Understanding Biases In Healthcare: Intersectionality, Personal Preferences, And Culturally Safe Practices

Framework of Intersectionality

To be an effective care worker, one has to ensure competent care that is free from biases to ensure comprehensive care (Curtis et al. 2019). Effective care aims to provide holistic care to meet the patients’ physiological, social, and psychological care needs (Zhang et al. 2019). As a future healthcare worker, my primary goal in life is to provide inclusive and comprehensive care. In this paper, I will reflect on my understanding of how biases in practice impact healthcare. This paper will assess the framework of intersectionality and assess how the personal preferences of an individual impact the process of care. This paper will also summarise the culturally safe practices that should be undertaken for care and advocate for non-biased treatment for improved care outcomes of the patients in the care facilities.

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As an individual, who comes from the majority section of the population, this module helped me understand the importance of intersectionality and its impact on care and practice. Intersectionality can be defined as an approach that recognises that an individual’s health is shaped by several features that overlap with each other and determine the overall well-being of the individuals and that of the communities (Fitzgerald and Campinha-Bacote 2019). The lens of intersectionality thus identifies multiple factors such as race, ethnicity, gender, abilities, sexual orientations, and class in determining an individual’s overall well-being and outcomes (Wilson et al. 2019). Through the perspective of healthcare, the framework of intersectionality is associated with a focus on the supportive rights of the individuals based on the development of a holistic understanding that can identify the key individuals involved in the care, impact of the factors that influence care and how they impact the overall outcomes of well-being for an individual (Fitzgerald and Campinha-Bacote 2019). I had limited experiences in my growing years based on understanding the individualistic motivations of an individual, however, with improved understanding and amalgamation of social structures and the healthcare and well-being. The knowledge of intersectionality has helped in shaping and supporting equity analysis. Further, it helps in driving the attention to the drivers of inequality and thus can promote improved targeted interventions and policies. Therefore, intersectionality helps provide holistic support to the patients and focuses on recognising stigma and minimisation of marginalisation and implicit bias in the process of care. The application of intersectionality and cultural identity (Wilson et al. 2019). Lack of intersectionality in the process of care has been associated with relatively poor life expectancy and higher rates of mental health problems. This needs to be seen in conjunction with the social determinants of health, where the social factors impact the healthcare of the individuals (Curtis et al. 2019).

Personal Preferences and Culture and its Impact on Care

Individual presuppositions have a major impact on the workings of an individual and also on how the worldview of a person is constructed (Flanagan 2021). This impacts the actions that are undertaken by the individuals and how their perspectives are developed. One of the major factors that impact the process of care is implicit bias. As an individual who belongs to the majority community, I have realised that several biases are ingrained in our thinking through social conventions and conditioning. The cultural bias impacts how one interprets the situations and actions and thus is of prime importance in consideration with the provision of healthcare support (Fitzgerald and Campinha-Bacote 2019). The cultural biases are grounded in inherent assumptions and social norms (Chenoweth et al. 2019). Hence, they need to be taken into special consideration when providing care. A crucial principle of ethics is the principle of justice. The principle of justice dictates that it is the fundamental right of every individual to be treated with dignity and respect and to be provided with quality care with an approach that is unprejudiced and inclusive (Albertsen 2021). The imposition of cultural bias in the process of care can result in discrimination in the practice of care and thus can lead to poor care outcomes. The cultural biases have also been associated with delays in diagnosis, poor competency for understanding the social and cultural needs of the individuals and poor health outcomes (Schill and Caxaj 2019). The implication of bias in the provision of care has been associated with the development of false assumptions and negative outcomes for the care needs. This thus additionally contributes to the health disparities and health inequities. As a future care professional (Albertsen 2021), I have been able to realise how my personal assumptions impacted individual actions. Hence, now I am more aware and more conscious of my approach. I have also been able to understand the importance of cultural competency and how one should act to ensure effective care that is unbiased and culturally competent.

One of the key factors that are associated with providing quality care is person-centred care and support. Person-centred care ensures the holistic care needs of the patient are considered, and suitable support is ensured. This is possible only when the cultural and social factors of the patient are taken into consideration (Shepherd 2019). Many communities have faced stigma and seclusion. This has resulted in limited participation of individuals from the minority communities in accessing healthcare and getting suitable care. The individuals from minority communities are also prejudiced against, and this may result in further deterring the communities from accessing care (Narayan 2019). Therefore, the application of holistic and culturally safe practices in care becomes essential. Through the learning of this course, I have been able to understand the importance of having cultural competence in the process of care. Cultural competence in the practice of care is associated with the fundamental understanding of cultures from which the patients come. This helps in preventing stereotyping of patients and promotes individualistic and holistic care (Kerrigan et al. 2020). It also helps in respecting their worldviews and focusing on improved support and care (Fitzgerald and Campinha-Bacote 2019). These assist in preventing stereotyping of the patients and provide them with required care and support. This is even more crucial for the patients who belong to CALD status. The CALD status is associated with the individuals that are born overseas and those belonging to countries that are not primarily English speaking. Individuals who belong to the CALD groups may face linguistic barriers in the process of care. It may impact how their individual preferences are farmed and acknowledged (Mkandawire-Valhmu 2018). As a future care service provider, I have been able to learn the importance of communication. Therefore, poor communication along with a lack of cultural competency with the individuals belonging to the CALD groups needs to be taken into primary consideration for holistic care and support of the patients.

Culturally Safe Practices to avoid Biasness

The role of nurses expands from the provision of suitable care to advocacy for the healthcare needs and rights of the patients. Advocacy is one of the primary responsibilities of the care service providers. As a healthcare service provider, it is important to understand the individual needs of the patient and advocate for them for improved health outcomes of the community (Mkandawire-Valhmu 2018). For ensuring advocacy of the healthcare needs and minimising bias in the care practice, it is crucial that the healthcare service provider is able to understand the impact and magnitude of unconscious bias and focus on ensuring holistic care. It is important that the care service providers focus on the individual care needs of the patients and advocate for their fair treatment and justice in care (Chenoweth et al. 2019). The focus on building cultural competencies and understanding diverse cultures is essential in providing quality healthcare. It is the primary responsibility of the healthcare service providers to ensure that the patients are given adequate support and care that is in consideration of their social as well as cultural needs (Albertsen 2021). As a care service provider in future, I will ensure that I develop as an informed practitioner and focus on the care needs of the individuals across all the domains. I will do this by focussing on building rapport and understanding the nuances of care. This will promote improved development of understanding of the care needs of the individuals and promote improved care outcomes and better patient and carer relationships.

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Conclusion

This paper provides a reflective analysis based on understanding the role and importance of biases in the process of providing care to individuals. This paper highlights how the principle of intersectionality asserts an important role in achieving suitable care outcomes. Through this paper, it can be concluded that competency in care and focus on minimisation of bias is an essential step that needs to be taken into consideration for improved outcomes for individuals. Through this reflection, I have been able to also develop my understanding of the impact of biases on the process of care and the need to improve my own competencies to advance as a professional with a capacity to ensure holistic care. 

References

Albertsen, A., 2021, ‘How the past matters for the future: a luck egalitarian sustainability principle for healthcare resource allocation’, Journal of Medical Ethics, vol.47, no.2, pp.102-103.

Chenoweth, L., Stein-Parbury, J., Lapkin, S., Wang, A., Liu, Z. and Williams, A., 2019, ‘Effects of person-centered care at the organisational-level for people with dementia. A systematic review’, PloS one, vol.14, no.2, pp.212686.

Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S.J. and Reid, P., 2019, ‘Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition’, International Journal for Equity in Health, vol.18, no.1, pp.1-17.

Fitzgerald, E. and Campinha-Bacote, J., 2019, ‘An intersectionality approach to the process of cultural competemility–Part II’, OJIN: The Online Journal of Issues in Nursing, vol. 24, no.2, pp. 126.

Flanagan, R., 2021,’ Teachers’ personal worldviews and RE in England: a way forward?’, British Journal of Religious Education, vol. 43, no.3, pp.320-336.

Kerrigan, V., Lewis, N., Cass, A., Hefler, M. and Ralph, A.P., 2020. ‘How can I do more?” Cultural awareness training for hospital-based healthcare providers working with high Aboriginal caseload’, BMC Medical Education, vol.20, no.1, pp.1-11.

Mkandawire-Valhmu, L., 2018. Cultural safety, healthcare and vulnerable populations: A critical theoretical perspective. Routledge.

Narayan, M.C., 2019,’CE: addressing implicit bias in nursing: a review’,AJN The American Journal of Nursing, vol.119, no.7, pp.36-43.

Schill, K. and Caxaj, S., 2019, ‘ Cultural safety strategies for rural Indigenous palliative care: a scoping review’, BMC palliative care, vol.18, no.1, pp.1-13.

Shepherd, S.M., 2019. Cultural awareness workshops: limitations and practical consequences. BMC Medical Education, vol.19, no.1, pp.1-10.

Wilson, Y., White, A., Jefferson, A. and Danis, M., 2019, ‘ Intersectionality in clinical medicine: the need for a conceptual framework’, The American Journal of Bioethics, vol.19, no.2, pp.8-19.

Zhang, Y., Tzortzopoulos, P. and Kagioglou, M., 2019,‘ Healing built-environment effects on health outcomes: Environment–occupant–health framework’, Building Research & Information, vol.47, no.6, pp.747-766.

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