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8/8/2019 Cultural Diversity in Healthcare
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Culture
Set of values, beliefs, attitudes,
languages, symbols, rituals, behaviors,customs of a group of people
Learned and shared
Dynamic and changing
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Ethnicity
Classification of people based on
national origin or cultureExamples: African American, Asian
American, European American, HispanicAmerican, Middle Eastern/ArabicAmerican, Native American
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Race
Classification of people based on
physical or biological characteristicsInvolves multiple cultures and ethnicgroups
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Cultural Diversity
Differences based on cultural, ethnic,and racial factors
Melting Pot or Salad Bowl approach
Must be considered when providinghealth care
Healthcare providers must recognizeand appreciate the characteristics of allpatients
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Holistic Care
Must be developed to include cultural
diversity of AmericaAddresses 3 aspects of well-being:mental/emotional, physical, and social
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Areas ofCultural Diversity
Family organization
LanguagePersonal space
Touching
Eye contact
Gestures
Health care beliefsSpirituality
Religion
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Cultural Diversity ImpactsBeliefsBirth
DeathHealth
Illness
Health Care
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Health
Varies Based on Cultural Background
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WorldHealth Organization
A state of complete physical, mental,
and social well-being, not merely theabsence of disease
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South African
Harmony with nature
Harmony of mind, body, and spirit
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Asian
Physical and spiritual harmony with
natureBalance of yin and yang
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European
Personal responsibility with diet, rest,
exercise, and prevention
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Hispanic
Good luck
Reward from GodBalance between hot and cold forces
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MiddleEastern/Arabic
Spiritual Causes
Cleanliness
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HealthfulHints from LongAgo
A sassafras root carried in the pocket
guards against illness. (superstition ofOld Saint Simons)
Asafetida worn on a string around theneck protects a child from manydiseases, and a buckeye carried in thepocket protects against rheumatism.(Blue Ridge and Great Smokey Mts.)
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A single, pierced nutmeg, worn
around the neck on a string, will protectyou from boils, croup, body lice, andvarious lung diseases. (New England)
A well-ventilated bedroom will preventmorning headaches and lassitude.(1914 Almanac)
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Illness
Abnormal functioning of a bodys
system or systemsCauses vary based on cultural/ethnicbackground
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South African
Spirits/demons
Conflicts in lifeGods punishment
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Asian
Imbalance of yin and yang
Supernatural forcesUnhealthy environment
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European
Sin
Outside sources: microorganisms,toxins
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Hispanic
Sins
FrightEvil Eye
Envy
Imbalance between hot and cold
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MiddleEastern/Arab
Sins
Evil EyeSpiritual causes
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Native American
Supernatural forces
Violation of a tabooImbalance between man and nature
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FolkRemedies
Beliefs and practices ethnically similar
Religion plays a role in perception of,interpretation of, and behavior in healthand illness
Women are usually the prime caregiversCan create delay in seeking professionalhelp
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Preventions
Jewish: camphor around the neck in
winter in a small cloth bag to preventmeasles and scarlet fever
Black and Native Americans: blackstrapmolasses
Black Africans (Ethiopia): eat hot & sourfoods i.e. lemons, fresh garlic, pepper
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Preventions
Germans: no sweets at meals, drink
glass of water at meals, cod-liver oil,plenty of milk, spring tonic (sulfuredmolasses)
Islam: dress properly for the season &weather, keep feet from getting wet inthe rain
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Preventions: Irish
Clean out bowels with senna for 8 days
Spring tonic of sulfured molassesOnions under the bed to keep nasalpassages clear
Bag of camphor around the neck duringflu season
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Preventions: Irish
Never go to bed with wet hair
Dont look in the mirror at night & closecloset doors (prevents evil spirits)
Eat lots of oily food
Take Father Johns Medicine every sooften
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Preventions: Italian
Garlic cloves strung on a piece of string
around neck of infants and children toprevent colds and evil stares
Red ribbon around neck of infant doesthe same thing
Never wash or bathe during period
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Preventions: Italian
Never wash hair before going outdoorsor at night
Keep a pair of open scissors undermattress of crib to prevent evil innewborn
Wrap a bandage around the baby fromthe waist to the feet for 1st6 months toprevent bowlegs
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Home Treatments: Jewish
Sore throat: find salted herring, wrap it
in a towel, put it around the neck, let itstay there overnight, gargle with saltwater
Boils: fry chopped onions, make acompress and apply to the infections
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Home Treatments: Blacks/N
ativeAmericansBloody nose: place keys on chain
around neckSore throat: suck yolks out of egg shell,honey and lemon, baking soda, salt ,warm water, onions around the neck
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Home Treatments: BlackAfrican
Evil Eye: put some kind of plant root on
fire and make the man who has the evileye smile and the man talks about hisillness
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Home Treatments: Germans
Coughs: honey & vinegar; boiled onion
water, honey, & lemon; hot water &Vicks
Swollen glands/mumps: put pepper onsalt pork and tie around the neck
Earache: few drops of warm milk in theear, laxatives when needed
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Home Treatments: Germans
Sty: cold tea-leaf compresses
Fever: mix whiskey, water, & lemonjuice to drink before bed (causes personto sweat and break fever)
Constipation: Ivory soap suppositories
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Home Treatments: Islam
Sore throat: gargle with vinegar and
waterIndigestion: baking soda and water
Sore muscles: alcohol and water
Rashes: apply corn starch
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Home Treatments: Irish
See doctor only in an emergency
Earache: heat salt, put in stockingbehind ear
Fever: spirits of niter on a dry sugarcube
Colds: hot lemonade and a tablespoonof whiskey; egg whites; ipecac
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Home Treatments: Irish
Coughs: linseed poultice on chest;
flaxseed poultice on back; red flannelcloth soaked in hot water and placed onchest all night
Menstrual cramps: hot milk sprinkled
with ginger, glass of warm wine, hot-water bottle on stomach
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Home Treatments: Irish
Nausea: castor oil, hot ginger ale, cupof hot boiled water
Sore throat: paint throat with iodine,honey and lemon, Karo syrup; paintwith kerosene oil with rag then tie sock
around the neck; paint with iodine orMercurochrome and gargle with saltwater, honey melted Vicks
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Home Treatments: Italian
Chicken soup for everything
Boils: cooked oatmeal wrapped in acloth (steaming hot) and applied todrain pus
Headache: kerchief with ice in itwrapped around the head
Cramps: crme de menthe
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Home Treatments: Italian
Acne: apply babys urine
To build up blood: eggnog with brandy;Marsala wine and milk
Backache: place a silver dollar on the sorearea and light a match to it, while the match
is burning put a glass over the silver dollarand slightly lift the glass, this causes suctionwhich lifts the pain out
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Healthcare Providers
Culture
Cultural Diversity in Health andIllness, Second Edition, p.70
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Beliefs
Standardizeddefinitions of health
and illnessThe omnipotence oftechnology
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Practices
The maintenance of health and theprevention of disease through suchmechanisms as the avoidance of stressand the use of immunizations
Annual physical examinations and
diagnostic procedures such as Papsmears
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Habits
Charting
The constant use ofjargon
Use of asystematic approach
and problem-solvingmethodology
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Likes
Promptness
Neatness and organizationCompliance
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Dislikes
Tardiness
Disorderliness anddisorganization
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Customs
Professional deference and adherenceto the pecking order found inautocratic and bureaucratic systems
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Customs
Handwashing
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Customs
Employment of certain proceduresattending birth and death
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Rituals
The physicalexamination
The surgicalprocedure
Limiting visitors and
visiting hours
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Cultural Beliefs Concerning
Epidemiology andPainMedical culture is in direct oppositionsometimes
Bacteria/viruses/carcinogens/pollutantsversus soul loss/spiritpossession/voodoo/witchcraft
Free, open expression of feelings versusnever revealing true feelings
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Examples ofCultural Clashes
Mr. Smith in room222 is the ideal
patient. He neverhas a singlecomplaint.
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Examples ofCultural ClashesMrs. Cohen in room223 is a real
complainer. She isconstantly asking forpain medication andputting on her light.
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Examples ofCultural ClashesMr. Chen in room225 says nothing. I
often wonder whathe is feeling.
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Healthcare Providers
Must change to accommodate othercultural beliefs and behaviors towardshealth and illness
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Religion andHealing
Vital role in perception of health andillness
Rites surrounding birth and death
Diet
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TraditionalEtiology:EvilEye
Power of eye strikes victim
Injury, illness, misfortune is suddenPerson with evil eye may not know it
Victim may not know source of evil
Prevented or cured by rituals/symbols,removal of spell or evil agent
Explains sickness and misfortune
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TraditionalMethods of
Prevention
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Protective Objects
Amulets
BanglesTalismans
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Protective Substances
Garlic
OnionsChachayotel
1000 year old eggs
Kosher foods
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ProtectiveReligious Practices
Social, moral, dietary practices
Burning candlesRituals of redemption
Prayer
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Examples ofSaintsforProtection
Blessing of the Throats on St. BlaiseDay
Virgin of Guadalupe
St. Anthony of Padua: barren women
St. Odilla: blindnessOur Lady of Lourdes: bodily ills
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Beliefs Affecting Therapy
Use of healers with divine powers
Natural products: herbs, berriesPurgatives
Blood-letting
Removal of person with evil eyeAvoidance of provocation of envy
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Forms ofSpiritualHealing
Spiritual healing
Inner healingPhysical healing
Deliverance or exorcism
Auric healingPilgrimages
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Healthcare Providers Must
Be Aware ofthe Multitude of
Sources Outside ofMainstream Medicine!
Embrace Diversity in Medicine. TeachTolerance to Healthcare Providers!