Healthcare in a multicultural context „Health ideology and health-care providers have learned that it is just as important to understand the patient’s culture as it is to understand the physiological repsonses in illness, disease, and injury…A lack of knowledge of patients’ language abilities and cultural beliefs can result in serious threats to life and quality of care for all individuals.” –L.D. Purnell, Transcultural Health Care: A Culturally Competent Approach

Culturally sensitive, competent healthcare delivery is directly dependent on clear, unambiguous communication among all involved individuals*

Healthcare belief systems across cultures Culture and ethnicity create unique patterns of beliefs and perceptions relating to well-being and the cause, prevention, and cure of illness* Supernatural/magico/religious Holistic Scientific/biomedical

Supernatural/magico/religious Disease is thought to result from the active intervention of supernatural beings or evil humans A disease is seen as a punishment rendered by a supernatural agent Haitians believe that some diseases are brought about by evil spirits displeased with some action that the person has done Treatment of illness by folk healers and prayer*

Considers an entity not as discrete parts but as an integrated whole Holistic Considers an entity not as discrete parts but as an integrated whole An individual is a whole composed of interdependent parts: physical, mental, emotional, and spiritual What happens to one part of the body also influences all the others Concerned with a person’s entire well-being „maintaining harmony is the driving force in Navajo life.” S. Caesar Followers of Taoism believe that good health requires maintaining a balance between the opposing forces of yin and yang Mexicans balance „hot” and „cold” foods*

Scientific/biomedical Rests on the premise of cause and effect Human body is seen in a biological and chemical context The cause and effect of illnesses, diseases, disorders can be determined through careful observation and study Medicines and therapy are used to manipulate the body’s physical and biochemical processes Primary cause of illness—pathogens (bacteria, viruses)*

Illness prevention across cultures What might be some different approaches to preventing and treating lower back pain?

Death and Dying across cultures In the west, patients are continually urged to execute advanced healthcare directives to specify desired treatment and procedures should they become incapacitated In the Navajo culture, even the mention of death is thought to invite it* *from Communication between cultures, Larry A. Samovar et Al. Cengage learning 2017