Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 13: Diversity and Difference in Health Care
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Cultural Diversity Race National origin Religion Language Physical size Gender Sexual orientation Age Disability Socioeconomic status Geographic location
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Personal Beliefs Cultural beliefs Social beliefs Religious beliefs Personal convictions
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences Definition of Culture –A shared system of beliefs, values, and behavioral expectations that provide structure for daily living
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Factors Influencing Culture –Beliefs –Habits –Likes –Dislikes –Customs –Rituals
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Facts About Culture –Provides shared identity for cultural group –Influences member’s view of: Self Expectations Behavior –Is shaped by social & physical environment –Is transmitted via language, formal teaching, & observation of elders
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Shared Characteristics of an Ethnic Group –Language & dialect –Religious practices –Literature –Folklore –Music –Political interests –Food preferences
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Characteristics Distinguishing Minority Group –Race –Religion –Beliefs –Customs or practices
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Physical Characteristics: Genetically Inherited Diseases –Tay-Sachs disease –Keloids –Lactase deficiency & lactose intolerance
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Psychological Characteristics –Consider patient’s perspective & concerns –Remember that different cultures & individuals interpret behaviors differently
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Reactions to Pain & Other Health Issues –Response to pain is culturally influenced –Patient in pain may not show it –Listen to patients who freely express their discomfort –Recognize influence of cultural & individual beliefs about health –Respect patient’s right to react to health care issues any way he wants to –Don’t stereotype a patient’s perceptions or responses based on culture
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Gender Roles –Dominant male role in many cultures –Recognize who is culturally dominant member of family
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Time Orientation –U.S.: punctuality is important –Other cultures (e.g., South Asian): punctuality not valued as highly –Different perceptions of past, present, & future
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Differences (cont’d) Food and Nutrition –Culture influences food preferences –Certain cultures have particular staple foods –Take cultural food differences into account when teaching about diet
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Differences Among Individuals Socioeconomic Factors –Family income affects health & access to health care –Upper income groups live longer & have fewer disabilities –Poverty often leads to inadequate care of infants & children –Poor housing conditions affect health
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Differences Among Individuals (cont’d) Age –Children & older adults less able to communicate symptoms, medication responses –Different health needs in young vs. old –Don’t make assumptions based on age of patient alone
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Differences Among Individuals (cont’d) Religion –Be sensitive to each patient’s values & beliefs
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Diversity in Health Care Practices Folk Medicine –Cutaneous stimulation –Therapeutic touch –Acupuncture –Acupressure
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Diversity in Health Care Practices (cont’d) Natural Remedies –Herbs –Be aware of possible interactions with prescriptions –Keep personal opinions & biases to yourself
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Diversity in Health Care Practices (cont’d) Complementary or Alternative Medicine –Healing through: Nutrition Exercise Relaxation –Emphasis on preventive medicine –Often borrowed from the practice of ethnic or cultural groups
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Diversity in Health Care Practices (cont’d) Acupuncture: a healing practice that originated in China