1. Cultural Diversity In Health Care
Show this power point after cultural diversity 2013
In Health Care

2. Basic Concepts:
Culture : Values, beliefs, languages, symbols, behaviors and customs unique to a particular group of people.
Cultural values: are learned, shared, social in nature and always changing.
Culturally diverse care: an approach needed to provide culturally appropriate care that incorporates an individual’s cultural values, beliefs, and practices.
Ethnocentrism : the perception that one's own way is best, supremacy of their own group.

3. Basic Concepts:
Ethnic : relates to large groups of people classified according to National origin, common traits or customs.
Race: Classification of people based on physical or biological characteristics.
Stereotype: Assumption that everyone in a particular group is the same.
Acculturation: Process of learning beliefs and behaviors of a dominant culture and assuming some of its characteristics
Sensitivity: Ability to recognize and appreciate personal characteristics of others.

4. Cultural Assimilation: absorption of a culturally distinct group into a dominate or prevailing culture
Salad
Melting Pot

5. Family Concepts
Extended Family:nuclear family plus grandparents, aunts, uncles and cousins
Patriarchal : father or oldest male is figure of authority
Nuclear Family:
Mom, Dad & children
Matriarchal :mother or oldest female if figure of authority

6. Health Care Beliefs
Asian: Yin and Yang, mind and body control leads to alternative medicine such as:
meditation ,hyponotherapy ,accupressure, pain endured silently.
European: Health maintained by diet, rest and exercise. Some express pain loudly, while others value self-control.

7. Health Care Beliefs (continued)
Hispanic:Health is good luck and a reward from God. Balance between cold and hot forces. Illness is punishment from God for sins - evil eye. Will express pain and accept treatment: pain is a part of life.
Middle Eastern: Health is due to Spiritual causes, cleanliness is essential for health. Males dominate and make decisions on Health care. Tolerating pain is a sign of strength. Self-inflicted pain is used as a sign of grief.

8. Health Care Beliefs (continued)
Native American: Health is harmony between man and nature, illness is imbalance between man and nature. Treatments: rituals, charms, prayer, meditation, medicine bags with herbs or good luck charms are blessed by the medicine man. Pain is normal part of life and tolerance of pain signifies strength and power.

9. Religious Beliefs in Health Care
Spirituality:
Agnostic :
beliefs individuals have about themselves, their connection with others and their relationship with a higher power.
Religion: organized system of belief in a higher power
person that believes the existence of a deity can’t be proved or disproven.
Atheist: person who doesn’t believe in any deity.

10. Some examples of Religious Beliefs
Jehovah’s Witness: No last rites, autopsy only when required by law. Organ donation not permitted, spirit and body shouldn’t be separated. Prohibited from receiving blood or blood products.
Christianity: baptism, take communion, physician is instrument for God’s intervention. Autopsy and organ donation permitted. Believe that accepting Jesus Christ is son of God they will be saved and inherit eternal life.
Christian Science: discourages organ donation but allows it to be individual’s decision.

11. Examples of some Religious Beliefs (continued)
Buddhism: belief in Buddha, strive for “Nirvana” the state of inner freedom and goal of existence. Believe in reincarnation, priest must be present at death. Body considered a shell so autopsy, cremation and organ donation permitted.
Hinduism: believe in reincarnation, ultimate goal is freedom from cycle of death and rebirth. Only family and friends may touch body at death. Priest ties string around neck or wrist and pours water in mouth. Cremation preferred Brahma is principle source of universe and center of all things. All forms of life are sacred: a person’s “karma” is determined from past lives.

12. Examples of some Religious Beliefs (continued)
Muslim: Believe in Allah, supreme deity, and Mohammed is chief prophet. Koran is holy book. Family must be with dying person. Ding person must confess sins and ask forgiveness. Only family touches or washes the dead body, it is turned toward Mecca. Organ donation is not permitted, must take medications with the right hand (left hand is considered dirty).
Judaism: Torah is basis of religion ( 5 books of Moses), Rabbi is spiritual leader, Star of David is religious symbol. Male circumcision on 8th day after birth. Person should never die alone, body is cleaned after death, bury on day of death and usually within 24 hours.

13. Examples of some Religious Beliefs (continued)
Mormon : infant blessed by clergy in church ASAP, baptism at 8 years. Special undergarments may be worn to symbolize dedication to God.
Seven Day Adventists: baptism only when individuals reach age of accountability. Literal acceptance of Bible, rite of communion important.

14. Biological Variations: the biological differences evident among people in various ethnic groups are rarely considered by the health care worker
Some examples:
Sickle cell anemia: is an inherited disease in which the red blood cells become crescent shaped. Affects approximately 1 out of every 500 African Americans
Phenylketonuria: a genetic disorder that is characterized by an inability of the body to utilize the essential amino acid, phenylalanine. Affects about one of every 10,000 to 20,000 Caucasian or Oriental births.

15. Biological Variations (continued)
Tay-Sachs: a progressive, neurodegenerative disorder caused by an enzymatic deficiency (hexosaminidase A). Death usually occurs by age 4, affecting 1 in 250 of general population but 1 in 25 Jews.
Cystic fibrosis: a disease passed down through families that cause thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. Whites are most often affected, at a rate of about 1 per 3500 births. Incidence is also high for Hispanics, at a rate of 1 per live births.

16. Health Care Professional Culture
Some differences include:
Language (medical terminology)
Social class
Different beliefs about health and illness

17. Assessment Measures:
1. Communication: Miscommunication is a frequent problem in hospitals, knowing what is the norm within the culture will help understanding
2. Space: The comfort level related to personal space, comfort in conversation, proximity to others, body movement, eye contact, space, and touch practices.
3. Social Organization: (e.g. high value placed on the decision of elders, the role of eldest male or female in families, or roles and expectation of children within the family).
4. Time: value tradition, or focus on the here and now
5. Environment Control: Health practices, values, definitions of health and illness.