Transcript The American Medical Association developed a policy of

Chapter 8
Cultural Influences on Context:
The Health Care Setting
 The goal of any health-care system is to
provide optimal care for all its clients.
 The influx of immigrants from different ethnic
and racial origins can make it difficult for care
providers to provide safe and effective care.
 Misunderstandings from ineffective
communication may cause needless
suffering.
 The American Medical Association now
trains physicians in intercultural
sensitivity.
 Cross-cultural health care requires a
complex combination of: knowledge,
attitude and skill (competence).
Worldview and Healthcare
Religion is not the only worldview that
influences health and illness.
Dualistic or holistic worldviews and
mechanistic or nonmechanistic
worldviews also determine how cultures
perceive everything.
Dualism – people and nature are separate
and distinct entities; emphasis on medical
intervention that is carried out by doctors,
nurses, and other health practitioners. Found
in Western religions: Judaism, Christianity, &
Islam.
Holistic – sees the world as a unit; unifies
body, mind, and spirit; the person’s entire
body must be part of the healing process.
Found in most Eastern cultures.
Mechanistic – common in the U.S.; thought
patterns are rational rather than mystic; the
individual can manipulate the universe; one
need not accept things as they are; they may
work on it or redesign it so that it is more to
their liking.
Nonmechanistic – common in India, Tibet,
Japan, China and Southeast Asia;
exemplified by spiritual traditions such as
Buddhism, Hinduism, Taoism and Zen.
Intuition transcends the data of the senses;
the manipulation of the mind is key to
obtaining truths that lie beyond reason.
Health Care Belief Systems
Biomedical System – follows from dualistic
and mechanistic views; the dominant belief
system in the U.S.; focuses on the objective
diagnosis and scientific explanation of
disease; illness is the result of abnormalities in
the body’s functioning or structure (from
bacteria and viruses.)
Personalistic System - disease is the
result of intervention by a supernatural
being (deity or god), a nonhuman being
(ghost or evil spirit), or a human (witch
or sorcerer). The person is a victim of
punishment; treatment involves
assuring positive association with spirits
& deities.
Naturalistic System - tend to be
nonmechanistic; explain illness as the
result of natural conditions of cold, heat,
winds, dampness and the upset in
balance of the basic elements; disease
can result from disequilibrium between
hot & cold elements of the body. Found
in Vietnamese cultures.
Cultural Diversity & the Causes of Illness
See p. 261
Cultural Diversity & the Treatment of Illness
Biomedical Treatments
Personalistic Treatments
Naturalistic Treatments
Cultural Diversity & the Prevention of Illness
See p. 264-265
Religion, Spirituality, & Health Care p.266
Spirituality includes all behaviors that
give meaning to life and provide strength
to the individual
Religion & spirituality have a strong
influence on the way people define
illness and choose to prevent it.
Religion has a strong influence over &
shapes nutrition practices & health care
practices.
Health Care For a Diverse Population
In health care, culture intervenes at every
step of the way.
Family Roles
Dominance Patterns – many cultures
make distinctions between what is
appropriate behavior for men and
women.
Modesty and Female Purity
Pregnancy and Childbirth
• Self-Disclosure
• Nonverbal Messages
Eye Contact
Facial Expressions
Touch/haptics – some cultures are not
accustomed to being touched by their
physicians or nurses.
Time/chronemics – a patient’s time
orientation may affect when or whether he/
she shows up for appointments.
• Formality
Improving Multicultural Health Care – the
hospital can be disorienting and
frightening to people of different
cultures; successful treatment of
patients requires that their beliefs
concerning the causes of illness, how
illness should be treated, and how it can
be prevented in the future must be
acknowledged.
Recognizing Diverse Medical Systems
the ability to be sensitive to a patient’s
beliefs requires a great deal of
information: cultural knowledge,
communication patterns, particular
knowledge of the individual; how
westernized is the patient?
Recognizing Ethnocentrism – there is no
one answer to all health care questions;
your ethnocentrism must be kept in
check.
Ask yourself: Am I imposing my own
views about illness and treatment on
other people without considering their
needs?
Point:
Cultures differ in:
• their understanding of what
causes illness
• how illness should be treated
• how illness can be prevented