Academic journal article Journal of Cultural Diversity

The Impact of Race, Ethnicity, and Country of Professional Preparation on Physical Therapists' Assessment and Treatment Preferences

Academic journal article Journal of Cultural Diversity

The Impact of Race, Ethnicity, and Country of Professional Preparation on Physical Therapists' Assessment and Treatment Preferences

Article excerpt

Abstract: The purpose of this study was to explore the impact of race, ethnicity, and country of professional preparation on physical therapists' assessment and treatment preferences. A three-part questionnaire consisting of demographic questions, a patient scenario, and a list of assessment and treatment options was completed by 187 physical therapists. Chi-square analysis showed no difference between physical therapists educated in this country and foreign-educated physical therapists in any of the assessment and treatment preferences. More minority (66%) than non-minority (46.3%) physical therapists indicated they would evaluate back extensor muscle strength. This is the first study to investigate the impact of race, ethnicity, and country of professional preparation on practice in physical therapy and opens the door to future studies.

Key Words: Assessment, Country of Professional Preparation, Ethnicity, Physical Therapists, Treatment

The United States is a multicultural society with many ethnic and racial groups (U.S. Census Bureau, 1990; U.S. Census Bureau, 2000). The total minority population has grown, from 24.4% of the total U.S. population in 1990 to 30.9% of the total U.S. population in the year 2000. Physical therapy, as a profession, while less diverse than the general population, is also becoming increasingly multicultural (Census '90,1990). According to U.S. Census data (2000), 12.6% of physical therapists are members of minority groups, with 5.6% self-identifying as Black, 3.6% as Hispanic, and 3.2% as Asian. It is important to recognize and understand the differences in attitudes, beliefs, and values that lead to different professional behaviors and decisions in a multicultural society.

Individuals are characterized by a variety of values, beliefs, attitudes, and behaviors that are culturespecific (Leavitt, 1999). Culture affects interpersonal communication (Kreps & Kunimoto, 1994); attitudes toward health, illness, and disability (Ang, Ibrahim, Burant, Siminoff, & Kwoh, 2002; Bakheit & Shanmugalingam, 1997; Gallaher & Hough, 2001; Harper & Peterson, 2001; Hojat et al, 2003; Kleinman, 1980; Paris, 1993; Trawick, 1990; Wang, Chan, Thomas, Lin, & Larson, 1997); and health related behaviors (Khan & Pillay, 2003; Lundqvist, Nilstun, & Dykes, 2003; MayTeerink, 1999; Reed, Assefi, Gooding, & Teklemariam, 2002; Spear & Kulbok, 2001). Health professionals' attitudes toward disability are known to affect their judgment and interaction with patients of the same and different cultures (Al-Abdulwahab & Al-Gain, 2003; Blackford & Street, 2002; Gething, 1992; Treloar, 1999). It is not known, however, if health professionals' racial or ethnic cultures affect the way they practice their profession or if professional norms and guidelines supersede culturally-based personal preferences.

BACKGROUND

A few studies in fields other than physical therapy have suggested that cultural differences have an impact on assessment and treatment preferences. Schmidt, Jacobs, and Barton (2002) found that British general practitioners (GPs) were more likely than German GPs to make referrals to complementary medicine practitioners. Perry, Swartz, Smith-Wheelock, Westbrook, and Buck (1996) found that non-white professionals in various fields (i.e., social workers, physicians, nurses, dialysis technicians, and dieticians) were less likely than were white professionals to discuss advanced directives with chronic dialysis patients. Kawamura, Iwamoto, and Wright (1997) found cross-cultural differences in health behaviors between Japanese and Australian dental students. In a qualitative study, Taylor (2005) found differences in the perception of nurses' roles among 11 overseas nurses, representing six different countries of origin, working in the United Kingdom (UK). Arthur, Chan, Fung, Wong, and Yeung (1999) found that professional training superseded cultural norms; they reported that western-trained mental health nurses in Hong Kong utilized western-style humanistic communication strategies which were not culturally sensitive with respect to their Chinese clients. …

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