Culture and Ethnicity

Culture Values, beliefs, norms & practices of a particular group Learned and shared Guide thinking, decisions, & actions in a patterned way

Concepts of Culture and Ethnicity Culture – a set of values, beliefs & traditions that are held by a specific social group and handed down from generation to generation Subculture – made up of people with a distinct identity, but who have certain ethnic, occupational or physical characteristics that are found in the larger culture Dominant group – the group within the culture that has the authority to control the value system. Minority group – usually has some physical or cultural characteristic that identifies the people within it as different

“Despite being technically competent, a nurse can be incompetent, formulating unworkable interventions because of an unwillingness or inability to understand the culturally different patient.” (West, 1994, .232)

“Having knowledge of a culture before trying to help a client and family is analogous to a nurse or a physician having basic knowledge of anatomy and physiology before doing physical assessment or attempting to meet a patient’s physical needs.” Madeleine Leininger

Ethnicity The sense of identification that a cultural group collectively has, largely based on the group’s common heritage. Race – Subculture of people characterized by specific characteristics.

Culture Culture Assimilation AKA acculturation When minority groups living within the dominant group loose the cultural characteristics that make them different. Stereotyping – involves assigning characteristics to a group of people without considering specific individuality.

Culture Cultural Imposition – the belief that everyone should conform to the majority belief system. Cultural conflict – when one ridicules others beliefs and traditions in an effort to make his or her own values more secure

Cultural and Ethnic Influences on Health Care Gender Roles – It is important to know who is the dominant figure in a family Language and Communication – Some clients may not be able to speak the English Language Orientation to Space and time – personal space Food and Nutrition Socioeconomic

Poverty The culture of poverty- the highest risk families are headed by one income single females, fixed income elderly and future generations of those living in poverty

Characteristics Feelings of despair, resignation & fatalism Day to day attitude toward life with no hope for the future Unemployment and need for financial or government aid Use of escape values such as alcohol and drugs Unstable family structure with abusiveness and abandonment Decline in self respect and retreat from community

Effects of Poverty on Health Care Lack of affordable and adequate housing Crowded living conditions The sick usually experience more complication Recovery time is longer Less likely to regain their preillness level of functioning Lack of access to health care insurance

Family Support Some cultures have large extended families and are unable to share private information with anyone outside the family. Some cultures have great respect for elderly and will not consider institutional care

Physical and Mental Health Physiologic Characteristics Keloid formation – overgrowth of connective tissue that occurs during healing process of injury, surgery—African heritage Lactose intolerance - lack of lactase to break down lactose during digestion - Hispanic, African, Chinese, Thai. Sickle Cell Anemia – sickle shaped red blood cells. Most common in African or Mediterranean ethnic background.

Continued… Tay Sacks Disease – a gene for a hereditary disorder – have very short life span – Eastern European, Jewish descent. G6PD deficiency – enzyme deficiency. Red blood cells have no cell membrane they are easily destroyed , which leads to anemia and increased billirubin levels. - 10% of African American population Thalassemia – genetic disorder effecting the Hgb in RBC function. Mediterranean, Asian, and African origin. Sarcoidosis – formation of multiple tubercles or nodules on various parts of the body - African American population. Gout – An increase of uric acid in the blood -males especially from Puerto Rican or Filipino descent.

Psychological Characteristics In most situations an individual will relate the behavior of another person to the individual’s own familiar culture. It is important to remember that what may seem perfectly reasonable & important to a client may seem ridiculous and irrelevant to a nurse. The reverse perception may also exist.

Culture Shock Feelings an individual experiences when placed in a different and often strange culture and may result in psychological discomfort or disturbances.

Cultural Imposition and Ethnocentrism Cultural Imposition. – the tendency for health personnel to impose their beliefs practices and values of other cultures, because they believe that their ideas are superior. Ethnocentrism – the belief that one’s own ideas, beliefs and practices are the best and superior.

Providing Transcultural Care Major Theme – Focus on caring practices of various cultures Nursing Role – Understand the client’s needs and to adapt care to meet those needs.

Cultural Assessment Identify factors that effect behavior by cultural assessment Values, religion, dietary practices, family lines of authority, family life patterns and beliefs and practices related to health and illness See guidelines on pp 47 & 52 See table 3-1 on page 48-51

Reaction to Pain Reactions are culturally prescribed ……….. Let’s discuss

Different Health Practices Folk Healers less expensive, more accessible and more understanding of cultural needs . Speak the client’s language Traditional Folk Medicine Herbs

Transcultural Nursing Nursing care planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing diverse cultural populations. The culture of health care: Assess: the cultural background expectations and beliefs about healthcare Cultural context of the encounter Degree of agreement between the 2 persons set of beliefs and values