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Defense mechanisms, cross cultural behavior
• All people use defense mechanisms to help them feel more comfortable and to rationalize their behavior
• Defense mechanisms = mental devises that help people cope with various situations
• Rationalization = finding a good reason to replace the real reason for a behavior
• Compensation = substituting one goal for another
• Projection = placing the blame for your actions on someone or something else because you cannot accept responsibility
• Sublimation = redirecting feelings towards a constructive objective
• Identification = idolizing someone you would like to be
• Idolizing = loving to excess
• Hostility = unfriendliness
• Aggressiveness = tendency to start fights without reason
• Health care workers interact with people from many cultural backgrounds
• It is important to know culturally acceptable and effective gestures, terms, and behaviors
• Our understanding and opinions of different cultures develops throughout our lives
• Culture includes a shared background and usually shared experiences
• The most common experiences shared by groups are:
• Language, communication style, belief system, customs, attitudes, perceptions, and values
• Prejudice = to decide or make a decision about a person based on perceived cultural facts
• Prejudices:
• Age, national, physical, mental, religious, racial
• Culture = relates to the behaviors, beliefs, and actions of a particular social, ethnic, or age group
• Ethnicity = refers to identity with or membership in a particular racial, national, or cultural group, and observance of that groups customs, beliefs, and language
• 6 main ethnic groups in the U.S.: African Americans, Asian American, European American, Hispanic American, Middle Eastern/Arab American, and Native American
• Race = a human population that is considered distinct based on physical characteristics, such as white, black, or Latino
• In a ‘melting pot’ country we see a lot of cultural assimilation
• Acculturation = the exchange of cultural features that results when groups come into continuous firsthand contact
• Health care professionals must be sensitive to all cultural backgrounds and always act in the best interest of the patient.
• i.e. Muslim women may not be examined by male members of the medical community
• Catholic doctors ethically should refer women seeking an abortion
Gestures, body language, personal space
• Personal space and touching – defined differently in different cultures, close-contact to distant-contact, touching can be misunderstood, some south Asian cultures believe that a person’s spirit is on the head so touching the head is an insult.
• CLOSE CONTACT:• Africa
• Indonesia
• Latin America
• Hispanic Americans
• Mediterranean
• Southern Europe
• French
• Greet by kissing on cheeks
• DISTANT CONTACT:
• Canada
• Great Britain
• Northern Europe
• U.S.
• Native Americans
• Middle Eastern
• Arabic
• Asian American
• Greet with handshake, hugs for close friends and relatives
• Greetings – important in all cultures, the way it is given and received often determines how positive or negative the meeting is
• GREETING GUIDELINES• Anglo American – shakes hand if desired
• Latin American – shake hands or hugs
• Cambodian or Laotian – do not shake hands, put hands together at different levels, equal = hands at chest, older or superior person or stranger = hands at chin, relative or teacher = hands at nose
• Vietnamese – salute by joining both hands and moving them against the chest
• Hmong (interior mountains of SE Asia peninsula) – bow head or shake hands
• Hand gestures – some mean different things in different cultures
• Wiggling finger is appropriate to call a person over in the U.S. – rude in many other cultures
• Sideways Pointing at a thing is ok in Asia, but not at a person, confrontational, in America its ok for person or thing
• Closed fist upright point – slight threat in America, strong threat made by superior in Asia (never used on girl)
• Eye contact – sometimes means a person is listening, sincere, or honest, or hostile or disrespectful
• EYE CONTACT:• Anglo American – important, interest, honesty, listening
• African American – not as important, being in same room indicates attentiveness
• Navajo – direct eye contact avoided, peripheral vision used, direct stares are considered hostile or a way to scold children
• Japanese, SE Asian, Hispanic – eye contact is avoided as a form of respect
• Family organization – important in all cultures, nuclear families, extended families, patriarchal or matriarchal
• Asia – mostly patriarchal, extended, family needs more important than individual needs
Spirituality and religion in medicine
• Folk medicine is a collection of traditional beliefs and customs for treating pain or illness
• Mostly Western (biomedical) medicine in the U.S.- important to learn about your client’s culture though
• Common folk medicine practices from various cultures:
• Armenians: • give mother a party 1 wk after baby is born, she is served bread,
which she dips in a paste of margarine sugar and flour. Celebration of birth of child
• prohibit menstruating women from going to church, taking a shower, or eating spicy foods
• Asians:• Think health is a balance of yin and yang
• Use treatments like acupuncture and herbal remedies
• Believe pain must be endured silently
• Cambodians:• Use herbs as medicine
• Use cupping for headache
• Use coining for pain
• Consider the color white to be a sign of bad luck
• Central and South Americans:• Use herbal home remedies
• Teach a menstruating woman not to get her head wet, and to avoid eating cucumbers, lemons, oranges, pork, lard, and deer meat
• Europeans:• Believe that illness is caused by outside source
• Focus on treatment with medicine, surgery, diet, and exercise
• Hispanics:• Believe that health is a reward from God
• Believe in good luck
• Use heat and cold remedies to restore balance
• Rely on prayers and massage
• Hmong and Mien Tribes:• Perform spiritual ceremonies to please the spirits that cause
illness
• Use herbal home remedies including opium
• Iranians:• Believe that poor health is predetermined (fatalism)
• Use herbs, foods, rituals, and magic formulas for healing
• Believe the ‘evil eye’ causes sudden illness
• When Islamic, require washing of the face and hands before prayer
• Require periodic baths for cleansing
• Koreans:• Practice alchemy
• Use acupuncture
• Go to hot springs for baths and rituals and massage
• Use energy and brain stimulants
• Middle Easterners:• Believe that health is spiritual
• Cleanliness is essential
• Males dominate and make decisions on health care
• Believe in spiritual causes of illness like the ‘evil eye’
• Native Americans:• Use herbs and spices
• Use modern medical practices
• Some rely on a healer/shaman to remove pain and evil spirits
• Believe that health is harmony with nature
• Believe that tolerance of pain signifies power and strength
• Believe that illness is caused by supernatural forces and evil spirits
• South Africans:• Believe in maintaining harmony of mind, body, and spirit
• Believe the causes of ill health are spirits, demons, or punishment from God
• Use prayer or religious rituals as treatment