Cultural competence in lifelong care and support for individuals with intellectual disabilities

Abstract

Objectives: Although an extensive amount of research has been devoted to models defining cultural competence of healthcare professionals in short-term care, there is unclarity about the cultural competencies that professionals providing lifelong care and support should have. The current study aimed to explore which cultural competencies are used by these healthcare professionals, and whether these competencies enabled them to make cultural adaptations to their regular care practices. Design: To investigate cultural competencies and cultural adaptations, semi-structured in-depth interviews were conducted with eight professionals who provide lifelong care and support to individuals with intellectual disabilities. Five cultural competencies were explored: awareness, knowledge, skills, motivation, and encounters. Results: A thematic analysis of the interviews revealed that professionals providing lifelong care and support used all cultural competencies in their care practices. Moreover, our analysis suggested that these competencies could be categorized as either practical or analytical cultural competencies. Although these competencies were conditional in order to make cultural adaptations to care practices, the presence of cultural competencies did not automatically lead to these cultural adaptations. Conclusions: All five cultural competencies were used by professionals in lifelong care and support. Our analysis revealed that both practical and analytical cultural competencies were essential in providing culturally sensitive lifelong care and support. We additionally suggest that the cultural competence of professionals is necessary, but not sufficient, for making cultural adaptations to lifelong care and support for individuals with intellectual disabilities. In many cases, other factors also played a role in a professional's final decision to adapt their care practices.

Coproduction with peer support groups: A new approach to culturally responsive social services

“…Coproduction in social services refers to collaborations between service users and providers to improve service quality and form a relationship that is beneficial to both parties (Radl‐Karimi et al, 2018, 2022). The utility of coproduction for cultural responsiveness in service provision has been empirically confirmed in a wide range of social service contexts (Allen et al, 2013; Fang & Fisher, 2019; Fang et al, 2021; van Herwaarden et al, 2021; Radl‐Karimi et al, 2020). However, these studies mainly focus on the coproduction at the individual level between people from culturally diverse backgrounds and service providers.…”

“…The increasing population diversity due to globalization means many countries are facing challenges in providing culturally responsive social services to people from culturally diverse backgrounds (van Herwaarden et al, 2021; Radl‐Karimi et al, 2022). Much has been discussed on barriers for people from culturally diverse backgrounds to access quality social services.…”

Dealing with disability: challenges in Dutch health care of parents with a non-Western migration background and a child with a developmental disability

“…Eslem also did not discuss her religious needs for her son and said that she was ok with her son not following her religious rules like fasting, sFpecial dietary requirements, and prayer, as these rules are "more flexible for people with disabilities". However, Dutch institutions for people with disabilities can, in many cases, easily manage to follow various religious preferences, if they are aware families would prefer that [53].…”

Providers’ perspectives on factors complicating the culturally sensitive care of individuals with intellectual disabilities

“…Again, this experience with different cultures, which the professionals believed influences the provision of culturally sensitive care, is a very personal characteristic of the professional. Organisations could deal with the randomness of these personal factors by formalizing culturally sensitive care; for example, the specific culturally sensitive attitudes could be included into the job requirements and task responsibilities of their personnel (Van Herwaarden et al, 2019).…”

“…13; Cross, Bazon, Dennis, & Isaacs, 1989;Sue & Sue, 2012). Culturally sensitive care refers to care in which regular practices are adapted to the culturally specific wishes or needs of the care receiver (Sue & Sue, 2012;Van Herwaarden, Rommes, & Peters-Scheffer, 2019). This may even be of greater importance for individuals with intellectual disabilities (IDs), who have limited cognitive abilities (i.e., IQ < 70) and limited adaptive skills and require intensive and chronic support.…”