Unit 6 Cultural diversity

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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)

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

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.

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

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

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.

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

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”

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

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

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

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

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.”

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

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

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

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

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

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

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.

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

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

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

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

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

End of Lecture