Chapter 8 Cultural Influences on Context: The Health Care Setting

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Chapter 8Cultural Influences on ContextThe
Health Care Setting
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• ? The goal of any health-care system is to
  provide optimal care for all its clients.
• ? The influx of immigrants from different ethnic
  and racial origins can make it difficult for care
  providers to provide safe and effective care.
• ? Misunderstandings from ineffective
  communication may cause needless suffering.

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• ? The American Medical Association now trains
  physicians in intercultural sensitivity.
• ? Cross-cultural health care requires a complex
  combination of knowledge, attitude and skill
  (competence).

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• Worldview and Healthcare
• Religion is not the only worldview that
  influences health and illness.
• Dualistic or holistic worldviews and mechanistic
  or nonmechanistic worldviews also determine how
  cultures perceive everything.

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• Dualism people and nature are separate and
  distinct entities emphasis on medical
  intervention that is carried out by doctors,
  nurses, and other health practitioners. Found in
  Western religions Judaism, Christianity,
  Islam.
• Holistic sees the world as a unit unifies
  body, mind, and spirit the persons entire body
  must be part of the healing process. Found in
  most Eastern cultures.

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• Mechanistic common in the U.S. thought
  patterns are rational rather than mystic the
  individual can manipulate the universe one need
  not accept things as they are they may work on
  it or redesign it so that it is more to their
  liking.
• Nonmechanistic common in India, Tibet, Japan,
  China and Southeast Asia exemplified by
  spiritual traditions such as Buddhism, Hinduism,
  Taoism and Zen. Intuition transcends the data of
  the senses the manipulation of the mind is key
  to obtaining truths that lie beyond reason.

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• Health Care Belief Systems
• Biomedical System follows from dualistic and
  mechanistic views the dominant belief system in
  the U.S. focuses on the objective diagnosis and
  scientific explanation of disease illness is the
  result of abnormalities in the bodys functioning
  or structure (from bacteria and viruses.)

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• Personalistic System - disease is the result of
  intervention by a supernatural being (deity or
  god), a nonhuman being (ghost or evil spirit), or
  a human (witch or sorcerer). The person is a
  victim of punishment treatment involves assuring
  positive association with spirits deities.

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• Naturalistic System - tend to be nonmechanistic
  explain illness as the result of natural
  conditions of cold, heat, winds, dampness and the
  upset in balance of the basic elements disease
  can result from disequilibrium between hot cold
  elements of the body. Found in Vietnamese
  cultures.

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• Cultural Diversity the Causes of IllnessSee p.
  261
• Cultural Diversity the Treatment of
  Illness Biomedical Treatments Personalistic
  Treatments Naturalistic Treatments
• Cultural Diversity the Prevention of
  IllnessSee p. 264-265

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• Religion, Spirituality, Health Care
  p.266Spirituality includes all behaviors that
  give meaning to life and provide strength to the
  individual
• Religion spirituality have a strong influence
  on the way people define illness and choose to
  prevent it.
• Religion has a strong influence over shapes
  nutrition practices health care practices.

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• Health Care For a Diverse PopulationIn health
  care, culture intervenes at every step of the
  way.Family Roles
• Dominance Patterns many cultures make
  distinctions between what is appropriate
  behavior for men and women. Modesty and
  Female Purity Pregnancy and Childbirth

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• Self-Disclosure
• Nonverbal Messages Eye Contact Facial
  Expressions Touch/haptics some cultures are
  not accustomed to being touched by their
  physicians or nurses. Time/chronemics a
  patients time orientation may affect when or
  whether he/ she shows up for appointments.
• Formality

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• Improving Multicultural Health Care the
  hospital can be disorienting and frightening to
  people of different cultures successful
  treatment of patients requires that their beliefs
  concerning the causes of illness, how illness
  should be treated, and how it can be prevented in
  the future must be acknowledged.

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• Recognizing Diverse Medical Systems
• the ability to be sensitive to a patients
  beliefs requires a great deal of information
  cultural knowledge, communication patterns,
  particular knowledge of the individual how
  westernized is the patient?

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• Recognizing Ethnocentrism there is no one
  answer to all health care questions your
  ethnocentrism must be kept in check.
• Ask yourself Am I imposing my own views about
  illness and treatment on other people without
  considering their needs?

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• Point
• Cultures differ in their understanding of
  what causes illness how illness should be
  treated how illness can be prevented