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Cultural diversityCultural diversityDr. Miada Mahmoud Rady Dr. Miada Mahmoud Rady

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Definitions Definitions

• Culture : The values, beliefs, standards, language,

thinking patterns, behavioral norms and

communications styles shared by a group of people.

• It guides decisions and actions of a group through

time.

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Cultural diversity Cultural diversity

• It is the cultural variety and differences that exist in the world,

a society or an institution.

• It is having a group of diverse people in one place working or

living together, all have different cultures.

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Manifestation of cultural diversity

Manifestation of cultural diversity

• Obvious manifestation :

A. Religion .

B. Ethnicity (Race) .

C. National Origin (Language).

D. Gender .

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• Less obvious manifestation :

1. Age

2. Educational Status

3. Disabling disease .

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Cultural Sensitivity Cultural Sensitivity

Definition : Being aware that cultural differences and

similarities exist and that they can have an effect of behavior,

values and learning.

It also means to be aware and tolerant of cultural differences

and acknowledging them when interacting with others.

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StereotypingStereotyping

• Definition : Categorizing individuals or groups of people into

an oversimplified or standardized image or idea.

• It’s when you assume that a belief or characteristic is shared

by all in one class, culture or ethic group

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Cultural favoritism Cultural favoritism

1. To give an advantage to one cultural over another.

2. To ignore the differences between cultures and impose

understanding based on the study of one culture to other

cultures.

3. To think one culture has precedence of the other.

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Cultural Influences on Healthcare

Cultural Influences on Healthcare

1. Physiologic Characteristics

2. Psychological Characteristics

3. Reactions to Pain

4. Gender roles

5. Language and communication

6. Food and nutrition

7. Socioeconomic Factors

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Physiological criteria Physiological criteria

Certain racial groups are more prone to specific diseases

and conditions such as :

1. Keloids is more common in Africans

2. Lactase deficiency and lactose intolerance is more common

in Australians.

3. Sickle cell anemia is common in Africans

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Psychological CharacteristicsPsychological Characteristics

In most situations, a person interprets the behaviors of another

person in terms of her or his own familiar culture.

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Gender Rules Gender Rules

In many cultures either the man or woman is the

dominant figure and generally makes decisions for the

family.

Knowing who is the dominant member of the family

is an important consideration when planning nursing

care.

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Language and communicationLanguage and communication

• Different peoples speak different language.

• To avoid misinterpretation of questions and answers, it is

important to use an interpreter who understands the healthcare

system.

• When caring for culturally and ethnically diverse patients it is

important to perform a transcultural assessment of

communication.

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Socioeconomic FactorsSocioeconomic Factors

• Research suggests that both physical and mental health are

highly affected by Socioeconomic status ( SES ) for example T.B

and nutritional disorders is more common in people with low

Socioeconomic standards.

• Studies suggest that lower SES is linked to poorer health

outcomes.

• Poor health also decrease an individual’s capacity to work, thus

reducing their ability to improve their SES.

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Any questions

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Cultural diversity 2Cultural diversity 2

Dr. Miada Mahmoud Rady

Dr. Miada Mahmoud Rady

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Duties of paramedics as part of diverse health care system

Duties of paramedics as part of diverse health care system

1. Paramedics have an obligation to be respectful and

sensitive to other's belief system.

2. Paramedics must be culturally competent and comfortable

with those they serve.

3. Paramedics should understand how their own personal

biases and values influence communication with patients,

families, and their co-workers.

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Culturally Competent Care

Culturally Competent Care

• Competence : Behaviors that reflect appropriate

application of knowledge and attitudes.

• Culturally competent health care : Care that is

planned and implemented in a way that is sensitive to

the needs of individuals, families, and groups from a

diverse populations within society.

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• Aims for quality of health care: safe, effective,

patient-centered, timely, efficient, and equitable.

• Cultural competency is at the core of high quality,

patient-centered care, and it directly impacts how

care is delivered and received.

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Developing culturally competent health care

Developing culturally competent health care

Several models of service care delivery have emerged

to meet the challenges of providing culturally

competent health care.

One of them is Campinha-Bacote’s model : The

Process of Cultural Competence in the Delivery of

Healthcare Services.

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Assumptions of the modelAssumptions of the model

1. Cultural competence is a process, not an event.

2. Cultural competence consists of five constructs: cultural

awareness, cultural knowledge, cultural skill, cultural

encounters, and cultural desire.

3. There is more variation within ethnic groups than across

ethnic groups (intra-ethnic variation).

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4. There is a direct relationship between the level of

competence of health care providers and their ability to

provide culturally responsive health care services.

5. Cultural competence is an essential component in rendering

effective and culturally responsive services to culturally and

ethnically diverse clients.

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Constructs of culturally competent care.

Constructs of culturally competent care.

• There are five constructs according to Campinha-Bacote’s

model :

1. Cultural awareness

2. Cultural knowledge

3. Cultural skill

4. Cultural encounters

5. Cultural desire.

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Cultural awareness Cultural awareness

• Cultural awareness : is the self-examination and in-depth

exploration of one’s own cultural and professional background.

• Or recognition of one’s biases, prejudices, and assumptions about

individuals who are different.

• Goal : to avoid Cultural imposition .

• Cultural imposition : is the tendency of an individual to impose

their believes, values, and patterns of behavior on another culture

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Cultural KnowledgeCultural Knowledge

• Definition: Cultural knowledge is the process of seeking and

obtaining a sound educational foundation about diverse cultural

and ethnic groups.

• In obtaining this knowledge base, the health care provider must

focus on the integration of three specific issues:

1. Health-related beliefs and cultural values

2. Disease incidence and prevalence

3. Treatment efficacy

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Cultural skill Cultural skill

• Cultural skill : is the ability to collect relevant cultural data

regarding the patients presenting problem and performing a

culturally based physical assessment.• Cultural skill is also required when performing a physical

assessment

• on ethnically diverse clients. The health care provider should

know how a client’s physical, biological, and physiological

• variations influence her ability to conduct an accurate and

appropriate physical evaluation

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Cultural EncountersCultural Encounters

• Definition : is the process that encourages the health care

provider to directly engage in cross-cultural interactions with

clients from culturally diverse backgrounds.

• Importance :

1. To refine or modify one’s existing beliefs about a cultural

group

2. To prevent possible stereotyping that may have occurred.

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Cultural DesireCultural Desire

• Definition : the motivation of the health care provider to want

to, rather than have to, engage in the process of becoming

culturally aware, culturally knowledgeable, culturally skillful,

and familiar with cultural encounters.

• ( Simply people don’t care how much you know, until they

first know how much you care )

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Health care providers trained in cultural competency:

1. Demonstrate greater understanding of the central role of culture

in health care

2. Recognize common barriers to cultural understanding among

providers, staff, and residents/patients

3. Identify characteristics of cultural competence in health care

settings

4. Interpret and respond effectively to diverse older adults’ verbal

and nonverbal communication cues

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5. Assess and respond to differences in values, beliefs, and

health behaviors among diverse populations and older adults

6. Demonstrate commitment to culturally and linguistically

appropriate services

7. Work more effectively with diverse health care staff

8. Act as leaders, mentors, and role models for other health care

providers

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Characteristic of culturally competent organization

Characteristic of culturally competent organization

1. Have a defined set of values and principles and demonstrate

behaviors, attitudes, policies, and structures that enable them

to work effectively cross culturally

2. Have the capacity to 1) value diversity; 2) conduct self-

assessment; 3)manage the dynamics of difference; 4) acquire

and institutionalize cultural knowledge; 5) adapt to the

diversity and cultural contexts of the communities they serve.

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3. Incorporate the above into all aspects of policy making,

administration, practice, and service delivery and

systematically involve consumers, key stakeholders, and

communities.

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Cultural Assessment Cultural Assessment

• Cultural assessment : is a “systematic appraisal or

examination of individuals, groups, and communities as to

their cultural beliefs, values, and practices to determine

explicit needs and intervention practices within the context of

the people being served”.

• an effective way to identify specific factors that influence a

patient’s behavior is to perform a cultural assessment.

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Checklist for Diversity & Cultural Competency

in Health Care Settings

Checklist for Diversity & Cultural Competency

in Health Care Settings

• The three checklists included are:

1. Areas of your organization’s culture that can

negatively impact quality of care (areas of

opportunity).

2. Barriers to cultural competency.

3. Recommendations for culturally competent care.

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Acquiring Cultural CompetenceAcquiring Cultural Competence

Be sensitive to personal health beliefs and practices:

Special foods, drinks, objects or clothes

Avoidance of certain foods, people or places

Customary rituals or people used to treat the illness

Will the patient take medicine even when he/she doesn't feel sick?

Is the patient taking other medicines or anything else to help him feel

well?

Who in the family makes decisions about health care?

Are illnesses treated at home or by a community member

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Acquiring Cultural Competence

Acquiring Cultural Competence

Be sensitive to language barriers:

1. Does the patient understand any English?

2. Consider literacy level

3. Use visual aids and demonstrate procedures

4. Check understanding

5. Is an interpreter necessary

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Acquiring Cultural CompetenceAcquiring Cultural Competence

Consider body language:

1. Eye contact

2. Touching

3. Personal space

4. Privacy/modesty

Other cultural factors to consider:

1. Gender

2. Wealth or social status

3. Presence of a disability

4. Sexual orientation

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Consider Religious/Spiritual factors .

Are there sensitivities/beliefs associated with

I. Birth, death

II. Certain treatments, blood products

III. Prayer, medication and worship

IV. Food preparation, clothing, special objects, and gender

practices

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