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HEA561 Health Assessment In A Bio/Psycho/Social Context

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HEA561 Health Assessment In A Bio/Psycho/Social Context Question The purposes of this assignment are to assist you to reflect on your cross-cultural communication skills and to improve your knowledge and understanding of another culture.       Critical analysis of an interview with a client from a culture different to your own To complete this option you will: conduct an interview with a client from a cultural background different to your own critically analyse your interview process and techniques, including reflection on areas of strength and strategies for improvement  use a reflective practice framework eg Gibb’s (1988) Reflective Cycle Model to guide your writing use appropriate peer reviewed professional references (published within the last 5 years preferable) to support your points.  Answer Introduction With the world gradually progressing towards becoming a much smaller space with rapid globalization, cultural diversity is becoming the notion of the day. With presence of multicultural entities in almost every sphere of life where we normally interact for personal as well as, and especially; in business context, it is safe to say that our social circles are expanding to include more and more culturally diverse people. This is even more evident in healthcare, education, sports, entertainment and ever more than before – the scientific communities (Tjosvold, 2017). It is hence also appropriate to point out that to thrive and succeed for self and greater good, cross-cultural awareness and usage of appropriate cross-cultural knowledge in practise is a new skill. This is very much in demand – the new knowledge and understanding of dealing with people from a diverse background (Adekola & Sergi, 2016). The intent of this analysis is to gauge self-knowledge and awareness in dealing with people from such diverse backgrounds. To understand the acceptable things and ‘not to be done’ things when dealing with people from a different cultural background. The analysis is also for assistance in gaining knowledge as well as understanding about the other’s cultural background. To achieve this, an interview was carried out with a client for proper interpretation of the actual scenario. The analysis highlights the efforts that were taken, roadblocks which were faced, pointing out to the spaces for improvement in techniques and understanding based approach. Reflection on the entire interview has helped to self-assess the interaction that took place with the client. They have been presented with some focus on the background/presumed reasons for the happenings. Finally, the conclusion shall provide a wholesome experience based understanding of the incident and discuss the possibilities of further discussion for deeper understanding. Background Interviews are important interactions with a quest to give and get information. A good interview is also started by keeping a goal in mind and concretizes the path to be taken with proper usage of the information that came out of the interview. It is all the more a good opportunity to present the client with the best and set good standards for client or customer care. A cross cultural interview involves two people from different cultural backgrounds who may or may not share the same country, religion, language or socioeconomic status. Time and again through various researches, complexities of conducting cross-cultural interviews have been highlighted, in fact major challenges have been identified which might involve fraternization, inter-cultural barriers, cultural boundaries set or even insider-outsider issues. Method & Context Situation (STAR) The interviewer in this case, me, is a Caucasian Australian and the interviewee, here, the client is an Aboriginal elder. The elder has approached for assistance in knowing about knowing healthcare benefits he could avail as his wife was very sick. The elder was staying in outskirts and till now he had no idea of new developments happening in mainstream Australia or never took interest. Since his wife had become very sick, he wanted proper help now. He really seemed vulnerable and afraid of asking around for fear of being dejected. Also, since he had no idea of administration and policies for Australian aboriginals who had a special status in the country (Dobia & Roffey, 2017). He was also afraid because he had hardly any money. Being a part of Information Department, I have been assigned the task to interview the client to clearly understand their needs, immediate thinking behind special requests-if any, budget, temperament. I was expected in my role to break the ice and offer a helpful solution in their assistance. A follow-up interview was also scheduled in 10 days to get an update on how the elder and his wife were doing and if they made any use of the information shared with them. During the interview, lot of information was exchanged and the entire interview was audiotaped with the family’s permission. The follow-up interview was audiotaped as well to help in better understanding of feelings and interpret the interviewer and interviewee. Task (Star) The interviewee was expected to firstly be available on given time for the appointment with client with complete preparations. Preparations included knowledge of frequently asked questions by aboriginal background people who come to the city for the first time and have ample apprehensions about being able to cope with the new culture. Mostly, such families face culture shock. As part of Information Department, it is expected that the interviewer will be able to break the ice and quickly forge a friendly helpful relationship in whom the client could trust and open up about the day to day issues being faced by him/her, kind of assistance required and be equipped with sufficient know-hows to assist the client with required information on an immediate basis. Find an appropriate alternative in case the suggestion did not work the first time and offer it in the follow up interview. Further find out if the client is doing better post the last interaction and all the information exchanged to help him/her ease up. Activity (Star) During the first meeting, the attempt to break the ice and make the client feel comfortable in sharing their requirements for the Information Department to assist them. After some pleasantries, the actual interview was conducted. The elder and his family’s permission was sought before recording the interaction. The interaction started with me giving an introduction of self, the organization I represented, my department and what kind of information and assistance we could provide to the family. The elder and his family were also explained the purpose of the meeting and what we jointly wanted to achieve through the interview. Some stages of the interview were explained which would eventually be crossed to gain more information to assist them better. That included starting with very basic questions about them and what kind of information or assistance they were seeking, their current address, contact details, age, details of sickness etc. I was successful in explaining to them that throughout the interview, some notes would be taken by me which they should not worry about as it was part of standard procedure. At this point, I also offered the family some refreshments. Post that, I started asking the family mostly general questions but requiring detailed explanations about them such as when they first got diagnosed with disease, symptom, what have they done so far, have they approached any medical facility etc. Thereafter, I asked the family some open-ended questions mostly based on their expectations of this place before she landed, how far has everything been, major difficulties they have faced till now and how or if they have tried to work up a solution, what kind of information was they looking for, any specific reasons for their requests etc. Thereafter, I asked them if they were able to understand me and if they wanted me to repeat any information/details for the answers that were provided to them. I also prodded them to let me know if there was anything else that they would like to share with me in case they was holding back. It was my best effort to provide the family with sound advice for their issues and queries so that they could get an immediate relief. There were however some questions for which I was not prepared for and noted down promising them that I would get back in touch with them with their answers. Last of all, the interview ended with me offering them any other assistance in case they left out anything. Results (Star) The family was quickly explaining their difficulties once we were able to settle into a conversation. Mainly, their difficulties were those of language, medical assistance, food and money. They were also interested in getting in touch with other people from their background who may be around and as soon as an interaction could be arranged (Gomes, 2015) as they were also longing to speak with someone who knew their language and culture as they were feeling homesick already. Reflection Post the interview, I made it a point to look back and try to overall gauge my feelings about the interaction with the family. Preparation is the key to any good interview and I had made specific mental preparations to questions they might have. Even from my experience, it is safe to state that the objective of interview is to precisely identify the requirement/s of the client from the situation at hand. To gather as much information so as to discuss; if possible, then and there in ways the client could be assisted and their objective achieved. It was also necessary to provide ample information to assist the client to make decisions in a good way to help them reach their goal while instilling the feeling of self-confidence so that client may trust us to handle their case appropriately (Shiraev & Levy, 2014). So, the preparation was good and the interaction had communication barriers which not only included verbal communication but since there actually was a language problem, most of the exchange also happened through non-verbal communication cues as well (Kinloch & Metge, 2014). This presented itself as challenge as I could not be sure if the exchange was truly fruitful or not. In fact, the second meeting was scheduled on 10th day and this time would provide the answer to the question if it worked properly or not. At the end of 10 days, upon meeting the family, they seemed much brighter and friendly. Their ambience seemed comfortable and the elder’s wife’s treatment had started. Most of the suggestions that were provided to them were understood by them as well as followed to my relief and they appreciated the assistance. Meanwhile, a letter had been sent to her with contact details of some aboriginal groups near where they were putting up so that they could interact and feel better. I found out that they had received the letter but the family only knew ancient texts and had no formal education whatsoever. This assistance could not be hence taken up by them. However, I read the letter and explained them the location and they seemed to understand and agree to my interaction quite pleasantly. I had interacted with them before and this time I felt, they had been more appreciative of my assistance to them. They had found a way to figure out their day to day issues in a new place-many of them those that they had not highlighted in the first meeting. More or less, they seemed positive. One by one, all their issues that they had approached with in first meeting were discussed again to help me understand their standing on them after 10 days. At the end of the meeting, once again I sat down to look at things that went well and which didn’t. They were eager to get in touch with the support group I had told them about. They also did not accept my offer to meet again next month just to check up on how they were coping up with their movement to a new place by themselves at the end of 2 months. It was easy to understand that the first interaction had been much successful to some extent. They seemed polite to attribute the medical assistance they got to the department and my efforts. From perspective of Purnell’s model, indeed it was agreeable that people usually carried their culture with them when travelling and it actually never leaves their thinking and upbringing. The meeting on the 10th day also proved that their restrictions on their own thoughts were quite relieved, so indeed the change in thought process and acceptance of culture is slow but gradual. Their thoughts specifically related to getting healthcare was a lot changed too. Purnell model does point out that culture affects a lot on an individual’s perception to reception of healthcare and response to it. Purnell’s model which works on building a framework mostly reflecting people’s characteristics like intentions, motivation etc. There is no doubt that cultural competencies are specific perceptive, sentimental, and psychomotor abilities that are indispensable for the assistance of educational similarity between supplier and patient. Cultural competence is not the end, a target of ensuing mastery is not achievable. Methodologies to cultural competence possession could be classified as fact-centered or outlook and skill-based. Analysis The aim of the interview was: a. To experience a cross cultural interaction in real world   b. Able to identify the barriers to a good and effective cross-cultural interaction   c. Identify the elements which worked towards making the interaction fruitions   d. Corrections that would be required in future interactions In keeping the above 4 objectives in mind, the interview gave an amazing platform to interact with a person from another cultural background, completely different ethnic background, language etc. for the very first time. The interaction was filled with anxiety in first ten to fifteen minutes as there was a language barrier. Eventually with use of lot of non-verbal cues, we both could automatically derive a language to understand, agree, disagree or even ask questions to each other pretty quickly. Not only that, there was also ample use of active listening on my part owing to the communication barrier-mostly it led to repeating for the family – most unfortunately. Some of the barriers which existed were: a. Knowledge and being aware that the family was aboriginal. This automatically changed the way I would have otherwise behaved with a local or even a native English speaking individual.    b. Language barrier – since both had different mother-tongues   c. Unclear and non-evident body gestures – the body gestures, in fact mostly all non-verbal cues had to be explained.  I got overwhelmed with the elder using his hand for explanation so much. They had a huge palette of body gestures, mine were limited and mostly I had stuck to yes or no   d. The family did not make a lot of eye contact and I felt that they was uneasy at first with me looking at them and trying to establish eye-contact. It took them sometime to get comfortable with it. Most of the time they spoke by looking either up or down   e. They were hesitant to open up and explain their woes even though I made it clear that I was a department representative. It took them some time to gauge that I was there for their assistance   f. They avoided formal questions that I was asking in the beginning to gain information and avoided questions related to their home. They seemed to be hesitant to share details and avoided chit-chat. They quickly tried to bring up the topic of their medical assistance they were here for to get started On the basis of challenges that presented itself during the interview and observing how they were overcome, it is fair to point out that the strengths that helped in overcoming the barriers in the interview were – a. Speaking slowly   b. Trying to get an agreement from them in confirming they understood early on in the interview phase when a lot of body gestures and hand waving had to be used to overcome the language difficulty   c. Always smiling and conveying to the family that the situation was under control and could be handled   d. Not making decisions on their part, rather offering choices   e. Giving a lot of examples of such families and their problems to make them feel comfortable and make them at ease, letting them understand that these difficulties are teething issues and they would receive our full cooperation till they were settled   f. Listening mostly to their issues Some of the take-aways from the interview process were: a. It would have made the process easier and probably more fruitful had there been an interpreter or a fellow colleague they could relate to, to ease the communication   b. The timing and order of questions could have been improved upon   c. The style of interviewing could have been made semi-formal instead of formal   d. Filling up of forms by them as a record. Since, they had not got much of formal education, it proved to be a challenge and had to be taken over by me.   e. Cross-cultural training curriculum for department representatives for better dealing (Lynch, 2014)   f. More paraphrasing   g. Usage on non-judgemental communication (Neuliep, 2017)   h. Noting interviewee’s mental state – a form or look for visible indications (Okun & Kantrowitz, 2014)   i. Look for ways to create a rapport and give a trustable environment   j. Associating the institution with more ethnic communities/organizations for proper professional expertise till the in-house workforce is trained   k. Work on strategies to ensure culturally acceptable/appropriate response system In light of the interview conducted and the follow-up interview thereafter, cross cultural elements such as verbal and non-verbal processes and general perception played a major role (Warren, 2017). The presence of perception which was presumed before meeting the family and post interaction changed a lot for the family because of coming from ethnically diverse backgrounds as much more open to settling in a new environment, who do not want to give up trying even when the situations were not favourable in the beginning. The presumed perception was that of a newcomer who must be afraid because of an environment of a new country. The family had researched well about daily lives later on and Australian cultures and way people dealt with each other but was unsure of application of the knowledge to gain acceptance. However, it was noticeable that the distance away from own culture or familiar language people was giving them accentuating stress. Conclusion Australia is now a multi-cultural country. Immigration has played an important factor in recent years in contributing to the inflow and natural level population growth of people with diverse backgrounds. There is however, a lot of in land movement as well. This situation requires that people from all cultural backgrounds are treated with equality, sensitivity, toleration and respect for their growth in the nation. The skills to deal with people from culturally and linguistically different backgrounds are more in demand now. There are, however, very few institutions actually paying attention to this and encouraging to take up the skills at a professional level. It is a continuous challenge to accommodate people from diverse backgrounds in to the mainstream daily regime and provide adequate assistance. Cross cultural differences (Moran, Abramson & Moran, 2014) stretch to difference in way people address and behave with each other, levels of formality or informality, non-verbal behaviour, self-grooming etc. (Thomas & Peterson, 2017). The cross-cultural elements such as perception, processes-both verbal and non-verbal have the power to affect the situation of people belonging from diverse cultures (Samovar et al., 2014) and the people dealing with people from such diverse background must be emotionally be equipped and have sound training (Landis et al., 2013) to give a suitable environment for gaining trust. Though the interview itself had some initial hiccups quick and thoughtful usage of non-verbal communication cues helped balance out the situation very well. Also since there was lot of active listening to properly hear out the client and then offer solutions instead of making decisions for them posed a workable solution to gain trust and further open up to other issues. It was very much evident that it would not be a good idea to proceed without knowing more about the client. Gathering information – ample as well as accurate to have a clearer understanding of the client’s requirements. That would also be helpful in supporting them with staying focused to the issues as well as step out of the situations to gain clear facts. Informing the client of the role of self and the association, helped set the expectation right of the family as well as have transparency. Allowing enough time throughout the conversation to get facts also was helpful. Body language, eye-contact, develop rapport, usage of non-verbal communication techniques, usage of affirmations, paraphrasing and summarising the entire discussion topics one by one helped close the interview at a fairly good note. Also, observation is a key skill which is required to understand the mental status of the client. The way the person sits, position of hands, type of dressing/appearance in total helps in getting the first mental impression. Acknowledgement of difference is important and probably; this is why, even thedepartment should opt for a more culturally diverse workforce which would definitely be helpful in these cases. As discussed earlier, what suggestions would be taken up by the institution should be further discussed most certainly and proper plan of action should be chalked out with regards to counselling methods that should be implemented (Pederson, et al. 2015). This is however, safe to say that irrespective of methods adopted, a relationship between a worker and culturally diverse client can only contribute to the outcome with proper sensitivity training, warmth, appropriate empathy, authenticity. That is possible through a proper skill development programme. Reference List Books Kinloch, P., & Metge, J. (2014). Talking past each other: problems of cross cultural communication. Victoria University Press. Samovar, L. A., Porter, R. E., McDaniel, E. R., & Roy, C. S. (2014). Intercultural communication: A reader. Cengage Learning. Landis, D., & Brislin, R. W. (Eds.). (2013). Handbook of intercultural training: Issues in training methodology (Vol. 116). Elsevier. Warren, T. L. (2017). Cross-cultural Communication: Perspectives in theory and practice. Routledge. Thomas, D. C., & Peterson, M. F. (2017). Cross-cultural management: Essential concepts. Sage Publications. Neuliep, J. W. (2017). Intercultural communication: A contextual approach. Sage Publications. Shiraev, E., & Levy, D. A. (2014). Cross-cultural psychology. Pearson Education Limited. Tjosvold, D. (2017). Cross-cultural management: foundations and future. Routledge. Adekola, A., & Sergi, B. S. (2016). Global business management: A cross-cultural perspective. Routledge. Okun, B., & Kantrowitz, R. (2014). Effective helping: Interviewing and counseling techniques. Nelson Education. Moran, R. T., Abramson, N. R., & Moran, S. V. (2014). Managing cultural differences. Routledge. Pedersen, P. B., Lonner, W. J., Draguns, J. G., Trimble, J. E., & Scharron-del Rio, M. R. (Eds.). (2015). Counseling across cultures. Sage. Journals Gomes, C. (2015). Negotiating everyday life in Australia: Unpacking the parallel society inhabited by Asian international students through their social networks and entertainment media use. Journal of Youth Studies, 18(4), 515-536. Lynch, M. (2014). Importance of Experiential Learning for Development of Essential Skills in Cross-Cultural and Intercultural Effectiveness. J. Experiential Learning, 1, i. Dobia, B., & Roffey, S. (2017). Respect for Culture—Social and Emotional Learning with Aboriginal and Torres Strait Islander Youth. In Social and Emotional Learning in Australia and the Asia-Pacific (pp. 313-334). Springer Singapore.

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