1. Culture of Healthcare

2. Beliefs “Standardized definitions of health and illness
“The omnipotence of technology”

3. Practices
“The maintenance of health and the prevention of disease through such mechanisms as the avoidance of stress and the use of immunizations”
“Annual physical examinations and diagnostic procedures such as Pap smears”

4. Habits “Charting” “The constant use of jargon”
“ Use of a systematic approach and problem-solving methodology”

5. Likes
“Promptness”
“Neatness and organization”
“Compliance”

6. Dislikes
“Tardiness”
“Disorderliness and disorganization”

7. Customs
“Professional deference and adherence to the ‘pecking order’ found in autocratic and bureaucratic systems”

8. Customs
“Handwashing”

9. Customs
“Employment of certain procedures attending birth and death”

10. Rituals “The physical examination” “The surgical procedure”
“Limiting visitors and visiting hours”

11. Cultural Beliefs Concerning Epidemiology and Pain
Medical culture is in direct opposition sometimes
Bacteria/viruses/carcinogens/pollutants versus “soul loss”/”spirit possession”/voodoo/witchcraft
Free, open expression of feelings versus never revealing true feelings

12. Examples of Cultural Clashes
“Mr. Smith in room 222 is the ideal patient. He never has a single complaint.”
Are you sure he has no complaints or is it his cultural influence not to be a bother?

13. Examples of Cultural Clashes
“Mrs. Cohen in room 223 is a real complainer. She is constantly asking for pain medication and putting on her light.”
Is she really in pain or is it her cultural programming concerning dealing with pain?

14. Examples of Cultural Clashes
“Mr. Chen in room 225 says nothing. I often wonder what he is feeling.”
What is really happening with Mr. Chen?

15. Healthcare Providers
Must change to accommodate other cultural beliefs and behaviors towards health and illness