QUALITY IN HEALTH: DIFFICULTIES DUE TO ETHNIC, CULTURAL AND RELIGIOUS DIVERSITY

Abstract

Quality in health is a complex theme, which can barely be understood in all its magnitude, without clearly defining first all the concepts involved, knowing the deontology that rules the clinical practice and characterising the target population of that practice. The recent cosmopolization of the Portuguese society has created new challenges for the national health care system, due to the diversification of the needs and expectations of the citizens. The purpose of this study was to make an informal listing of the difficulties inherent to this new social reality, through oral interviews with 33 health care professionals. The results obtained showed problems at the levels of communication with foreigners, disrespect for religious beliefs during illness, treatment and dying, and insufficient training of non-medical professionals with responsibilities in health care environments. These problems showed a true paradox towards the health concept definition, as we seem to be assuring the state of complete physical well-being of the patients to the detriment of their state of complete mental and social well-being. In order to begin to remedy this, it is suggested that the ministry of health should take positive action, by nominating an empowering committee to fully characterize the situation in the field, promote the open and prejudice-free dialogue between the interested parties and create conceptual and normative conditions to facilitate the implementation of the necessary changes in the Portuguese health care system. To help improve the actual situation until long-term actions can be fully implemented, some immediate short-term/low-cost actions are also suggested in the conclusions.

Bio

Sandra Feliciano is an auditor, trainer and consultant in quality management systems. She is the Operations Director of QEC - Quality & Environmental Certification Ltd. for Portugal and Sweden (QEC is a British certification body accredited by UKAS). She is also a supply member to the board of directors of ALUBRAT (the Portuguese-Brasilian Transpersonal Psychology Association).