โ Scribed by Jacquelyn C. Campbell; Doris W. Campbell
No coin nor oath required. For personal study only.
This article explains the concept of cultural competence, adding advocacy to models of culturally competent health care already in the literature and demonstrating how it relates to domestic violence. Abuse stages according to Landenburger's model of entrapment and recovery are presented with applicable cultural differences and specificities. Cultural issues related to specific childbearing-stage abuse interventions are also discussed. The principles of cultural competence, abuse-and childbearingstage specificity, and empowerment are used as the basis for this model of clinical intervention with abused women.
Clinical interventions for abused women should be based on four important principles: cultural competence, abuse-stage specificity, childbearing cycle-stage specificity, and empowerment. Such interventions build on the advanced communication skills that clinician midwives and other clinicians have learned and developed. They are not prescriptive or uniform; rather, they are based on the specific needs of the woman involved, her cultural background and definition of the situation, and on a trusting relationship developed by the health care provider with the client. In fact, this relationship is part of the last principle of empowerment. Using an attitude of mutuality and reciprocity (instead of paternalism), empowerment involves brainstorming solutions with the woman (rather than telling her what she ought to do), facilitating her achievement of the goals she has set, and helping her understand and make sense of the situation and her responses to it (I). This article will present briefly the concept of cultural competence and then will discuss its application to clinical interventions with battered women in the childbearing period, with specific reference to the principles outlined above. (Issues for immigrant battered women are discussed in Orloff's article elsewhere in this JNM issue and will not be covered here.)
Both Campinha-Bacote (2) and Rorie and colleagues (3) have proposed appropriate models of culturally competent health care.
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