Table 3 Components of cultural competency

Dress

1. Respectful clothing appropriate to region

2. Do host people need certain clothing to maintain their dignity?

1. Tank tops, short skirts inappropriate in Muslim country

2. Cover people with torn or absent clothing with a blanket

Language

1. What is the language?

2. How to greet people?

Learn words for hello, how are you, thank you, good bye

Gender, age, power

1. Can male responders treat and care for women?

2. Who is the community leader?

3. Who is the decision maker in the family?

1. Be aware that in some cultures, community leaders may traditionally be involved in medical decision-making

2. Identify patient preferences regarding how medical information is shared

Touching and behavior

1. What are the usual customs for touching?

2. Is it ok to hold someone’s hand?

3. What are special considerations for interaction with women, children, elderly?

1. In some cultures, “thumbs up” is a rude gesture

2. Touching someone’s head or face is rude in South Asia

3. Showing the soles of your feet is rude in the Middle East

Beliefs and religion

1. Who are the different ethnic and religious groups of the region?

2. What are the beliefs and practices that are important?

3. How might they understand or explain what has happened?

1. Ask if the patient would want a religious leader present at end-of-life

2. Ask about patient/family’s beliefs about treatment of the body (viewing, handling, burial) after death (WHO et al. 2018)