Cultural Diversity (Lecture 2 (Bias, Prejudice, and Stereotyping (Ways to…
Bias, Prejudice, and Stereotyping
Bias: preference or inclination that inhibits impartial judgment
Individuals who believe in the supremacy of their own ethnic group(ethnocentric). These people also believe their cultural values are better than everyone else.
People who have a bias may antagonize and alienate people from other cultures
Common biases can include:
Age- Young people are physically and mentally superior to older people
Education- College-educated individuals are superior to uneducated individuals
Economic- Rich people are superior to poor people
Physical size- Obese and short people are inferior
Occupation- Nurses are inferior to doctors
Sexual preference- Homosexuals are inferior to heterosexuals
Gender- Women are inferior to men
Prejudice: strong feelings or beliefs about a person or subject; pre-judging others without reviewing facts or information; often based on fear
They regard their ideas or behavior as right and others as wrong
Every person is prejudice to some degree (we all want to feel that our beliefs are correct)
Stereotyping: making the assumption that everyone in a group is the same
Ignore individual characteristics and labels an individual
All blondes are dumb
Bias, prejudices, and stereotyping are barriers to effective relationships with others. You need to be on alert to these and make every effort to avoid them
Health care workers need to avoid feelings and assumptions
Ways to avoid bias, prejudice, and stereotyping
Know and be consciously aware of your own personal and professional beliefs
Obtain as much information as possible about different ethnic/cultural beliefs
Be sensitive to behaviors and practices different then your own.
Remember you are not being pressured to adopt other beliefs, but you must respect them
Develop friendships with a wide variety of people from different groups
Ask questions and encourage questions from others to share ideas and beliefs
Evaluate all information before you form an opinion
Be open to differences
Avoid jokes that may offend
Remember that mistakes happen. Apologize and forgive.
Understanding Cultural Diversity
Cultural and ethnic beliefs will affect behavior
Health care worker needs to be aware of these beliefs to meet the physical, social, emotional, and mental needs of individuals (Holistic Care)
Care that provides for the well-being of the whole person and meets not only physical
Areas of cultural diversity include:
Health care beliefs
Family organization is the structure of family and the dominant or decision-making person in a family.
Nuclear (mom, dad, children– it can also be a single parent and child(ren))
Basic unit in European American Families but extended family is important
Basic unit for Asians, Hispanic, and Native Americans is generally the extended family with several different generations living in the same household
Privilege to take care of the elderly in Asian families
Extended (includes nuclear family and grandparents, aunts, uncles, and cousins
Patriarchal versus matriarchal
Patriarchal is where the father or oldest son is the authority figure.
Matriarchal- mother or oldest female is the authority figure.
Come across some people who say they have to check with their spouse to see if they are going to have the surgery.
Recognition and acceptance of family organization is essential in all aspects of the health care field
To determine a patient’s family structure and learn about a patient’s preferences, the health care provider should talk with the patient or ask questions:
Who are the members of your family?
Do you have any children? Who will care for them while you are sick?
Do you have extended family? For example, aunts, uncles, cousins, nephews, nieces?
Who will be carrying for you while you are sick?
Who is the head of the household?
Where do you and you or family live?
What do you and your family do together for recreation?
Do you have family members who will be visiting you? (if admitted to a HCF)
In US dominate language is English but US Census Bureau verified more then 20% of population younger than 65 speaks a language other than English at home
Variations within a language caused by different dialects
German taught in school may ne different from the language spoken by Germans from different areas of Germany
Talk with pts and ask questions:
Do you speak Enlgish as your primary language?
What language is spoken at home?
Do you read English? Do you read in another language?
Do you have a family member or friend who can interpret information for you
find an interpreter whenever possible, speak slowly and use simple words orphrases
Most states require that any medical permission form requiring written signature be printed in the patients language to ensure that the pt understands what they are signing.
Personal space and touch (aka territorial space)
Arabs are very close contact and touchy
French and Latin Americans tend to be very close hugs, handshakes
African Americans prefer a little space between you. (2-4 feet)
Cambodia members of opposite sex may never touch each other in public, not even brother and sisters. Only a parent can touch the head of a child
Vietnamese allow only the elderly to touch the head of a child b/c the head is considered sacred
Take vitals– be slow and explain ease fears
Most European Americans regard eye contact during a conversation as interest and trustworthiness
Some Asian Americans consider direct eye contact very rude
Native Americans may use peripheral (side) vision and avoid direct eye contact
Some Hispanic and African Americans use little eye contact to indicate respect and attentiveness
Muslim woman avoid eye contact as a sign of modesty
India avoid eye contact with different socioeconomic classes
Gestures (India is opposite of us for yes and no)
Health care beliefs
Most common health care system in the US is biomedical healthcare or “Western” system
System of health care bases the cause of disease on such things as microorganisms, diseased cells and the process of aging.
Cause of disease if found care is directed towards eliminating the cause
Physicians receive medical training and are licesnced to practice
Beliefs include: learning about illness, teaching self care, using mediations and technology to cure or decrease the effects of disease
Major change in practice of our healthcare system:
Alternative health care methods (in addition to, or as a replacement for biomedical care and include chiropractors, homeopaths, naturopaths an hypnotist)
Health concepts: maintain harmony of body, mind, and spirit. Harmony with nature, illness can be prevented by diet, rest, and cleanliness
Cause of illness: conflict shame or disharmony in life Punishment from God, spirits and demons
Traditional Healers: root doctor folk practitioners
Method of Treatment: restore harmony, prayer and meditation, herbs, roots, charms
Response to pain: Tolerating pain is a sign of strength
No infant baptism (usually between the ages of 16-25)
Many give birth at home- birth control not forbidden but usually not used since large families are a gift from God.
No last rites, body may be embalmed, buried in plain coffin in grave dug by hand, cremation not used, organ donation allowed
Believe in living a simple life in harmony with nature- Important to keep body pure and spotless, do not buy health insurance– church establishes a mutual aid fund
Accepts blood transfusions, surgery and chemo, may not use prescription and rely on herbal remedies
Health concepts: Health is a state of physical and spiritual harmony with nature . Balance of two energy forces: Yin (cold) and yang(hot)
Causes of illness: imbalance between yin and yang. Supernatural forces such as God, evil spirits, Unhealthily environment
Traditional Healers: Herbalist, Physician, Shaman healer
Methods of Treatment: cold remedies, herbal remedies, acupuncture and acupressure, energy restore of the yin and yang
Response to pain: Pain must be accepted and endured silently. Displaying it in public brings disgrace– may refuse pain medication
Health Concepts: health can be maintained by rest, diet, and exercise. Immunizations and preventive practices- good health is personal responsibility
Causes of illness: outside source like germs, pollutants or punishment for sins, lack of cleanliness or self abuse.
Traditional Healers: Nurse and Doctor
Methods of treatment: Medications, surgery, prayers, and religious rituals, diet and exercise, home remedies
Response to pain: some express loudly, others value self control pain can be helped by medications
Response to pain: many will express pain verbally and accept treatment, others feel pain is a part of life and must be endured.
Methods of treatment: Hot and cold remedies torestor balance, prayers, medals, candles, herbal remedies, massage, wearing an azabache (black stone) to ward off the veil eye
Traditional healers: Native healers, spiritualist, herbalist
Causes of illness: punishment from God, Susto (fright) malojo (evil eye) or envidia envy)
Health Concept: Health is a reward from God, Health is good luck, balance between hot and cold.
What is the Key??
Some ways to achieve the goal or respecting and appreciating others:
Respect spirituality, religious beliefs, symbols, and rituals
Be sensitive to how a pt responds to eye contact, touch and invasion of personal space
Recognize and promote positive interaction with pt and family
You are not expected to adopt beliefs of others
Allow pts to practice and express beliefs
Evaluate all information before forming an opinion
Ask questions to determine a person’s beliefs
Recognize and avoid bias, prejudice, and stereotyping
Learn more about the culture and ethnic groups
Appreciate the differences
Listen to pts as they express their beliefs
Health care workers must be aware of the needs of each individual in order to provide total care
Regard each person as a unique individual
Wrapping it up
Examples of questions that can be asked:
Do you fast or abstain from eating certain foods?
Should your food be prepared in a certain way
Do you prefer certain types of foods
Do you have religious objects that require a special care?
DO you wear clothing or jewelry with a religious significance
Would you like a visit from a representative of your religion?
Are there spiritual practices that help you feel better?
DO you have a religious affiliation?
Polytheists worship and believe in many Gods, like the Chinese folk religion, Hinduism, and some believer of Buddhism
Monotheists- believe in the existence of one God, ac characteristic of Judaism, Christianity, and the Islamic religion
Even though a religion may establish certain beliefs and rituals, it is important to understand that not everyone follows all of the beliefs or rituals of their own religion.
Science and Health by Mary Baker Eddy is basic textbook for CS
Bible is holy book, rite of communion, prayer and faith will maintain health and prevent disease
May refuse blood transfusions, may NOT use medicine or surgical procedures, most will accept legally mandated immunizations
Organ donation discouraged but individuals decision
No last rites and autopsy only when required by law
Abortions discouraged but regarded as an individual’s decision, same as birth control
Cows are sacred and feeding a cow is an act of worship
Karma is determined by the accumulation of merits and demerits that results from all actions the soul has committed from past lives
Will accept most medical procedures
Vedas (four books) are the sacred scripture
Belief about death: believe in reincarnation as humans, animals, or even plants, ultimate goal is freedom from the cycle of death and rebirth, priest ties threat around the neck or wrist of the deceased and may pour water in the mouth. Only family and friends may touch and wash the body.
Abortion can only be performed to save the life of the mother
Beliefs about birth: no ritual at birth, naming ceremony is performed 10-11 days after birth to obtain blessings from gods and goddesses
May wear items with words from Koran on arm, neck, or waist– do not allow them to get wet
Fast during daylight hours in month of Ramadan
Oran is holy book of Islam
Holy day of worship is sunset Thursday to Friday
Illness is an atonement for sins. Face Mecca 5 times a day and there is a ritual washing before and after prayer and they need to take medication with right hand because left hand is considered dirty
Cremation not permitted
Only family touches and cleans the body after dying and body is turned towards Mecca after death
Family must be with dying person and dying person must confess sins and ask forgiveness
Abortion not permitted after 120 days and father must give permission if done before
Believes that first words an infant should hear at birth are “There is no God but Allah and Muhammad is His prophet.”
Spirituality and Religion
Agnostic is an individual who believes that the existence of God cannot be proved or disproved
Atheist- a person who does not believe in any deity
Religion is an organized system of beliefs in a superhuman power or higher power.
Spirituality is defined as the beliefs individuals have about themselves, their connections with others, and their relationship with a higher power. Also known as an individual trying to find meaning and purpose in their life.
Response to pain: pain is a normal part of life, tolerance signifies strength and power
Methods of treatment: rituals, charms, masks, prayer and meditation to restore harmony, plants and herbs, medicine bag
Traditional healers: shaman, medicine man
Causes of illness: supernatural forces and evil spirits, violation of taboo, imbalance between man and nature
Health Concept: health is harmony between man and nature, balance among mind, body, spirit, spiritual powers control body’s harmony.
Response to pain: Tolerating pain is a sign of strength self inflicted pain is used as a sign of grief
Methods of Treatment: medication, charms and amulets, surgery, meditation, male health professionals cannot touch or examine a female patient.
Traditional Healers: Traditional healers, physicians
Cause of illness: spiritual causes, punishment for sins evil spirits, or evil eye
Health concepts: health is caused by spiritual forces, cleanliness essential for health, male individuals dominate and make decisions on health care
Process of learning the beliefs and behaviors of a dominant culture and assuming some of the characteristics
Need to develop sensitivity to differences
Sensitivity is the ability recognize and appreciate the personal characteristics of others
Example- Native Americans or Asians- calling an adult by first name is not acceptable except for close friends and relatives
Every individual has unique blend of characteristics and as a healthcare workers it is important to remember these factors and also that not everyone is 100% anything
Occurs slowly over a long period, usually many years
2nd-3rd generation would use English as main language
1st generation likely to use language of the country came from.
In previous years the United States was called a “melting pot,” now it is striving to become more like a “salad bowl?”
Cultural differences are appreciated and respected
Very important to remember that differences exist within ethnic/cultural groups and in individuals within a group
These differences influence a person’s behavior
Is the differences among people resulting from cultural, ethnic, and racial factors
Race cuts across multiple ethnic and cultural groups
There are white and black Hispanics, white Africans and Caribbean's, and white and black Asians.
Classification of people based on physical or biological characteristics
Frequently used to label a rop of people and explain patterns of behavior
Color of skin, hair, and eyes
It is also important to make note that within each of the ethnic groups , there are numerous subgroups each with its own lifestyle and beliefs within larger ethnic groups. European group includes Italians and Germans both with different languages and lifestyles
Common ethnic groups and their countries of origin
Native American include Eskimos more than 500 tribes
Middle Eastern/Arabic Americans(Egypt, Iran, Iraq, Kuwait, Lebanon, Yemen and so on)
European American(England, France, Germany, the Netherlands, ,Ireland, Italy, Norway, Poland, Russia, Scandinavia, Scotland, and Switzerland)
Hispanic American (Mexico, Puerto Rico, Spain, and Spanish speaking countries in Central and South America)
Asian/Pacific American (Cambodia, China, Guam, Hawaii, India, Indonesia, Pacific Island countries, Japan, Korea, Loas, Philippines, Samoa, and Vietnam)
African American (Central and South Africa, Dominican Republic, Haiti, and Jamaica)
Every individual in an ethnic group might now practice all beliefs, they are still influenced by them
Members of an ethnic group can share common heritage, geographic location, national origin, social customs, language, and beliefs
Classification of people based on national origin and/or culture
Even though differences exist
There are four basic characteristics of culture:
Culture is dynamic and constantly changing: Group can meet the needs by adapting to environmental changes
Culture is social in nature: People in a cultural group understand appropriate behavior based on traditions that have been passed down generation after generation.
Culture is shared:Common practices and beliefs are shared within a cultural group
Culture is learned, it does not just happen, it is taught by others: Children learn patterns by imitating others
Our family relationships, the way we bring our children up, education, occupational choices, social interactions, spirituality, religious beliefs, food preferences, , health beliefs, and health care are all influenced by culture
Foundation of behavior, but variances (culture Is not uniform among all members of a group and individuals within a cultural group)
Often defined set of rules because culture provides us with an individual blueprint or general design for living.
Passed from one generation to next
Defined as values, beliefs, attitudes, language, symbols, rituals, behaviors, and customs unique to a particular group of people
Culture, Ethnicity, and Race
Greatest influence is cultural/ethnic heritage
Uniqueness is influenced by many things including physical characteristics (sex, body size, and hair, nails, and skin color) family life, socioeconomic status, religious beliefs, geographical location, education, occupational and life experiences
Respect individuality. And be aware of factors that cause each person to be unique
Health care workers are involved with many different people. Not only will you take care of others but you will work with others