Cultural competence for the physical therapy professional

Headnote

Physical therapy professionals need to develop culturally competent communication skills and understandings in order to interact effectively with clients of diverse cultures. In reality, all physical therapy clinical encounters carry a degree of cultural diversity when one considers that culture is composed of both primary characteristics, which are largely unchangeable, and secondary characteristics, which result from life experiences and circumstances. Even the physical therapy professional brings to the encounter a professional subculture, representing the US model of professional medical practice, beliefs regarding health and wellness, and attitudes about independence and rehabilitation. Purnell's cultural model has been recognized as a valuable cultural assessment tool within the nursing profession and has direct application for the physical therapy profession as well. The model consists of 12 cultural domains set within the influence of family, community, and global society. This article explores 3 of the cultural domains--communication, health care practices, and health care practitioners--as they apply to the physical therapy cultural encounter. Recent research demonstrates that the acquisition cultural competency has proven elusive to health care professionals. This article describes 4 steps in the development of cultural competency: (1) identification of personal cultural biases, (2) understanding general cultural differences, (3) accepting and respecting cultural differences, and (4) application of cultural understandings. The acquisition of cultural competence requires time, sensitivity, study, and practice. Purnell's cultural model offers a means by which physical therapy professionals may move forward in their development of the cultural competence needed for successful clinical encounters.

Key Words: Cultural competence. Cultural models.

INTRODUCTION

Physical therapy professionals need to possess excellent interpersonal and communication skills if they are to effectively treat clients. When the client comes from a cultural background different from than of the physical therapist, the potential for miscommunications and misunderstandings increase and may lead to cultural barriers. The myriad of cultural differences can be overwhelming to new students, and even many seasoned clinicians are simply unaware that these cultural barriers exist. The physical therapist attempting to meet the health and wellness needs of a client risks miscommunicating and potentially rendering ineffective care if the cultural misalignment is not acknowledged. For example, a client may not respond to the instruction and intervention of the physical therapist if he or she does not agree with the...