1. 1 Transcultural Guidelines for Health Care Givers

2. 2 World Religions VS. El Paso World 2005 Statistics: Christianity 33% Islam 21% Hinduism 14% Buddhism 6% Judaism0.22% Other 25% El Paso 2002 Statistics: Catholic 58% Other Christian 25% Islam 0.3% Judaism 0.8% Other 16.9%

3. 3 Definitions (Cornell University) - Describes your family “origins” e.g. American Native or Alaskan Native Origins in any of the original peoples of North & South America (including Central America), & who maintains tribal affiliation or community attachment Ethnicity

4. 4 Asian Far Eastern countries Black/African American African or Caribbean Caucasian/White/Not of Hispanic origin Europe, Middle East, North Africa, Australia, New Zealand Mexican American Of Mexican culture or origin regardless of race Ethnicity

5. 5 Native Hawaiian or other Pacific Islander Hawaii, Guam, Samoa, Pacific Islands Puerto Rican Puerto Rican culture or origin, regardless of race Other Hispanic Cuban, South or Central American, Dominican Republic, or other Spanish culture or origin, regardless of race Ethnicity

6. 6 Hispanic vs. Non-Hispanic 2006 Statistics Approximately 81.4% Hispanic Non-Hispanic 14.2% What other things contribute to diversity? If I’m Hispanic is a non-Hispanic another culture? Maybe… Reviewed October, 2008 El Paso’s Population

7. 7 Including culture, religion, language, age, and gender…. HAVE CONSIDERABLE EFFECT ON HOW WE ACCESS & VIEW HEALTH CARE SERVICES Many Things..

8. 8 Some may think culture determines certain things: Physical attributes hair or skin color Diet Language Our religious & spiritual beliefs Culture

9. 9 Ethnocentrism Despite the fact that we understand that everyone is different, we still tend to subconsciously believe that our culture & religion is the right one. We may view other cultures or religions as bizarre, strange, inferior or unenlightened. This is called ethnocentrism.

10. 10 Ethnocentrism It can cause misunderstandings and harm patients by: –Incorrect diagnosis –Failure to provide adequate pain relief –Arrest of parents for child abuse due to misunderstood cultural childrearing beliefs and practices

11. 11 Understanding of own self Knowledge of various cultural characteristics Understanding of cultural characteristics Application of cultural knowledge & understanding in the healthcare setting Cultural Competency

12. 12 Avoid Stereotyping We must not presume that all people of a certain cultures adhere to all aspects of their culture The healthcare provider must identify which aspects are appropriate for each patient during the admission process

13. 13 Do Not Assume Anything Be truly open-minded & respectful toward other’s beliefs, values, & practices You can help patients feel more comfortable Many of us belong to more than one ethnic group, cultural group, age group, and social group

14. 14 Language & Translation Those whose English is limited often wish to speak their native language when possible Feel that both their explanations & their understandings can be more accurate It is more comfortable

15. 15 Family members are not good translators Issues of privacy and confidentiality Interpreter errors could be a previously unrecognized root cause of medical errors (Healthcare Risk Management (2003) Lost in Translation

16. 16 Avoid Ad Hoc Translators Flores, 2003 (University of Wisconsin) Omission by interpreter 52% Addition by interpreter 8% Substitution by interpreter 13% Editorialization by interpreter 10% False fluency 16% 63% of errors were found to have potential medical consequences

17. 17 Translation Line Services Find someone in your facility who knows the policy It is important to be facility specific Should be HIPAA & Joint Commission Compliant Policy & Procedure

18. 18 Facial expressions, body language & tone of voice play a much greater role in many cultures. Face & Body Language

19. 19 Some Cultures: May perceive a response like “maybe” or “that would be difficult” as a polite no Some cultures prefer indirect communication and talking around the issue Cultural Differences

20. 20 Gestures Use with care – may have negative meanings in other cultures Thumbs-up and the OK sign are obscene gestures in parts of South America & the Mediterranean Pointing or beckoning with the index finger as “come here”, or snapping fingers are seen as rude in some cultures

21. 21 To touch or not to touch is only part of the question Cultures also have different rules about who can be touched & where Even casual touching people of the opposite gender can be offensive in some cultures Touch

22. 22 In Summary Observe the kinds of cultures you see in your patient population Adjust your care for patients of different cultures Look for resources available for patients of different cultures Provide translation for a patient that doesn’t speak English