1. Cultural Diversity By: Cindy Quisenberry

2. Definitions  Culture – the values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs unique to a particular group of people and passed from one generation to the next  Ethnicity – a classification of people based on national origin and/or culture  Race – a classification of people based on physical or biological characteristics such as color of skin, hair, and eyes; facial features; blood type; and bone structure

3. Definitions  Bias– a preference that inhibits impartial judgment (ie: individuals who believe in the supremacy of their own ethnic group)  Can you think of other bias?  Prejudice – a strong feeling or belief about a person or subject that is formed without reviewing facts of information (Prejudiced individuals regard their ideas or behavior as right and other ideas or behavior as wrong.)  Stereotyping – occurs when an assumption is made that everyone in a particular group is the same

4. Definitions  What is a nuclear family?  What is an extended family?

5. Definitions  Personal Space – often called territorial space; the distance people require to feel comfortable while interacting with others  Close Contact Cultures  Arabs  French  Latin Americans  Hispanic Americans  Asian Americans may stand close but do not touch (kissing or hugging never done in public

6. Definitions  Monotheist – believe in one God  Polytheist – believe in many gods  Atheist – does not believe in any deity  Agnostic – believes that the existence of God cannot be proved or disproved

7.  The key to respecting cultural diversity is to regard each person as a unique individual. Healthcare workers must learn to appreciate and respect the personal characteristics of others by:  Listen to patients as they express their beliefs.  Appreciate differences in people.  Learn more about the cultural and ethnic groups that you see frequently.  Recognize and avoid bias, prejudice, and stereotyping.  Ask questions to determine a person’s belief.  Evaluate all information before forming an opinion. Respecting Cultural Diversity

8.  Allow patients to practice and express their beliefs as much as possible.  Remember that you are not expected to adopt another’s beliefs, just accept and respect them.  Recognize and promote the patient’s positive interactions with family.  Be sensitive to how patients respond to eye contact, touch, and invasion of personal space.  Respect spirituality, religious beliefs, symbols, and rituals. Respecting Cultural Diversity

9.  African American – Central & South African countries, Dominican Republic, Haiti, and Jamaica  Asian/Pacific American – Australia, Cambodia, China, Guam, Hawaii, India, Indonesia & Pacific Island countries, Japan, Korea, Laos, New Zealand, Philippines, Samoa, Taiwan, Thailand, and Vietnam  European American – Austria, Czech Republic, Denmark, England, France, Germany, Greece, Hungary, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Russia, Scotland, Sweden, and Switzerland Common Ethic Groups

10.  Hispanic American – Cuba, Mexico, Puerto Rico, Spain, and Spanish-speaking countries in Central and South America  Middle Eastern/Arabic Americans – Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Saudi Arabia, Syria, Turkey, Yemen, and other North African and Middle Eastern countries  Native American – more than 500 tribes of American Indians and Eskimos such as Apache, Choctaw, Cherokee, and Navajo Common Ethic Groups

11. Definitions  Personal Space – often called territorial space; the distance people require to feel comfortable while interacting with others  Distant Contact Cultures  European  African Americans (2-4 feet)  Cambodia – members of the opposite sex may never touch in public  Vietnamese allow only the elderly to touch the head of a child because the head is considered sacred  Native Americans  Middle Eastern – men may not touch female individuals who are not immediate family members

12. Definitions  Eye Contact  European Americans – indicative of interest and trustworthiness  Asian Americans – considered to be rude  Native Americans – may use peripheral vision and avoid eye contact (may regard direct stares as hostile and threatening)  Hispanic and African Americans – may use brief eye contact, but then look away to indicate respect and attentiveness  Muslim women – may avoid eye contact as a sign of modesty  India – different socioeconomic classes may avoid eye contact with each other

13. Definitions  Gestures (head up and down for “yes”, side to side for “no”, etc.)  Can mean an exact opposite in some countries  Asian and Native Americans, pointing can represent a strong threat  “OK” can be insulting to some Asians

14. Baptist  Some believe in the healing power of “laying on of hands”  Physician is instrument for God’s healing  No last rites  Oppose abortion  Birth control is an individual’s decision

15. Buddhism  Suffering is inevitable  Illness is the result of negative Karma  Cleanliness is important to maintain health  May refuse medications that affect mental alertness (mindful awareness is essential)  Oppose abortion  Birth control is an individual’s decision  Believes in reincarnation  Buddhist priest must be present at death  Limited touching during during the process of death  Last rites chanted at bedside right after death

16. Hinduism  Some believe illness is punishment for sins  Some believe in faith healing  Will accept most medical interventions  Naming ceremony is performed 10-11 days after birth to obtain blessings form gods and goddesses  Abortion allowed only to save the life of the mother  Birth control allowed, but the duty of having a family is stressed

17. Hinduism  Believe in reincarnation  Priest ties thread around the neck or wrist and may pour holy water in the mouth of the deceased  Only family and friends may touch and wash the body  Organ donation discouraged  Cremation preferred  Some do not eat meat

18. Lutheran  Communion often administered by clergy to sick or prior to surgery  Birth control allowed  Abortion discouraged  No last rites

19. Methodist  May request communion before surgery or while ill  Birth control allowed  Abortion discouraged  No last rites

20. Presbyterian  Prayer and counseling an important part of healing  May request communion while ill or before surgery  Birth control allowed  Abortion discouraged  No last rites

21. Seventh Day Adventist  May avoid OTC medications and caffeine  May anoint body with oil  Use prayer for healing  Some believe only in divine healing  Will accept required immunizations  Birth control is individual’s decision  Therapeutic abortions permitted as an individual’s decision  No last rites  Sabbath worship is sunset on Friday to sunset on Sat.  Encouraged to practice a vegetarian diet

22. Episcopal  May use anointing of the sick with oil as a healing sacrament  Abortion opposed  Birth control is an individual’s decision  Some observe last rites by priest

23. Roman Catholic  Sacrament of the Sick and anointing with oil  Life is sacred; abortion and contraceptive use prohibited  Believe embryos are human beings and should not be destroyed or used for research  Infant baptism mandatory  Baptism necessary for salvation (any baptized Christian may perform an emergency baptism)  Sacrament of the Sick (last rites) performed by priest  May avoid meat at certain times

24. Islam (Muslim)  Illness is atonement for sins  Face city of Mecca 5 times a day to pray to Allah  Ritual washing before and after prayer  Must take meds with right hand since left hand is considered dirty  At birth, the infant should hear “There is no God but Allah, and Mohammed is His prophet”  Circumcision before 7 days old  Abortion forbidden  Family must be with dying person  Dying person must confess sins and ask forgiveness

25. Islam (Muslim)  Only family touches and washes body after death  Body is turned toward Mecca after death  Cremation not permitted  Avoid pork and shellfish  Usually do not consume alcohol  During holy month of Ramadan, all-day fasts are required for those who are able.

26. Judaism  May refuse surgical procedure or diagnostic tests on Sabbath or holy days  Family may want surgically removed body parts for burial  Ritual handwashing upon awakening and prior to eating  Male circumcision on 8 th day after birth by child’s father or Jewish physician  Birth control allowed  Abortion permitted only in specific circumstances  Person should never die alone  Body is ritually cleaned after death

27. Judaism  May bury dead before sundown on day of death and usually within 24 hours  Organ donation permitted only after consultation with rabbi  Sabbath is sunset Friday to sunset Saturday  Fast during some holy days  May observe certain dietary laws called “kosher” diets

28. Jehovah’s Witness  Prohibited from receiving blood and blood products  Elders will pray and read scriptures to promote healing  Medications okay if not derived from blood products  Birth control personal decision  Abortion allowed only to save the life of the mother  No last rites  Organ donation discouraged due to transmission of blood (All organs and tissues must be drained of blood before transplant)

29. Russian Orthodox  Holy Unction and anointing body with oil used for healing  Will accept most medical treatments but believe in divine healing  Birth control prohibited  Abortion prohibited  List rites by ordained priest mandatory  Arms of deceased are crossed  Organ donations not encouraged  May wear a cross necklace that should not be removed

30. Mormon (LDS)  May believe in divine healing with “laying on of hands” or blessing by the church elders  Anointing with oil can promote healing  Infant blessing by clergy in church ASAP after birth  Baptism at 8 years of age  Abortion prohibited  Birth control individual’s choice  May want church elders present at birth  No last rites

31. Mormon (LDS)  Special undergarments may be worn and should not be removed unless necessary  Fast on first Sunday of each month  Avoid medications containing alcohol and caffeine  Avoid coffee, tea, caffeine-containing beverages and alcoholic beverages

32. Amish  May give birth at home  Birth control not forbidden – but most do not use (large families are a gift from God)  Prohibit abortion  No last rites  Cremation not used  Do not buy health insurance – church has mutual aid fund  May refuse prescription meds (use herbal remedies)

33. Christian Scientist  Illness can be eliminated through prayer and spiritual understanding  May not use medicine or surgical procedures  May refuse blood transfusions  Most will accept mandated immunizations  Abortion discouraged  Birth control individual’s decision  No last rites  Organ donation discouraged  Most do not drink alcohol, coffee, or tea