Global Applications of Culturally Competent Health Care: Guidelines for Practice ed. by Marilyn "Marty" Douglas et al. (review)

Population diversity characterizes many countries, and diversified workforces have become noticeable on the managerial level, which affects the medical field. However, there is limited discussion of this issue from a health care perspective. This compilation, Global Applications of Culturally Competent Health Care: Guidelines for Practice, complies with the Guidelines for Culturally Competent Health Care endorsed by International Councils of Nurses to advance reductions in social inequality and the maintenance of health equity, and shares practical and clinical experiences in putting guidelines into practice. One set of goals of culturally competent care are to achieve decreases in hospital readmissions, length of stays in hospital, and revisits to the emergency department, as well as eventual improvements in health outcomes.

Widely covering the Guidelines in its 10 parts (totalling 43 chapters), this book comprehensively elucidates the sophisticated skills used by health care professionals pertaining to their cultural knowledge, multicultural communication abilities, critical reflection capability, cross-cultural leadership manifestation, culturally competent health care implementation, allowance of patient empowerment, and sufficient training connected to these guidelines. It also articulates the importance of organizational resources and multicultural manpower in assessing the success of this health care model. Additionally, advocating research on culturally competent interventions, it promotes evidence-based studies that support the applicability of the Guidelines. The structure in each part contains a theory chapter and three or four case studies that exemplify cultural and social-structural factors, and subsequently propose culturally competent strategies for individual, organizational, and community-level interventions. In some cases, they also specify the role of human rights within a culturally competent health care system.

This compilation highlights marginalisation within health care systems related to underserved (such as ethnic minorities and immigrants) and underprivileged (for example, the poor, sexual minorities, and victims of abuse) groups. In order to ensure extensive coverage, the authors of this book hail from North America, Asia, Europe, and the Middle East, enabling the editors to unveil the afflictions and hurdles caused by health inequalities that exist commonly across different continents. In particular, one autobiography (chapter 37) narrated the experience of a girl born in Sierra Leone, and how difficult it was to become educated in the nursing service in a country where females are normally excluded from schools.

Summarizing suggestions from the authors, this compilation elaborates on collective wisdom from various dimensions. A macro view associated with environmental factors contributes by not only providing a culturally safe context that reduces patient fear, but also providing culturally responsive community resources that ensure adequate patient supplies. Equally important, micro domains emphasise practitioner attributes and empowerment. The former requires a compassionate mindset and multifaceted skills such as humour, respect, empathetic understanding, interactive patient-practitioner relationships, cross-cultural leadership, cultural congruence, and psychoeducation. The latter allows for patient autonomy and informed decisions, as well as fostering collaborative engagement. In addition, alternative rapport is inseparable from supportive services such as peer groups and the buddy system, traditional medicine and healing measures such as adjunctive therapy, religious coping or spirituality, health advocacy, and financial assistance. All these aim at approaching an individual comfort level and generating solutions that fit individual needs (that is, individualized patent care).

With its macro and micro analyses of social and personal factors, this book sheds light on the importance of cultural sensitivity in modern medical organisations. Awareness of cultural diversity reaches professional quality when it helps the practitioner serve patients best, both physiologically and emotionally. It is necessary for health care specialists to enrich their conscious and unconscious cultural competence as an integral part of their practice, and to be well trained in counselling techniques.

Although this book attempts to embrace diverse cultures, it seemingly inclines more towards Muslim cultures and pays limited attention to Western and...