Transcript Cultural Diversity

Cultural Diversity
 Health care providers must work with and provide care
to may different people.
 Therefore, every health care provider must be aware of
factors that cause each individual to be unique.
Uniqueness
 Uniqueness is influenced by many factors:
 Physical Characteristics
 Gender
 Body Size
 Skin Color
 Also:
 Family Life
 Socioeconomic status
 religious Beliefs
 Geographic Location
 Education, Occupation and life experience
• A major influence on a person’s uniqueness is Cultural and Ethnic
Heritage
Culture
• Culture is defined as the :
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Values
Beliefs
Attitudes
Languages
Symbols
Rituals
Customs of a particular group of people often passed down from generation
to generation
Culture
Culture provides a blueprint or set of rules for living.
 Culture is learned – It is taught by others, ie: children learn behavior
by imitating parents.
 Culture is shared – common practices and beliefs are shared with
others in cultural group.
Culture is social in nature – understand appropriate behavior based
on traditions.
Culture is dynamic and ever changing – New ideas generate different
standards this allows cultural groups to meet changing needs.
Ethnicity
Ethnicity – is the classification of people based on national origin
and/or culture.
• Members of a certain ethnic group may share common heritage,
customs, language and beliefs.
• Many different ethnic groups in US – Melting Pot:
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African American
Asian American
European American
Hispanic American
Middle Eastern American
Native American
• Within each group there are subgroups ie: German-Italian
Race
Race is a classification based on physical or biological characteristics
such as color of skin, hair, eye color, facial features blood type or bone
structure.
• Race is usually used to label a group of people and to explain patterns
of behavior.
• In reality race cuts across multiple ethnic/cultural groups
• African Blacks and Caribbean Blacks
• Share same physical features : very different cultural beliefs and values
Cultural Diversity
• Culture, Ethnicity and race do influence a person’s behavior, selfperception and judgment - this is called: Cultural Diversity
• Cultural Assimilation – process where multiple cultures blend to
become one – United States – Melting Pot
• In reality U.S. is becoming a “Salad Bowl” – cultural differences are
appreciated and respected – multicultural society
• Sensitivity – the ability to recognize differences is essential in todays
health care. ie: calling someone by first name is not acceptable in
some cultures
Bias – Prejudice - Stereotyping
• Bias – (You prefer one over another) a preference that inhibits and
leads to impartial judgment
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Age – young people are physically and mentally superior to older people
Education – College educated people are superior (smarter) to uneducated
Economic – Rich people are superior (deserve better treatment) to poor
Physical Size – Obese and short people are inferior
Occupation – Nurses are inferior to doctors
Sexual Preferences – Homosexuals are inferior to heterosexuals
Gender - Women are inferior to men
Bias – Prejudice - Stereotyping
Prejudice – means to pre-judge. A prejudice is a strong feeling or belief
about a person without reviewing the facts.
• Prejudice people view their ideas, beliefs or behaviors as right and
others as wrong.
• They are frequently afraid of things that are different.
• Prejudices causes fear and distrust and interferes with relationships
• Every individual is prejudice to some degree – we all want to feel like
our beliefs are right.
• However it is important to be aware of our prejudices and make
every effort not let them influence our behavior in health care.
• Obtain as much information as possible about other individuals to
better understand them and communicate successfully.
Bias – Prejudices - Stereotyping
Stereotyping – assumption is made that everyone in a particular group
is the same.
• Labels individuals
• ie: All blondes are dumb
• Similar stereotypes exists with regard to race, gender, ethnic/cultural
group, occupation, etc.
• It is essential to remember everyone is unique.
Bias – Prejudice - Stereotyping
• All are barriers to effective communication and relationships with
others.
• Health care workers must be alert/aware to the barriers and make
every effort to avoid them.
Overcoming Bias, Prejudice, Stereotyping
Ways to avoid barriers in Health Care:
• Know and be aware of your own values & beliefs
• Obtain as much information on others as possible
• Be sensitive to behaviors of others
• Remember, you are not being pressured to adopt other beliefs – just
respect theirs
• Develop friendships with a wide variety of people from other groups.
• Ask questions and encourage others to ask questions to share beliefs
• Evaluate all information before making decisions
• Be open to differences
• Avoid jokes that may offend others
• Remember, mistakes happen and apologize and/or forgive.
Family Organization
Refers to the structure of a family and the dominant or decision-making
person in the family.
Nuclear Family – usually consists of a mother, father and children, may
also consist of single parent and children (European/American Families)
Extended Family – includes nuclear family and grandparents, aunts
uncles, cousins (Asian, Hispanic and Native American)
Family Organization
• Usually affects care of:
• Children
• Sick
• Elderly
• Extended Family usually care for its own while Nuclear tends to use
outside assistance
• Patriarchal – father or oldest male makes decisions
• Matriarchal – Mother or oldest female makes decisions
• Its important to ask questions and observe the family when making
health care decisions
Family Organization
Important to ask questions
• Who are the members of family?
• Do you have any children? Who will care for them when you are sick?
• Do you have an extended family?
• Who will care for you while you are sick?
• Who is the head of household?
• Where do you live?
• Was your entire family born on the US?
• Do you have family that will be visiting you?
Language
Language many times can be a barrier to communication.
Health care provider must determine patients ability to communicate
not only to patient but to family.
• Do you speak English as primary language?
• What is language spoken at home?
• Do you read English or another language?
• Do you have a family member or friend that can interpret information
for you?
Language
Important when speaking to someone who has limited English skills to:
• Talk slowly
• Use simple terms
• Use gesture or pictures
• Use non-verbal clues – smiles, gentle touch.
• Avoid talking louder.
• Try learning some words or phrases in patient’s language
• Use translation services or translation cards or Translation App
Personal Space and Touch
• Often called territorial space – the distance required between people
to feel comfortable.
• Varies greatly between cultures – some cultures like close contact ie:
Arabs are very close contact, like touch and even smell of person.
Women stand closer than men, children closer than adults
• Cambodians never touch opposite sex in public, only parent may
touch child on head.
• Never assume something about a person’s personal space- always ask
questions.
Personal Space and Touch
• Health Care providers have to use touch and invade personal space
to provide care.
• Blood pressure cuff , use of a stethoscope, EKG electrodes
• Health care provider should use slow movements, explain
procedures, encourage patient to relax.
• Patients sometimes still are uncomfortable so be alert to signals:
tensing up, turning head, pulling away.
Personal Space and Touch
When providing personal care (BODY WASHING, ETC.) Ask patient if
they have any preferences?
• Do you prefer to do as much as you can on your own?
• Would you like a family member to assist?
• Are there any special routines you follow?
• Do you prefer to bath in morning or evening?
• Is there anything I can do to make you more comfortable?
Eye Contact
• Eye contact varies between cultures
• Europeans Americans view it as trustworthy, show of interest.
• Asian Americans sometimes consider it rude.
• Native Americans – only side (peripheral) vision, direct vision is
hostile and threatening.
• Hispanic/African use brief contact but look away as sign of respect
and inventiveness.
• Health care workers must be alert to comfort levels of patients while
using direct eye contact
• Recognize cultural diversity – ie: Lack of eye contact is often
interpreted as not listening while it can indicate respect (Asian
Culture).
Gestures
Gestures are used to communicate many different things:
• Nodding head for yes, side to side for no
• In India – head motions are exact opposite.
• Pointing finger in US is common to stress a specific point
• Asian and native American its considered a threat.
• OK sign is considered insulting to Asians
Health care workers must be aware of how patients respond to hand
gestures, if you notice a person uncomfortable, avoid using it.
Health Care Beliefs
Most common health care system in U.S. is biomedical or “Western
Medicine”
• Cause of disease based on microorganisms, diseased cells and process of
aging. Value put on education and prevention
• When cause is determined than health care is performed to eliminate the
cause.
• Use licensed doctors or practitioners
Other cultures believe in harmony of body and spirituality
• Use Folk Practitioners – Spiritualists, Herbalists Native healers
Its important to remember not all individuals believe in and follow
U.S. or Western Medicine.
Alternative Medicine
• Nutritional Medicine – organic food, herbs, vitamins, anti-toxins
• Mind and Body Control – relaxation, meditation, hypnotherapy
• Body Movement Methods- Chiropractor, yoga, tai chi
• Spiritual Methods – Faith healing, prayer and spiritual counseling
Every individual has the right to believe what they want and to choose
what method they prefer
• Healthcare workers need to be aware of the differences and accommodate
when reasonably available.
Spirituality and Religion
Spirituality and religion are inherent part of every cultural group.
Spirituality – is defined as the beliefs individuals have about
themselves, there connections with others and relationship with a
higher power.
• When a person’s spiritual beliefs are firmly established, they tend to
have a basis for understanding life.
• Beliefs can be varied
• Atheist – don’t believe in any deity
• Agnostic – believe existence in god can not be proved or disproved
Religion
• Do you have a religious affiliation?
• Are there any religious practices that make you feel better?
• Do you normally pray at certain times of the day?
• Would you like a person of some religion to visit? Priest, etc.
• Do you consult a religious healer
• Do your beliefs restrict certain foods or drinks?
• Do you observe any specific holidays, have objects that need certain
care?
• As long as they do not cause harm, every effort should be made to
accommodate the religious needs of every patient.
Respecting Cultural Diversity
• The key is to regard each person as a unique individual
• Be ware of the needs of every patient
• Respect the needs of each patient
• Try to accommodate for every need as long as it does not harm the
patient.