1. 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.

2. 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

3. 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?

4. 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

5. 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

6. 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

7. 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

8. 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. 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

10. 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.

11. 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