NURS 171 Week 11: Culture and Ethnicity Flashcards
Cultural Competence
- helps nurses when providing care
- helps nurses when teaching, supervising, and modeling culturally competent care to others
What is meant by Culture?
-what people in a group have in common
-changes over time
-blend of ethnicity, race, + religion
“the totality of socially transmitted behavior patterns, arts, beliefs, values, customs, lifeways… that guides their worldview and decision making”
Culture Definition
the totality of socially transmitted behavior patterns, arts, beliefs, values, customs, lifeways…that guides their worldview and decision making
Culture Characteristics
- provide identity and sense of belonging
- common beliefs + practices: beliefs, traditions and customs
- exists at many levels: art, literature, dress, artifacts
- passed down from generation to generation
- assumptions and habits are unconscious
- diversity
Ethnicity, Race and Religion
- culture is a blend of all of these
- they are not interchangeable
- Ethnic group: French Canadians, Portuguese Americans
- Racial Group: white, black, Chinese, Japanese, other Asian
- Religion: Catholic, Jewish
Ethnicity
- members share a common social and cultural heritage that is passed down from generation to generation
ex: French Canadians, Roman Catholics, Latinos - may include race but not the same as race
- subculture: members of some ethnic groups have same characteristics in common
Race
-strictly related to biology: skin color, blood type, or bone structure US Census terms on race: -White -Black, African American or Negro -American Indian or Alaska Native -Asian -Native Hawaiian -Pacific Islander
Religion
- ordered system of beliefs regarding the cause, nature, and purpose of the universe
- ordered system of beliefs related to the worship of god or gods
- in many cultures religion is a high priority
- separate from ethnicity but
- may overlap as in Jewish Culture and Jewish Religion
Socialization
learning to become a member of a society or group
Immigrants
new members of a group or country
Acculturation
when an immigrant assumes characteristics of new culture while retaining own culture traits
Cultural Assimilation
take on essential values, beliefs, and behaviors of dominant culture (language)
Dominant Culture
group that has the most authority or power to control values ( usually the largest group)
Ethnocentrism
tendency to think your own group is superior
Subculture
groups within larger culture that share some characteristics yet some are different
ex: nurses, women, people with disabilities
Minority Groups
fewer members than dominant culture
-sometimes refers to those who receive different and unequal treatment from others in society
Vulnerable Populations
more likely to develop health problems ex: -homeless -mentally ill -poor -disabled -young -old (often have limited access to healthcare)
Values
help shape health-related beliefs and practices
-personal values: principle or standard that has meaning or worth to an individual
Personal Values
principle or standard that has meaning or worth to an individual
Beliefs
something one accepts to be true
Practice
set of behaviors that one follows
How Do Cultural Values, Beliefs, + Practices Affect Health?
- culture values, beliefs, + practices: principles, standards, ideas, and behaviors that members of a cultural group share
- do not assume a client shares the values, beliefs, and practices of the dominant culture
Culture Universals
are values, beliefs, and practices that people from all cultures share
Culture Specifics
values, beliefs, and practices that are special or unique to a culture
Archetypes
something recurrent, based on facts
dark skin, blue eyes of culture members
Stereotypes
widely held but oversimplified beliefs that have no basis in fact
Cultural Specifics that Affect (Influence) Health
- communication
- space
- time orientation
- social organization
- environmental control
- biological variations
- religion
- education
- technology
- politics and law
- economy
Cultural Specifics that Affect Health: Communication
-language barriers
-cultural norms
ex:
-Arabs show direct eye contact but only between the same sex
-Asians + Native Americans do not make eye contact
Cultural Specifics that Affect Health: Space
Personal space + territoriality
ex:
-North Americans + Northern Europeans want 18 inches in personal space
-Arabs: stand close
-Germans: far space. Looking into rooms = invasion of privacy
Cultural Specifics that Affect Health: Time Orientation
-present/future oriented; rooted in past
ex:
-European Americans: future
-Native Americans + Latinos: present. may forget appointments
Cultural Specifics that Affect Health: Social Organization
family unit affects how and who gets healthcare
- specifics of closeness may vary
- social organization of the clients family will influence what treatment will be acceptable to the client
Cultural Specifics that Affect Health: Environmental Control
health and illness beliefs and practices
- does patient believe his actions will help him get better? may delay treatment
- Asians: cant view circumstances as something to be controlled so will accept pain stoically
Cultural Specifics that Affect Health: Biological Variations
- differences genetically and physiologically
- may be more susceptible to certain diseases
- have different response to treatment
Cultural Specifics that Affect Health: Religion
beliefs may affect choices
Cultural Specifics that Affect Health: Education
influences perception of wellness/ illness and knowledge of options
Cultural Specifics that Affect Health: Technology
expectation that supplies and equipment are available
Cultural Specifics that Affect Health: Politics and Law
- affordable care act
- medicare
Cultural Specifics that Affect Health: Economy
- funded programs
- ability to pay
Indigenous Healthcare System
folk medicine and traditional healing methods, OTC and self healing
Professional Healthcare System
run by professional healthcare providers
North American = Western Medicine
Alternative and Complementary Medicine
- therapeutic touch
- reflexology
- acupressure
- chiropractic
What are Health and Illness Beliefs?
- Scientific/ biomedical health system
- Magico-religious system
- Holistic belief system
Health + Illness Beliefs: Scientific/ biomedical Health System
western medicine
Health + Illness Beliefs: Maigco-religious System
belief in supernatural forces dominates (mystical, voodoo)
Health + Illness Beliefs: Holistic Belief System
focuses on need for harmony and balance of body with nature
Nursing Values
- silent suffering as a response to pain
- objective reporting and description of pain
- use of nursing process
- nursing autonomy
- caring
- knowledge
- critical thinking
Nursing
- largest subculture in healthcare culture
- need to examine their own professional values
- understand health + illness from patients point of view
ex: Mexicans may believe that illness is caused by bodys imbalance of hot + cold
Traditional Healing
all cultures think their healthcare system and belief are “traditional”
Folk Medicine
- natural medicines such as herbs, plants, minerals, animal substances
- beliefs and practices that members of a cultural group follow when they are ill
- all cultures use some form of folk medicine (from generation to generation)
Magico-religious Folk Medicine
use charms, holy words, rituals and holy actions
Complementary Medicine
uses rigorously tested therapies to complement those of conventional medicine
-chiropractic
Alternative Medicine
therapies used instead of conventional medicine, reliability has not been validated by clinical testing in U.S. (magnet therpay)
What is Culturally Competent Care?
- a development process
- achieved on a continuum (incompetent to competent)
Cultural Awareness
appreciation of the external signs of diversity
Cultural Sensitivity
personal attitudes and being mindful to not be offensive to someone of another culture
Cultural Competence
a developmental process related to awareness of the needs of various cultural groups
Native Americans Dominant Values
- bonding to family/ group
- acceptance of nature
- tradition
- sharing
- belief in spiritual power
- respect of elders
Native American Health + Illness Beliefs
- health means living in harmony with nature (holistic)
- surviving under difficult circumstances
- body treated with respect
- illness associated with disharmony or evil spirits
- illness caused by an action that should have not been performed
Native American Health + Illness Practices
- rituals + ceremonies
- chanting
- purification
- meditation
- herbs
Asian + Pacific Islander Dominant Values
- extended family
- respect for elders
- group orientation
- subordination to authority
- conformity
- self-respect
- self-control
- love of the land
Asian + Pacific Islander Health + Illness Beliefs
- health is a state of physical + spiritual harmony
- illness is the disharmony of basic principles: yin and yang
Asian + Pacific Islander Health + Illness Practices
- acupuncture
- amulets
- moxibustion
- mediation
- herbs
Black or African American Dominant Values
- family bonding
- matrifocal
- spiritual orientation
- present oriented
Black or African American Health + Illness Beliefs
- health is harmony with nature (mind, body, spirit)
- illness is the result of disharmony or failure to eat proper foods
Black or African American Health + Illness Practices
- prayer
- laying on of hands
- magic rituals
- voodoo
- herbs
Hispanic or Latino Dominant Values
- extended family
- group emphasis
- fatalistic
- faith + spirituality
Hispanic or Latino Health + Illness Beliefs
- health is good luck or a reward for good behavior, a gift from god
- illness is body imbalance (hot or cold, wet or dry) or punishment
Hispanic or Latino Health + Illness Practices
- prayer
- belief in miracles
- wearing of religious medals or amulets
- religious relics in home
- herbs + spices
- rituals
- “hot” or “cold” therapy
White or European American Dominant Values
- independence
- individuality
- wealth
- comfort
- cleanliness
- achievement
- youth + beauty
White or European American Health + Illness Beliefs
- health is a state of physical and emotional well-being
- illness is a contagion or contamination that is hereditary, psychosomatic or supernatural
White or European American Health + Illness Practices
- biomedical care
- home remedies
- religious traditions
- diet + exercise
Barriers to Culturally Competent Care
- bias
- ethnocentrism
- cultural stereotypes
- prejudice
- discrimination
- racism
- sexism
- male chauvinism
- language barrier
- street talk, slang, healthcare jargon
Barriers to Culturally Competent Care: Bias
lack of impartiality, one sidedness
Barriers to Culturally Competent Care: Ethnocentrism
believing own values are right and other cultures are wrong or bizarre
Barriers to Culturally Competent Care: Cultural Stereotypes
unsubstantiated belief that all people of a certain racial or ethnic group are alike in certain respects
Barriers to Culturally Competent Care: Prejudice
negative attitudes toward other people based on faulty and rigid stereotypes about race, gender, sexual orientation and so on
Barriers to Culturally Competent Care: Discrimination
behavior manifestations of prejudice
- behavior that results from a prejudice
ex: admits Hispanic patients to a room at the end of the hall so the noise from the family will not disturb others
Barriers to Culturally Competent Care: Racism
- form of prejudice + discrimination
- race is the principle determining factor of human traits and capabilities
- racial differences produce an inherent superiority (or inferiority)
- nurses must recognize that racism can play a major role in communication
Barriers to Culturally Competent Care: Sexism
assumption that members of one sex are superior to those of the other sex
-male nurses may experience rejection by peers and patients
Barriers to Culturally Competent Care: Male Chauvinism
male superiority is common in many cultures and healthcare settings
Barriers to Culturally Competent Care: Language Barrier
- many clients do not speak English in their home
- speak English poorly
- affects your ability to communicate with clients
Barriers to Culturally Competent Care: Street Talk, Slang, Healthcare Jargon
pot their own set of communication challenges
Nursing Strategies for Response to a Clients Cultural Health Practices
- find out if orders conflict with folk or alternative medicine beliefs- if so suggest modifications
- provide educational materials that are translated
- make community referrals as needed
How Should I Respond to a Clients Cultural Health Practice?
step in and negotiate when practices might be harmful to client
How Do I Communicate With Clients Who Speak a Different Language?
- use a professional medical interpreter
- family + friends should not be used as an interpreter
Developing Strategies
- respect your clients
- never force, pressure, manipulate or coerce them to participate in care that conflicts with their values + beliefs
- appreciate client as unique
- learn about clients cultural group
- incorporate clients cultural values/ behaviors into care plan
Being Considerate of Cultural Specifics: Verbal/ Nonverbal Communication
- is touch expected or prohibited
- is eye contact expected or avoiding
- ask client how he wishes to be addressed
Being Considerate of Cultural Specifics: Personal Space
know usual comfortable distance for conversing
Being Considerate of Cultural Specifics: Body Language
- smiling does not universally indicate friendliness
- know what gestures are acceptable
Being Considerate of Cultural Specifics: Time Orientation
- keep time commitments to client
- avoid surprise visits
Being Considerate of Cultural Specifics: Social Organization
know which person in family is leader or decision maker
Being Considerate of Cultural Specifics: Environmental Control
- know clients health traditions and practices are
- do they believe they have the ability to change things?
- know the general influence of culture on perception and tolerance of pain
- what foods are forbidden, not eaten together
