideologies of the practitioners. In the situation of managing cultural diversity, the application of critical thinking as advanced by Hammell focus on the promotion of critical thinking in choosing the approach to employ in addressing cases. In another study conducted by , support to the above critical thinking perspective is provided by examining the client-centered nature of the healthcare setting. Rebeiro employs interviews with those clients that obtain mental health services to reveal the experiences they have with OT practice that is hospital based. The interviews revealed that the prescription of the activities was one of the challenges that client-centered approaches suffered. The absence of choice and the much-advocated illness that the OT practitioners pay to the illness and not the individual are considered as failures in a client-centered approach. Implementation of a client-centered approach will aid in, therefore, understanding the individual obtaining OT services hence improving the ability of the practice to be effective. Understanding the individual will also improve the elimination of the dominant ideologies and promote the focus on workable ideologies that will improve patient-practitioner relationships.

Improving Perceptions of Client-Centered Approaches

examines the perceptions that the clients and the occupational therapists have regarding the application of a client-centered approach in addressing OT issues. The study was conducted through an interview with 30 clients and 11 OT practitioners revealing the practitioners employed a client-centered thinking while their clients indicated to mixed perceptions on the role they are supposed to play in promoting this approach. The clients indicated no competence of the approach in the working place. Changes in the perceptions of the clients are indicated to provide positive implications for the study with the focus on the development of the practice in the working environment arising from positive perceptions. In support of the above, affirm that the development of respect for those people seeking OT services and partnering with them improves the nature of services offered also improving the client-centered approach. The development of positive perceptions of the practitioners and the clients on the same has an impact on the outcomes obtained in the delivery of OT services. Also, the application of a client-centered approach in delivering OT contributes to the improvement of care for children with the association between the parents and the practitioner. Improving the perceptions will also include the promotion of positive perceptions on the parent practitioner relationship which is essential in handling pediatric cases of OT nature.

Relating to Gerald’s Situation

The development of a client-centered approach in addressing cultural competence issues would aid in handling Gerald's situation. The development of this kind of environment would ensure highly sensitive OT practitioners aware of the cultures, values, and beliefs of Gerald hence increasing their efficiency in handling his case. The presence of culturally competent professionals in the hospital setting will also ensure that nurses understand the three elements proposed by Australian Government, (2015) that emphasizes the being, doing and knowing aspects. The nurses will know the cultures, the history, beliefs, and custom of Gerald. The being part also emphasizes the being part in which the authenticity of the cultural competence is enhanced by the beliefs of the nurses. Lastly, the doing part will see the OT practitioners put their knowledge on Gerald's cultures into practice hence improving the quality of services they provide to him and others.