Cultural Diversity

1. Cultural Diversity Health Team Relations

2. 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

3. Individuality/Uniqueness influenced by the following: • Physical characteristics • Family life • Socioeconomic status • Religious beliefs • Geographical location • Education • Occupation • Life experiences

4. 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

5. 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

6. 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

7. 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)***

8. 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.

9. 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

10. Cultural Diversity cont… • In reality the U.S. is more like a salad bowl now where cultural differences are appreciated and respected • Acculturation = the process of learning the beliefs and behaviors of a dominant culture and assuming some of the characteristics • This process occurs slowly over time • Recent 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

11. 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

12. 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

13. Common Biases include: • Age • Younger people are more physically and mentally superior to older people • Education • College educated people are superior to uneducated people • Economic • Rich people are superior to poor people • Physical • Obese and short people are inferior to slender and taller people • Occupation • Nurses are inferior to doctors • Sexual preference • Homosexuals are inferior to heterosexuals • Gender • Women are inferior to men

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

15. Stereotyping • Stereotyping occurs when an assumption is made that everyone in a particular group is the same • Labels individuals • Example = “All blondes are dumb.”

16. 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

17. Ways to avoid bias, prejudice, and stereotyping in Health Care: • Know and be consciously aware of your own personal and professional values and beliefs • Obtain as much information as possible about different ethnic/cultural groups • Be sensitive to behaviors and practices different from your own • Remember you are not be pressured to adopt your patients’ beliefs, but you must respect them

18. Ways to avoid bias, prejudice, and stereotyping in Health Care cont… • Develop friendships with a wide variety of people • Ask questions about your patients’ beliefs/culture • Evaluate all information before you form an opinion • Be open to differences • Avoid jokes that may offend • Remember mistakes happen, apologize if you hurt someone’s feelings, and forgive if someone hurts your feelings

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

20. 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

21. 2 Main Types of Families • 1. Nuclear family • Usually consists of a mother, father, and children (single-parent and children) • Common type for European American families • 2. Extended family • Usually includes nuclear family plus grandparents, aunts, uncles, and cousins • Common type for Asian, Hispanic, and Native American families

22. 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

23. Matriarchal Families • In these families the mother or oldest female is the authority figure and makes the decisions for the family

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

25. 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?

26. 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

27. 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

28. 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-verbals • HC providers should use a slow, relaxed approach and explain the procedure

29. Eye Contact • European Americans regard eye contact during conversation as a sign of interest and trustworthiness • Asian Americans consider direct eye contact to be rude • The many beliefs regarding eye contact can lead to misunderstandings when people of different cultures interact

30. 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

31. 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 aging • When the cause is determined, HC is directed toward eliminating microorganisms, conquering disease process, and/or preventing the aging process • HC providers in the U.S. are trained and licensed to practice

32. Western HC Beliefs • Encouraging patients to learn as much as possible about their illness • Informing patients about terminal illnesses • Teaching self-care • Using medications and technology to cure or decrease effects of disease/illness • Teaching preventative care

33. 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

34. Alternative Health Care • Nutritional methods • Organic foods, herbs, vitamins • Mind and body control • Relaxation, meditation, biofeedback • Hypnotherapy, imagery • Energetic touch therapy • Massage, acupuncture • Body-movement methods • Chiropractic, yoga, tai chi • Spiritual methods • Faith healing, prayer, and spiritual counseling

35. 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

36. Spirituality vs. Religion • The beliefs individuals have about themselves, their connections with others, and their relationship with a higher power • Individual’s need to find meaning and purpose in life • Organized system of belief in a superhuman power • Form of worship • Ex. Going to church

37. Major Religious Beliefs • Pg 145-148

38. Atheist • Someone who does not believe in a higher power

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

40. THE END!!!