9.3 Understanding Cultural Diversity Behavior of individuals will be affected by cultural and ethnic beliefs. HCP must be aware of these beliefs to provide holistic care Holistic Care: Care that provides for the well-being of the whole person and meets not only physical needs, but also social needs, emotional, and mental needs.

9.3 The Nine Areas of Cultural Diversity a HCP Might Encounter. Family Organization Language Personal Space Issues Touching Eye Contact Gestures Health Care Beliefs Spirituality Religion

9.3 Family Organization Communication Skills © Nuclear Family – Father, Mother, and Children Extended Family – Nuclear family plus grandparents, aunts, uncles, and cousins Patriarchal – Father or oldest male is the authority figure Matriarchal – Mother or oldest female is the authority figure Communication Skills © A HCP must ask the pt questions to determine family structure, and pt’s preferences Ex. Of Questions: Who are the members of your family? Do you have children? Who will care for them? Do you have extended family? Who is caring for you while you are sick?, Who is the head of the household? , Where do you and your family live? Was your entire family born in the e US?, What do you and your family do together for recreation? , Do you have e family members who will be visiting you?

9.3 Language English dominant in USA 20 % of the population under 65 speak another language HCP must determine a pt’s ability to communicate by: Asking Questions Finding a translator (roster of employees who speak another language) Speak slowly Use simple words Use gestures or pictures to clarify Use non-verbal communication Avoid speaking louder Try to learn words or phrases in the pts language Legal issue(most states): Any medical permit requiring a written signature must be printed in the pt’s language

9.3 Personal Space, Touch, and Eye Contact: Personal Space: territorial space, the distance people require to feel comfortable while interacting with others, Read pg 280 HCP use Touch and invade personal space to give care Ask questions to determine pt’s preferences for personal care, read pg. 281 Eye contact: affected by cultural beliefs European Americans want eye contact to show interest and trustworthiness Asian Americans consider direct eye contact to be rude Native Am. Use peripheral (side) vision Hispanic and African Am. May use brief eye contact Muslim women may avoid eye contact as a sign of modesty India, people of different socioeconomic classes avoid eye contact

9.3 Gestures & Health Care Beliefs Gestures are used to communicate many things Common in US, head up and down for “yes”, and side to side for “no” India the head motions for “yes” and “no” are just the opposite Pointing common in US, to Asian and Native Am. This can represent a strong threat Most common health care system in US is: the biomedical or “Western” system Based on finding the cause of disease, or aging and then: Treating it, eliminating the cause, or prevention Health care beliefs vary greatly (Read Table 9-1) HCP must understand that every culture has a health system based on values and beliefs that have existed for generations

9.3 Health Care Beliefs Continued Major change in US is the use of Alternative health care methods (chiropractors, homeopaths, naturopaths, and hypnotists) 5 Types of treatments: Nutritional methods: Vit., herbs, organic foods Mind and body control methods: relaxation meditation, biofeedback, hypnotherapy , and imagery Energetic Touch: message, acupuncture, acupressure, and therapeutic touch Body movement: chiropractic, yoga, and tai chi Spiritual: faith healing, prayer, and spiritual counseling Individuals have a right to choose their method of treatment, HCP must ask ?’s to determine pt’s preferences

9.3 Spirituality & 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 Spirituality is an individual’s need to find meaning and purpose in life Religion: An organized system of belief in a superhuman power or higher power. Religious beliefs are associated with a particular form or place of worship Some individuals are non-believers Atheist: person who does not believe in any deity Agnostic: individual who believes that the existence of God cannot be proved or disproved Once again a HCP must talk with a pt, and ask ?’s to determine a pt’s religious needs, Read Table 9-2

9.4 Respecting Cultural Diversity The key is to regard each person as a unique individual HCP must be aware of the needs of each individual in order to provide total care. HCP must learn to appreciate and respect the personal characteristics of others Ways to achieve this goal are: Listen to pt’s Appreciate differences Learn more about cultural and ethnic groups that you see often

9.4 Respecting Cultural Diversity Recognize and avoid bias, prejudice, and stereotyping Ask ?’s to determine a person’s beliefs Evaluate all information before forming an opinion Allow pt’s to practice and express their beliefs as much as possible Not expected to adopt another’s beliefs just accept and respect them Promote the pt’s interactions with family Be sensitive to how pt’s respond to eye contact, touch, and invasion of personal space. Respect spirituality, religious beliefs, symbols, and rituals.

Summary: Cultural Diversity HCP must show sensitivity, because the US is a multicultural society HCP must be alert to barriers to effective relationships and avoid them HCP must give holistic health care Regard each person as a unique individual Appreciate and respect the personal characteristics of others