Health Team Relations Melissa Lewis, RN Cultural Diversity Health Team Relations Melissa Lewis, RN

INTRODUCTION HC providers must provide care to many different types of patients No two patients are alike HC providers must be aware of and respect the individuality of each patient

Individuality/Uniqueness influenced by the following: Physical characteristics Family life Socioeconomic status Religious beliefs Geographical location Education Occupation Life experiences

Culture Defined as values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs unique to a particular group of people and passed from one generation to the next Set of rules about things like family relations, child rearing, education, occupational choice, social interactions, spirituality, religious beliefs, food preferences, health beliefs, and HC

All Cultures have 4 things in common: 1. Culture is learned** 2. Culture is shared 3. Culture is social in nature 4. Culture is dynamic and constantly changing

Ethnicity Defined as a classification of people based on national origin and/or culture Members of an ethnic group may share common heritage, geographical location, social customs, language, and beliefs

Ethnic Groups in the United States 1. African American 2. Asian American 3. European American 4. Hispanic American 5. Middle Eastern/Arab Americans 6. Native Americans (Indians and Eskimos)***

Race Classification of people based on the physical characteristics (color or hair, skin, and eyes) There are different races present in most ethnic groups. Ex. There are black and white African Americans.

Cultural Diversity This is the differences in culture, ethnicity, and racial factors among people In previous times the United States used to be called the “melting pot” to represent the absorption of many cultures in the dominant culture. This is called cultural assimilation when people come from other countries and adapt to the American way of doing things

Cultural Diversity cont… In reality the U.S. is more like a salad bowl now where cultural differences are appreciated and respected Acculturation = the process of learning the beliefs and behaviors of a dominant culture and assuming some of the characteristics This process occurs slowly over time Recent immigrants to the U.S. are more likely to follow patterns of their native land than their children and grandchildren who have lived here longer

Cultural Sensitivity The ability to recognize and appreciate the personal characteristics of others is essential in health care Ex. In some cultures, called an adult by their first name is not acceptable except for close friends/relatives. Sensitive HC workers will address patients by Mr./Mrs. and their last name

Bias A bias is a preference that prevents impartial judgment Example: Individuals that believe in the supremacy of their own ethnic group (ethnocentric). These people believe that their cultural values are better than the cultural values of others

Common Biases include: Age Younger people are more physically and mentally superior to older people Education College educated people are superior to uneducated people Economic Rich people are superior to poor people Physical Obese and short people are inferior to slender and taller people Occupation Nurses are inferior to doctors Sexual preference Homosexuals are inferior to heterosexuals Gender Women are inferior to men

Prejudice Prejudice means to pre-judge. It is a strong feeling/belief about a person/subject that is formed without reviewing facts/information This causes fear and distrust and interferes with interpersonal relationships Everyone is prejudiced to a certain degree!

Stereotyping Stereotyping occurs when an assumption is made that everyone in a particular group is the same Labels individuals Example = “All blondes are dumb.”

Bias, Prejudice, and Stereotyping These are all barriers to effective communication and relationships with patients HC providers must be alert to these barriers and make every effort to avoid them

Ways to avoid bias, prejudice, and stereotyping in Health Care: Know and be consciously aware of your own personal and professional values and beliefs Obtain as much information as possible about different ethnic/cultural groups Be sensitive to behaviors and practices different from your own Remember you are not be pressured to adopt your patients’ beliefs, but you must respect them

Ways to avoid bias, prejudice, and stereotyping in Health Care cont… Develop friendships with a wide variety of people Ask questions about your patients’ beliefs/culture Evaluate all information before you form an opinion Be open to differences Avoid jokes that may offend Remember mistakes happen, apologize if you hurt someone’s feelings, and forgive if someone hurts your feelings

Holistic Care HC providers must be aware of cultural diversity to provide holistic care (well-being of the whole person) to their patients

Family Organization This is the structure of a family and the dominant or decision-making person in the family Families vary in their composition and in the roles assumed by family members

2 Main Types of Families 1. Nuclear family 2. Extended family Usually consists of a mother, father, and children (single-parent and children) Common type for European American families 2. Extended family Usually includes nuclear family plus grandparents, aunts, uncles, and cousins Common type for Asian, Hispanic, and Native American families

Patriarchal Families In these families the father or oldest male is the authority figure and makes the decisions for the family So, this is the person who would make the health care decisions as well Women are expected to be obedient

Matriarchal Families In these families the mother or oldest female is the authority figure and makes the decisions for the family

Language Dominant language used in United States is English However, 20% of population under 65 years of age speaks another language A health care provider must determine the patient’s ability to communicate by talking with pateint/relative and asking questions

Common Questions to Determine Patient’s Understanding Do you speak English as your first language? What language is spoken at home? Do you read English? Do you have a family member/friend that can interpret for you?

Health Care Providers should: Find a translator when possible Speak slowly and use simple words Use gestures/pictures to clarify meaning of words Use nonverbal communication (smile or gentle touch) when appropriate Avoid tendency to speak louder Try to learn some words/phrases in their language

Personal Space Personal space = territorial space This describes the distance people require to feel comfortable while interacting with others This varies among different ethnic groups Close contact groups: comfortable standing very close to and even touching Distant contact groups

HC Providers & Personal Space HC providers have to invade a patient’s personal space at times to do certain skills (ex. Taking vital signs, baths, etc.) HC providers should always be alert to patients verbals and non-verbals HC providers should use a slow, relaxed approach and explain the procedure

Eye Contact European Americans regard eye contact during conversation as a sign of interest and trustworthiness Asian Americans consider direct eye contact to be rude The many beliefs regarding eye contact can lead to misunderstandings when people of different cultures interact

Gestures Shaking head “yes” or “no” In India, it is the complete opposite Pointing at someone with a finger represents a strong threat by Asian and Native Americans

Health Care Beliefs The “Western” system is the most common HC system in the U.S. This system is based on the cause of disease being microorganisms, diseased cells, and the process of aging When the cause is determined, HC is directed toward eliminating microorganisms, conquering disease process, and/or preventing the aging process HC providers in the U.S. are trained and licensed to practice

Western HC Beliefs Encouraging patients to learn as much as possible about their illness Informing patients about terminal illnesses Teaching self-care Using medications and technology to cure or decrease effects of disease/illness Teaching preventative care

Health Care Beliefs of Different Ethnic Groups Look in book on page 142-143 Make your own table with six rows down and five columns down I will help you condense chart in book

Alternative Health Care Nutritional methods Organic foods, herbs, vitamins Mind and body control Relaxation, meditation, biofeedback Hypnotherapy, imagery Energetic touch therapy Massage, acupuncture Body-movement methods Chiropractic, yoga, tai chi Spiritual methods Faith healing, prayer, and spiritual counseling

Traditional vs. Alternative Treatments All individuals have the right to choose the type of HC system and method of treatment that they feel is best for them HC providers must respect this, even if they do not agree

Spirituality vs. Religion The beliefs individuals have about themselves, their connections with others, and their relationship with a higher power Individual’s need to find meaning and purpose in life Organized system of belief in a superhuman power Form of worship Ex. Going to church

Major Religious Beliefs Pg 145-148

Atheist Someone who does not believe in a higher power

Agnostic A person who believes that the existence of a higher power can not be proven or disproven

THE END!!!