1. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 2 Cultural Diversity

2. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural Diversity Varying cultures Racial and ethnic origin Religion Physical size, age, and gender Sexual orientation Disability Socioeconomic and occupational status Geographical location

3. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Culture Shared system of beliefs, values, and behavioral expectations Provides social structure for daily living Defines roles and interactions with others and in families and communities Apparent in the attitudes and institutions unique to the culture

4. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. Culture includes the beliefs, habits, likes and dislikes, and customs and rituals learned from one’s family. A. True B. False

5. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer A. True. Culture is defined as a shared system of beliefs, values, and behavioral expectations that provides social structure for daily living. It includes the beliefs, habits, likes and dislikes, and customs and rituals learned from one’s family.

6. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Subculture Large group of people who are members of a larger cultural group Have certain ethnic, occupational, or physical characteristics not common to the larger culture

7. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Groups in Society Dominant group (usually largest group) –Group has the most authority to control values and sanctions of society Minority group (smaller group) –A physical or cultural characteristic identifies the people as different than dominant group

8. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural Definitions Cultural assimilation (acculturation) –Minorities living within a dominant group lose the characteristics that made them different –Values replaced by those of dominant culture Culture shock –The feelings a person experiences when placed in a different culture –May result in psychological discomfort or disturbances

9. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following occurs when a minority group, living with a dominant group, begins to blend in and lose the characteristics that made them distinct? A. Cultural imposition B. Cultural conflict C. Cultural assimilation D. Cultural shock

10. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer: C. Cultural Assimilation Rationale: Cultural assimilation occurs when one’s values are replaced by the values of the dominant culture. Cultural imposition is the belief that everyone should conform to the majority belief system. Cultural conflict occurs when people become aware of cultural differences, feel threatened, and act negatively. Cultural shock refers to the feelings a person experiences when placed in a different culture.

11. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Ethnicity Sense of identification with a collective cultural group Largely based on group’s common heritage

12. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Race Typically based on specific characteristics –Skin pigmentation, body stature, facial features, hair texture Five major categories: –American Indian or Alaska Native –Asian –Black or African American –Native Hawaiian or Other Pacific Islander –White

13. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Stereotyping One assumes that all members of a culture or ethnic group act alike May be positive or negative –Negative includes racism, ageism, and sexism

14. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. Stereotyping occurs when people ignore differences in the cultures in which they live and proceed as if they do not exist. A. True B. False

15. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. False Cultural blindness occurs when people ignore differences in the cultures in which they live and proceed as if they do not exist.

16. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Identifying Prejudices: the First Step to Eliminating Them

17. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural Terminology Cultural imposition –Belief that everyone should conform to the majority belief system Cultural blindness –Ignores differences and proceeds as if they did not exist

18. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Culture Conflict People become aware of differences and feel threatened Response—ridiculing beliefs and traditions of others to make themselves feel more secure

19. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Ethnocentrism Belief that one’s ideas, beliefs, and practice are the best or superior, or are most preferred to those of others

20. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following describes the concept that occurs when a nurse believes that her own ideas, beliefs, and practices are the best or superior to those of her colleagues and patients? A. Cultural diversity B. Culture shock C. Stereotyping D. Ethnocentrism

21. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer: D. Ethnocentrism Rationale: Ethnocentrism is the belief that one’s ideas, beliefs and practices are superior or preferred to those of others. Cultural diversity refers to the existence of diverse groups in society with varying cultural characteristics. Culture shock describes the feelings a person experiences when placed in a different culture. Stereotyping is the practice of assuming that all members of a cultural group act alike.

22. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural Influences on Healthcare Physiologic variations Reactions to pain Mental health Gender roles Language and communication Orientation to space and time Food and nutrition Family support Socioeconomic factors

23. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Culturally Sensitive Nursing Care—Patient in Pain Recognize each person holds various beliefs about pain. Respect the patient’s right to respond to pain in his own fashion. Never stereotype a patient’s responses to pain based on his culture.

24. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Culture of Poverty Feelings of despair Day-to-day attitude toward life Unemployment and need for financial or government aid Unstable family structure Decline in self-respect and retreat from community involvement

25. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. The healthcare system is a culture of its own with nursing being its largest subculture. A. True B. False

26. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer A. True. The healthcare system is a culture of its own with nursing being its largest subculture.

27. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Culturally Competent Nursing Care Care must be sensitive to needs of individuals, families, or groups from diverse cultures. The healthcare system is a culture with customs, rules, values, and a language of its own. Nursing is the largest subculture of the healthcare system.

28. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors That Affect Culturally Diverse Interactions Cultural background of each participant Expectations and beliefs of each person about healthcare Cultural context of the encounter Degree of agreement between the sets of beliefs and values of the two persons –Andrews & Boyle, 2008

29. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Guidelines for Providing Culturally Competent Nursing Care Develop cultural self-awareness. Develop cultural knowledge. Accommodate cultural practices in healthcare. Respect culturally based family roles. Avoid mandating change. Seek cultural assistance.