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Culture. Set of values, beliefs, attitudes, languages, symbols, rituals, behaviors, customs of a group of peopleLearned and sharedDynamic and changing. Ethnicity. Classification of people based on national origin or cultureExamples: African American, Asian American, European American, Hispanic American, Middle Eastern/Arabic American, Native American.
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2. Culture Set of values, beliefs, attitudes, languages, symbols, rituals, behaviors, customs of a group of people
Learned and shared
Dynamic and changing
3. Ethnicity Classification of people based on national origin or culture
Examples: African American, Asian American, European American, Hispanic American, Middle Eastern/Arabic American, Native American
4. Race Classification of people based on physical or biological characteristics
Involves multiple cultures and ethnic groups
5. Cultural Diversity Differences based on cultural, ethnic, and racial factors
“Melting Pot” or “Salad Bowl” approach
Must be considered when providing health care
Healthcare providers must recognize and appreciate the characteristics of all patients
6. Holistic Care Must be developed to include cultural diversity of America
Addresses 3 aspects of well-being: mental/emotional, physical, and social
7. Areas of Cultural Diversity Family organization
Language
Personal space
Touching
Eye contact
Gestures
Health care beliefs
Spirituality
Religion
8. Cultural Diversity Impacts Beliefs Birth
Death
Health
Illness
Health Care
9. Health Varies Based on Cultural Background
10. World Health Organization A state of complete physical, mental, and social well-being, not merely the absence of disease
11. South African Harmony with nature
Harmony of mind, body, and spirit
12. Asian Physical and spiritual harmony with nature
Balance of yin and yang
13. European Personal responsibility with diet, rest, exercise, and prevention
14. Hispanic Good luck
Reward from God
Balance between hot and cold forces
15. Middle Eastern/Arabic Spiritual Causes
Cleanliness
16. Healthful Hints from Long Ago “A sassafras root carried in the pocket guards against illness.” (superstition of Old Saint Simons)
“Asafetida worn on a string around the neck protects a child from many diseases, and a buckeye carried in the pocket protects against rheumatism.” (Blue Ridge and Great Smokey Mts.)
17. “ A single, pierced nutmeg, worn around the neck on a string, will protect you from boils, croup, body lice, and various lung diseases.” (New England)
“A well-ventilated bedroom will prevent morning headaches and lassitude.” (1914 Almanac)
18. Illness Abnormal functioning of a body’s system or systems
Causes vary based on cultural/ethnic background
19. South African Spirits/demons
Conflicts in life
God’s punishment
20. Asian Imbalance of yin and yang
Supernatural forces
Unhealthy environment
21. European Sin
Outside sources: microorganisms, toxins
22. Hispanic Sins
Fright
Evil Eye
Envy
Imbalance between hot and cold
23. Middle Eastern/Arab Sins
Evil Eye
Spiritual causes
24. Native American Supernatural forces
Violation of a taboo
Imbalance between man and nature
25. Folk Remedies Beliefs and practices ethnically similar
Religion plays a role in perception of, interpretation of, and behavior in health and illness
Women are usually the prime caregivers
Can create delay in seeking professional help
26. Preventions Jewish: camphor around the neck in winter in a small cloth bag to prevent measles and scarlet fever
Black and Native Americans: blackstrap molasses
Black Africans (Ethiopia): eat hot & sour foods i.e. lemons, fresh garlic, pepper
27. Preventions Germans: no sweets at meals, drink glass of water at meals, cod-liver oil, plenty of milk, spring tonic (sulfured molasses)
Islam: dress properly for the season & weather, keep feet from getting wet in the rain
28. Preventions: Irish Clean out bowels with senna for 8 days
Spring tonic of sulfured molasses
Onions under the bed to keep nasal passages clear
Bag of camphor around the neck during flu season
29. Preventions: Irish Never go to bed with wet hair
Don’t look in the mirror at night & close closet doors (prevents evil spirits)
Eat lots of oily food
Take Father John’s Medicine every so often
30. Preventions: Italian Garlic cloves strung on a piece of string around neck of infants and children to prevent colds and “evil” stares
Red ribbon around neck of infant does the same thing
Never wash or bathe during period
31. Preventions: Italian Never wash hair before going outdoors or at night
Keep a pair of open scissors under mattress of crib to prevent “evil” in newborn
Wrap a bandage around the baby from the waist to the feet for 1st 6 months to prevent bowlegs
32. Home Treatments: Jewish Sore throat: find salted herring, wrap it in a towel, put it around the neck, let it stay there overnight, gargle with salt water
Boils: fry chopped onions, make a compress and apply to the infections
33. Home Treatments: Blacks/Native Americans Bloody nose: place keys on chain around neck
Sore throat: suck yolks out of egg shell, honey and lemon, baking soda, salt , warm water, onions around the neck
34. Home Treatments: Black African Evil Eye: put some kind of plant root on fire and make the man who has the evil eye smile and the man talks about his illness
35. Home Treatments: Germans Coughs: honey & vinegar; boiled onion water, honey, & lemon; hot water & Vicks
Swollen glands/mumps: put pepper on salt pork and tie around the neck
Earache: few drops of warm milk in the ear, laxatives when needed
36. Home Treatments: Germans Sty: cold tea-leaf compresses
Fever: mix whiskey, water, & lemon juice to drink before bed (causes person to sweat and break fever)
Constipation: Ivory soap suppositories
37. Home Treatments: Islam Sore throat: gargle with vinegar and water
Indigestion: baking soda and water
Sore muscles: alcohol and water
Rashes: apply corn starch
38. Home Treatments: Irish See doctor only in an emergency
Earache: heat salt, put in stocking behind ear
Fever: spirits of niter on a dry sugar cube
Colds: hot lemonade and a tablespoon of whiskey; egg whites; ipecac
39. Home Treatments: Irish Coughs: linseed poultice on chest; flaxseed poultice on back; red flannel cloth soaked in hot water and placed on chest all night
Menstrual cramps: hot milk sprinkled with ginger, glass of warm wine, hot-water bottle on stomach
40. Home Treatments: Irish Nausea: castor oil, hot ginger ale, cup of hot boiled water
Sore throat: paint throat with iodine, honey and lemon, Karo syrup; paint with kerosene oil with rag then tie sock around the neck; paint with iodine or Mercurochrome and gargle with salt water, honey melted Vicks
41. Home Treatments: Italian Chicken soup for everything
Boils: cooked oatmeal wrapped in a cloth (steaming hot) and applied to drain pus
Headache: kerchief with ice in it wrapped around the head
Cramps: crème de menthe
42. Home Treatments: Italian Acne: apply baby’s urine
To build up blood: eggnog with brandy; Marsala wine and milk
Backache: place a silver dollar on the sore area and light a match to it, while the match is burning put a glass over the silver dollar and slightly lift the glass, this causes suction which lifts the pain out
43. Healthcare Providers’ Culture Cultural Diversity in Health and Illness, Second Edition, p.70
44. Beliefs “Standardized definitions of health and illness
“The omnipotence of technology”
45. Practices “The maintenance of health and the prevention of disease through such mechanisms as the avoidance of stress and the use of immunizations”
“Annual physical examinations and diagnostic procedures such as Pap smears”
46. Habits “Charting”
“The constant use of jargon”
“ Use of a systematic approach and problem-solving methodology”
47. Likes “Promptness”
“Neatness and organization”
“Compliance”
48. Dislikes “Tardiness”
“Disorderliness and disorganization”
49. Customs “Professional deference and adherence to the ‘pecking order’ found in autocratic and bureaucratic systems”
50. Customs “Handwashing”
51. Customs “Employment of certain procedures attending birth and death”
52. Rituals “The physical examination”
“The surgical procedure”
“Limiting visitors and visiting hours”
53. Cultural Beliefs Concerning Epidemiology and Pain Medical culture is in direct opposition sometimes
Bacteria/viruses/carcinogens/pollutants versus “soul loss”/”spirit possession”/voodoo/witchcraft
Free, open expression of feelings versus never revealing true feelings
54. Examples of Cultural Clashes “Mr. Smith in room 222 is the ideal patient. He never has a single complaint.” Are you sure he has no complaints or is it his cultural influence not to be a bother?Are you sure he has no complaints or is it his cultural influence not to be a bother?
55. Examples of Cultural Clashes “Mrs. Cohen in room 223 is a real complainer. She is constantly asking for pain medication and putting on her light.” Is she really in pain or is it her cultural programming concerning dealing with pain?Is she really in pain or is it her cultural programming concerning dealing with pain?
56. Examples of Cultural Clashes “Mr. Chen in room 225 says nothing. I often wonder what he is feeling.” What is really happening with Mr. Chen?What is really happening with Mr. Chen?
57. Healthcare Providers Must change to accommodate other cultural beliefs and behaviors towards health and illness
58. Religion and Healing Vital role in perception of health and illness
Rites surrounding birth and death
Diet
59. Traditional Etiology: Evil Eye Power of eye strikes victim
Injury, illness, misfortune is sudden
Person 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
60. Traditional Methods of Prevention
61. Protective Objects Amulets
Bangles
Talismans
62. Protective Substances Garlic
Onions
Chachayotel
1000 year old eggs
Kosher foods
63. Protective Religious Practices Social, moral, dietary practices
Burning candles
Rituals of redemption
Prayer
64. Examples of Saints for Protection Blessing of the Throats on St. Blaise Day
Virgin of Guadalupe
St. Anthony of Padua: barren women
St. Odilla: blindness
Our Lady of Lourdes: bodily ills
65. Beliefs Affecting Therapy Use of healers with divine powers
Natural products: herbs, berries
Purgatives
Blood-letting
Removal of person with evil eye
Avoidance of provocation of envy
66. Forms of Spiritual Healing Spiritual healing
Inner healing
Physical healing
Deliverance or exorcism
Auric healing
Pilgrimages
67. Healthcare Providers Must Be Aware of the Multitude of Sources Outside of Mainstream Medicine! Embrace Diversity in Medicine. Teach Tolerance to Healthcare Providers!