Understanding Cultural Diversity Health Team Relations NOTE TO TEACHERS: This PowerPoint is designed to stimulate interaction and discussion from students. Students will be able to contribute to the discussion from personal knowledge and experiences. A key point throughout the discussion is to recognize why “understanding” is important to health care workers, and the fact that ALL people within a culture do not act and feel in the same way. ALL INDIVIDUALS are unique, and it is essential for the health care worker to seek to understand an individual’s needs.

Holistic Care Physical Mental Social Emotional Definition: Care for the well-being of the whole person. Physical Mental Social Emotional TEACHER ASKS: What aspect of a person’s well-being are we concerned with in health care? Is that true for all professions? RESPONSE: Students should recognize that health care workers must be aware of cultural and ethnic beliefs in order to treat the whole person and provide holistic care. This is not a requirement for all professions, but it is in health care.

Western System The most common health care in the US. We believe that medication and technology can be useful in treating disease. Alternative therapies are increasing in US.

Illness has a Spiritual Connection Hispanics Asians Middle Eastern cultures

Family Organization Nuclear German Extended Asian TEACHER ASKS: What is a nuclear family? What is an extended family. RESPONSE: Students should recognize that a nuclear family is parent(s) and child(ren) and an extended family is parents, children, aunts, uncles, cousins and grandparents.

Nuclear or Extended Hispanic American Native American Polish American Italian American African American British American TEACHER ASKS: What is usually the basic family unit in the following cultures? RESPONSE: Hispanic American = extended Native American = extended Polish American = nuclear Italian American = nuclear African American = extended British American = nuclear Note: Requires critical thinking in understanding examples of European American.

Family Organization Patriarchal Matriarchal TEACHER ASKS: The authority figure in the families of the patients you care for will vary. Who is the authority figure in your family? RESPONSE: Should have a variety of answers, including “both.” Help students understand that some cultures have strong patriarchal authority. TEACHER ASKS: How would you respond if a man of Middle Eastern culture wanted to make all the decisions for his hospitalized wife? RESPONSE: Recognition and acceptance of family organization is essential for health care providers. Help students discuss and explore this concept. TEACHER ASKS: To determine a patient’s family structure, what questions might you ask? RESPONSE: There are sample questions in the textbook. See if students can generate their own answers.

Language Dominant language in U.S. is ENGLISH What percent of U.S. population speaks a language other than English at home? 20% Health care workers must ask questions to determine the patient’s ability to communicate. When possible, find a translator. TEACHER: After 2nd bullet, ask the question it presents. After 4th bullet, ask - What kinds of questions could you ask to determine the patient’s ability to communicate? RESPONSE: Questions are given on page 138 of the textbook. Let students try to formulate their own questions. Help them understand the importance of finding out what language the patients speaks and reads, and to not make assumptions.

Techniques for Non-English Speaking Patients Speak slowly and use simple words Use gestures or pictures Use non-verbal – smile and touch DON’T speak louder Learn a few essential words and phrases Show all bullets on the slide. After the last bullet: TEACHER ASKS: Imagine you were to care for a patient from Russia. How would you learn a few essential words and phrases? RESPONSE: To generate some fun discussion and thinking….see what ideas they can generate. Answers might include “the Internet”, family members, in the hospital library, Barnes and Noble, etc.

Personal Space and Touch Stay out of my space! Close contact vs. distant contact cultures Show first bullet, and then ask the question: TEACHER ASKS: What does it mean to be a close contact or distant contact culture? RESPONSE: Should talk about territorial space, and the distance people need to feel comfortable when interacting. Show the picture and “stay out of my space” balloon after students suggest and example of distant contact.

Personal Space and Touch Arab French & Latin Americans Hispanic Americans Close Contact Gender European & African Americans Asian Americans Cambodia Vietnamese Middle Eastern Not close contact Native American BEFORE REVEALING BULLETS, TEACHER ASKS: I’m going to show you a variety of cultures and countries. We can discuss examples of how people from those cultures often react to person space and touch. Keep in mind that these are just examples, and not everyone from a specific culture or ethnic groups responds in exactly the same way. QUESTION TO STUDENTS: If that’s true, then why bother to learn about personal space and touch? RESPONSE: Should realize that understanding differences is a good starting point for understanding behavior, etc. REVEAL EACH BULLET and let students suggest how each group responds to personal touch and space. The answers are on pages 139-140 in the textbook.

Eye Contact European Americans Maintaining eye contact sign of interest and trustworthiness Show first bullet and ask: TEACHER ASKS: How do European Americans feel about eye contact? After student responses, show correct answer and picture.

Eye Contact What about other cultures? TEACHER ASKS: What are some examples of how people from different cultures typically react to eye contact? RESPONSES: Some Asian Americans consider direct eye contact to be rude. Native Americans – use peripheral vision and avoid direct eye contact, may regard direct stares as hostile and threatening Hispanic and African American – may use brief eye contact but then look away to indicate respect and attentiveness Muslim women avoid eye contact as a sign of modesty India – people of different socioeconomic classes may avoid eye contact with each other TEACHER NOTES: The goal here is not to memorize the different examples, but rather to understand that when someone from a culture other than our own does not maintain eye contact, it could be for cultural reasons.

Gestures Hand gestures mean different things in different countries. Health care workers must be sensitive when using hand gestures Show the first two bullets and picture, then stimulate classroom instruction on examples of gestures that mean different things in different cultures. Examples in book include: U.S. nodding head up and down is “yes” and back and forth is “no.” In India, it’s the exact opposite. In U.S. pointing is OK, but to many Asians and Native Americans, could represent a strong threat Hand gesture for OK can be insulting to some Asians THIS ENDS THE POWERPOINT – move to summary activity.

Japanese Culture Do not point with your finger or maintain direct eye contact.

Religion Should always ask if there is anything I need to know about your spiritual needs? WHY??? To provide the best possible care.

Spiritual vs. Religious Spiritual-Belief in a higher power. Religious-Attends church and/or faith based services.

ATHEIST They do not follow any religion and do not believe in God. Somebody who does not believe in God or deities

Agnostic To have no religious practices. Somebody who believes that it is impossible to know whether or not God exists.

Jehovah’s Witness Support their spiritual beliefs by allowing clergy to visit privately.

Different Cultures Different Cultures have different beliefs but not all people in a specific culture follow all the customs of the culture they belong. Today in the US cultural differences are more appreciated and respected. Example: All southern white people don’t eat collars!

Culturally Sensitive To recognizes and respects the culture of others. You can be taught other CULTURES.

Ethnic Groups Relating to a person or to a large group of people who share a national, racial, linguistic, or religious heritage, whether or not they reside in their countries of origin.

RACE Any one of the groups into which the world’s population can be divided on the basis of physical characteristics such as skin or hair color.

Ethnocentric A belief in or assumption of the superiority of your own social or cultural group.

Native Americans Proud people Understand cultural beliefs. They value the treatment of the mind, body, and spirit, and uses the natural elements to cure illnesses. Respect their wishes. Examples of Native Americans: Cherokee, Europeans, & Seminoles

PREJUDICE A preformed opinion, usually an unfavorable one, based on insufficient knowledge, irrational feelings, or inaccurate stereotypes

BIAS An unfair preference for or dislike of something. Examples: Blonds Obese people Skinny people Good-looking people Dumb jocks

Cultural Diversity Customs, traditions, food choices and backgrounds that are ethnic varied, as well as socioeconomic and gender varied.

Cultural Acculturation A change in the cultural behavior and thinking of an individual or group through contact with another culture. Example: Dresses like mainstream

Cultural Assimilation The process in which one cultural group takes on the cultural and other traits of a larger group. Example: Language