Cultural Competency Division Brochure

    In this Issue   (January 2006)

• BMHG:  Sikh Perspectives on Health Care
• BCCQ:  Cultural Assessment
• MHS:  Lecture Series and Video Lending
• In the Spotlight:  Cherie Holodnick, RN, EHS
• National News:  Commonwealth Foundation, KFF, & RWJF

    BMHG    (Biweekly Multicultural Health Generalization)

• The sanctity of life is an injunction, therefore:
  • Assisted suicide and euthanasia are not encouraged.
  • Therapeutic genetic engineering is accepted.
• Organ transplants and blood transfusions are accepted. Furthermore, the Sikh youth are encouraged to become donors.
• When possible, consult the patient and family before procedures requiring the removal of hair.
• Advanced directives are individual choices.
• Maintaining a terminal patient on artificial life support for a prolonged period in a vegetative state is not encouraged. Most Sikhs will probably specify a period of time during which they would prefer to be kept on life support.
• At end-of-life, allow time for relatives and granthi (a spiritual leader) to recite Shabad Kirtan (sacred music).
• When possible, avoid interrupting prayer or meditation when patient care can be delayed.
• When feasible, allow the family and granthi to follow traditions to prepare the body for cremation.
• The body should be cremated expediently, unless the family is waiting for other relatives to arrive.
• There is no contraindication to autopsies.

Sources:
Bhatia, J.M. (2004). "Sikh Perspectives on Healthcare." Multicultural Health Series, UMHS, PMCH, Cultural Competency Division.
Andrews, J.D. (2005). “Sikhs.” Cultural, Ethnic, and Religious Reference Manual for Health Care Providers. (3rd edition). JAMARDA Resources, Inc. Winston-Salem, NC.
Sikh Patient’s Protocols for Health Care Providers. (2001) http://www.sikhwomen.com/health/care/protocol.htm#Practices (accessed 1/05)

* For additional Biweekly Multicultural Health Generalizations, please visit:   http://www.med.umich.edu/multicultural/ccp/bmhg.htm

    BCCQ   (Biweekly Cultural Competency Question)

Q:  Where can I find a tool to better understand what shapes patients' ideas about       health, illness, and disease?

A:  http://www.med.umich.edu/multicultural/ccp/assess.htm#assessment

    MHS   (Multicultural Health Series)

The Japanese Art of "Belly Reading" and Issues When Interpreting for Japanese Clients
Presented by: Jeanette Kibler, MA

Time: January 24, Tuesday from 12:00 - 1:00 PM

Location: MCHC Auditorium
(located on the second floor of the Mott Children's Hospital,
near the Towsley Triangle)

Videoconferenced at:
- Brighton Health Center (large conference room)
- Canton Health Center (large conference room)
- KMS Building (small conference room)

To view a list of multicultural health presentations on videotape available for borrowing, please visit http://www.med.umich.edu/multicultural/ccp/videos.htm.

We look forward to fulfilling your requests!

    In the Spotlight   
    (An excerpt from this participant's 1st Annual Cultural Competency Exchange application.)

Many foreign born individuals do not have any records of vaccines which they may have received in their home country; routine adult recommended vaccines for adults born in the US often differ from those required in other countries; US vaccine names may be unrecognizable; and although they may have been given, an individual may not know they have received the vaccine. For example, many immigrants are vaccinated in immigration centers and are not given any record of the vaccines they have received.

A cultural issue that often occurs is that many of the foreign born clients are not familiar with US vaccines and language barriers make it challenging to explain the need for vaccination. If a vaccine is not required in their home country, they may not understand the need to be vaccinated here in the US.

Fortunately, the Immunization Coalition website provides translations of Vaccine Information Sheets (VISs) in many languages to assist in explaining vaccines. These sheets are information sheets produced by the Centers for Disease Control and Prevention (CDC) that explain both the benefits and risks of a vaccine. EHS clients are better able to identify what vaccines they have had when they see the VIS form in their native language. Therefore, clients are more willing to get the vaccines they need after reviewing the risks and benefits and are less suspicious about strongly being encouraged to get a vaccine that they believe they do not need.

Cherie Holodnick also discovered that Tetanus is not a common vaccine in Asia. With the assistance of the translated VIS, she has been able to review this vaccine with individuals from Asian countries. Another common misunderstanding by individuals born outside the US is tuberculosis screening. Understanding the health recommendations of their clients' home countries can help providers to educate their clients about the health concerns of tuberculosis in the US.

In conclusion, when information is provided in a clients' native language, language barriers are lessened. This then, allows for EHS providers to more easily address their clients' concerns, since both the providers and the clients understand the information provided.

    National News   (Commonwealth Foundation, KFF, & RWJF)

National Standards for Medical Interpreters
Commonwealth Foundation
November 18, 2005
http://www.cmwf.org/tools/tools_show.htm?doc_id=318839&#doc318839

Study Finds Small Differences Between Minorities, Whites in Medical Participation, Suggests Boosting Outreach Efforts
Kaiser Family Foundation
December 6, 2005
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=3&DR_ID=34154

Universal Health Symbols Provide Direction for Many in Hospitals
Robert Wood Johnson Foundation
December 14, 2005
http://www.rwjf.org/newsroom/newsreleasesdetail.jsp?id=10387

Patient's Attitudes Toward Health Care Providers Collecting Information About Their Race and Ethnicity
Commonwealth Foundation
January 2006
http://www.cmwf.org/publications/publications_show.htm?doc_id=333638&#doc333638

NAACP and Nitromed Form Partnership to Address Racial Health Disparities
Kaiser Family Foundation
January 4, 2006
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=34593

Disparities in Health Care Growing for Latinos, Gap Closes for Other Minorities
Kaiser Family Foundation
January 10, 2006
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=34697

    Feedback   (The Cultural Competency Michigan Difference)