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Cultural diversityCultural diversityDr. Miada Mahmoud Rady Dr. Miada Mahmoud Rady
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Definitions Definitions
• Culture : The values, beliefs, standards, language,
thinking patterns, behavioral norms and
communications styles shared by a group of people.
• It guides decisions and actions of a group through
time.
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Cultural diversity Cultural diversity
• It is the cultural variety and differences that exist in the world,
a society or an institution.
• It is having a group of diverse people in one place working or
living together, all have different cultures.
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Manifestation of cultural diversity
Manifestation of cultural diversity
• Obvious manifestation :
A. Religion .
B. Ethnicity (Race) .
C. National Origin (Language).
D. Gender .
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• Less obvious manifestation :
1. Age
2. Educational Status
3. Disabling disease .
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Cultural Sensitivity Cultural Sensitivity
Definition : Being aware that cultural differences and
similarities exist and that they can have an effect of behavior,
values and learning.
It also means to be aware and tolerant of cultural differences
and acknowledging them when interacting with others.
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StereotypingStereotyping
• Definition : Categorizing individuals or groups of people into
an oversimplified or standardized image or idea.
• It’s when you assume that a belief or characteristic is shared
by all in one class, culture or ethic group
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Cultural favoritism Cultural favoritism
1. To give an advantage to one cultural over another.
2. To ignore the differences between cultures and impose
understanding based on the study of one culture to other
cultures.
3. To think one culture has precedence of the other.
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Cultural Influences on Healthcare
Cultural Influences on Healthcare
1. Physiologic Characteristics
2. Psychological Characteristics
3. Reactions to Pain
4. Gender roles
5. Language and communication
6. Food and nutrition
7. Socioeconomic Factors
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Physiological criteria Physiological criteria
Certain racial groups are more prone to specific diseases
and conditions such as :
1. Keloids is more common in Africans
2. Lactase deficiency and lactose intolerance is more common
in Australians.
3. Sickle cell anemia is common in Africans
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Psychological CharacteristicsPsychological Characteristics
In most situations, a person interprets the behaviors of another
person in terms of her or his own familiar culture.
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Gender Rules Gender Rules
In many cultures either the man or woman is the
dominant figure and generally makes decisions for the
family.
Knowing who is the dominant member of the family
is an important consideration when planning nursing
care.
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Language and communicationLanguage and communication
• Different peoples speak different language.
• To avoid misinterpretation of questions and answers, it is
important to use an interpreter who understands the healthcare
system.
• When caring for culturally and ethnically diverse patients it is
important to perform a transcultural assessment of
communication.
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Socioeconomic FactorsSocioeconomic Factors
• Research suggests that both physical and mental health are
highly affected by Socioeconomic status ( SES ) for example T.B
and nutritional disorders is more common in people with low
Socioeconomic standards.
• Studies suggest that lower SES is linked to poorer health
outcomes.
• Poor health also decrease an individual’s capacity to work, thus
reducing their ability to improve their SES.
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Any questions
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Cultural diversity 2Cultural diversity 2
Dr. Miada Mahmoud Rady
Dr. Miada Mahmoud Rady
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Duties of paramedics as part of diverse health care system
Duties of paramedics as part of diverse health care system
1. Paramedics have an obligation to be respectful and
sensitive to other's belief system.
2. Paramedics must be culturally competent and comfortable
with those they serve.
3. Paramedics should understand how their own personal
biases and values influence communication with patients,
families, and their co-workers.
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Culturally Competent Care
Culturally Competent Care
• Competence : Behaviors that reflect appropriate
application of knowledge and attitudes.
• Culturally competent health care : Care that is
planned and implemented in a way that is sensitive to
the needs of individuals, families, and groups from a
diverse populations within society.
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• Aims for quality of health care: safe, effective,
patient-centered, timely, efficient, and equitable.
• Cultural competency is at the core of high quality,
patient-centered care, and it directly impacts how
care is delivered and received.
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Developing culturally competent health care
Developing culturally competent health care
Several models of service care delivery have emerged
to meet the challenges of providing culturally
competent health care.
One of them is Campinha-Bacote’s model : The
Process of Cultural Competence in the Delivery of
Healthcare Services.
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Assumptions of the modelAssumptions of the model
1. Cultural competence is a process, not an event.
2. Cultural competence consists of five constructs: cultural
awareness, cultural knowledge, cultural skill, cultural
encounters, and cultural desire.
3. There is more variation within ethnic groups than across
ethnic groups (intra-ethnic variation).
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4. There is a direct relationship between the level of
competence of health care providers and their ability to
provide culturally responsive health care services.
5. Cultural competence is an essential component in rendering
effective and culturally responsive services to culturally and
ethnically diverse clients.
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Constructs of culturally competent care.
Constructs of culturally competent care.
• There are five constructs according to Campinha-Bacote’s
model :
1. Cultural awareness
2. Cultural knowledge
3. Cultural skill
4. Cultural encounters
5. Cultural desire.
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Cultural awareness Cultural awareness
• Cultural awareness : is the self-examination and in-depth
exploration of one’s own cultural and professional background.
• Or recognition of one’s biases, prejudices, and assumptions about
individuals who are different.
• Goal : to avoid Cultural imposition .
• Cultural imposition : is the tendency of an individual to impose
their believes, values, and patterns of behavior on another culture
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Cultural KnowledgeCultural Knowledge
• Definition: Cultural knowledge is the process of seeking and
obtaining a sound educational foundation about diverse cultural
and ethnic groups.
• In obtaining this knowledge base, the health care provider must
focus on the integration of three specific issues:
1. Health-related beliefs and cultural values
2. Disease incidence and prevalence
3. Treatment efficacy
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Cultural skill Cultural skill
• Cultural skill : is the ability to collect relevant cultural data
regarding the patients presenting problem and performing a
culturally based physical assessment.• Cultural skill is also required when performing a physical
assessment
• on ethnically diverse clients. The health care provider should
know how a client’s physical, biological, and physiological
• variations influence her ability to conduct an accurate and
appropriate physical evaluation
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Cultural EncountersCultural Encounters
• Definition : is the process that encourages the health care
provider to directly engage in cross-cultural interactions with
clients from culturally diverse backgrounds.
• Importance :
1. To refine or modify one’s existing beliefs about a cultural
group
2. To prevent possible stereotyping that may have occurred.
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Cultural DesireCultural Desire
• Definition : the motivation of the health care provider to want
to, rather than have to, engage in the process of becoming
culturally aware, culturally knowledgeable, culturally skillful,
and familiar with cultural encounters.
• ( Simply people don’t care how much you know, until they
first know how much you care )
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Health care providers trained in cultural competency:
1. Demonstrate greater understanding of the central role of culture
in health care
2. Recognize common barriers to cultural understanding among
providers, staff, and residents/patients
3. Identify characteristics of cultural competence in health care
settings
4. Interpret and respond effectively to diverse older adults’ verbal
and nonverbal communication cues
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5. Assess and respond to differences in values, beliefs, and
health behaviors among diverse populations and older adults
6. Demonstrate commitment to culturally and linguistically
appropriate services
7. Work more effectively with diverse health care staff
8. Act as leaders, mentors, and role models for other health care
providers
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Characteristic of culturally competent organization
Characteristic of culturally competent organization
1. Have a defined set of values and principles and demonstrate
behaviors, attitudes, policies, and structures that enable them
to work effectively cross culturally
2. Have the capacity to 1) value diversity; 2) conduct self-
assessment; 3)manage the dynamics of difference; 4) acquire
and institutionalize cultural knowledge; 5) adapt to the
diversity and cultural contexts of the communities they serve.
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3. Incorporate the above into all aspects of policy making,
administration, practice, and service delivery and
systematically involve consumers, key stakeholders, and
communities.
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Cultural Assessment Cultural Assessment
• Cultural assessment : is a “systematic appraisal or
examination of individuals, groups, and communities as to
their cultural beliefs, values, and practices to determine
explicit needs and intervention practices within the context of
the people being served”.
• an effective way to identify specific factors that influence a
patient’s behavior is to perform a cultural assessment.
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Checklist for Diversity & Cultural Competency
in Health Care Settings
Checklist for Diversity & Cultural Competency
in Health Care Settings
• The three checklists included are:
1. Areas of your organization’s culture that can
negatively impact quality of care (areas of
opportunity).
2. Barriers to cultural competency.
3. Recommendations for culturally competent care.
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Acquiring Cultural CompetenceAcquiring Cultural Competence
Be sensitive to personal health beliefs and practices:
Special foods, drinks, objects or clothes
Avoidance of certain foods, people or places
Customary rituals or people used to treat the illness
Will the patient take medicine even when he/she doesn't feel sick?
Is the patient taking other medicines or anything else to help him feel
well?
Who in the family makes decisions about health care?
Are illnesses treated at home or by a community member
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Acquiring Cultural Competence
Acquiring Cultural Competence
Be sensitive to language barriers:
1. Does the patient understand any English?
2. Consider literacy level
3. Use visual aids and demonstrate procedures
4. Check understanding
5. Is an interpreter necessary
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Acquiring Cultural CompetenceAcquiring Cultural Competence
Consider body language:
1. Eye contact
2. Touching
3. Personal space
4. Privacy/modesty
Other cultural factors to consider:
1. Gender
2. Wealth or social status
3. Presence of a disability
4. Sexual orientation
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Consider Religious/Spiritual factors .
Are there sensitivities/beliefs associated with
I. Birth, death
II. Certain treatments, blood products
III. Prayer, medication and worship
IV. Food preparation, clothing, special objects, and gender
practices
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