CULTURAL DIVERSITY

Unit 6

Health care providers must work with and provide care to many different people. They must also respect the individuality of each person.

A major influence on any individual’s uniqueness is the person’s cultural/ethnic heritage

Cultural Diversity (Don’t Write)

Factors of individual uniqueness:Physical characteristicsFamily lifeSocioeconomic statusReligious beliefsGeographical locationEducationOccupationLife experiences

Cultural Diversity (Don’t Write)

CultureValues, beliefs, attitudes, languages,

symbols, rituals, behaviors, and customs which are unique to a particular group of people and passed on from one generation to the next

Set of RulesBlueprint or general design for living

Cultural Diversity (Write)

CultureInfluenced by culture:

○Family relations○Child rearing (raising)○Education○Occupational choice○Social interactions○Spirituality○Religious beliefs

Cultural Diversity

CultureInfluenced by culture:

○Food preferences○Health beliefs○Health care

Culture is NOT uniform among all members within a cultural group, but does provide a foundation for behavior

Cultural Diversity

CultureAll cultures have 4 basic

characteristics:1. Culture is learned

○ Culture does not just happen○ It is taught to others○ Children learn patterns of behavior by

imitating adults and developing attitudes accepted by others

Cultural Diversity

CultureAll cultures have 4 basic characteristics:2. Culture is shared:

○ Common practices and beliefs are shared with others in a cultural group

3. Culture is social in nature:○ Individuals in a cultural group

understand appropriate behavior based on traditions passed from generation to generation

Cultural Diversity

CultureAll cultures have 4 basic

characteristics:4. Culture is dynamic & constantly

changing:○ New ideas may generate different

standards for behavior○ Needs of the group are met through

change

Cultural Diversity

EthnicityClassification of people based on

natural origin and/or cultureShare common heritage, national

origin, social customs, language and beliefs

Even though every individual in the group may not practice all beliefs, the individual is still influenced by other members of the group

Cultural Diversity

EthnicityCommon groups in U.S. & countries of

origin:○African American: Central & South

African countries, Dominican Republic, Haiti, Jamaica

○Asian American: Cambodia, China, Hawaii, India, Indonesia & Pacific Island countries, Japan, Korea, Laos, Pakistan, Philippines, Samoa, Vietnam

Cultural Diversity

EthnicityCommon groups in U.S. & countries of

origin:○European American: England, France,

Germany, Ireland, Italy, Poland, Russia, Scandinavia, Scotland

○Hispanic American: Cuba, Mexico, Puerto Rico, Spain, & Spanish speaking countries in Central and South America

Cultural Diversity

EthnicityCommon groups in U.S. & countries of

origin:○Middle Eastern/Arab American: Egypt,

Iran, Jordan, Kuwait, Lebanon, Palestine, Saudi Arabia, Yemen & other North African & Middle Eastern countries

○Native American: Over 500 tribes of American Indians and Eskimos

Cultural Diversity

EthnicityIt is important to recognize that within

each of the ethnic groups there are numerous subgroups, each with it’s own lifestyle and beliefs.

Example: ○ European American group includes Italians

and Germans; each has different languages and lifestyles

Cultural Diversity

RaceClassification of people based on

physical, or biological characteristics○ Color of skin, hair, eyes○ Facial features○ Blood type○ Bone structure

Frequently used to label a group of people and explain patterns of behavior

Cultural Diversity

RaceValues, beliefs and behaviors learned

from the ethnic/cultural group that generally account for behaviors attributed to race (Example Below)○Blacks from Africa and blacks from the

Caribbean share many of the same physical characteristics, but they represent different ethnic groups and have different cultural beliefs and values

Cultural Diversity

RaceThere are also different races present in

most ethnic groups○White & black Hispanics○White African & Carribbeans○White & Black Asians

Cultural Diversity

Cultural DiversityDifferences among people resulting

from cultural, ethnic and racial factors Cultural Assimilation

The absorption of other cultures into the dominant culture

The U.S. seen as “melting pot”Requires that cultural groups alter

beliefs and behaviors (mercy killings)

Cultural Diversity

AcculturationLearning the beliefs and behaviors of

the dominant cultureAssuming some characteristics of the

dominant cultureOccurs slowly over long periods of time

SensitivityThe ability to recognize and appreciate

the personal characteristics of others

Cultural Diversity

SensitivityExample: In Native American and

Asian cultures, calling a patient by their first name is disrespectful

Health care workers will always address patients (or residents) by their last name, unless the patient requests to be addressed by their first name or nickname.

Cultural Diversity

BiasA preference that prevents impartial

judgmentEthnocentric: believe that their ethnic

group is supreme above all other groups○May antagonize or be unfriendly toward

people from other cultures

Cultural Diversity

BiasExamples of common biases:Age: young people believing that they are

physically and mentally superior to older people

Education: college-educated individuals believing that they are superior to uneducated individuals

Economic: wealthy people believing that they are superior to the less wealthy

Cultural Diversity

BiasExamples of common biases:Physical appearance: thin people

believing that they are superior to obese people

Occupation: physicians believing that nurses are inferior medical professionals

Sexual preference: Heterosexuals believing that homosexuals are inferior

Gender: Men believing women are inferior.

Cultural Diversity

PrejudiceStrong feeling about a person or

subject; to prejudgeFormed without reviewing facts or

informationThey are right; everyone else is wrongALL individuals are prejudice to some

degree

Cultural Diversity

StereotypingAssumption made that everyone in a

particular group is the sameIndividual characteristics are ignoredIndividuals are “labeled”Example:

○“All blondes are dumb”

Cultural Diversity

StereotypingThere is NO room for stereotyping of

any kind in health care.Avoid jokesWith patients: Be open about subjects

you would normally not even discussEvaluate all information before you form

an opinionYou are a professional

Cultural Diversity

Family OrganizationFamilies vary in their composition and

in the roles assumed by family membersTwo Types:

○Nuclear family: mother, father, children (biological or “step”)

○People outside family usually care for children, sick or elderly

Cultural Diversity

Family OrganizationTwo Types:

○Extended family: nuclear family plus grandparents, aunts, uncles, cousins

○Families tend to take care of their children, sick or elderly

○Hispanic / Asian Cultures

Cultural Diversity

Family OrganizationPatriarch / Matriarch:Patriarchal Family: Father or oldest

male is authority figure○Will make most health care decisions for all

family members○Asian / Middle Eastern cultures believe that

the male has the power and authority and women are expected to be obedient

○Husbands makes medical decisions for wife

Cultural Diversity

Family OrganizationPatriarch / Matriarch:Matriarchal Family: Mother or oldest

female is authority figure○Will make most health care decisions for all

family members○Mother and father may make some

decisions together○ “I have to check with my husband (wife)

before making a decision.”

Cultural Diversity

Language20% of the U.S. population speaks a

language other than English at homeDifferent dialectsMay speak English, but not read it.Find Translator

Cultural Diversity

LanguageFor health care workers:

○ Nonverbal communication is very important (smile, gentle touch - if culturally appropriate)

○Communication boards○Most states require that any medical

permit requiring a written signature be printed in the patient’s primary language

Cultural Diversity

LanguageFor health care workers – DO NOT:

○Express frustration because the patient does not speak English

○Be offended if patient or family members communicate in their primary language, even if the patient speaks English

Cultural Diversity

LanguageFor health care workers – DO NOT:

○ Speak inappropriately to other staff about a patient (EVER) because you think they do not understand what you are saying.

○Laugh or make fun of the words or foreign language spoken

○Forget that your patient does not understand, is likely scared & needs help

Cultural Diversity

Personal Space and TouchDistance that people require to feel

comfortable while interacting with othersVaries greatly among different culturesClose Contact vs. Distant Contact

Cultures

Cultural Diversity

Personal Space and TouchClose Contact Cultures

○Arabs: touch, feel, and smell people with whom they interact

○French and Latin Americans: stand very close together while interacting

○Hispanics: hugs and handshakes to greet others

Cultural Diversity

Personal Space and TouchDistant Contact Cultures

○European and African: may shake hands as a greeting, but want 2-6 feet separation during interaction

○Asians: stand close together, but not touch; kissing, hugging seen as very intimate acts and are NEVER done in public.

Cultural Diversity

Personal Space and TouchDistant Contact Cultures

○Cambodians: all members of opposite sex – even if related – never touch each other; only parent can touch the head of a child

○Vietnamese: only elderly to touch head of a child because head is considered sacred

Cultural Diversity

Personal Space and TouchDistant Contact Cultures

○Middle Eastern: men may not touch females who are not immediate family; only men can shake hands with other men; may cause female patients to refuse care from male nurse.

○Native Americans: value personal space as important; will only lightly touch other person’s hand when greeting

Cultural Diversity

Eye ContactEuropeans: regard eye contact as sign

of interest and trustworthinessAsians: consider direct eye contact

rudeNative Americans: use peripheral vision

to avoid direct eye contactHispanic & African Americans: brief eye

contact, but then look away as a sign of respect and attentiveness

Cultural Diversity

GesturesUS: nodding head up & down means

“yes” and side-to-side for “no”India: head motions for “yes” and “no

are exact oppositeUS: pointing is acceptedAsian & Native Americans: pointing is

seen as a serious threat

Cultural Diversity

Gestures

US: “OK” hand gestureAsian Culture: can be seen as an

insult

Cultural Diversity

End of Lecture