1. Unit 6
Cultural diversity

2. Cultural Diversity (Don’t Write)
Health care providers must work with and provide care to many different people. They must also respect the individuality of each person.
A major influence on any individual’s uniqueness is the person’s cultural/ethnic heritage

3. Cultural Diversity (Don’t Write)
Factors of individual uniqueness:
Physical characteristics
Family life
Socioeconomic status
Religious beliefs
Geographical location
Education
Occupation
Life experiences

4. Cultural Diversity (Write)
Culture
Values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs which are unique to a particular group of people and passed on from one generation to the next
Set of Rules
Blueprint or general design for living

5. Cultural Diversity Culture Influenced by culture: Family relations
Child rearing (raising)
Education
Occupational choice
Social interactions
Spirituality
Religious beliefs

6. Cultural Diversity Culture Influenced by culture:
Food preferences
Health beliefs
Health care
Culture is NOT uniform among all members within a cultural group, but does provide a foundation for behavior

7. Cultural Diversity Culture All cultures have 4 basic characteristics:
Culture is learned
Culture does not just happen
It is taught to others
Children learn patterns of behavior by imitating adults and developing attitudes accepted by others

8. Cultural Diversity Culture All cultures have 4 basic characteristics:
Culture is shared:
Common practices and beliefs are shared with others in a cultural group
Culture is social in nature:
Individuals in a cultural group understand appropriate behavior based on traditions passed from generation to generation

9. Cultural Diversity Culture All cultures have 4 basic characteristics:
Culture is dynamic & constantly changing:
New ideas may generate different standards for behavior
Needs of the group are met through change

10. Cultural Diversity Ethnicity
Classification of people based on natural origin and/or culture
Share common heritage, national origin, social customs, language and beliefs
Even though every individual in the group may not practice all beliefs, the individual is still influenced by other members of the group

11. Cultural Diversity Ethnicity
Common groups in U.S. & countries of origin:
African American: Central & South African countries, Dominican Republic, Haiti, Jamaica
Asian American: Cambodia, China, Hawaii, India, Indonesia & Pacific Island countries, Japan, Korea, Laos, Pakistan, Philippines, Samoa, Vietnam

12. Cultural Diversity Ethnicity
Common groups in U.S. & countries of origin:
European American: England, France, Germany, Ireland, Italy, Poland, Russia, Scandinavia, Scotland
Hispanic American: Cuba, Mexico, Puerto Rico, Spain, & Spanish speaking countries in Central and South America

13. Cultural Diversity Ethnicity
Common groups in U.S. & countries of origin:
Middle Eastern/Arab American: Egypt, Iran, Jordan, Kuwait, Lebanon, Palestine, Saudi Arabia, Yemen & other North African & Middle Eastern countries
Native American: Over 500 tribes of American Indians and Eskimos

14. Cultural Diversity Ethnicity
It is important to recognize that within each of the ethnic groups there are numerous subgroups, each with it’s own lifestyle and beliefs.
Example:
European American group includes Italians and Germans; each has different languages and lifestyles

15. Cultural Diversity Race
Classification of people based on physical, or biological characteristics
Color of skin, hair, eyes
Facial features
Blood type
Bone structure
Frequently used to label a group of people and explain patterns of behavior

16. Cultural Diversity Race
Values, beliefs and behaviors learned from the ethnic/cultural group that generally account for behaviors attributed to race (Example Below)
Blacks from Africa and blacks from the Caribbean share many of the same physical characteristics, but they represent different ethnic groups and have different cultural beliefs and values

17. Cultural Diversity Race
There are also different races present in most ethnic groups
White & black Hispanics
White African & Carribbeans
White & Black Asians

18. Cultural Diversity Cultural Diversity Cultural Assimilation
Differences among people resulting from cultural, ethnic and racial factors
Cultural Assimilation
The absorption of other cultures into the dominant culture
The U.S. seen as “melting pot”
Requires that cultural groups alter beliefs and behaviors (mercy killings)

19. Cultural Diversity Acculturation Sensitivity
Learning the beliefs and behaviors of the dominant culture
Assuming some characteristics of the dominant culture
Occurs slowly over long periods of time
Sensitivity
The ability to recognize and appreciate the personal characteristics of others

20. Cultural Diversity Sensitivity
Example: In Native American and Asian cultures, calling a patient by their first name is disrespectful
Health care workers will always address patients (or residents) by their last name, unless the patient requests to be addressed by their first name or nickname.

21. Cultural Diversity Bias A preference that prevents impartial judgment
Ethnocentric: believe that their ethnic group is supreme above all other groups
May antagonize or be unfriendly toward people from other cultures

22. Cultural Diversity Bias Examples of common biases:
Age: young people believing that they are physically and mentally superior to older people
Education: college-educated individuals believing that they are superior to uneducated individuals
Economic: wealthy people believing that they are superior to the less wealthy

23. Cultural Diversity Bias Examples of common biases:
Physical appearance: thin people believing that they are superior to obese people
Occupation: physicians believing that nurses are inferior medical professionals
Sexual preference: Heterosexuals believing that homosexuals are inferior
Gender: Men believing women are inferior.

24. Cultural Diversity Prejudice
Strong feeling about a person or subject; to prejudge
Formed without reviewing facts or information
They are right; everyone else is wrong
ALL individuals are prejudice to some degree

25. Cultural Diversity Stereotyping
Assumption made that everyone in a particular group is the same
Individual characteristics are ignored
Individuals are “labeled”
Example:
“All blondes are dumb”

26. Cultural Diversity Stereotyping
There is NO room for stereotyping of any kind in health care.
Avoid jokes
With patients: Be open about subjects you would normally not even discuss
Evaluate all information before you form an opinion
You are a professional

27. Cultural Diversity Family Organization
Families vary in their composition and in the roles assumed by family members
Two Types:
Nuclear family: mother, father, children (biological or “step”)
People outside family usually care for children, sick or elderly

28. Cultural Diversity Family Organization Two Types:
Extended family: nuclear family plus grandparents, aunts, uncles, cousins
Families tend to take care of their children, sick or elderly
Hispanic / Asian Cultures

29. Cultural Diversity Family Organization Patriarch / Matriarch:
Patriarchal Family: Father or oldest male is authority figure
Will make most health care decisions for all family members
Asian / Middle Eastern cultures believe that the male has the power and authority and women are expected to be obedient
Husbands makes medical decisions for wife

30. Cultural Diversity Family Organization Patriarch / Matriarch:
Matriarchal Family: Mother or oldest female is authority figure
Will make most health care decisions for all family members
Mother and father may make some decisions together
“I have to check with my husband (wife) before making a decision.”

31. Cultural Diversity Language
20% of the U.S. population speaks a language other than English at home
Different dialects
May speak English, but not read it.
Find Translator

32. Cultural Diversity Language For health care workers:
Nonverbal communication is very important (smile, gentle touch - if culturally appropriate)
Communication boards
Most states require that any medical permit requiring a written signature be printed in the patient’s primary language

33. Cultural Diversity Language For health care workers – DO NOT:
Express frustration because the patient does not speak English
Be offended if patient or family members communicate in their primary language, even if the patient speaks English

34. Cultural Diversity Language For health care workers – DO NOT:
Speak inappropriately to other staff about a patient (EVER) because you think they do not understand what you are saying.
Laugh or make fun of the words or foreign language spoken
Forget that your patient does not understand, is likely scared & needs help

35. Cultural Diversity Personal Space and Touch
Distance that people require to feel comfortable while interacting with others
Varies greatly among different cultures
Close Contact vs. Distant Contact Cultures

36. Cultural Diversity Personal Space and Touch Close Contact Cultures
Arabs: touch, feel, and smell people with whom they interact
French and Latin Americans: stand very close together while interacting
Hispanics: hugs and handshakes to greet others

37. Cultural Diversity Personal Space and Touch Distant Contact Cultures
European and African: may shake hands as a greeting, but want 2-6 feet separation during interaction
Asians: stand close together, but not touch; kissing, hugging seen as very intimate acts and are NEVER done in public.

38. Cultural Diversity Personal Space and Touch Distant Contact Cultures
Cambodians: all members of opposite sex – even if related – never touch each other; only parent can touch the head of a child
Vietnamese: only elderly to touch head of a child because head is considered sacred

39. Cultural Diversity Personal Space and Touch Distant Contact Cultures
Middle Eastern: men may not touch females who are not immediate family; only men can shake hands with other men; may cause female patients to refuse care from male nurse.
Native Americans: value personal space as important; will only lightly touch other person’s hand when greeting

40. Cultural Diversity Eye Contact
Europeans: regard eye contact as sign of interest and trustworthiness
Asians: consider direct eye contact rude
Native Americans: use peripheral vision to avoid direct eye contact
Hispanic & African Americans: brief eye contact, but then look away as a sign of respect and attentiveness

41. Cultural Diversity Gestures
US: nodding head up & down means “yes” and side-to-side for “no”
India: head motions for “yes” and “no are exact opposite
US: pointing is accepted
Asian & Native Americans: pointing is seen as a serious threat

42. Cultural Diversity Gestures US: “OK” hand gesture
Asian Culture: can be seen as an insult

43. End of Lecture