1. CULTURAL DIVERSITY

2.  Health care providers work with a diverse group of people, so they must be aware of, and respect, the unique factors of each individual  A major influence of a person’s uniqueness is their culture or ethnic heritage RATIONALE

3.  Culture: the values, beliefs, attitudes, languages, symbols, rituals, behaviors, and customs unique to a particular group of people and passed from one generation to the next  Provides blueprint for living  Not uniform for all people involved in a culture group, but allows a foundation for behavior CULTURE

4. 1.Culture is learned  Ex) Child imitating adults 2.Culture is shared Beliefs and practices are shared within a culture group 3.Culture is social in nature Appropriate behavior is learned by past traditions 4.Culture is dynamic and constantly changing New ideas allow a culture group to adapt to environmental changes FOUR CHARACTERISTICS OF ALL CULTURE

5.  Ethnicity: a classification of people based on national origin and/or culture  Everyone within an ethnic group may not practice all the same beliefs, but they are influenced by the other members  There are many ethnic groups across the United States ETHNICITY

6. 1.African American Central and South Africa, Dominican Republic, Haiti, and Jamaica 2.Asian/Pacific American Cambodia, Hawaii, Japan, Korea, and Vietnam 3.European American England, France, Italy, Poland, and Russia 4.Hispanic American Cuba, Mexico, Puerto Rico, Spain 5.Middle Eastern/Arabic Americans Egypt, Iran, Iraq, Saudi Arabia, Middle Eastern countries 6.Native Americans  Over 500 tribes from American Indians and Eskimos SIX COMMON ETHNIC GROUPS IN THE UNITED STATES

7.  Race: classification of people based on physical or biological characteristics such as the color of skin, hair, eyes; facial features; blood type; and bone structure  Race is used to label a group of people and explain patterns of behavior  Race cuts across multiple culture and ethnic groups; it is the values, beliefs, and behaviors learned from the ethnic/cultural group that accounts for behaviors attributed to race RACE

8.  Cultural diversity: differences among individuals based on cultural, ethnic, and racial favors  Cultural assimilation: absorption of a culturally distinct group into a dominant or prevailing culture  United States is known a “melting pot”, but strives to be more like a “salad bowl”  Acculturation: the process of learning beliefs and behaviors of a dominant culture and assuming some of the characteristics  2nd and 3 rd generation Americans are more likely to use English as their main language and follow American patterns  Sensitivity: the ability to recognize and appreciate the personal characteristics of others  Essential in health care  Ex) Asians believe using a first name is unacceptable unless used by family or close friends CULTURAL DIVERSITY

9.  Bias, prejudice, and stereotyping can all interfere with acceptance of cultural diversity  Bias: a preference that inhibits impartial judgment  Ex) Person believing in the supremacy of their own ethnic group are called ethnocentric  People who are ethnocentric believe their culture is better than others  May antagonize or alienate people form other cultures  May be biased with regard to other factors BIAS

10. 1.Age Young people are superior to older people 2.Education College education people are superior than uneducated people 3.Economic Rich people are superior to poor people 4.Physical size Skinny and tall people are superior to obese and short people 5.Occupation Doctors are superior to nurses 6.Sexual preference Heterosexual people are superiors to homosexual people 7.Gender Men are superior to women SEVEN COMMON BIASES

11.  Prejudice: “prejudge”; strong feeling or belief formed about a person or subject that is formed without reviewing facts or information  Prejudice people view their ideas a right and others wrong; afraid of change  We are all prejudice to some degree, but it is important as health care workers to be aware of our prejudices and to obtain as much information about a situation as possible to allow us to learn about others, understand their beliefs, and communicate successfully  Stereotyping: process of assuming that everyone in a particular group are the same  Ignored individuality; labels people  Ex) All blondes are dumb PREJUDICE AND STEREOTYPING

12. Be aware of own personal values and beliefs Obtain information about other cultures and ethnic groups Be sensitive to practices of people from other cultures Don’t feel pressured to adopt others beliefs, but respect them Be diverse when building friendships Ask questions and encourage others to share ideas Evaluate information before forming an opinion Be open to differences Avoid offensive jokes Mistakes happen; apologize if you hurt another’s feelings WAYS TO AVOID BIAS, PREJUDICE, AND STEREOTYPING

13.  Holistic care: care that provides for the well-being of the whole person and meets not only physical needs, but also social, emotional, and mental needs  Cultural diversity may affect areas such as personal space, touching, eye contact, and family organization HOLISTIC CARE

14.  Nuclear family: usually consists of a mother, father, and children  May consist of single parents and child(ren)  Basic unit for European American families  In nuclear families, people outside the family frequently care for sick, children, or elderly relatives  Extended family: Includes the nuclear family plus grandparents, aunts, uncles, and cousins  Basic unit for Asian, Hispanic, and Native American families  In extended families, the families tend to take care of the sick, children, or elderly relatives in their home  Ex) Asian families see it as an honor to take care of their elder relatives  Never assume!  Ask questions and observe the family FAMILY ORGANIZATION

15.  Patriarchal: the father or oldest male is the authority figure  Ex) Some Asian and Middle Eastern men attend all medical appointments with their wives and handle all healthcare decisions  Matriarchal: the mother or oldest female is the authority figure  Ex) Some women make healthcare decisions for the entire family FAMILY ORGANIZATION CONT.

16.  Recognition and acceptance of family organizations is essential for health care providers  Patients who have extended families as basic units may have many visitors in the hospital or long-term care; all with be concerned with the care provided and will want to make decisions regarding care  Some may even try to provide person care to the patient  Questions to ask to determine a patient’s structure includes: Who are the members of your family? Who is the head of your household? Where do you and your family live? Do you have children? Who will care for them while your sick? FAMILY ORGANIZATION AND HEALTHCARE

17.  Health care workers frequently encounter patients who do not use English as their dominant language  Health care worker must determine a patient’s ability to communicate by talking with them and asking questions such as: Do you speak English as your primary language? What language is spoken at home? Do you read English? Do you read another language? Do you have a family member or friend who can interpret information for you?  Find an interpreter if needed  Another health care worker, consultant or family member may be able to assist LANGUAGE

18.  When providing people who have limited English, speak slowly, use simple works, use gestures and pictures to clarify meaning, and give smiles or gentle touches if culturally appropriate  Make every attempt to learn at least a few works of the patient's language, they appreciate this gesture  If working with a large number of patient’s who peak a certain language, take an intro course or get an audiobook to learn basics of that language  Most states require that any medical permit requiring a signature by the patient must be printed in the patient’s native language, so the health care worker must be aware of the legal requirements within LANGUAGE CONT.

19.  Personal space: “territorial space”; describes the distance people require to feel comfortable while interacting with others  Each culture differentiates in how they feel comfortable when interacting with others, so it is important to understand the personal space requirements for each culture when working in health care  Health care providers use touch and invade personal space to give many types of care  Use a slow, relaxed approach, explain the procedures, and encourage the patient to relax  Be alert for a patient’s verbal and nonverbal communication PERSONAL SPACE

20.  Eye contact is affected by different cultural beliefs  Ex) European Americans think eye contact is a sign of interest, while some Asian Americans may consider eye contact to be rude  Health care providers must be alert to the comfort levels of patients while using direct eye contact and recognize the cultural diversity that exists  Lack of eye contact typically means “not listening”, when it can actually mean respect EYE CONTACT

21.  Gestures are used to communicate many things  In the United States, a common gesture for saying “yes” is nodding the head up and down and for “no” is nodding the head side to side; In India, the head motions are the completes opposite  Pointing the finger is also a common gesture in the United States, but can signify a “strong threat” to Asians and Native Americans GESTURES

22.  Most common health care system in the United States is the biomedical health care system, or “Western” system  This system bases the causes of disease on things such as microorganisms and fungus. When the cause is determined, health care focuses on eliminating the disease.  Health care beliefs vary greatly among, and within, different cultures HEALTH CARE BELIEFS

23. 1.Nutritional methods Organic foods, herbs, vitamins, and antioxidants 2.Mind and body control methods Relaxation, medication, and imagery 3.Energetic touch therapy Massage, acupuncture, and acupressure 4.Body-movement methods Chiropractic, yoga, and tai chi 5.Spiritual methods Faith healing, prayer, and spiritual counseling  It is important to remember that every patient has the right to choose the type of health care system fits them best ALTERNATIVE HEALTH CARE TREATMENTS

24.  Spirituality: the beliefs individuals have about themselves, their connections with each other, and their relationship with a higher power; an individuals need to find meaning and purpose in life  Often expressed through religious practices  Religion: an organized system of belief in a superhuman power or higher power  Associated with a specific form or place of worship SPIRITUALITY AND RELIGION

25. 1.Be a willing listener 2.Provide support for spiritual and religious practices 3.Respect religious symbols and books 4.Allow privacy for patient during clergy time or during observation of religious customs 5.Refrain from imposing your beliefs on the patient RESPECTING BELIEFS

26.  The key to respecting cultural diversity is to regard each person as a unique individual  Every individual has a pattern based off of culture, ethnicity, race, life experiences, spirituality, and religion  Health care workers must be aware of the needs of an individual to provide total care  Health care workers must learn to appreciate and respect the personal characteristics of others by: Listening to patients express their beliefs Evaluate all information before forming an opinion Be sensitive to the response of a patient to contact, touch, and invasion of private space Respect spirituality, religious beliefs, symbols, and rituals RESPECTING CULTURAL DIVERSITY