Transcript Slide 1

Cultural Diversity in Health
Care
Introduction:
• Every aspect of a person’s life is influenced by
that person’s culture.
• Because nurses provide health care to
culturally diverse client populations in various
settings, knowledge of culturally relevant
information is essential for delivery of
competent nursing care.
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CULTURE:
• This structure provides the group of people with a
general design for living.
• Shared system of beliefs, values, and behavioral
expectations
• An integrated, dynamic structure of knowledge,
attitudes, behaviors, beliefs, ideas, habits, customs,
languages, values, symbols, rituals, and ceremonies
unique to a particular group of people.
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Culture (cont.)
 Provides social structure for daily living
 Defines roles and interactions with others
and in families and communities
 Apparent in the attitudes and institutions
unique to the culture
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ETHNICITY AND RACE
 Ethnicity–a cultural group’s perception of
itself, or a group identity.
 Race–a group of people with biological
similarities.
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Typically based on specific
characteristics:
 Skin pigmentation, body stature, facial features,
hair texture
 Five major categories:
 American Indian or Alaska Native
»Asian
»Black or African American
»Native Hawaiian or Other Pacific
Islander
»White
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CULTURAL DIVERSITY ALSO
INCLUDES:
 Ethnocentrism–the assumption of cultural
superiority and inability to accept another
culture’s ways.
 Oppression–when the rules, values and
ideals of one group are imposed on
another group.
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Cultural Diversity also
Includes (cont.)
 Stereotyping–belief that people in same ethnic, racial, or
cultural group act the same way, share same beliefs,
attitudes.
 Dominant culture–the group whose values prevail within
a given society.
 Minority group–constituting less than a numerical
majority of the population.
 Acculturation–the process of learning beliefs, norms, and
behavioral expectations of a group
 Cultural assimilation–members of a minority group are
absorbed by the dominant culture, taking on the
characteristics of the dominant culture.
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Which of the following occurs
when a minority group, living
with a dominant group, begins to
blend in and lose the
characteristics that made them
distinct?
A. Cultural imposition
B. Cultural conflict
C. Cultural assimilation
D. Cultural shock
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CULTURE’S COMPONENTS
 Perception of self and the individual: refers to personal
identity, respect for individuals, and value.
 Motivation–explains the methods and value of
achievement.
 Activity–identifies the ways people organize and value
work.
 Social relations–explains the structure and importance of
friendships, gender roles, and class.
 Perception of the world–indicates the explanation of
religious beliefs and life events
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CULTURE’S
CHARACTERISTICS:
 Culture is not inherited or innate, rather, it is integrated
throughout all the interrelated components, motivations,
activities, world views, relationships, and individuality are
affected by consistent patterns of behavior and form a
cohesive whole.
 Culture is learned.
 Culture is shared.
 Culture is dynamic (constantly changing).
 Culture is tacit (unspoken). Everyone in the cultural
group understands acceptable behavior
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INFLUENCES ON HEALTH CARE
BELIEFS AND PRACTICES:
 Cultural values define human responses to
illness and will determine whether an
individual seeks professional care when ill
and complies with prescribed treatment.
 Clients tend to define wellness and illness
in the context of their own culture.
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PRACTITIONERS AND
REMEDIES:
 Variety in health/illness care providers is a natural
extension of:
– Culturally diverse concepts of etiology.
– Definitions of health and illness.
 Nurses must be able to:
– Relate care and treatment to the client’s cultural
context.
– Incorporate informal caregivers, healers, and other
members of the client’s support system as allies in
treatment
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BELIEFS OF SELECT CULTURAL
GROUPS:





European Americans
African Americans
Hispanic Americans
Asian Americans
Native Americans
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EUROPEAN AMERICANS:
 Traditional healers: nurse, physician.
 Healing practices: exercise, medications,
modified diets, amulets, religious healing
rituals.
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AFRICAN AMERICANS:
 Traditional healers: elderly
women healers, “community
mother” or “granny,” “root doctor,”
voodoo healer, spiritualist.
 Healing practices: herbs, roots,
oils, poultices, rituals, talismans
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HISPANIC AMERICANS:
 Traditional healers: curandero,
espiritualista, yerbero, brujo, sobadora,
santiguadora.
 Healing practices: hot and cold foods,
herbal teas, prayers and religious medals,
massage, azabache, “three baths” ritual.
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NATIVE AMERICANS:
 Traditional healers: shaman, medicine
man/woman.
 Healing practices: plants and herbs,
medicine bundle or bag, sweet grass
burned to purify the ill person, estafiate
(dried leaves) tea, the Blessingway
ceremony, sand paintings
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CULTURAL AND RACIAL
INFLUENCES ON CLIENT CARE:
 Can be viewed through:
 Communication
 Orientation to space and time
 Social organization
 Biological variations
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COMMUNICATION:
 Not everyone shares the same language.
 This can lead to misunderstanding and
frustration.
 Alternative methods include gestures and
flash cards.
 Family members may be able to assist.
 Interpreters may be used.
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ORIENTATION TO TIME AND
SPACE:
 The distance that a person prefers to
maintain from another is determined by
one’s culture.
 Individual’s orientation to time may affect:
– Promptness, attendance at appointments.
– Compliance with self-medication schedules.
 Reporting the onset of illness
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SOCIAL ORGANIZATION:
 Refers to the ways that cultural groups
determine rules of acceptable behavior
and roles of individual members and
includes:
 Family structure.
 Gender roles.
 Religion
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BIOLOGICAL VARIATION:
 Distinguishes one racial or cultural group
from another.
 Includes variations in hair texture, eye
shape, skin color, thickness of lips, and
body structure.
 Also includes enzymatic differences and
susceptibility to disease.
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CULTURAL ASPECTS OF NURSING
PROCESS–ASSESSMENT:
 Culturally sensitive nursing care begins
with examination of own culture, beliefs.
 It is followed by an assessment of the
client’s cultural beliefs and background.
 Even if we cannot understand or accept
particular cultural practices, it is important
to show respect for them.
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CULTURALLY APPROPRIATE
CARE
 Respect clients for their beliefs.
 Be sensitive to behaviors and practices
different from your own.
 Accommodate differences if they are not
detrimental to the client’s health.
 Listen for cues from client that relay
unique ethnic beliefs about disease.
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