Cultural diversity in adolescent health care

Abstract

In Australia, where about 16% of young people are born overseas and 24% are from a non‐English‐speaking background, adolescent health care is a multicultural challenge. “Cultural competency” involves challenging one's own cultural assumptions and beliefs, developing empathy for people from other cultures, and applying specific communication and interaction skills in clinical encounters. For health professionals, sensitivity to the cultural, ethnic, linguistic and social diversity among young people helps to avert problems and misunderstandings, improves satisfaction for all concerned and leads to better outcomes. Engaging the family and gaining the trust of parents is critical in treating young people from cultural backgrounds in which participation in health care is a family concern rather than an individual responsibility.

Representations and coverage of non-English-speaking immigrants and multicultural issues in three major Australian health care publications

“…Of these, 10 were categorised as articles concerned primarily with multicultural health-related issues, 15 as moderately inclusive and 29 as having a minor mention of multicultural health issues. Examples of articles concerned primarily concerned with multicultural health issues included: an article outlining the importance of cultural competence in dealing with adolescents [68] or in medical practice [69]; an argument for the introduction of RU-486 in Australia [70]; a discussion of the forced detention of non-compliant TB sufferers [71]; discussions about the usage of complementary and alternative medicines and the need to introduce its study into medical schools [72,73]; a case study of a neonate with high lead levels associated with the mother's ingestion of herbal remedies [74]; a discussion of the legal and ethical implications of medically enforced feeding of detained asylum seekers who are on hunger strike [75]; concerns about the limited rights to healthcare of asylum seekers [76,77]; and an article detailing the trauma experienced by children and their families held in detention [78]. …”

Predictors of unmet needs and psychological distress in adolescent and young adult siblings of people diagnosed with cancer

“…In a study examining sibling relationships amongst older adolescents and young adults (mean age = 19.8 years old), siblings who were further apart in age or the same gender had less conflict, and siblings in larger families had more rivalry and less warmth [14]. Having parents born overseas can lead to greater family burden, as cultural or linguistic differences can impact interactions with the medical system [15], or the ability to access support services [16]. Families with a single parent have a greater emotional and financial burden, and children often need to take on more responsibility [17].…”

“…Internal consistency of the subscales ranges from 0.65 to 0.86. A higher score on the Interpersonal subscale (range 9-45) indicates that the young person perceived the cancer experience to have had a negative impact on them, whereas a higher score on the Communication subscale indicates better communication (range [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Responding to cultural diversity at two Sydney‐based children's hospitals

“…Further, inter‐generational discord among the child or young person, the parents and the broader family, residing either in Australia or in the country of origin, is of particular relevance in the paediatric setting. The increasing breadth of cultural and linguistic diversity in Australian society has been documented, 1–3 and the impact on health care has been recognised 5,15–32 . The Australian literature has, to a limited extent, recognised the influence of culture and migration on particular aspects of child health, as exemplified by refugee populations, 26–30 childhood obesity, 18 adolescent health care, 24 and organisational or systemic service development 19–23 …”

“…However, the majority of the research undertaken in this domain has been largely derived from North American and European settings, and tends to focus on specific population groups 7–14 . The requirement for an Australian health‐care response to immigrant families, starting with maternal and infant care, 15,16 and encompassing aspects of child health and paediatric practice, 17–24 as well as recognition of the substantial health needs of recent waves of refugee children, 25–30 has further emphasised the importance of such gaps in research.…”