Cultural Diversity

Health Team Relations

Melissa Lewis, RN

INTRODUCTION

HC providers must provide care to many different types of patients

No two patients are alike

HC providers must be aware of and respect the individuality of each patient

Individuality/Uniqueness influenced by the following:

Physical characteristicsFamily lifeSocioeconomic statusReligious beliefsGeographical locationEducationOccupationLife experiences

Culture

Defined as values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs unique to a particular group of people and passed from one generation to the next

Set of rules about things like family relations, child rearing, education, occupational choice, social interactions, spirituality, religious beliefs, food preferences, health beliefs, and HC

All Cultures have 4 things in common:

1. Culture is learned**

2. Culture is shared

3. Culture is social in nature

4. Culture is dynamic and constantly changing

Ethnicity

Defined as a classification of people based on national origin and/or culture

Members of an ethnic group may share common heritage, geographical location, social customs, language, and beliefs

Ethnic Groups in the United States

1. African American

2. Asian American

3. European American

4. Hispanic American

5. Middle Eastern/Arab Americans

6. Native Americans (Indians and Eskimos)***

Race

Classification of people based on the physical characteristics (color or hair, skin, and eyes)

There are different races present in most ethnic groups.

Ex. There are black and white African Americans.

Cultural Diversity

This is the differences in culture, ethnicity, and racial factors among people

In previous times the United States used to be called the “melting pot” to represent the absorption of many cultures in the dominant culture.

This is called cultural assimilation when people come from other countries and adapt to the American way of doing things

Cultural Diversity cont…

In reality the U.S. is more like a salad bowl now where cultural differences are appreciated and respectedAcculturation = the process of learning the beliefs and behaviors of a dominant culture and assuming some of the characteristics

This process occurs slowly over timeRecent immigrants to the U.S. are more likely to follow patterns of their native land than their children and grandchildren who have lived here longer

Cultural Sensitivity

The ability to recognize and appreciate the personal characteristics of others is essential in health care

Ex. In some cultures, called an adult by their first name is not acceptable except for close friends/relatives. Sensitive HC workers will address patients by Mr./Mrs. and their last name

Bias

A bias is a preference that prevents impartial judgment

Example: Individuals that believe in the supremacy of their own ethnic group (ethnocentric). These people believe that their cultural values are better than the cultural values of others

Common Biases include:

AgeYounger people are more physically and mentally superior to older people

EducationCollege educated people are superior to uneducated people

EconomicRich people are superior to poor people

PhysicalObese and short people are inferior to slender and taller people

OccupationNurses are inferior to doctors

Sexual preferenceHomosexuals are inferior to heterosexuals

GenderWomen are inferior to men

Prejudice

Prejudice means to pre-judge.It is a strong feeling/belief about a person/subject that is formed without reviewing facts/informationThis causes fear and distrust and interferes with interpersonal relationshipsEveryone is prejudiced to a certain degree!

Stereotyping

Stereotyping occurs when an assumption is made that everyone in a particular group is the same

Labels individuals

Example = “All blondes are dumb.”

Bias, Prejudice, and Stereotyping

These are all barriers to effective communication and relationships with patients

HC providers must be alert to these barriers and make every effort to avoid them

Ways to avoid bias, prejudice, and stereotyping in Health Care:

Know and be consciously aware of your own personal and professional values and beliefsObtain as much information as possible about different ethnic/cultural groupsBe sensitive to behaviors and practices different from your ownRemember you are not be pressured to adopt your patients’ beliefs, but you must respect them

Ways to avoid bias, prejudice, and stereotyping in Health Care cont…

Develop friendships with a wide variety of peopleAsk questions about your patients’ beliefs/cultureEvaluate all information before you form an opinionBe open to differencesAvoid jokes that may offendRemember mistakes happen, apologize if you hurt someone’s feelings, and forgive if someone hurts your feelings

Holistic Care

HC providers must be aware of cultural diversity to provide holistic care (well-being of the whole person) to their patients

Family Organization

This is the structure of a family and the dominant or decision-making person in the family

Families vary in their composition and in the roles assumed by family members

2 Main Types of Families1. Nuclear family

Usually consists of a mother, father, and children (single-parent and children)

Common type for European American families

2. Extended familyUsually includes nuclear family plus grandparents, aunts, uncles, and cousins

Common type for Asian, Hispanic, and Native American families

Patriarchal Families

In these families the father or oldest male is the authority figure and makes the decisions for the family

So, this is the person who would make the health care decisions as well

Women are expected to be obedient

Matriarchal Families

In these families the mother or oldest female is the authority figure and makes the decisions for the family

Language

Dominant language used in United States is EnglishHowever, 20% of population under 65 years of age speaks another languageA health care provider must determine the patient’s ability to communicate by talking with pateint/relative and asking questions

Common Questions to Determine Patient’s Understanding

Do you speak English as your first language?

What language is spoken at home?

Do you read English?

Do you have a family member/friend that can interpret for you?

Health Care Providers should:

Find a translator when possible

Speak slowly and use simple words

Use gestures/pictures to clarify meaning of words

Use nonverbal communication (smile or gentle touch) when appropriate

Avoid tendency to speak louder

Try to learn some words/phrases in their language

Personal Space

Personal space = territorial space

This describes the distance people require to feel comfortable while interacting with others

This varies among different ethnic groups

Close contact groups: comfortable standing very close to and even touching

Distant contact groups

HC Providers & Personal Space

HC providers have to invade a patient’s personal space at times to do certain skills (ex. Taking vital signs, baths, etc.)HC providers should always be alert to patients verbals and non-verbalsHC providers should use a slow, relaxed approach and explain the procedure

Eye Contact

European Americans regard eye contact during conversation as a sign of interest and trustworthinessAsian Americans consider direct eye contact to be rudeThe many beliefs regarding eye contact can lead to misunderstandings when people of different cultures interact

Gestures

Shaking head “yes” or “no”

In India, it is the complete opposite

Pointing at someone with a finger represents a strong threat by Asian and Native Americans

Health Care Beliefs

The “Western” system is the most common HC system in the U.S.This system is based on the cause of disease being microorganisms, diseased cells, and the process of agingWhen the cause is determined, HC is directed toward eliminating microorganisms, conquering disease process, and/or preventing the aging processHC providers in the U.S. are trained and licensed to practice

Western HC Beliefs

Encouraging patients to learn as much as possible about their illnessInforming patients about terminal illnessesTeaching self-careUsing medications and technology to cure or decrease effects of disease/illnessTeaching preventative care

Health Care Beliefs of Different Ethnic Groups

Look in book on page 142-143

Make your own table with six rows down and five columns down

I will help you condense chart in book

Alternative Health Care

Nutritional methodsOrganic foods, herbs, vitamins

Mind and body controlRelaxation, meditation, biofeedbackHypnotherapy, imagery

Energetic touch therapyMassage, acupuncture

Body-movement methodsChiropractic, yoga, tai chi

Spiritual methodsFaith healing, prayer, and spiritual counseling

Traditional vs. Alternative Treatments

All individuals have the right to choose the type of HC system and method of treatment that they feel is best for them

HC providers must respect this, even if they do not agree

Spirituality vs. Religion

The beliefs individuals have about themselves, their connections with others, and their relationship with a higher powerIndividual’s need to find meaning and purpose in life

Organized system of belief in a superhuman powerForm of worshipEx. Going to church

Major Religious Beliefs

Pg 145-148

Atheist

Someone who does not believe in a higher power

Agnostic

A person who believes that the existence of a higher power can not be proven or disproven

THE END!!!