Hospitals and cultural diversity: social worker experiences and reflections
DOI:
https://doi.org/10.11157/anzswj-vol29iss2id280Keywords:
Cultural diversity, hospitals, social workAbstract
INTRODUCTION: Social work accrediting bodies mandate that workers analyse ways in which cultural values and structural forces shape client experiences and opportunities and that workers deconstruct mechanisms of exclusion and asymmetrical power relationships. This article reports the findings of a small-scale qualitative study of frontline hospital social workers’ experiences and understanding of their mandate for culturally sensitive practice.
METHODS: The study involved one-hour, semi-structured interviews with 10 frontline hospital social workers. The interviews sought to understand how frontline workers and their organisations understood sensitive practice. Drawing on their own social cultural biographies, workers described organisational policy and practices that supported (or not) culturally sensitive practice. Narrative analysis was used to extract themes.
FINDINGS: Data indicate that frontline hospital social workers demonstrated their professional mandate for culturally sensitive practice. Workers were firm in their view that working with the culturally other requires humility as well as a preparedness to value and engage the multiple cultural meanings that evolve in the patient–worker encounter.
CONCLUSION: The findings highlight that mandating cultural sensitivity does not necessarily result in such practice. Cultural sensitivity requires an understanding of how cultural and social location may be implicated in sustaining the dominant cultural narrative and signals the need for workers, systems and organisations to facilitate appropriate learning experiences to explore culturally sensitive practice.
References
Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., & Normand, J. (2003). Culturally competent healthcare systems: A systematic review. American Journal of Preventive Medicine, 24(3), 68–79.
Australian Association of Social Workers (AASW). (2010). AASW code of ethics. Canberra, ACT: Author.
Australian Association of Social Workers. (AASW). (2013). Australian social work education accreditation standards. Canberra, ACT: Author.
Australian Human Rights Commission. (2014). Face the facts: Cultural diversity. In Australian Human Rights Commission (Ed.). Sydney, NSW: Author.
Barcinski, M. (2007). The co-construction of female criminal identities: The role of reflexivity. Ciênc. saúde coletiva, 14(5), 1843–1853.
Brach, C., & Fraserirector, I. (2000). Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review, 57(4 suppl), 181–217.
Chalmers, S., Allon, F., White, L., Savage, M., & Choucair, S. (2002). “We all come from somewhere”: Cultural diversity at Sydney Children's Hospital. Centre for Cultural Research: University of Western Sydney.
Cross, T. L., Bazron, B. J., Dennis, K. W., & Isaacs, M. R. (1989). Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed. Retrieved from https://www.ncjrs.gov/App/publications/abstract.aspx?ID=124939
Danso, R. (2016). Cultural competence and cultural humility: A critical reflection on key cultural diversity concepts. E-Journal of Social Work. doi:10.1177/1468017316654341
Dodd, S.-J., & Epstein, I. (2012). Practice-based research in social work: A guide for reluctant researchers. Abingdon, UK: Routledge.
Dudas, K. (2012). Cultural competence: An evolutionary concept analysis. Nursing Education Perspectives, 33(5), 317–321.
Dwyer, S. C., & Buckle, J. L. (2009). The space between: On being an insider-outsider in qualitative research. International Journal of Qualitative Methods, 8(1), 54–63.
Fisher-Borne, M., Cain, J. M., & Martin, S. L. (2015). From mastery to accountability: Cultural humility as an alternative to cultural competence. Social Work Education, 34(2), 165–181.
Furlong, M., & Wight, J. (2011). Promoting “critical awareness” and critiquing “cultural competence”: Towards disrupting received professional knowledges. Australian Social Work, 64(1), 38–54.
Garran, A. M., & Werkmeister Rozas, L. (2013). Cultural competence revisited. Journal of Ethnic And Cultural Diversity in Social Work, 22(2), 97–111.
Grant, J., Parry, Y., & Guerin, P. (2013). An investigation of culturally competent terminology in healthcare policy finds ambiguity and lack of definition. Australian and New Zealand Journal of Public Health, 37(3), 250–256.
Harrison, G., & Turner, R. (2011). Being a “culturally competent”social worker: Making sense of a murky concept in practice. British Journal of Social Work, 41(2), 333–350.
Henn, M., Weinstein, M., & Foard, N. (2009). A critical introduction to social research. London, UK: Sage.
Hook, J. N., Davis, D. E., Owen, J., Worthington Jr, E. L., & Utsey, S. O. (2013). Cultural humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology, 60(3), 353–366.
Horevitz, E., Lawson, J., & Chow, J. C. C. (2013). Examining cultural competence in health care: Implications for social workers. Health & Social Work, 38(3), 135–145.
Hosken, N. (2013). Social work supervision and discrimination. Advances in Social Work and Welfare Education, 15(1), 92–104.
International Federation of Social Workers (IFSW). (2014). Global standards. Retrieved from http://ifsw.org/policies/global-standards/
Institute for Community Ethnicity and Policy Alternatives (ICEPA). (2009). Review of current cultural and linguistic diversity and cultural competence reporting requirements, minimum standards and benchmarks for Victoria health services project: Literature review. Melbourne, VIC: Victoria University.
Jovanovic, M. (2011). Cultural competency and diversity among hospice palliative care volunteers. American Journal of Hospice and Palliative Medicine, 29(3), 165–170.
Khawaja, N. G., McCarthy, R., Braddock, V., & Dunne, M. (2013). Characteristics of culturally and linguistically diverse mental health clients. Advances in Mental Health, 11(2), 172–187.
Knowles, E. D., & Peng, K. (2005). White selves: Conceptualizing and measuring a dominant-group identity. Journal of Personality and Social Psychology, 89(2), 223–241.
Liamputtong. P., & Ezzy. D. (2005). Qualitative research methods (2nd ed.). Melbourne, VIC: Oxford University Press.
Metropolitan Health and Aged Care Services Division. (2006). Cultural diversity plan for Victoria’s specialist mental health services 2006–2010. Blackburn, VIC: Print Bound.
Morley, C., Macfarlane, S., & Ablett, P. (2014). Engaging with social work: A critical introduction. Port Melbourne, VIC: Cambridge University Press.
Nadan, Y. (2014). Rethinking “cultural competence” in international social work. International Social Work, 60(1), 74–83.
National Health Workforce Taskforce. (2009). Health workforce in Australia and factors for current shortages. Canberra ACT: KPMG.
Ritchie, J., Lewis, J., McNaughton Nicholls, C., & Ormston, R. (Eds.). (2014). Qualitative research practice: A guide for social science students and researchers (2nd ed.). London, UK: Sage.
Ryan, G. W., & Bernard, H. R. (2003). Techniques to identify themes. Field methods, 15(1), 85–109.
Spencer, L., Ritchie, J., Ormston, R., O’Connell, W., & Barnard, M. (2014). Analysis: Principles and processes. In J. Ritchie, J. Lewis, C. McNaughton Nicholls, & R. Ormston (Eds.), Qualitative research practice: A guide for social science students and researchers (2nd ed., pp. 269–290). London, UK: Sage.
Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125.
VicHealth. (2005). Social inclusion as a determinant of mental health and well being, Melbourne, VIC: Health and Wellbeing Unit.
VicHealth. (2007). More than tolerance: Embracing diversity for health: Discrimination affecting migrant and refugee communities in victoria, its health consequences, community attitudes and solutions—A summary report. Melbourne, VIC: Victorian Health Promotion Foundation (VicHealth).
Western Health. (2015). Strategic plan 2015–2020. Melbourne, VIC: Author.
Williams, C. (2006). The epistemology of cultural competence. Families in Society: The Journal of Contemporary Social Services, 87(2), 209–220.
Wong, Y.-L. R., Cheng, S., Choi, S., Ky, K., LeBa, S., Tsang, K., & Yoo, L. (2003). Deconstructing culture in cultural competence: Dissenting voices from Asian-Canadian practitioners. Canadian Social Work Review/Revue Canadienne de Service Social, 20(2), 149–167.
Yan, M. C. (2005). How cultural awareness works: An empirical examination of the interaction between social workers and their clients. Canadian Social Work Review/Revue Canadienne de Service Social, 22(1), 5–29.
Yan, M. C. (2008). Exploring cultural tensions in cross-cultural social work practice. Social Work, 53(4), 317–328.
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
By completing the online submission process, you confirm you accept this agreement. The following is the entire agreement between you and the Aotearoa New Zealand Association of Social Workers (ANZASW) and it may be modified only in writing.
You and any co-authors
If you are completing this agreement on behalf of co-authors, you confirm that you are acting on their behalf with their knowledge.
First publication
By submitting the work you are:
- granting the ANZASW the right of first publication of this work;
- confirming that the work is original; and
- confirming that the work has not been published in any other form.
Once published, you are free to use the final, accepted version in any way, as outlined below under Copyright.
Copyright
You assign copyright in the final, accepted version of your article to the ANZASW. You and any co-authors of the article retain the right to be identified as authors of the work.
The ANZASW will publish the final, accepted manuscript under a Creative Commons Attribution licence (CC BY 4.0). This licence allows anyone – including you – to share, copy, distribute, transmit, adapt and make commercial use of the work without needing additional permission, provided appropriate attribution is made to the original author or source.
A human-readable summary of the licence is available from http://creativecommons.org/licenses/by/4.0, which includes a link to the full licence text.
Under this licence you can use the final, published version of the article freely – such as depositing a copy in your institutional research repository, uploading a copy to your profile on an academic networking site or including it in a different publication, such as a collection of articles on a topic or in conference proceedings – provided that original publication in Aotearoa New Zealand Social Work is acknowledged.
This agreement has no effect on any pre-publication versions or elements, which remain entirely yours, and to which we claim no right.
Reviewers hold copyright in their own comments and should not be further copied in any way without their permission.
The copyright of others
If your article includes the copyright material of others (e.g. graphs, diagrams etc.), you confirm that your use either:
- falls within the limits of fair dealing for the purposes of criticism and review or fair use; OR
- that you have gained permission from the rights holder for publication in an open access journal.
