Cultural Diversity
By: Cindy Quisenberry
Definitions
 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
 Ethnicity – a classification of people based on national
origin and/or culture
 Race – a classification of people based on physical or
biological characteristics such as color of skin, hair, and
eyes; facial features; blood type; and bone structure
Definitions
 Bias– a preference that inhibits impartial judgment (ie:
individuals who believe in the supremacy of their own ethnic
group)
 Can you think of other bias?
 Prejudice – a strong feeling or belief about a person or
subject that is formed without reviewing facts of information
(Prejudiced individuals regard their ideas or behavior as
right and other ideas or behavior as wrong.)
 Stereotyping – occurs when an assumption is made that
everyone in a particular group is the same
Definitions
 What is a nuclear family?
 What is an extended family?
Definitions
 Personal Space – often called territorial space; the
distance people require to feel comfortable while
interacting with others
 Close Contact Cultures
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Arabs
French
Latin Americans
Hispanic Americans
Asian Americans may stand close but do not touch (kissing or hugging never
done in public
Definitions
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Monotheist – believe in one God
Polytheist – believe in many gods
Atheist – does not believe in any deity
Agnostic – believes that the existence of God cannot be
proved or disproved
Respecting Cultural
Diversity
 The key to respecting cultural diversity is to regard each
person as a unique individual. Healthcare workers must
learn to appreciate and respect the personal
characteristics of others by:
 Listen to patients as they express their beliefs.
 Appreciate differences in people.
 Learn more about the cultural and ethnic groups that you see
frequently.
 Recognize and avoid bias, prejudice, and stereotyping.
 Ask questions to determine a person’s belief.
 Evaluate all information before forming an opinion.
Respecting Cultural
Diversity
 Allow patients to practice and express their beliefs as much as
possible.
 Remember that you are not expected to adopt another’s beliefs,
just accept and respect them.
 Recognize and promote the patient’s positive interactions with
family.
 Be sensitive to how patients respond to eye contact, touch, and
invasion of personal space.
 Respect spirituality, religious beliefs, symbols, and rituals.
Common Ethic
Groups
 African American – Central & South African countries,
Dominican Republic, Haiti, and Jamaica
 Asian/Pacific American – Australia, Cambodia, China,
Guam, Hawaii, India, Indonesia & Pacific Island countries,
Japan, Korea, Laos, New Zealand, Philippines, Samoa,
Taiwan, Thailand, and Vietnam
 European American – Austria, Czech Republic,
Denmark, England, France, Germany, Greece, Hungary,
Ireland, Italy, the Netherlands, Norway, Poland, Portugal,
Russia, Scotland, Sweden, and Switzerland
Common Ethic
Groups
 Hispanic American – Cuba, Mexico, Puerto Rico, Spain,
and Spanish-speaking countries in Central and South
America
 Middle Eastern/Arabic Americans – Egypt, Iran, Iraq,
Israel, Jordan, Kuwait, Lebanon, Saudi Arabia, Syria,
Turkey, Yemen, and other North African and Middle
Eastern countries
 Native American – more than 500 tribes of American
Indians and Eskimos such as Apache, Choctaw,
Cherokee, and Navajo
Definitions
 Personal Space – often called territorial space; the
distance people require to feel comfortable while
interacting with others
 Distant Contact Cultures
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European
African Americans (2-4 feet)
Cambodia – members of the opposite sex may never touch in public
Vietnamese allow only the elderly to touch the head of a child because the
head is considered sacred
Native Americans
Middle Eastern – men may not touch female individuals who are not immediate
family members
Definitions
 Eye Contact
 European Americans – indicative of interest and trustworthiness
 Asian Americans – considered to be rude
 Native Americans – may use peripheral vision and avoid eye
contact (may regard direct stares as hostile and threatening)
 Hispanic and African Americans – may use brief eye contact, but
then look away to indicate respect and attentiveness
 Muslim women – may avoid eye contact as a sign of modesty
 India – different socioeconomic classes may avoid eye contact with
each other
Definitions
 Gestures (head up and down for “yes”, side to side for
“no”, etc.)
 Can mean an exact opposite in some countries
 Asian and Native Americans, pointing can represent a strong
threat
 “OK” can be insulting to some Asians
Baptist
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Some believe in the healing power of “laying on of hands”
Physician is instrument for God’s healing
No last rites
Oppose abortion
Birth control is an individual’s decision
Buddhism
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Suffering is inevitable
Illness is the result of negative Karma
Cleanliness is important to maintain health
May refuse medications that affect mental alertness
(mindful awareness is essential)
Oppose abortion
Birth control is an individual’s decision
Believes in reincarnation
Buddhist priest must be present at death
Limited touching during during the process of death
Last rites chanted at bedside right after death
Hinduism
Some believe illness is punishment for sins
Some believe in faith healing
Will accept most medical interventions
Naming ceremony is performed 10-11 days after birth to
obtain blessings form gods and goddesses
 Abortion allowed only to save the life of the mother
 Birth control allowed, but the duty of having a family is
stressed
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Hinduism
 Believe in reincarnation
 Priest ties thread around the neck or wrist and may pour
holy water in the mouth of the deceased
 Only family and friends may touch and wash the body
 Organ donation discouraged
 Cremation preferred
 Some do not eat meat
Lutheran
 Communion often administered by clergy to sick or prior to
surgery
 Birth control allowed
 Abortion discouraged
 No last rites
Methodist
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May request communion before surgery or while ill
Birth control allowed
Abortion discouraged
No last rites
Presbyterian
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Prayer and counseling an important part of healing
May request communion while ill or before surgery
Birth control allowed
Abortion discouraged
No last rites
Seventh Day Adventist
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May avoid OTC medications and caffeine
May anoint body with oil
Use prayer for healing
Some believe only in divine healing
Will accept required immunizations
Birth control is individual’s decision
Therapeutic abortions permitted as an individual’s decision
No last rites
Sabbath worship is sunset on Friday to sunset on Sat.
Encouraged to practice a vegetarian diet
Episcopal
 May use anointing of the sick with oil as a healing
sacrament
 Abortion opposed
 Birth control is an individual’s decision
 Some observe last rites by priest
Roman Catholic
 Sacrament of the Sick and anointing with oil
 Life is sacred; abortion and contraceptive use prohibited
 Believe embryos are human beings and should not be
destroyed or used for research
 Infant baptism mandatory
 Baptism necessary for salvation (any baptized Christian
may perform an emergency baptism)
 Sacrament of the Sick (last rites) performed by priest
 May avoid meat at certain times
Islam (Muslim)
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Illness is atonement for sins
Face city of Mecca 5 times a day to pray to Allah
Ritual washing before and after prayer
Must take meds with right hand since left hand is
considered dirty
At birth, the infant should hear “There is no God but
Allah, and Mohammed is His prophet”
Circumcision before 7 days old
Abortion forbidden
Family must be with dying person
Dying person must confess sins and ask forgiveness
Islam (Muslim)
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Only family touches and washes body after death
Body is turned toward Mecca after death
Cremation not permitted
Avoid pork and shellfish
Usually do not consume alcohol
During holy month of Ramadan, all-day fasts are required
for those who are able.
Judaism
 May refuse surgical procedure or diagnostic tests on
Sabbath or holy days
 Family may want surgically removed body parts for burial
 Ritual handwashing upon awakening and prior to eating
 Male circumcision on 8th day after birth by child’s father or
Jewish physician
 Birth control allowed
 Abortion permitted only in specific circumstances
 Person should never die alone
 Body is ritually cleaned after death
Judaism
 May bury dead before sundown on day of death and
usually within 24 hours
 Organ donation permitted only after consultation with
rabbi
 Sabbath is sunset Friday to sunset Saturday
 Fast during some holy days
 May observe certain dietary laws called “kosher” diets
Jehovah’s Witness
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Prohibited from receiving blood and blood products
Elders will pray and read scriptures to promote healing
Medications okay if not derived from blood products
Birth control personal decision
Abortion allowed only to save the life of the mother
No last rites
Organ donation discouraged due to transmission of blood
(All organs and tissues must be drained of blood before
transplant)
Russian Orthodox
 Holy Unction and anointing body with oil used for healing
 Will accept most medical treatments but believe in divine
healing
 Birth control prohibited
 Abortion prohibited
 List rites by ordained priest mandatory
 Arms of deceased are crossed
 Organ donations not encouraged
 May wear a cross necklace that should not be removed
Mormon (LDS)
 May believe in divine healing with “laying on of hands” or
blessing by the church elders
 Anointing with oil can promote healing
 Infant blessing by clergy in church ASAP after birth
 Baptism at 8 years of age
 Abortion prohibited
 Birth control individual’s choice
 May want church elders present at birth
 No last rites
Mormon (LDS)
 Special undergarments may be worn and should not be
removed unless necessary
 Fast on first Sunday of each month
 Avoid medications containing alcohol and caffeine
 Avoid coffee, tea, caffeine-containing beverages and
alcoholic beverages
Amish
 May give birth at home
 Birth control not forbidden – but most do not use (large
families are a gift from God)
 Prohibit abortion
 No last rites
 Cremation not used
 Do not buy health insurance – church has mutual aid fund
 May refuse prescription meds (use herbal remedies)
Christian Scientist
 Illness can be eliminated through prayer and spiritual
understanding
 May not use medicine or surgical procedures
 May refuse blood transfusions
 Most will accept mandated immunizations
 Abortion discouraged
 Birth control individual’s decision
 No last rites
 Organ donation discouraged
 Most do not drink alcohol, coffee, or tea