360° of Cultural Competence: Addressing Religious Diversity in Patient Centered Care

Although religious beliefs play a large role in shaping patients' perspectives on health issues, little emphasis is placed on this vital area. The Joint Commission has sought to address this issue through recommendations (published August 2010) for hospitals in providing culturally competent care. Nevertheless, efforts in health care tend to focus on language access and racial and ethnic health disparities. Health care practitioners and institutions at large are therefore often unprepared to respectfully inquire about patients' religious beliefs, respond appropriately, and anticipate potential areas of conflict. The lack of religio-cultural competence in patient provider relationships can erode trust, hamper communication, and may ultimately marginalize certain cultural and religious groups. This presentation will seek to highlight ways that religion emerges in health care decision-making and demonstrate how implementing religio-culturally competent practices into patient care can result in more effectively serving diverse populations and reducing health care disparities.

To begin, participants will briefly be introduced to a list of themes that often trigger religious issues for patients and providers in a health care setting. Three of these topics: diet, modesty, and proselytizing, will then be further explored by presenting case studies of challenges hospitals faced in relation to these issues and briefly highlighting the methods that were developed to address these challenges. For instance, a hospital in Maine noticed that the substantial female Muslim population in their area was not coming in for care. After identifying that the women had modesty concerns over wearing flimsy hospital gowns and offering a gown that provided more coverage, the hospital experienced a lasting increase in Muslim women coming in for preventive care. Similar anecdotes will be presented in relation to religious dietary needs and concerns.

Lastly, we will introduce for examination and discussion the issue of proselytizing, asking health care professionals to contemplate if and when it is appropriate for providers to bring their own religious beliefs into the patient-provider relationship. The spectrum of behavior associated with proselytizing can have a profound impact on this delicate relationship. Participants will be asked to consider developing institutional guidelines and policies defining appropriate behavior in relation to proselytizing.

The goal of this brief presentation is to raise awareness and introduce the topic of religio-cultural competency so that health care practitioners can begin identifying the challenges they may be facing within their own patient population regarding religious diversity and consider ways to build religio-cultural competency within health care settings.