Cultural Diversity

1
Cultural Diversity

• NPN 105
• Joyce Smith RN, BSN

2
Cultural Diversity

• U.S. population is increasing in diversity.
• Dominant culture
• Variant cultural patterns
• Subcultures
• Ethnicity
• Race

3
Health Disparities

• Unequal burdens of disease morbidity and
  mortality rates experienced by racial and ethnic
  groups
• Differences contribute to lower quality of health
  services.
• Health provider bias, stereotyping, prejudice,
  and poor provider-patient communication add to
  problem.

4
Cultural Conflict

• Influences on patients and health care
  practitioners
• Bias
• Prejudice
• Cultural imposition
• Stereotypes

5
Cultural Conflicts

• We all believe we have the best way of life
  possible
• We do not want to change
• We sometimes feel that other ways are wrong
• Through these attitudes comes racism, biases,
  prejudices and discrimination.
• Health care workers must avoid stereotypes
• We must not impose our values on our patients

6
Culture in Health and Illness

• Culture
• The integrated patterns of human behavior that
  include language, thoughts, communication,
  actions, customs, beliefs, and values
• Illness
• Personal, interpersonal, and cultural reaction to
  disease
• Disease
• Malfunctioning or maladaptation

7
Comparative Worldviews About Health and Illness

• Worldviews
• We are educated in our own social and ethnic
  cultures and as the world gets smaller we must
  look at other practices
• US culture encourages self care (we decide what
  will be done for us)
• Where others seek care from family (family
  members make decisions about care)
• Some societies use folk healers and holistic
  practices
• Some use magic and religious ceremonies to heal
  the sick

8
Cultural Healers

• Chinese and Southeast Asians
• Herbalist, acupuncturist, fortune teller, shaman
• Asian Indians
• Ayurvedic practitioner, homeopath
• Native American
• Shaman

9
Cultural Healerscontd

• African American
• Old lady, spiritualist, voodoo practitioners,
  hougan (male), mambo (female)
• Hispanics
• Curandero/a, parteras (lay midwives), yerbero
  (herbalist), sabador (bonesetters), espiritista
  (spiritualist), santeroa

10
Culturally Competent Care

• The Office of Minority Health has defined
  cultural and linguistic competence as
• A set of behaviors and attitudes that comes
  together among professionals to allow effective
  work in a cross cultural environment
• Culturally Competent
• Cultural awareness
• Cultural knowledge
• Cultural skills
• Cultural encounters

11
Cultural Assessment

• A systematic and comprehensive examination of
  cultural care values, beliefs, and practices of
  individuals, families, and communities
• The challenge
• To assess the cultural values, belief, and
  practices of different backgrounds and ethnicity
• Building relationships which are trans-cultural

12
Goals for Cultural Assessment

• No miscommunication
• Determine the patients language
• No misinterpretation of nonverbal communication
• Main goal is to obtain knowledge of patients
  values, beliefs, and language skills
• Do not rush the assessment
• Show interest in patient

13
Selected Components of Cultural Assessment

• Ethnic history
• Biocultural history
• Social organization
• Religious and spiritual
• Communication patterns
• Time orientation
• Caring and belief practices

14
Selected Components of Cultural Assessmentcontd

• Transitions during life experiences
• Grief and loss
• Experiences with professional health care

15
Implications for Nursing Practice

• Each culture has specific practices to which
  nurses must be sensitive.
• Patients need education on causes of illness
  within the the context of cultural beliefs.
• Good communication is important.
• Cultural medical practices should be incorporated
  into the plan of care.

16
Culturally Competent Nursing Actions

• Identify areas of potential conflicts between
  professional care and patients values and
  practices.
• Cultural care perspective or maintenance
• Cultural care accommodation or negotiation
• Cultural care repatterning or restructuring