What Is Cultural Humility in Cancer Care?
Learning about other cultures is a common concept in the multicultural U.S. However, cultural humility advances beyond the simple act of learning about cultures and toward fostering change in health disparities. Here’s a look at cultural humility, the impact of cultural humility in cancer care, and cultural factors in cancer care.
What Is Cultural Humility?
The definition of cultural humility is a layered and ongoing process. Cultural humility involves not only self-reflection about one’s own background but also learning about the background of others paired with a willingness to acknowledge and honor the values, customs, and beliefs of other people.
How Cultural Humility Can Impact Cancer Care
Cultural humility is top-of-mind and essential in the process of improving care for all patients – especially patients who may have medical distrust. Healthcare professionals must advance beyond understanding cultural differences and the methods to overcome them to possess cultural humility. Cultural humility in the context of healthcare requires healthcare professionals to have a willingness to learn from their patients and to adopt a more patient-centered approach to their care. Patient lives may depend on this willingness to learn from patients, especially for patients in need of cancer care.
Consider the following situation as an example of one that needs cultural humility. A young, undiagnosed Black sickle cell disease patient who recently moved out of state to attend college and who must advocate for himself for his first doctor visit away from home. He’s experiencing a pain crisis and goes to see a new doctor at the university’s health center with some knowledge about SCD pain crisis. The doctor notices that the patient seems worried about taking pain medication, even though he is in acute pain. The doctor doesn’t know why the patient is against taking medication but doesn’t ask further questions to learn more. The patient’s condition could advance from sickle cell disease to renal medullary carcinoma if he goes untreated.
Conversely, if the doctor takes the time to listen carefully to the patient and to ask questions about his reluctance about pain medication, they would be more likely to learn about his religious beliefs against medication and set the patient on a path to improved care by educating him. This is a real-life situation that has happened to some sickle cell disease patients and others where a doctor’s willingness to learn from the patient can make a real impact.
Instituting a practice of cultural humility can make a difference in changing the future of healthcare and cancer statistics for many BIPOC patients and other underserved groups. The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) program gathers statistics that show key cancer disparities for different Black, Indigenous, and People of Color (BIPOC) groups in the U.S. Data shows that some specific groups suffer a unequal burden in terms of prevalence, incidence, mortality, survivorship, outcomes, and other measures of some certain cancer types – including, but not limited to, breast cancer mortality rates in Black women, kidney cancer mortality rates in Alaskan Native/American Indian people, and prostate cancer mortality rates in Black men.
Cultural Factors to Consider in Cancer Care
In addition to medical distrust, there are additional cultural factors that are essential to consider when it comes time to discuss treatment options with a cancer patient. Their care and treatment outcomes are often dependent on these factors. Some of the cultural factors include:
Gender roles and family dynamics. The way family members interact in a household around concerns like caregiving and who takes care of certain things at home. Providers must make sure to think about these considerations.
Body autonomy. Some groups of people possess certain beliefs about what happens to their bodies. Their beliefs may lead them to opt against treatment options like transfusions, stem cell transplants, and sometimes even reconstructive surgery.
Shame. The belief systems of some patients may connect past actions, also known as karma, to a cancer diagnosis. This may lead to stigma and shame. Some patients may not even want to utter the word “cancer” or may be against telling others about their diagnosis. If the patient is against informing their support network, try to learn about their reasons for this.
Grief and loss. Practices and rituals around grief and loss can vary by culture. Some may handle their grief privately rather than around others. Also take into consideration situations like change in housing or income and family dynamics.
End-of-life considerations. Discussing death and end-of-life issues like estate planning can vary greatly by cultural groups or families,. Some think of it as bad luck to discuss matters of death while a patient is still alive.
If healthcare professionals can continue to advance from cultural awareness to an ongoing practice of cultural humility with cancer patients, then cancer disparities will begin to decrease. Cancer patients can also help with the process by informing their healthcare professionals about their cultural beliefs. Cultural beliefs are part of every cancer patient’s life and should be honored in their journeys through care.
Sources
Angelique Caba, LCSW-R. Cultural Humility: A Way to Reduce Health Disparities in the BIPOC Community. OncologyNurseAdvisor website. Accessed November 18, 2022. https://www.oncologynurseadvisor.com/home/departments/from-cancercare/bipoc-black-indigineous-cultural-humility-cancer-care/
What Is Cultural Humility? The Basics. University of Oregon website. Accessed November 18, 2022. https://inclusion.uoregon.edu/what-cultural-humility-basics
Dinah Schuster. Honing Cultural Humility Skills Can Improve Health Care as a Whole. Penn Medicine News website. Accessed November 18, 2022. https://www.pennmedicine.org/news/news-blog/2021/may/honing-cultural-humility-skills-can-improve-health-care-as-a-whole
For Health Care Professionals: Cultural Humility in Cancer Care. CancerCare website.Accessed November 18, 2022. https://www.cancercare.org/publications/423-for_health_care_professionals_cultural_humility_in_cancer_care
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