1. Chapter 5 The Provider

2. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.2 Formation The Process of Development: learning how to meet our own needs We gravitate toward people who are like us, which puts limits on our beliefs. In order to respond appropriately to many different people, we need to be aware of the limitations of beliefs, both ours and theirs.

3. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.3 Multiculturalism Multiculturalism: the bringing of people together with widely different customs, values, and beliefs. Individualistic culture values both independence and personal responsibility. Collectivistic culture values conformity to group values and rules.

4. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.4 Multiculturalism Ethnocentrism: the belief that your culture’s values, beliefs, and practices are the right ones, making others wrong. Ethnic groups have a strong tendency to –isolate themselves in pocket communities and –interact with each other when spread throughout a new community

5. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.5 The Ethnocentric Brain The Brain is divided into four layers: –The stem –Reptilian complex –Limbic system –Neocortex

6. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.6 The Ethnocentric Brain Reptilian behaviors include: –Territory –Status People instinctively defend their territory. –Ritual: words, tone of voice, gestures, and body language –Aggression: actions that negatively impact another’s well being

7. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.7 The Ethnocentric Brain “Us”: people we recognize as belonging in our territory and are accepted “Them”: do not belong in our territory and are not accepted or allowed Status: the person with the better territory –Higher status: individuals with more power who are given more rights and freedoms –Lower status: lack of power and control and being in a dependent position

8. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.8 Stigma, Bias, and Discrimination Stigma is anything that marks a person as being different in a way that defines them as less. Bias is perceiving a person as less based on a stigma. Stereotyping is the belief that everyone who shares a specific stigma has the same character.

9. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.9 Prejudice: prejudging a person based on stereotyping; assuming that a stigma tells you all you need know to judge someone Discrimination: a difference in how a person is treated In the health care system, discrimination is aggression; it negatively impacts the well being of another. Stigma, Bias, and Discrimination

10. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.10 Tribal stigma: a mark that identifies a person as belonging to another group: –Color –Religion –Language –Accent –Clothing –Economic level Stigma, Bias, and Discrimination

11. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.11 Physical stigma: physical imperfections that lower a person’s status within the group and may include –Appearance –Disability –Disease Stigma, Bias, and Discrimination

12. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.12 Character deficit: seen as a psychological or behavioral difference that lowers a person’s status: –Honesty –Ambition –Aggressiveness Stigma, Bias, and Discrimination

13. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.13 Institutionalized discrimination: biased beliefs shared across a culture that lead to reduced access to goods, services, and opportunities; openly enforced by law Personal discrimination: personally denying another’s access to goods, services, or opportunities based on bias Stigma, Bias, and Discrimination

14. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.14 Internalized discrimination: the tendency of a person who is raised as a victim of discrimination to see themselves as undeserving of the same goods, services, or opportunities that others most often take for granted Stigma, Bias, and Discrimination

15. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.15 In the delivery of health care some of the common biases that exist include –Socioeconomic –Age –Substance abuse –Ethnic –Racial Stigma, Bias, and Discrimination

16. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.16 –Gender –HIV and AIDS –Mental illness –Obesity –Disability Stigmatizing a client or blaming them for their own illness is discrimination. Stigma, Bias, and Discrimination

17. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.17 All health care providers need to –recognize that biases exist in others and within themselves, –attempt to understand the differences, and –eliminate their own biases. To achieve these, health care education has to be available with ongoing support, programs, and seminars Stigma, Bias, and Discrimination

18. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.18 Professionalism Professionalism is acting in the best interest of the client and a commitment to deliver quality health care to all individuals. Honor that commitment by not making judgments of the many clients we encounter in our everyday lives.

19. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.19 Summary Beliefs are formed during our development as we learn to meet our own needs. As adults we work to get our needs met in a world made up of others who act the same way as us. The reptilian complex area of the brain defines our territory and status in life.

20. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.20 Summary We defend our territory and status with ritual and aggression. This leads to stigma, bias, stereotyping, prejudice, and discrimination. These may become institutionalized in the way people are taught to think about others, and internalized in the way people learn to think about themselves.

21. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved.21 Summary What a health care provider believes about a client motivates the way health care is delivered. We need to accept people for who they are, be aware of our own biases and limitations, not make judgments, and provide the best quality health care.