CULTURAL DIVERSITY
RATIONALE
 Health care providers work with a diverse group of people, so
they must be aware of, and respect, the unique factors of
each individual
 A major influence of a person’s uniqueness is their culture or
ethnic heritage
CULTURE
 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
 Provides blueprint for living
 Not uniform for all people involved in a culture group, but
allows a foundation for behavior
FOUR CHARACTERISTICS OF ALL
CULTURE
1. Culture is learned
 Ex) Child imitating adults
2. Culture is shared
• Beliefs and practices are shared within a culture group
3. Culture is social in nature
• Appropriate behavior is learned by past traditions
4. Culture is dynamic and constantly changing
• New ideas allow a culture group to adapt to environmental
changes
ETHNICIT Y
 Ethnicity: a classification of
people based on national origin
and/or culture
 Everyone within an ethnic group
may not practice all the same
beliefs, but they are influenced
by the other members
 There are many ethnic groups
across the United States
SIX COMMON ETHNIC GROUPS IN THE
UNITED STATES
1.
African American
• Central and South Africa, Dominican Republic, Haiti, and Jamaica
2.
Asian/Pacific American
• Cambodia, Hawaii, Japan, Korea, and Vietnam
3.
European American
• England, France, Italy, Poland, and Russia
4.
Hispanic American
• Cuba, Mexico, Puerto Rico, Spain
5.
Middle Eastern/Arabic Americans
• Egypt, Iran, Iraq, Saudi Arabia, Middle Eastern countries
6.
Native Americans
 Over 500 tribes from American Indians and Eskimos
RACE
 Race: classification of people based on physical or biological
characteristics such as the color of skin, hair, eyes; facial
features; blood type; and bone structure
 Race is used to label a group of people and explain patterns
of behavior
 Race cuts across multiple culture
and ethnic groups; it is the
values, beliefs, and behaviors
learned from the ethnic/cultural
group that accounts for behaviors
attributed to race
CULTURAL DIVERSIT Y
 Cultural diversity: dif ferences among individuals based on
cultural, ethnic, and racial favors
 Cultural assimilation: absorption of a culturally distinct group
into a dominant or prevailing culture
 United States is known a “melting pot”, but strives to be more like a “salad bowl ”
 Acculturation: the process of learning beliefs and behaviors of a
dominant culture and assuming some of the characteristics
 2nd and 3 rd generation Americans are more likely to use English as their
main language and follow American patterns
 Sensitivity: the ability to recognize and appreciate the personal
characteristics of others
 Essential in health care
 Ex) Asians believe using a first name is unacceptable unless used by
family or close friends
BIAS
 Bias, prejudice, and stereotyping can all interfere
with acceptance of cultural diversity
 Bias: a preference that inhibits impartial judgment
 Ex) Person believing in the supremacy of their own ethnic
group are called ethnocentric
 People who are ethnocentric believe their culture is
better than others
 May antagonize or alienate people form other cultures
 May be biased with regard to other factors
SEVEN COMMON BIASES
1. Age
• Young people are superior to older people
2. Education
• College education people are superior than uneducated people
3. Economic
• Rich people are superior to poor people
4. Physical size
• Skinny and tall people are superior to obese and short people
5. Occupation
• Doctors are superior to nurses
6. Sexual preference
• Heterosexual people are superiors to homosexual people
7. Gender
• Men are superior to women
PREJUDICE AND STEREOT YPING
 Prejudice: “prejudge”; strong feeling or belief formed about
a person or subject that is formed without reviewing facts or
information
 Prejudice people view their ideas a right and others wrong; afraid
of change
 We are all prejudice to some degree, but it is important as health
care workers to be aware of our prejudices and to obtain as much
information about a situation as possible to allow us to learn
about others, understand their beliefs, and communicate
successfully
 Stereotyping: process of assuming that everyone in a
particular group are the same
 Ignored individuality; labels people
 Ex) All blondes are dumb
WAYS TO AVOID BIAS, PREJUDICE, AND
STEREOT YPING
Be aware of own personal values and beliefs
Obtain information about other cultures and ethnic
groups
Be sensitive to practices of people from other cultures
Don’t feel pressured to adopt others beliefs, but respect
them
Be diverse when building friendships
Ask questions and encourage others to share ideas
Evaluate information before forming an opinion
Be open to differences
Avoid offensive jokes
Mistakes happen; apologize if you hurt another’s feelings
HOLISTIC CARE
 Holistic care: care that provides for the well-being of
the whole person and meets not only physical needs,
but also social, emotional, and mental needs
 Cultural diversity may affect areas such as personal
space, touching, eye contact, and family organization
FAMILY ORGANIZATION
 Nuclear family: usually consists of a mother, father, and children
 May consist of single parents and child(ren)
 Basic unit for European American families
 In nuclear families, people outside the family frequently care for sick,
children, or elderly relatives
 Extended family: Includes the nuclear family plus grandparents,
aunts, uncles, and cousins
 Basic unit for Asian, Hispanic, and Native American families
 In extended families, the families tend to take care of the sick, children,
or elderly relatives in their home
 Ex) Asian families see it as an honor to take care of their elder relatives
 Never assume!
 Ask questions and observe the family
FAMILY ORGANIZATION CONT.
 Patriarchal: the father or oldest male is the authority figure
 Ex) Some Asian and Middle Eastern men attend all medical
appointments with their wives and handle all healthcare decisions
 Matriarchal: the mother or oldest female is the authority figure
 Ex) Some women make healthcare decisions for the entire family
FAMILY ORGANIZATION AND HEALTHCARE
 Recognition and acceptance of family organizations is essential
for health care providers
 Patients who have extended families as basic units may have
many visitors in the hospital or long -term care; all with be
concerned with the care provided and will want to make
decisions regarding care
 Some may even try to provide person care to the patient
 Questions to ask to determine a patient’s structure includes:
Who are the members of your family?
Who is the head of your household?
Where do you and your family live?
Do you have children? Who will care for them while your sick?
LANGUAGE
 Health care workers frequently encounter patients who do not
use English as their dominant language
 Health care worker must determine a patient’s ability to
communicate by talking with them and asking questions such as:
Do you speak English as your primary language?
What language is spoken at home?
Do you read English? Do you read another language?
Do you have a family member or friend who can interpret information for
you?
 Find an interpreter if needed
 Another health care worker, consultant
or family member may be able to assist
LANGUAGE CONT.
 When providing people who have limited English, speak slowly,
use simple works, use gestures and pictures to clarify meaning,
and give smiles or gentle touches if culturally appropriate
 Make every attempt to learn at least a few works of the patient's
language, they appreciate this gesture
 If working with a large number of patient’s who peak a certain
language, take an intro course or get an audiobook to learn
basics of that language
 Most states require that any medical permit requiring a signature
by the patient must be printed in the patient’s native language,
so the health care worker must be aware of the legal
requirements within
PERSONAL SPACE
 Personal space: “territorial space”; describes the distance
people require to feel comfortable while interacting with others
 Each culture dif ferentiates in how they feel comfortable when
interacting with others, so it is important to understand the
personal space requirements for each culture when working in
health care
 Health care providers use touch and invade personal space to
give many types of care
 Use a slow, relaxed approach, explain the procedures, and encourage
the patient to relax
 Be alert for a patient’s verbal and nonverbal communication
EYE CONTACT
 Eye contact is af fected by dif ferent cultural beliefs
 Ex) European Americans think eye contact is a sign of interest, while
some Asian Americans may consider eye contact to be rude
 Health care providers must be alert to the comfort levels of
patients while using direct eye contact and recognize the cultural
diversity that exists
 Lack of eye contact typically means “not listening”, when it can actually
mean respect
GESTURES
 Gestures are used to communicate many things
 In the United States, a common gesture for saying “yes” is
nodding the head up and down and for “no” is nodding the
head side to side; In India, the head motions are the
completes opposite
 Pointing the finger is also a common gesture in the United
States, but can signify a “strong threat” to Asians and Native
Americans
HEALTH CARE BELIEFS
 Most common health care system in the United States is the
biomedical health care system, or “Western” system
 This system bases the causes of disease on things such as
microorganisms and fungus. When the cause is determined,
health care focuses on eliminating the disease.
 Health care beliefs vary greatly among, and within, dif ferent
cultures
ALTERNATIVE HEALTH CARE TREATMENTS
1. Nutritional methods
• Organic foods, herbs, vitamins, and antioxidants
2. Mind and body control methods
• Relaxation, medication, and imagery
3. Energetic touch therapy
• Massage, acupuncture, and acupressure
4. Body -movement methods
• Chiropractic, yoga, and tai chi
5. Spiritual methods
• Faith healing, prayer, and spiritual counseling
 It is important to remember that every patient has the right to choose
the type of health care system fits them best
SPIRITUALIT Y AND RELIGION
 Spirituality: the beliefs individuals have about themselves,
their connections with each other, and their relationship with
a higher power; an individuals need to find meaning and
purpose in life
 Often expressed through religious practices
 Religion: an organized system of belief in a superhuman
power or higher power
 Associated with a specific form or place of worship
RESPECTING BELIEFS
1.
2.
3.
4.
Be a willing listener
Provide support for spiritual and religious practices
Respect religious symbols and books
Allow privacy for patient during clergy time or during
observation of religious customs
5. Refrain from imposing your beliefs on the patient
RESPECTING CULTURAL DIVERSIT Y
 The key to respecting cultural diversity is to regard each person
as a unique individual
 Every individual has a pattern based off of culture, ethnicity, race, life
experiences, spirituality, and religion
 Health care workers must be aware of the needs of an individual
to provide total care
 Health care workers must learn to appreciate and respect the
personal characteristics of others by:
Listening to patients express their beliefs
Evaluate all information before forming an opinion
Be sensitive to the response of a patient to contact, touch, and invasion
of private space
Respect spirituality, religious beliefs, symbols, and rituals