Cultural Diversity Flashcards
The Nature of culture
Culture is a total way of life.
Culture is a social phenomenon learned through life experiences.
Shared system of values that provides a framework for who we are.
Culture is an abstract concept, composed of the values, beliefs, roles, and norms that make groups of people band together
Cultural values strongly influence thinking and actions.
A culture’s belief system develops over generations.
Formed by feelings and convictions that are believed to be true.
May or may not include a religion
Provides social structure for daily living
Defines roles and interactions with others and in families and communities
Culture reflects its members; it is dynamic, changing, and adaptive.
Apparent in the attitudes and institutions unique to the culture
An individual’s behavior may or may not represent the culture.
Culture is NOT:
Based on color of skin
Based solely on country of origin
Race
Beliefs about health and illness have a strong impact on outcomes of treatment.
Values and beliefs help to define norms, which are a culture’s behavioral standards.
A role is an expected pattern of behaviors associated with a certain position, status, or gender.
Cultural Vocab
Unconscious Bias – a bias we are unaware of and happens outside of our control. Directs quick judgements and assessments of people and situations
Cultural Identity
belonging to a certain culture
Cultural Competence – means to be able to understand, appreciate, and work with people from other cultures
Stereotype
an assumed belief about a particular group
Health Disparity
Health difference linked closely to social, economic, and/or environmental disadvantages
Ethnic Identity/Ethnicity – belonging to a certain cultural group
Acculturation
when an individual or group transitions from one culture and develops traits of another culture
Ethnocentrism
the belief that one’s own cultural and worldview are superior to those from different cultural, ethnic, or racial backgrounds
Health disparities
- Population-specific differences in the presence of disease, health outcomes, or access to health care
- Recent study showed that where you access health care can make a difference in the care you receive
- those hospitals that treat a higher percentage of minorities also have a higher nurse/client ratio
- Standards of care can vary
- Less access to healthcare providers and facilities
- Minorities have higher incidence of many cancers due to lack of prevention such as pap smears and mammograms
impact of culture on health
Perceptions or explanations of disease and treatment can vary due to educational level, religious beliefs, alternative health system belief
On response to pain
Recognize that each person holds various beliefs about pain and that pain is what the patient says it is.
Respect the patient’s right to respond to pain in one’s own fashion.
Never stereotype a patient’s responses to pain based on the patient’s culture.
Be sensitive to nonverbal signals of discomfort, such as holding or applying pressure to the painful area or avoiding activities that intensify the pain.
On sleeping practices
Be aware that cultural sleep practices may alter the kinds of environmental sleep disruption that require management.
Assess cultural tendencies to co-sleep or bed-share with infants and children.
On body hygiene
Ask the patient for input on bathing habits and cultural bathing preferences.
In many cultures, body odor is offensive, but some see it as natural.
In many Asian cultures, it is customary to not shower or bathe for 1 full month after giving birth.
impact of culture on health; food and nutrition
In many cultures food has a social or ceremonial role. Certain foods are highly prized; others are reserved for special holidays or religious feasts; still others are a mark of social position. There are cultural classifications of food such as ‘inedible’, ‘edible by animals’, ‘edible by human beings but not by one’s own kind of human being’, ‘edible by human being such as self’, ‘edible by self’. In different cultures, certain foods are considered ‘heavy’, some are ‘light’ some as ‘foods for strength’; some as ‘luxury’, etc1.
Different cultures can produce people with varying health risks, though the role of diet is not always clear. For example, Southern-style fried foods, biscuits and ham hocks tend to increase heart disease and diabetes. But what about other causes? Income levels, limited access to healthier foods and exercise habits might play a role as well. Menus stressing lower-fat foods and lots of vegetables, such as those of many Asian cultures, can result in more healthful diets, even reducing the risks for diseases such as diabetes and cancer
As people from one culture become assimilated into another, their diets might change, and not always for the better. A shift to a higher-fat, Americanized diet has raised the obesity rate among Latinos and the health risks that go with it.
impact of culture on health
On conventional health care
Culture has no impact on disease, but illness and its attendant behaviors are strongly influenced by culture.
Degree of acceptance of Western versus folk medicine and treatment
pharmacologic versus holistic
Degree of trust or suspicion of care providers – could have a history of suffering mistreatment or discrimination
Who makes the health care decisions (not always the patient)
Gender roles
Family support
impact of culture on health
On mental illness
* Clients and their care providers may have very different belief systems about mental disorders.
- Members of a culture may define normal and abnormal behaviors differently from those outside the culture.
- Cultural descriptions of mental dysfunction are classified as naturalistic illness or personalistic illness.
On stress and coping
* Cultures classify members by gender and age.
- In many cultures, adolescence can be a stressful time.
- Women often are placed in stressful roles as a result of their cultures.Ways of coping with stress are culturally determined.
impact of culture on health
On physical, sexual, mental, emotional, and substance abuse
- Growing in frequency in our society
- A learned behavior in most cases (most abusers have at one time been abused)
religion
Religion
* Spirituality and religion play important roles in the concept of culture
- Defined as belief in a higher power (not the same for everyone) ; greater than any human being.
- Religion relates to a defined, organized, and practiced system of worship.
- Deeply rooted and often stereotyped
- Important to some patients and nonexistent to others
- Religion may:
- Influence the procedures a patient will allow
- Determine who is allowed to care for that patient
- Require services/ceremonies to be done at the bedside
- Nurses need to be comfortable discussing patients’ needs pertaining to their spirituality or offer to get assistance from others who can help (chaplain, social worker, etc.)
influencer of culture
Families headed by biological parents, single parent families, foster parent families, blended families, lesbian, gay, bisexual and transgender families
Family structure
adoption, divorce, single income home
Parenting Style
Authoritarian, Authoritative, Permissive
Socioeconomic Level
Social Class, Educational Level, Health Literacy
Poverty
costs, transportation, time off from work, government aid
Refugees and Immigrants Grief, PTSD, poor living conditions, malnutrition
Distance and Orientation personal space, crowded conditions, lateness
Examples of Common Health Problems in Specific Populations
Native Americans and Alaska Natives
* heart disease, cirrhosis of the liver, diabetes mellitus, fetal alcohol syndrome
African Americans
* hypertension, stroke, sickle cell anemia, lactose intolerance, keloids.
Asians
* hypertension, cancer of the liver, lactose intolerance, thalassemia*
Hispanics
* diabetes mellitus, lactose intolerance.
Whites/Caucasians
* breast cancer, heart disease, hypertension, diabetes mellitus, obesity.
Eastern European Jews
- cystic fibrosis, Gaucher’s disease, spinal muscular atrophy, Tay-Sachs’ disease.
Examples of Health-Related Beliefs of Selected Religious Groups
Catholicism
Abstain from eating meat on Ash Wednesday and Fridays of Lent, prohibits contraception and abortion, sacrament of the sick
LDS/Mormons
Abstain from coffee and hot tea, elders anoint with oil
Hinduism
Prohibits eating meat, Cremation is common
Islam
Fasting during daytime hours during Ramadan, Ritual cleansing prior to eating, Prohibited from eating pork
Jehovah’s Witness
Prohibits transfusion of blood or transplants
Judaism
Prohibits eating pork or shellfish, or mixing milk/meat dishes, Kosher food prep, circumcision on 8th day, rabbi visits sick
Seventh-Day Adventist
Prohibits pork or shellfish, encouraged to eat vegetarian
healthy people 2020 goals for cultural care
Goal for cultural competence
Use communication strategically to improve health
Goal for decreasing health disparities:
Improve access to comprehensive, high quality health care for all regardless of race
transcultural nursing
- Transcultural nursing is culturally specific & competent care provided to clients from a culture that is different from that of the nurse
- Culturally based knowledge used in creative, congruent, and meaningful ways to provide beneficial and satisfying health care to diverse cultures.
- Part of a nurse’s role is to learn about traits that are common among people as well as those that are different
- Nursing interventions must fit cultural values, beliefs and practices to be effective and acceptable to the client, family, and community.
