Cultural Diversity Spring 2015

Culture Values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs unique to a particular group of people passed from one generation to the next. Examples: family relations, child rearing, education, social interactions, spirituality, religion. Is shared Is social in nature Is dynamic and changing

Ethnicity Classification of people based on national origin and/or culture May share common heritage, geographic location, language, and beliefs Examples: African Americans, Asian American, European American, Hispanic American, Middle Eastern, Native American

Race Classification of people based on physical or biological characteristics such as color of skin, hair, and eyes; facial features, blood type, and bone structure

Cultural Diversity Differences based on cultural, ethnic, and racial factors Differences can exist within ethnic/cultural groups and in individuals within a group

Cultural Assimilation The process of the absorption of many cultures into the dominant culture Requires that the newly arrived cultural group alter unique beliefs and behaviors and adopt the ways of the dominant culture

Acculturation Process of learning the beliefs and behaviors of a dominant culture and assuming some of the characteristics Occurs slowly over period of time

Cultural Sensitivity Ability to recognize and appreciate the personal characteristics of others Essential in healthcare

Bias Preference that prevents impartial judgment Examples of some biases: Age: Young people are physically and mentally superior to older people Education: College-educated individuals are superior to uneducated individuals

Ethnocentric Believing in the supremacy of your own ethnic group Believe that cultural values are better than the cultural values of others.

Prejudice To pre-judge Strong feeling or belief about a person or subject that is formed without reviewing the facts or information We all want to feel that our own beliefs are correct, which means we are prejudiced to some degree

Stereotyping Occurs when an assumption is made that everyone in a particular group is the same. Ignores individual characteristics and “labels” an individual

Holistic Care Care that provides for the well-being of the whole person. Meets not only physical needs, but also social, emotional, and mental needs Family organization, language, personal space, eye contact, gestures, health care beliefs, spirituality and religion

Family Organization Structure of a family and the dominant or decision making person in a family

Nuclear Family Usually consists of a mother, father, and children. Single parent and child(ren) Typically basic unit in European American

Extended Family Includes the nuclear family plus grandparents, aunts, uncles, and cousins Basic unit for Asian, Hispanic, and Native American Example: Most Asian families have a great respect for their elders and consider it a privilege to care for them

Patriarchal Father or oldest male is authority figure Will make most healthcare decisions Examples: Asian and Middle Eastern families, men have the power and authority Women are expected to be obedient and men often accompany woman to doctor’s appts

Matriarchal Mother or oldest female is the authority figure Will make all of the healthcare decisions for family

Language Health care provider must determine the patient’s ability to communicate by talking with the patient or relative Get translator when possible Speak slowly, use simple words Use gestures or pictures Avoid tendency to speak louder Try to learn some words or phrases

Personal Space Territorial space, distance people require to feel comfortable with interacting with others. Varies greatly among different ethnic/cultural groups Arabs: very close contact, touch, feel with people they interact French and Latin American tend to stand very close while talking Hispanic Americans comfortable with close contact

Personal Space European and African Americans prefer distance Asian Americans will stand closer but usually do not touch during conversation Middle Eastern countries: men may not touch females who are not immediate family and only men may shake hands with other men

Personal Space When personal care must be provided to a patient, the health care provider should determine the patient’s preference by talking with the patient or asking questions. What are some examples of questions you might ask?

Personal Space Do you prefer to do as much of your own personal care as possible or would you like assistance? Would you like a family member to assist with your personal care? Are there any special routines you would like followed while receiving personal care? Do you prefer to bathe in the morning or evening? Is there anything I can do to make you more comfortable?

Eye Contact Health care providers must be alert to the comfort levels of patients while using direct eye contact and recognize the cultural diversity that exists. Most European Americans regard eye contact during a conversation a sign of interest. Some Asian Americans consider direct eye contact to be rude Native Americans may use peripheral vision and avoid direct eye contact. May regard direct stares as hostile.

Eye contact Hispanic and African Americans may use brief eye contact, but then look away to indicate respect and attentiveness. Muslim women may avoid eye contact as a sign of modesty In India, people of different socioeconomic classes may avoid eye contact with each other.

Gestures Common gesture in the US is nodding your head up and down for yes and side to side for no; In India, the head motions for yes and no are the exact opposite Pointing at someone is very common in US and is frequently used to stress specific ideas; to Asian and Native Americans, this can represent a strong threat.

Health Care beliefs United States uses biomedical or “Western” system Bases cause of disease on such things as microorganisms, diseased cells, and the process of aging Health care is directed toward eliminating microorganism, conquering disease process and/or preventing effects of aging.

Health care beliefs Beliefs of the “Western” system: Encourage patients to learn as much as possible about their illnesses Informing patients about terminal diseases Teaching self-care Using medications and technology to cure or decrease effects of disease Teaching preventive care

Health care beliefs Beliefs vary greatly among cultures In US, increasing use of alternative methods Individuals have right to choose their method of health care

Health care beliefs in different cultures South African: Maintain harmony of body, mind, and spirit Causes of illness: spirits, demons or punishment from God Treatment: prayer or religious rituals

Health care beliefs in different cultures Asian Health is a balance of yin and yang Treatment: herbal remedies, acupuncture Believe pain must be endured silently

Health care beliefs in different cultures European: Illness caused by outside source Treat with medication, surgery, diet, exercise

Health care beliefs in different cultures Hispanic: Health is a reward from God, good luck Heat and cold remedies to restore balance, prayers, massage

Health care beliefs in different cultures Middle eastern: Health is spiritual, cleanliness essential Males dominate and make decisions on health care Spiritual causes of illness, evil eye

Health care beliefs in different cultures Native Americans Health is harmony with nature Illness caused by supernatural forces and evil spirits Healer: medicine man Tolerance of pain signifies strength and power

Spirituality and Religion Part of every ethnic or cultural group Spirituality: the beliefs individuals have about themselves, their connections with others, and their relationship with a higher power. Individuals need to find meaning and purpose in life Spirituality and religion are not the same

Religion Organized system of belief in a superhuman power or higher power Particular form or place of worship

Atheist A person who does not believe in any deity.

Agnostic Individual who believes that the existence of God cannot be proved or disproved As a healthcare provider, you must determine what each individual holds important.

Showing respect for a patient’s spiritual beliefs and practices Be a willing listener Support for spiritual and religious practices Respect of symbols and books Privacy during clergy visits Refrain from imposing your beliefs on a patient