Innovative practice: exploring acculturation theory to advance rehabilitation from pediatric to adult “cultures” of care

Abstract

Introduction: This perspective paper explores the application of acculturation and the inherent concepts and ideas associated with this theory in rehabilitation to provide a framework for interpreting patient circumstances, responses and behaviours as they move from one culture to the next. Traditionally acculturation theory has been use to examine changes in culture in an ethnic or country sense, however, this paper is among the first to apply acculturation theory to the rehabilitation service cultures from pediatric to adult care for youth with chronic health conditions. Purpose: The objectives of this paper are threefold: (1) to critically appraise key literature in the development of acculturation theory, (2) to discuss how acculturation theory can be applied in rehabilitation practice through a clinical vignette, and finally (3) to discuss how acculturation theory can advance rehabilitation by enhancing client-centered practice. Implications for rehabilitation: Acculturation theory can provide insight into how patients are experiencing a change in health care “cultures”, in the context of their overarching life circumstances. This, coming from a broader societal perspective can in turn inform an optimal approach to client-centered practice, and the application of rehabilitation-specific team inputs. This theoretical framework can heighten practitioners’ awareness of patients’ unique worldviews related to their expectations for care and treatment thus reducing fear of diversity to establish positive partnerships between patients and clinicians. Conclusions: An understanding of patients’ acculturation processes will add new insight into how we can best deliver services and supports to optimise health, opportunities and experiences for youth with chronic conditions.

Implications for Rehabilitation

• The integration of acculturation theory and inherent concepts can provide a reassuring framework upon which to rely in interpreting patient circumstances, responses and behaviours when moving from one culture to the next.

• Cultural intelligence will reduce fear of diversity and establish positive partnerships between patients and clinicians.

• Acculturation can become a natural worldview for health systems practitioners when integrated into clinical practice frameworks.

• Acculturation
• adolescent
• culture
• enculturation
• transition

Acknowledgements

The authors would like to thank the Faculty at the School of Rehabilitation Science and the CanChild Center for Childhood Disability Research for supporting the development of this paper. The first author would like to acknowledge support from the Canadian Institutes of Health Research Doctoral Fellow – Frederick Banting and Charles Best Canada Graduate Scholarship.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.