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4. Cultural and Religious Dietary Needs

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4. Cultural and Religious Dietary Needs 4. Cultural and Religious Dietary Needs This topic covers information about: Profile of the Community Diet and Religion Cultural and Religious Menu Planning Activities in this topic cover the following performance criteria: Identify client group, use correct terminology and observe cultural customs Consider cultural groups and general characteristics of their cuisine Identify dietary regimes and factors associated with cultural and religious groups that may influence food choices Plan and modify meals and menus to meet specific cultural and religious needs of client group in line with organisational guidelines Follow processes defined by dietitian to evaluate meals and menus to ensure they meet cultural and religious needs of the clients 4.1 Profile of the Community Australia is a multicultural society. Cultural groups in our society include but are not limited to: Asian Aboriginal and Torres Strait islander Caucasian/European Indian Mediterranean Middle Eastern South Sea Islanders South American African There are many factors that may influence food choices of different cultural backgrounds including: Background – where did they come from? Migration pathway – did they come straight here or spend time in another country? Was it a choice to migrate or forced migration? Allied Health Nutrition & Dietetics Skill Set Electives pre-requisite units for Certificate IV in llied Health Assistance – Combined Learner Guide for HLTAHA 018, HLTAHA019, HLTHA020, HLTAHA021 - 186 - How old were they? Did they have children and if so how old are their children? Can they speak the language? What is their level of education? Are they able to work and if so do they work outside of the home? Are there other community members here and if so can they access that community? Are there other family members? Are familiar foods available? Are shopping facilities familiar? Are cooking facilities familiar? What is their income? What are the pressures to conform? Do specific cultural foods have different cultural values? (ASeTTS, 2007) These factors may vary significantly from country to country and region to region and also within a country. Each cultural group may also have special food traditions; specific ways of preparing, cooking, serving and eating food; special occasions of food celebration (feast); and times of fasting or avoidance of certain foods/drinks (e.g. Lent or Eid). Modern changes to the traditional diet are not always healthier particularly when more processed western food is used, which tends to be higher in saturated fat, salt and sugar. Many people prefer bland or traditional foods (i.e. or food from childhood) when they are unwell (such as steamed or sticky rice in some Asian diets). Education about the positive aspects of the traditional diet alongside suitable modern choices can be provided in hospital and may help improve intake during admission and on discharge. Queensland is considered a culturally and religiously diverse state (Australian Bureau of Statistics, 2011: 26.3 % (1 in 4) Queenslanders were born overseas in more than 230 countries (↑ from 17.9% 2006 survey and 16.7% 1996) 23.2% of Qld population spoke a language other than English at home Recently Queensland Health published a document on community profiles for health providers for Queensland Health and is a useful introductory reference. http://www.health.qld.gov.au/multicultural/health_workers/profiles-complete.pdf Allied Health Nutrition & Dietetics Skill Set Electives pre-requisite units for Certificate IV in llied Health Assistance – Combined Learner Guide for HLTAHA 018, HLTAHA019, HLTHA020, HLTAHA021 - 187 - Arrivals in Queensland People from New Zealand and the United Kingdom have been constantly arriving since before 1970. Pre 1970 - Dominated by European arrivals 1970’s – PNG (following independence from Aust) and Vietnam (following Vietnam war) 1980’s – Philippines, Fiji and China 1990’s – Asian countries (Philippines, Taiwan, Vietnam, China) and South Africa 2000’s – China, India, Philippines, South Korea, Japan Religious affiliations in Queensland (Australian Bureau of Statistics, 2011) Christianity (62.0%) Buddhism (1.5%) Islam (0.8%) Hinduism (0.7%) Other (1.2%) No religion (22.3%) Not stated (12.7%) More than 147,313 (3.4%) people in Qld followed a religion other than Christianity Between 2006 - 2011 the fastest growing religions were Islam and Hinduism Increasing cultural, linguistic, and religious diversity in the Queensland population means that to be safe, health services need to be culturally appropriate and responsive. Research indicates a strong link between: Poor quality health Cultural outcomes and incompetence significant risks Figure 9: Link between cultural background and Nutrition (Johnston and Kanitsaki 2005) Allied Health Nutrition & Dietetics Skill Set Electives pre-requisite units for Certificate IV in llied Health Assistance – Combined Learner Guide for HLTAHA 018, HLTAHA019, HLTHA020, HLTAHA021 - 188 - Levels of adherence to a religious or cultural custom are a personal decision. Whilst some clients prefer to be strict and follow their religious beliefs to be 100% compliant, others may be less strict. Islam, Hinduism, Sikhism, and Buddhism are universal religions which are practiced in many countries around the world Each of these religions place responsibility on the individual to practice his/her religion Varying degrees of orthodoxy exist; people who follow particular faiths may follow food related customs fully or in part. Personal and cultural variations make it difficult to provide definitive rules and regulations that apply to all patients that identify with a particular religion. Therefore it is best to consult a patient on an individual/personal level for religious observances. For example, a Muslim from West Africa may have a slightly different way of observing Islam when compared to a Muslim from Bosnia, Indonesia, or Iran. It is important that healthcare providers do not stereotype their clients. Stereotypes assume that all people from certain race, nationality, social group, religion, or culture automatically share the same beliefs and values. Do not assume dietary preferences: . Even if the client appears to comes from a specific group, or is perceived to have certain cultural affiliations . As with all clients, it is best to identify a patient’s individual dietary preferences/customs and religious observances Appropriate terminology is vital when communicating with clients from different cultures. It is essential to be politically correct and non-discriminatory with all clients to reduce the risk of offending clients and their families. Effective communication occurs when clients and carers have common terms of reference and it is the healthcare providers responsibility (within reason) to learn and use the terminology that will be used and understood by clients, which includes food and food terminology. Allied Health Nutrition & Dietetics Skill Set Electives pre-requisite units for Certificate IV in llied Health Assistance – Combined Learner Guide for HLTAHA 018, HLTAHA019, HLTHA020, HLTAHA021 - 189 - A Nutrition Assistant is unable to assist a client with food preferences if they do not recognise/understand what the client is requesting. Resources available to assist with communicating with patients from culturally-diverse backgrounds include: Interpreters – Be aware of your healthcare facilities protocol to access interpreters as usually booking in advance is required. – Via phone contact – Face to face – a Nutrition Assistant may be involved directly or indirectly via Dietitian Ward Communication tool Communication tools developed by individual facilities Queensland Health provides a list of interpretive resources on their website. http://www.health.qld.gov.au/multicultural/public/language.asp http://www.health.qld.gov.au/multicultural/support_tools/WCT.asp Allied Health Nutrition & Dietetics Skill Set Electives pre-requisite units for Certificate IV in llied Health Assistance – Combined Learner Guide for HLTAHA 018, HLTAHA019, HLTHA020, HLTAHA021 - 190 - The following pictures/tools are courtesy of Mater Health Services who developed these tools to help communicate dietary preferences with West African inpatients. Figure 10a: Dietary preference communication tool (West African) (Mater Health Service, 2008) Allied Health Nutrition & Dietetics Skill Set Electives pre-requisite units for Certificate IV in llied Health Assistance – Combined Learner Guide for HLTAHA 018, HLTAHA019, HLTHA020, HLTAHA021 - 191 - Figure 10b: Dietary preference communication tool (West African) (Mater Health Service, 2008) Allied Health Nutrition & Dietetics Skill Set Electives pre-requisite units for Certificate IV in llied Health Assistance – Combined Learner Guide for HLTAHA 018, HLTAHA019, HLTHA020, HLTAHA021 - 192 - There are several factors that influence food choices and these include: Availability Accessibility Familiarity Beliefs and Values Food advertising Cultural preferences Therapeutic diet requirements Cultural preferences Special food traditions/customs Different religious needs Specific ways of preparing, cooking, serving and eating food Holy Days/Festivals/Special Occasions which impact on food intake Fasting or avoidance of certain foods/drinks Allied Health Nutrition & Dietetics Skill Set Electives pre-requisite units for Certificate IV in llied Health Assistance – Combined Learner Guide for HLTAHA 018, HLTAHA019, HLTHA020, HLTAHA021 - 193 - Observing
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