Concept | Features | Adverse consequences |
---|---|---|
Cultural Safety | · Health professional are self-aware of their ontology, epistemology and axiology. | Actions that diminish, demean or disempower the cultural identity and well-being of an individual is unsafe clinical practice [3, 4]. |
· An environment that facilitates and nurtures relationships | Patients viewed the medical system as cold, indifferent and inflexible [2] | |
· Health services do not comprise the patients legitimate cultural rights, views and values.” [1] | ||
· High staff turnover [2] | ||
(Mis) Communication | · Language (verbal and non-verbal), | · May result in misdiagnosis; ineffective and inefficient clinical management; and marginalisation of the patient 6–8. |
· Rules, conventions and etiquette; | ||
Communication between the community primary health care provider and the tertiary institution [5] | · An inefficient model of care i.e. ‘no shows’ in patient travel and patient has limited understanding of their clinical care [5]. | |
(Dis) Empowerment | · A distressing patient journey [5] | · Patients feel disempowered, discriminated by their race and clinicians show a lack of empathy toward them [2, 3, 5]. |
· Financial burden | ||
· Language barriers | ||
· Lack of culturally appropriate resources | ||
· Inadequate pre-operative preparation and post-operative follow-up. | ||
(Mis) Trust | · Informed by a whole of life experience; which included systemic oppression and discrimination with societal institutions (particularly justice and education settings). | · In response to racist treatment people felt ashamed, humiliated, powerless and fearful; which in turn contributed to the lack of trust [3]. |
· In an individual encounter. | ||
Biomedical Model | · The dominance of medical language used to explain clinical diagnosis, management and long-term care. | · Removes the opportunity to construct a shared understanding of health care [20]. |
· Marginalisation of the patience preferred language or knowledge [2, 20]. | · Patients feel alienated and less likely to participate with the recommended care [16] |