Cultural Diversity

Cultural Diversity Health Team Relations Melissa Lewis, RN

INTRODUCTION • HC providers must provide care to many different types of patients • No two patients are alike • HC providers must be aware of and respect the individuality of each patient

Individuality/Uniqueness influenced by the following: • Physical characteristics • Family life • Socioeconomic status • Religious beliefs • Geographical location • Education • Occupation • Life experiences

Culture • Defined as values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs unique to a particular group of people and passed from one generation to the next • Set of rules about things like family relations, child rearing, education, occupational choice, social interactions, spirituality, religious beliefs, food preferences, health beliefs, and HC

All Cultures have 4 things in common: • 1. Culture is learned** • 2. Culture is shared • 3. Culture is social in nature • 4. Culture is dynamic and constantly changing

Ethnicity • Defined as a classification of people based on national origin and/or culture • Members of an ethnic group may share common heritage, geographical location, social customs, language, and beliefs

Ethnic Groups in the United States • 1. African American • 2. Asian American • 3. European American • 4. Hispanic American • 5. Middle Eastern/Arab Americans • 6. Native Americans (Indians and Eskimos)***

Race • Classification of people based on the physical characteristics (color or hair, skin, and eyes) • There are different races present in most ethnic groups. • Ex. There are black and white African Americans.

Cultural Diversity • This is the differences in culture, ethnicity, and racial factors among people • In previous times the United States used to be called the “melting pot” to represent the absorption of many cultures in the dominant culture. • This is called cultural assimilation when people come from other countries and adapt to the American way of doing things

Cultural Diversity cont… • In reality the U.S. is more like a salad bowl now where cultural differences are appreciated and respected • Acculturation = the process of learning the beliefs and behaviors of a dominant culture and assuming some of the characteristics • This process occurs slowly over time • Recent immigrants to the U.S. are more likely to follow patterns of their native land than their children and grandchildren who have lived here longer

Cultural Sensitivity • The ability to recognize and appreciate the personal characteristics of others is essential in health care • Ex. In some cultures, called an adult by their first name is not acceptable except for close friends/relatives. Sensitive HC workers will address patients by Mr./Mrs. and their last name

Bias • A bias is a preference that prevents impartial judgment • Example: Individuals that believe in the supremacy of their own ethnic group (ethnocentric). These people believe that their cultural values are better than the cultural values of others

Common Biases include: • Age • Younger people are more physically and mentally superior to older people • Education • College educated people are superior to uneducated people • Economic • Rich people are superior to poor people • Physical • Obese and short people are inferior to slender and taller people • Occupation • Nurses are inferior to doctors • Sexual preference • Homosexuals are inferior to heterosexuals • Gender • Women are inferior to men

Prejudice • Prejudice means to pre-judge. • It is a strong feeling/belief about a person/subject that is formed without reviewing facts/information • This causes fear and distrust and interferes with interpersonal relationships • Everyone is prejudiced to a certain degree!

Stereotyping • Stereotyping occurs when an assumption is made that everyone in a particular group is the same • Labels individuals • Example = “All blondes are dumb.”

Bias, Prejudice, and Stereotyping • These are all barriers to effective communication and relationships with patients • HC providers must be alert to these barriers and make every effort to avoid them

Ways to avoid bias, prejudice, and stereotyping in Health Care: • Know and be consciously aware of your own personal and professional values and beliefs • Obtain as much information as possible about different ethnic/cultural groups • Be sensitive to behaviors and practices different from your own • Remember you are not be pressured to adopt your patients’ beliefs, but you must respect them

Ways to avoid bias, prejudice, and stereotyping in Health Care cont… • Develop friendships with a wide variety of people • Ask questions about your patients’ beliefs/culture • Evaluate all information before you form an opinion • Be open to differences • Avoid jokes that may offend • Remember mistakes happen, apologize if you hurt someone’s feelings, and forgive if someone hurts your feelings

Holistic Care • HC providers must be aware of cultural diversity to provide holistic care (well-being of the whole person) to their patients

Family Organization • This is the structure of a family and the dominant or decision-making person in the family • Families vary in their composition and in the roles assumed by family members

2 Main Types of Families • 1. Nuclear family • Usually consists of a mother, father, and children (single-parent and children) • Common type for European American families • 2. Extended family • Usually includes nuclear family plus grandparents, aunts, uncles, and cousins • Common type for Asian, Hispanic, and Native American families

Patriarchal Families • In these families the father or oldest male is the authority figure and makes the decisions for the family • So, this is the person who would make the health care decisions as well • Women are expected to be obedient

Matriarchal Families • In these families the mother or oldest female is the authority figure and makes the decisions for the family

Language • Dominant language used in United States is English • However, 20% of population under 65 years of age speaks another language • A health care provider must determine the patient’s ability to communicate by talking with pateint/relative and asking questions

Common Questions to Determine Patient’s Understanding • Do you speak English as your first language? • What language is spoken at home? • Do you read English? • Do you have a family member/friend that can interpret for you?

Health Care Providers should: • Find a translator when possible • Speak slowly and use simple words • Use gestures/pictures to clarify meaning of words • Use nonverbal communication (smile or gentle touch) when appropriate • Avoid tendency to speak louder • Try to learn some words/phrases in their language

Personal Space • Personal space = territorial space • This describes the distance people require to feel comfortable while interacting with others • This varies among different ethnic groups • Close contact groups: comfortable standing very close to and even touching • Distant contact groups

HC Providers & Personal Space • HC providers have to invade a patient’s personal space at times to do certain skills (ex. Taking vital signs, baths, etc.) • HC providers should always be alert to patients verbals and non-verbals • HC providers should use a slow, relaxed approach and explain the procedure

Eye Contact • European Americans regard eye contact during conversation as a sign of interest and trustworthiness • Asian Americans consider direct eye contact to be rude • The many beliefs regarding eye contact can lead to misunderstandings when people of different cultures interact

Gestures • Shaking head “yes” or “no” • In India, it is the complete opposite • Pointing at someone with a finger represents a strong threat by Asian and Native Americans

Health Care Beliefs • The “Western” system is the most common HC system in the U.S. • This system is based on the cause of disease being microorganisms, diseased cells, and the process of aging • When the cause is determined, HC is directed toward eliminating microorganisms, conquering disease process, and/or preventing the aging process • HC providers in the U.S. are trained and licensed to practice

Western HC Beliefs • Encouraging patients to learn as much as possible about their illness • Informing patients about terminal illnesses • Teaching self-care • Using medications and technology to cure or decrease effects of disease/illness • Teaching preventative care

Health Care Beliefs of Different Ethnic Groups • Look in book on page 142-143 • Make your own table with six rows down and five columns down • I will help you condense chart in book

Alternative Health Care • Nutritional methods • Organic foods, herbs, vitamins • Mind and body control • Relaxation, meditation, biofeedback • Hypnotherapy, imagery • Energetic touch therapy • Massage, acupuncture • Body-movement methods • Chiropractic, yoga, tai chi • Spiritual methods • Faith healing, prayer, and spiritual counseling

Traditional vs. Alternative Treatments • All individuals have the right to choose the type of HC system and method of treatment that they feel is best for them • HC providers must respect this, even if they do not agree

The beliefs individuals have about themselves, their connections with others, and their relationship with a higher power Individual’s need to find meaning and purpose in life Organized system of belief in a superhuman power Form of worship Ex. Going to church Spirituality vs. Religion

Major Religious Beliefs • Pg 145-148

Atheist • Someone who does not believe in a higher power

Agnostic • A person who believes that the existence of a higher power can not be proven or disproven

THE END!!!

Cultural Diversity