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

2. 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

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

4. 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

5. 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

6. 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

7. 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)***

8. 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.

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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!

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

16. 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

17. 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

18. 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

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

20. 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

21. 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

22. 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

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

24. 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

25. 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?

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

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

34. 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

35. 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

36. 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

37. Major Religious BeliefsPg

38. Atheist
Someone who does not believe in a higher power

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

40. THE END!!!