Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 1 CHAPTER 5 CULTURE AND HEALTH CARE
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Culture Overview Importance of cultural values and connections on health care Patient’s culture Health care worker’s cultural background Culture Act of belonging to a designated group “Colo” Latin – to cultivate Effect is unconscious
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 3 Culture Is Reflected in Many Aspects of Life Eating habits Language Dress Hobbies Living patterns Occupational choices Education Religious affiliations Political points Interpersonal relationships
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Acculturation Learning cultural behaviors from one group or person Evolves slowly Always occurring Subcultures within each large cultural group Can be broad and varied United States Census Bureau Collects data on U.S. population every 10 years
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 5 Table 5-1
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 6 Ethnography Branch of anthropology Studies and records human cultures Ethnographic studies provide information to teach cultural competence
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 7 Cultural Impact on Health Care Every interaction with a patient has cultural implications
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 8 Wellness and Health Prevention Various cultures have different views on preventive medicine Exercise Preventive doctor visits Immunizations
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 9 Touch and Physical Space Differing views on close touching and human contact As a health care worker: Always ask permission before touching any patient, regardless of cultural differences Be alert to positive or negative signs
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 10 Communication Vital to our survival Language Language barriers affect communication Language is a form of cultural connection Assimilation Process of accepting and exchanging cultural information
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 11 General and Invasive Procedures Important for the health care worker to be sensitive to patients who are not comfortable in removing clothing for examinations or who fear invasive procedures. All health care team members should announce their arrival and wait a few moments before entering a room.
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 12 Dietary Needs Social tool and biological need Many ethical and religious implications with food All attempts should be made to meet the patient’s nutritional needs and preferences
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 13 Box 5-1 Yin and Yang Foods
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 14 Spirituality Essential for recovery and strength for many ethnicities Belief should be accepted and assistance offered when requested Using incorrect terminology is a sign of great disrespect
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 15 Death Views vary greatly Rituals vary greatly Deaths from suicide have many cultural implications
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 16 Medications Actions and side effects vary based on patient ethnicity FDA and ISMP studies Antilipemic drugs BiDill Drug dosage
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 17 Pain Management Beliefs about pain vary Important for the health care worker to use listening and assessment skills to look for nonverbal cues of pain
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 18 Other Cultural Differences That Have an Impact on Health Care Refusal to give blood or get blood transfusions Refusal to donate or receive organ transplants Refusal to place aging parents into nursing home Fertility control Mental illnesses
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 19 Signs of Cultural Barriers Important to listen to the patient closely and look for nonverbal cues Signs that cultural barriers exist: Resistant to change Uncooperative Argumentative Overly agreeable and flaccid Noncompliance after multiple teaching attempts
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 20 Obstacles to Cultural Competence Ethnocentrism Belief that one’s own culture is superior to another Often unconscious Seen in many daily activities Health care provider cannot allow this to interfere with providing care
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 21 Obstacles to Cultural Competence (Continued) Stereotyping Seeing or viewing patients in one ethnic group all molded together as one Assumes conformity Patients need to feel trusted and safe Prejudice and discrimination Stereotyping can lead to prejudice, which leads to discrimination
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 22 All health care providers must agree to care for patients regardless of race, age, color, sex or ethnic origin. All health care providers must agree to care for patients regardless of race, age, color, sex or ethnic origin.
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 23 Overcoming Obstacles Explore personal ideas and perceptions about different cultures Learn as much as you can about local cultures Always use the patient’s family name unless given permission to use first name only Be aware of eye contact
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 24 Overcoming Obstacles (Continued) Encourage patients to talk about their illnesses and look for areas of misunderstanding Look for confusion and fear Treat all patients with respect, concern, and compassion Recognize that other cultures are not as time sensitive as Americans Respect spirituality