Demonstrate Culturally Appropriate Behaviour

Many people think culture is about ‘race’ and ‘ethnicity’, but culture is much more than just which part of the world someone comes from. Culture also affects many other aspects of a person's identity, including age, abilities or disabilities, gender, sexual orientation, group affiliations and connections. Culture is about how people see themselves, think about things and behave.

The people you work with and support in a health setting may differ from you in many ways including:

• age
• gender
• ability
• spirituality
• sexual orientation
• immigrant status
• disability
• socio-economic status or employment
• ethnicity

Cultural identity

Cultural identity is defined as the distinct identity of people or groups. We are often born into our cultural identities. Categories that make up cultural identities include age, sexual orientation, ethnicity, gender, religion or spirituality beliefs, social class, occupation, disability, immigrant or refugee status, or region. Culture also reflects group values, norms, and behaviours. Cultural preferences include food, music, clothing, communication, customs, and celebrations.

Below is a list of some of the aspects that inform a person's cultural identity:

• Values: The principles, standards of behaviour and/or things that a person considers important in life. 
• Beliefs: What a person accepts as true and believes in.
• Use of language: The words a person uses and how they use them to get their point across.
• Cultural practices: The traditions, customs, and habits of people from a particular culture.
• Accepted protocols: The accepted rules and behaviours for certain situations.
• Gender roles: How someone thinks men and women should think, speak, dress and act, based on their gender.
• Stigma: When someone views a situation or action as having shame, disgrace or dishonour associated with it.
• Discrimination: When someone treats another person differently because of the person’s gender, age, culture, etc.

Why cultural competence matters

Cultural competence is essential for creating a harmonious and effective work environment. It entails understanding and engaging effectively with people from diverse cultural backgrounds. Building strong relationships relies on mutual respect and understanding, encompassing factors like ethnicity, gender, spiritual beliefs, and more.

Elements of cultural competence

• Awareness: Recognising how our culture shapes interactions.
• Sensitivity: Being aware of cultural dynamics in interactions.
• Knowledge: Gaining insights into other cultures and their practices.
• Skills: Adapting knowledge in practice for meaningful interactions.

Cultural safety

Cultural safety is different from cultural awareness. Cultural awareness is about being aware that there are different cultures whose ways of interacting with others may differ from our own ways. Cultural safety is about the person who is receiving services being safe in a health and wellbeing setting.

It’s about feeling:

• physically safe
• culturally safe
• emotionally safe
• spiritually safe

Culturally safe practices

Cultural safety is about providing an environment in which the cultural identity, background, needs and differences of every person are recognised and respected. People must be able to express themselves freely and safely, without being judged by others.

Generally, culturally safe practices include understanding and respecting cultural values and principles of tangata and their whānau. Cultural safety means healthcare workers and their organisations need to think about how their own culture might influence the way they take care of patients. This means they have to acknowledge their own biases, attitudes, and assumptions that could affect the quality of care. It's like looking in a mirror to better understand themselves and making sure they give care that respects the patient's culture.

When people feel safe about using health, disability, and community services they will use them. If they don’t feel safe about using these services they won’t, and their health could deteriorate. Cultural safety occurs when people who are being supported feel valued, listened to and respected.

Bias

Bias is having a prejudiced view (either positively or negatively) about other people, often based on specific characteristics such as age, gender or race. Unconscious biases are ones that we are generally unaware of. However, it is possible to develop an understanding of our own unconscious biases if we are willing to question ourselves. Understanding your biases is an important part of cultural safety.

Culturally responsive interactions

Culturally responsive interactions refer to engaging and communicating with individuals from diverse cultural backgrounds in a manner that acknowledges, respects, and values their cultural perspectives and experiences. Culturally responsive interactions aim to create an inclusive environment where people from different cultures feel heard, understood, and valued.

These interactions require individuals to be aware of their own cultural biases, stereotypes, and assumptions and to actively challenge and overcome them.

Click on the following headings to display information on culturally responsive interactions.

By engaging and practising culturally responsive interactions, we as individuals and workers can foster inclusivity, build positive relationships, and promote mutual understanding and respect across different cultures.

Strategies for supporting a person from a different culture

There are strategies that you can use as a health and wellbeing support worker to ensure a culturally safe environment and a service that meets the cultural needs of the tangata you support.

Most strategies are based on being aware that a person’s culture is different from your own, and finding out how you can support their culture.

Pacific populations

The Pacific community, which refers to people from Pacific nations, constitutes the fourth-largest major ethnic group in the 2013 New Zealand Census, following the European, Māori, and Asian ethnic groups. In the census, 295,941 individuals identified with one or more Pacific ethnic groups, which accounts for 7.4 percent of the total New Zealand population.

It's important to note that the Pacific community encompasses a diverse range of individuals, including people who were born in the Pacific Islands and have emigrated to New Zealand as well as people who were born in New Zealand and who identify as Pacific people. Within the Pacific communities of New Zealand, there are distinct differences, and these should be considered with respect to their own unique contexts (Wilson-Uili et al., 2022).

Pacific values

If you are not part of the Pasifika community, you will need to work hard to understand some of the key aspects of Pacific culture that may be different from your own.

For instance, in Pacific cultures, it holds great significance to understand and honour an individual's prayers, ceremonies, and spiritual beliefs. These elements play a vital role in their life and well-being. Be attentive to their references to God, which may be frequent and hold deep meaning. Supporting them in attending ceremonies reflects your respect for their values and traditions.

Cultural customs and protocols have evolved over time and hold immense importance. They represent the authentic and respectful ways of engaging within a specific community. It's crucial to acknowledge and uphold these customs, as they symbolize the right and accepted way of doing things.

By embracing these insights, you'll not only show your respect for Pacific cultures but also contribute to creating a supportive and inclusive environment for the individuals you are assisting. Your understanding and sensitivity will help foster meaningful connections and genuine support.

The Ministry of Pacific Peoples has identified the values important to Pacific people and their families in Kapasa - The Pacific Policy Analysis Tool (Kapasa, 2023). These are described in the activity below.

Learning about Māori values in a health and wellbeing setting will help you to incorporate them into your role as a support worker every day.

The 3Ps of Te Tiriti O Waitangi

• partnership
• participation
• protection

Partnership

Partnership is about working together with tangata, their whānau, hapū and iwi so that they are all involved in the tangata‘s health and well-being support. It means valuing the person and their support networks, and sharing decision-making and resources. Partnership is about working with tangata, sharing skills, sharing power and treating tangata equally in relationships.

Working in partnership requires people to:

• respect and value differences
• show empathy
• share knowledge and empower others
• share decision-making processes

Support workers need to:

• Act in good faith based on Te Tiriti principles.
• Work alongside the person they support and their whānau, including them as equals in the working relationship.
• Recognise that partnership involves support workers and other members of a multidisciplinary team working together and alongside the tangata and their whānau.

Participation

Participation is about allowing time for people, their whānau, hapū and iwi to be part of discussions and decision-making about their needs, for example, when the personal plan is designed or reviewed. Participation requires everyone to be inclusive of the person and their whānau.

Participation occurs when there is:

• open discussion and genuine consultation
• good faith
• support for tangata to share their ideas and have their ideas supported

Support workers need to:

• Ensure the tangata they support and their whānau are included in their assessments, goal setting, decision-making and creation of personal plans.
• Ensure support services are geographically accessible, culturally responsive and financially affordable and that tangata can use available transportation options.
• Recognise Māori rights to equitable access to services, enabling them to attain optimal health and well-being outcomes.

Protection

Protection is about ensuring tangata are supported and protected from inequality in the health system. It involves ensuring they have access to services that meet their needs. It also involves safeguarding Māori elements, including taha Māori (culture) and te reo Māori (language), and protecting tangata from threats to their wellbeing and quality of life. A threat to someone’s cultural practices and values can directly impact their wellbeing. Protection requires:

• advocacy and honesty
• knowledge and awareness
• protecting the things that are important to the person

Support workers should:

• Safeguard Māori health.
• Ensure their clients have access to all services available and appropriate for them. Advocate for your client if you think they are missing out on support.
• Ensure the support they provide is culturally, spiritually, and emotionally safe, in addition to being physically appropriate.
• Seek feedback from the person and their whānau to ensure the support aligns with their needs. Avoid making assumptions about what's best for them.
• Acknowledge that health and well-being are precious taonga (treasures) and collaborate with the individual to protect and enhance them.

Tikanga

In Māori terms, following tikanga means behaving in culturally appropriate ways. It is woven into all aspects of life and can be seen in everyday tasks like cooking, as well as in formal activities like the pōwhiri (welcome).

Tikanga can vary among different iwi (tribes) and hapū (sub-tribes). Despite this variation, there are several common areas that tikanga encompasses.

• Whakapapa: the genealogical connection that Māori have with their ancestors. It is an essential aspect of tikanga and establishes relationships, rights, and responsibilities within the community.
• Pōwhiri: the traditional Māori welcoming ceremony. It involves a series of rituals and protocols to acknowledge and welcome visitors onto the marae (traditional meeting grounds).
• Karakia: traditional Māori prayers or incantations used to invoke spiritual guidance, protection, or blessings. They are performed in various settings, such as the beginning or end of a gathering, before meals, or during specific ceremonies.
• Tangihanga: the Māori funeral customs and practices. It involves a series of rituals to mourn the deceased, pay respects, and support the grieving whānau (family).
• Manaakitanga: emphasises the value of hospitality, respect, and care for others. It involves showing kindness, generosity, and support to visitors, guests, and community members.

Tikanga and support work

Tikanga involves support workers:

• Behaving appropriately in people’s homes, residential facilities and in meetings.
• Providing health care in an environment that is culturally sensitive to those using it.
• Acknowledging cultural protocols and protecting people’s rights to follow them.

This helps build trust and confidence in a relationship.

Professionalism and tikanga

You learnt about professionalism earlier in the course. Characteristics of a professional include being trustworthy, competent at your job, respectful, considerate of others and acting with integrity. Being professional from a Māori cultural perspective means acknowledging and applying Māori values, for example:

• Whānaungatanga – is about relationships, kinship and a sense of family connection. It is created through shared experiences and working together and gives people a sense of belonging.
• Manaakitanga – Supporting tangata in a way that recognises their mana to support greater well-being.
• Kaitiakitanga – The value of recognising, nurturing and protecting that which is important in order to engage in trusting relationships to support greater well-being.
• Kotahitanga – The value of working collaboratively to support greater well-being.

Professionalism and cultural safety also encompass following the Te Tiriti o Waitangi principles of partnership, protection and participation.

Te Reo Māori

Some of the clients you provide care for may speak te reo Māori. Learning some words will be invaluable in your work as a caregiver.

Activity

Click on the link to display the Te reo Māori quiz provided by Te Papa. Complete the quiz to test your knowledge.

Pepeha

Incorporating Māori greetings shows respect for the culture and acknowledges the diverse backgrounds of your support users. A pepeha greeting helps create a welcoming and inclusive environment where Māori patients feel valued and understood. It also demonstrates your commitment to culturally appropriate care, which is important for building trust and rapport with your users.

Activity

You created and practiced your pepeha earlier in the course. Is it ready to use at your workplace? Now would be a good time to practice it.

Effective communication is a two-way process that means getting your message across and also understanding what the other person has to say. The term ‘own cultural communication needs’ refers to the communication preferences and expectations that individuals have based on their cultural background and upbringing.

This includes things like the:

• use of language
• body language
• tone
• other cultural norms and values that shape how people communicate

In some cultures, certain ways of communicating, like speaking loudly, making direct eye contact, using acronyms or jargon, or gesturing while talking, might be considered offensive. Differences which may be based in culture can include:

Understanding and respecting these cultural communication needs is important for effective intercultural communication while at the same time building positive relationships with people from diverse backgrounds.

Being effective in this involves being mindful of one’s own cultural biases and then learning to better adapt to the communication styles of others to promote mutual understanding and respect.

You can proactively improve your knowledge about other cultures. This will help you work competently with others while demonstrating respect for diversity and inclusiveness. For example, you may: 

• Participate in cultural festivals: Holi, Diwali, Chinese New Year celebrations, Pasifika Festival, and Matariki celebrations.
• Talk to members of other cultures about their beliefs and practices.
• Watch movies and documentaries and read books about other cultures. 
• Try foods from other cultures.
• If you find yourself passing judgement on another person’s actions or beliefs, ask yourself: could I be judging them based on the standards of my own culture, even unconsciously? 
• Proactively participate in all workplace training on diversity, cultural competence, and cultural safety.
• Encourage cultural inclusion in the workplace, e.g., suggest a cultural day where workers share food from their own culture and discuss their cultural experiences. 
• If you identify any culturally inappropriate work practices, bring them to the attention of management. 
• Learn how to work effectively with an interpreter.