Culture and Ethnicity

1. Culture and Ethnicity

2. Concepts of Culture and Ethnicity • Culture – a set of values, beliefs & traditions that are held by a specific social group and handed down from generation to generation • Subculture – made up of people with a distinct identity, but who have certain ethnic, occupational or physical characteristics that are found in the larger culture • Dominant group – the group within the culture that has the authority to control the value system. • Minority group – usually has some physical or cultural characteristic that identifies the people within it as different

3. Ethnicity • The sense of identification that a cultural group collectively has, largely based on the group’s common heritage. • Race – Subculture of people characterized by specific characteristics.

4. Culture • Culture Assimilation • AKA Cultural acculturation • When minority groups living within the dominant group loose the cultural characteristics that make them different. • Stereotyping – involves assigning characteristics to a group of people without considering specific individuality.

5. Culture • Cultural Imposition – the belief that everyone should conform to the majority belief system. • Cultural conflict – when one ridicules others beliefs and traditions in an effort to make his or her own values more secure

6. Cultural and Ethnic Influences on Health Care • Gender Roles – It is important to know who is the dominant figure in a family • Language and Communication – Some clients may not be able to speak the English Language • Orientation to Space and time – personal space • Food and Nutrition • Socioeconomic

7. Poverty • The culture of poverty- the highest risk families are headed by one income single females, fixed income elderly and future generations of those living in poverty

8. Characteristics • Feelings of despair, resignation & fatalism • Day to day attitude toward life with no hope for the future • Unemployment and need for financial or government aid • Use of escape values such as alcohol and drugs • Unstable family structure with abusiveness and abandonment • Decline in self respect and retreat from community

9. Effects of Poverty on Health Care • Lack of affordable and adequate housing • Crowded living conditions • The sick usually experience more complication • Recovery time is longer • Less likely to regain their preillness level of functioning • Lack of access to health care insurance

10. Family Support • Some cultures have large extended families and are unable to share private information with anyone outside the family. • Some cultures have great respect for elderly and will not consider institutional care

11. Physical and Mental Health • Physiologic Characteristics • Keloid formation – overgrowth of connective tissue that occurs during healing process of injury, surgery—African heritage • Lactose intolerance 0 lack of lactase to break down lactose during digestion - Hispanic, African, Chinese, Thai. • Sickle Cell Anemia – sickle shaped red blood cells. Most common in African or Mediterranean ethnic background.

12. Continued… Tay Sacks Disease – a gene for a hereditary disorder – have very short life span – Eastern European, Jewish descent. G6PD deficiency – enzyme deficiency. Red blood cells have no cell membrane they are easily destroyed , which leads to anemia and increased billirubin levels. - 10% of African American population Thalassemia – genetic disorder effecting the Hgb in RBC function. Mediterranean, Asian, and African origin. Sarcoidosis – formation of multiple tubercles or nodules on various parts of the body - African American population. Gout – An increase of uric acid in the blood -males especially from Puerto Rican or Filipino descent.

13. Psychological Characteristics • In most situations an individual will relate the behavior of another person to the individual’s own familiar culture. • It is important to remember that what may seem perfectly reasonable & important to a client may seem ridiculous and irrelevant to a nurse. The reverse perception may also exist.

14. Culture Shock • Feelings an individual experiences when placed in a different and often strange culture and may result in psychological discomfort or disturbances.

15. Cultural Imposition and Ethnocentrism • Cultural Imposition. – the tendency for health personnel to impose their beliefs practices and values of other cultures, because they believe that their ideas are superior. • Ethnocentrism – the belief that one’s own ideas, beliefs and practices are the best and superior.

16. Providing Transcultural Care • Major Theme – Focus on caring practices of various cultures • Nursing Role – Understand the client’s needs and to adapt care to meet those needs.

17. Cultural Assessment • Identify factors that effect behavior by cultural assessment • Values, religion, dietary practices, family lines of authority, family life patterns and beliefs and practices related to health and illness • See guidelines on pp 47-52 • See table 3-1 on page 46-50

18. Reaction to Pain • Reactions are culturally prescribed ……….. Let’s discuss

19. Different Health Practices Folk Healers less expensive, more accessible and more understanding of cultural needs . Speak the client’s language Traditional Folk Medicine Herbs

20. Transcultural Nursing • Nursing care planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing diverse cultural populations. • The culture of health care: Assess: • the cultural background • expectations and beliefs about healthcare • Cultural context of the encounter • Degree of agreement between the 2 persons set of beliefs and values