Copyright © 2015 Wolters Kluwer All Rights Reserved Cultural Diversity Taylor Chapter 5

Copyright © 2015 Wolters Kluwer All Rights Reserved Definition – Diversity: Diversity refers to the differences between people based on a shared set of beliefs, customs, and lifestyles (American Nurses Association Position Statement, 1991). Nurses must be sensitive to diversity by not imposing personal beliefs on others, avoiding stereotyping, and recognizing the impact that these differences may make on clients’ health care decisions and practices (Taylor et al., 2015). The unique variations among and between individuals, variations that are informed by genetics and cultural background, but that are refined by experience and personal choice.

Copyright © 2015 Wolters Kluwer All Rights Reserved Varying cultures Racial and ethnic origin Religion Physical size, age, and gender Sexual orientation Disability Socioeconomic and occupational status Geographical location Cultural Diversity

Copyright © 2015 Wolters Kluwer All Rights Reserved 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 Culture

Copyright © 2015 Wolters Kluwer All Rights Reserved 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 Question

Copyright © 2015 Wolters Kluwer All Rights Reserved Answer: A. True. Rationale: 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. Answer

Copyright © 2015 Wolters Kluwer All Rights Reserved Large group of people who are members of a larger cultural group Members have certain ethnic, occupational, or physical characteristics not common to the larger culture. Subculture

Copyright © 2015 Wolters Kluwer All Rights Reserved 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 from dominant group. Groups in Society

Copyright © 2015 Wolters Kluwer All Rights Reserved 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 Cultural Definitions

Copyright © 2015 Wolters Kluwer All Rights Reserved Which of the following occurs when members of 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 Question

Copyright © 2015 Wolters Kluwer All Rights Reserved 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. Answer

Copyright © 2015 Wolters Kluwer All Rights Reserved Sense of identification with a collective cultural group Largely based on group’s common heritage One can belong to an ethnic group through birth or adoption of characteristics of that group. Groups share unique cultural and social beliefs and behavior patterns. Largely develops through day-to-day life with family and friends within the community. Ethnicity

Copyright © 2015 Wolters Kluwer All Rights Reserved 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 - Caucasian Race

Copyright © 2015 Wolters Kluwer All Rights Reserved The assumption that all members of a culture or ethnic group act alike May be positive or negative Negative includes racism, ageism, and sexism Stereotyping

Copyright © 2015 Wolters Kluwer All Rights Reserved 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 Question

Copyright © 2015 Wolters Kluwer All Rights Reserved Answer: B. False Rationale: Cultural blindness occurs when people ignore differences in the cultures in which they live and proceed as if they do not exist. Answer

Copyright © 2015 Wolters Kluwer All Rights Reserved Identifying Prejudices: the First Step to Eliminating Them

Copyright © 2015 Wolters Kluwer All Rights Reserved Cultural imposition Belief that everyone should conform to the majority belief system Cultural blindness Ignores differences and proceeds as if they did not exist Cultural Terminology

Copyright © 2015 Wolters Kluwer All Rights Reserved People become aware of differences and feel threatened. Response—ridiculing beliefs and traditions of others to make themselves feel more secure Culture Conflict

Copyright © 2015 Wolters Kluwer All Rights Reserved Belief that one’s ideas, beliefs, and practice are the best or superior, or are most preferred to those of others Ethnocentrism

Copyright © 2015 Wolters Kluwer All Rights Reserved Which term describes what occurs when a nurse believes that one’s own ideas, beliefs, and practices are the best or superior to those of colleagues and patients? A. Cultural diversity B. Culture shock C. Stereotyping D. Ethnocentrism Question

Copyright © 2015 Wolters Kluwer All Rights Reserved 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. Answer

Copyright © 2015 Wolters Kluwer All Rights Reserved Physiologic variations Reactions to pain Mental health Gender roles Language and communication Orientation to space and time Food and nutrition Family support Socioeconomic factors Cultural Influences on Health Care

Copyright © 2015 Wolters Kluwer All Rights Reserved Recognize that each person holds various beliefs about pain and that pain is what the patient says it is. Respect the patient’s right to respond to pain in one’s own fashion. Never stereotype a patient’s responses to pain based on the patient’s culture. Be sensitive to nonverbal signals of discomfort, such as holding or applying pressure to the painful area or avoiding activities that intensify the pain. Culturally Competent Nursing Care— Patient in Pain

Copyright © 2015 Wolters Kluwer All Rights Reserved Feelings of despair, resignation, and fatalism Day-to-day attitude toward life; no hope for future Unemployment and need for financial or government aid Unstable family structure; possibly characterized by abusiveness and abandonment Decline in self-respect and retreat from community involvement The Culture of Poverty

Copyright © 2015 Wolters Kluwer All Rights Reserved Tell whether the following statement is true or false. The health care system is a culture of its own, with nursing being its largest subculture. A. True B. False Question

Copyright © 2015 Wolters Kluwer All Rights Reserved Answer: A. True. Rationale: The health care system is a culture of its own, with nursing being its largest subculture. Answer

Copyright © 2015 Wolters Kluwer All Rights Reserved Developing self-awareness Demonstrating knowledge and understanding of a patient’s culture Accepting and respecting cultural differences Not assuming that the health care provider’s beliefs and values are the same as the client’s Resisting judgmental attitudes such as “different is not as good” Being open to and comfortable with cultural encounters Accepting responsibility for one’s own cultural competency Elements of Cultural Competence

Copyright © 2015 Wolters Kluwer All Rights Reserved Cultural background of each participant Expectations and beliefs of each person about health care Cultural context of the encounter Degree of agreement between the sets of beliefs and values of the two persons Andrews & Boyle, 2008 Factors That Affect Culturally Diverse Interactions

Copyright © 2015 Wolters Kluwer All Rights Reserved Develop cultural self-awareness. Develop cultural knowledge. Accommodate cultural practices in health care. Respect culturally based family roles. Avoid mandating change. Seek cultural assistance. Guidelines for Providing Culturally Competent Nursing Care

Copyright © 2015 Wolters Kluwer All Rights Reserved Beliefs, values, traditions and practices of a culture Culturally defined, health-related needs of individuals, families, and communities Culturally based belief systems of the etiology of illness and disease and those related to health and healing Attitudes toward seeking help from health care providers Cultural Assessment/Areas Nurses Need to Understand

Copyright © 2015 Wolters Kluwer All Rights Reserved The Power of Transcultural Nursing” “Cultural Diversity Tips for Communicating with Cultural Awareness” Gestures, meanings and cultures