Sixth Lesson

Question 1

Assimilation

Answer 1

Assimilation describes the process of social, cultural, and political integration of a minority into a dominant culture and society. This is the melting pot theory, when the new group loses its own identity and becomes part of the majority culture. Up until the 1980ies, it was expected of ethnic minorities to ’melt into’ the new society and give up their own characteristics. Cultural pluralism is the contrast

Question 2

Cultural pluralism

Answer 2

Smaller groups within a larger society maintain their unique cultural identities, and their values and practices are accepted by the wider culture provided they are consistent with the laws and values of the wider society. It is not only a fact but a societal goal, Assimilation is not required here, just peaceful co-existence and mutual respect. It is the mosaic society. It is the basic idea behind intercultural healthcare. People are entitled to keep their own practices in health care settings as well, as long as nobody is hurt

Question 3

Culture

Answer 3

The common heritage shared by the people of a society, consisting of customs, values, language, ideas, and objects. Culture is society in you. It is your learnt view of the world. It includes ideas, beliefs, norms and values. It is passed on from one generation to the next but it does change

Question 4

Compliance

Answer 4

in healthcare, compliance means the patient follows doctor’s orders. Non- compliance is a very great problem. Many patients do not do what the doctor told them to do. They don’t take the medicine, don’t lose weight etc…

Question 5

Deviance

Answer 5

describes an action or behaviour that violates social norms in a society. deviant actions are unacceptable by society’s standards. As social norms differ from culture to culture, deviance is relative to culture. Doctors must try to avoid being judgmental about behaviors in intercultural encounters. Something which is morally suspect in one culture might be perfectly acceptable in another. As doctors have great authority, if they label something as deviant, it might have serious consequences for the identity of the patient

Question 6

Discrimination

Answer 6

The unequal and unfair treatment of individuals or groups on the basis of some irrelevant characteristic, such as race, ethnicity, religion, sex, or social class. A person is treated negatively because he or she belongs to a group

Question 7

Ethnic group

Answer 7

A group that shares a common cultural tradition and sense of identity.

Question 8

Ethnocentrism

Answer 8

The tendency to see one’s own culture as superior to all others

Question 9

Health beliefs

Answer 9

Health related ideas and beliefs of lay (non-medical) people. These ideas might be very different from what is held by medical professionals, but they are logical and make good sense to the lay people believing in them. They depend on culture. People makes sense of their symptoms and take action based on their health beliefs

Question 10

Health literacy

Answer 10

the ability to obtain, read, understand and use healthcare information to make appropriate health decisions and follow instructions for treatment. It is not only whether the patient understands what the doctors say but also the ability to get good information online, being able to decide what information is good, knowing what source to believe and being able to take action to improve one’s health. People with higher SES generally have better health literacy

Question 11

Intercultural

Answer 11

Any interaction between members of different cultures attempting at least to lessen misunderstandings stemming from living together. It can be very difficult. The important thing is the intention. If you want to understand people from other cultures, you will be able to do so

Question 12

Illness behaviour

Answer 12

Activities people undertake in trying to make sense of their symptoms, interpret them and seek remedy if necessary

Question 13

Minority group

Answer 13

Any recognizable racial, religious, ethnic, or social group that suffers from some disadvantage resulting from the action of a dominant group with higher social status and greater privileges. It is not necessarily about numbers. There were more black people than white in South Africa during apartheid, but the black people were still a minority as they had less power. There are many studies showing that members of ethnic minorities have worse health status than the majority population (there are some exceptions, for example in the case of dental health.) This is partly due to their lower socioeconomic position. They don’t have the resources needed to maintain good health. Their health literacy is lower, too. They have communication problems stemming from language barriers and lower education

Question 14

Labelling theory

Answer 14

It is how important fractions of society reacts to deviance that matters not whether or not the act is done. According to this theory deviance is caused by a) the deviant’s being labelled as morally inferior, b) the deviant’s internalizing the label and c) finally the deviant’s acting according to that specific label. Medicine is a strong moral authority. So for example, if you label a patient as a hypochondriac because he or she expresses pain more dramatically than you think is justified, you will lead to that person feeling like a deviant

Question 15

Prejudice

Answer 15

A “prejudged” unfavourable attitude toward the members of a particular group, who are assumed to possess negative traits. This is not action (see discrimination). It is a negative attitude. As members of the helping profession, doctors are expected to control their prejudices (if they have any) and not discriminate

Question 16

Race

Answer 16

A classification of humans into groups based on distinguishable physical characteristics that may form the basis for significant social identities. Sociologist don’t believe that race influences behaviour. Only racism does so

Question 17

Racism

Answer 17

The institutionalized domination of one racial group by another. Race based discrimination and prejudice

Question 18

Stereotype

Answer 18

over-generalized belief about a particular category of people. Stereotypes are generalized because one assumes that the stereotype is true for each individual person in the category. It is based on distortion and is usually negative. In intercultural encounters one of the difficulties is to accept the existence of cultural characteristics without stereotyping members of that culture

Question 19

Subculture

Answer 19

A group that adopts a way of living that is different from that of the dominant culture. Can be an ethnic minority or any other group that belongs to the majority in some ways but differs in others. See for example punks, football hooligans etc…

Question 20

The cultural dimension model

Answer 20

The Hofstede model of national culture consists of six dimensions. It is a way to compare national cultures along six important dimensions.

Question 21

power distance index (pdi)

Answer 21

This dimension expresses the degree to which the less powerful members of a society accept and expect that power is distributed unequally. The fundamental issue here is how a society handles inequalities among people. This is relevant in a health care setting as it will influence the doctor patient relationship as well as hospital hierarchy. In low power distance countries patients will want to be treated as partners and your boss will not order you around. In high power-distance countries, patient will accept doctors’ authority and the boss orders people around

Question 22

individualism versus collectivism (idv)

Answer 22

A society’s position on this dimension is reflected in whether people’s self-image is defined in terms of “I” or “we.” Do people think of themselves as individuals or members of groups? In cultures where individualism is low there will be huge groups of relatives at the bedside or consultations and decisions are made in groups, too. In high individualism countries, it is only the patient you will have to deal with, not the family. People from highly individualistic cultures are less likely to be vocal about pain as they don’t see the use of complaining while people from collectivist cultures will express pain more fiercely as they rely on group sympathy

Question 23

masculinity versus femininity (mas)

Answer 23

The Masculinity side of this dimension represents a preference in society for achievement, assertiveness, and material rewards for success. Society at large is more competitive. Its opposite, Femininity, stands for a preference for cooperation, modesty, caring for the weak and quality of life. Society at large is more consensus-oriented. High masculinity cultures are more achievement oriented. They live to work. low masculinity countries are more care and cooperation oriented. They work to live

Question 24

uncertainty avoidance index (uai)

Answer 24

The Uncertainty Avoidance dimension expresses the degree to which the members of a society feel uncomfortable with uncertainty and ambiguity. The fundamental issue here is how a society deals with the fact that the future can never be known: should we try to control uncertainty with a lot of bureaucracy and regulations or just let things happen? Low uncertainty countries are more laid back when it comes to dealing with risks. High uncertainty avoidance countries are very bureaucratic and controlling as this is how they try to reduce uncertainty. It is done through rules and regulations. Defensive medicine (ordering all the possible tests ’just in case’) is also more characteristic of high uai countries

Question 25

long term orientation versus short term normative orientation (lto)

Answer 25

Societies who score low on this dimension prefer to maintain time-honoured traditions and norms while viewing societal change with suspicion.Those nations with a culture scoring high here, take a more pragmatic approach: they encourage thrift and efforts in modern education as a way to prepare for the future. High lto countries are more open to new things and approaches. You can innovate here. Low lto countries do not improvise and are not likely to change protocol. Stick to time honoured ways in these countries

Question 26

indulgence versus restraint (ind)

Answer 26

Indulgence stands for a society that allows relatively free gratification of basic and natural human drives related to enjoying life and having fun. Restraint stands for a society that suppresses gratification of needs and regulates it by means of strict social norms. High restraint societies are less verbal about expressing pain and more apt to be able to control their vices in preventive behaviour