Cultural Religious Competence in Clinical Practice

The diversity of religions around the world creates challenges for health care providers and systems to provide culturally competent medical care. Cultural competence is the ability of health providers and organizations to deliver health care services that meet the cultural, social, and religious needs of patients and their families. Culturally competent care can improve patient quality and care outcomes. Strategies to move health professionals and systems towards these goals include providing cultural competence training and developing policies and procedures that decrease barriers to providing culturally competent patient care. If providers and health care systems are not working together to provide culturally competent care, patients may have untoward health consequences, receive poor quality care, and be dissatisfied with the care they receive. The quality of patient-health professional interactions is decreased. Lower-quality patient-health professional interactions are associated with decreased satisfaction in the healthcare provider. In fact, African Americans, Asian Americans, Latinos, and Muslims report that the quality of their care was diminished because of their ethnicity or race. Why should providers and systems be culturally and spiritually sensitive? The Joint Commission (TJC) requires hospitals to be accountable for maintaining patient rights, including accommodation for cultural, religious, and spiritual values. Healthcare professionals and systems must care for patients as whole persons; this includes the body, mind, and spirit.  It is important for healthcare to include the cultural and spiritual needs of the patient. Healthcare professionals should be empowered with the knowledge and skills to respond to the needs of patients and their families at an intensely stressful time. Institutions that seek or maintain TJC accreditation need to demonstrate expertise in cultural and religious competence.  Health systems and healthcare providers are developing strategies and techniques to respond to the religious and spiritual needs of patients and families for a number of reasons. One reason is that, in addition to TJC, state and federal guidelines encourage institutional responsiveness to population diversity. These strategies are essential to meeting the federal government's Healthy People goal of eliminating ethnic and racial health disparities. Patient's beliefs, behaviors, and values are shaped by factors such as ethnicity, gender, language, mental ability, nationality, occupation, race, religion, sexual orientation, and socioeconomic status. Cultural competence is the provider and systems able to understand and integrate cultural intelligence into the delivery of healthcare. The goal of providing culturally competent health care services is to provide consistent quality of care to every patient, regardless of their cultural, ethnic, racial, or religious background. Strategies for improving cultural competence in individuals and systems include: Encouraging family to participate in healthcare decision making. Incorporating culture-specific values into health promotion. Providing cultural awareness training. Providing an environment that allows traditional healers. Providing interpreter services. Recruiting minority staff. When individuals and systems are able to provide a positive environment of cultural competence that meets the religious and spiritual needs of those who are cared for, the outcome for patients improves, and the healthcare system as a whole becomes a more positive environment. Why are religion and spirituality important in healthcare? Religion and spirituality are important factors in the majority of patients seeking care. Unfortunately, health providers may not take religious beliefs into account when they are dealing with difficult medical decisions for patients and their families.  In the history of man, religious leaders and health providers were often the same. Only within recent times has medicine taken on a scientific approach that has resulted in a separation between medicine and religion. The challenge for health professionals is in understanding that patients often turn to their religious and spiritual beliefs when making medical decisions. Religion and spirituality can impact decisions regarding diet, medicines based on animal products, modesty, and the preferred gender of their health providers. Some religions have strict prayer times that may interfere with medical treatment. Healthcare providers should be respectful of a patient’s religious and spiritual needs. Many patient’s anxieties are reduced when they turn to their faith during healthcare challenges. Because many patients turn to their beliefs when difficult healthcare decisions are made, it is vital for healthcare professionals to recognize and accommodate the patient's religious and spiritual needs. Health professionals should provide an opportunity for patients to discuss their religious and spiritual beliefs and tailor their evaluation and treatment to meet their specific needs.