Second National Conference on
Quality Health Care for Culturally Diverse Populations:
Strategy and Action for Communities, Providers, and a Changing Health System

II-A2: Accessing Sacred Stories: Cultural And Spiritual Assessment In A Clinical Setting

Care providers need to know their clients in order to provide culturally/spiritually competent, individualized care. In 1927 Francis Wold Peabody stated: The secret of the care of the patient is caring for the patient...the good physician knows his patient through and through. The treatment of a disease can be impersonal. The care of a patient must be completely personal. The concept of listening to and attending to the client is not new. In our fast-paced, technological society it has become more and more difficult for providers to find the time required to establish a trusting relationship with their clients. The pressure to see more patients in less time and frequent changes in providers means that there are many obstacles in getting to know your clients. One of the best ways to overcome these barriers is through a self report cultural spiritual assessment process.

The data could be summarized and be available for each individual provider within the system to assist in providing culturally/spiritually competent, individualized care for everyone without wasting the time of each provider to explore the same area. This process could also assist in the speedy identification of spiritual and cultural mentors and leaders who might be valuable for the support they offer in times of health crisis.

As valuable as this information might be to a provider, the primary reason for cultural spiritual assessment is not simply identification, as important as that is but rather the delivery of culturally competent, individualized care. Cultural competency is a critical skill for health care providers who deal daily with diverse people in life-and-death situations. Use of cultural profiles as simplistic, straightforward predictors of beliefs or behavior will lead to harmful stereotyping of patient's and their families and result in culturally and spiritually insensitive care. The benefit of a cultural/spiritual assessment is the opportunity to provide culturally competent, individualized care that addresses patient needs respectful of their beliefs and worldview. It also allows for more efficient utilization of limited health care resources through recognizing optimal approaches for individual patients and accessing existing family and community support. The greatest challenge is in convincing providers to commit the additional time required to listen to and know their patients.

The findings from several pilot test studies of the Berg Cultural/Spiritual Assessment Tool include:

It strengthens the therapeutic alliance with the patient.
It enhances the patient's level of self-esteem and cultural/spiritual awareness.
It provides valuable information about patients across ethnic, religious, spiritual, racial and gender groups.
It helps in identification of patients who are bi/tri-cultural in identity.
The assessment tool works for all patients.
The assessment data is only helpful when the staff is prepared and committed to deliver culturally/ spiritually competent patient focused care.

Participants in this workshop will learn how to approach the topic of spiritual/cultural assessment, will discover more about the contributions of culture and spirituality to healing, will practice using a cultural/spiritual assessment tool and explore how they can adapt this tool for their setting.

Reverend David F. Berg, MA, MDiv
Chaplain Supervisor
Fairview Recovery Services
Fairview University Medical Center
Phone: (612) 672-4861
Fax: (612) 672-4860
Email: dberg1@fairview.org

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