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Culture and Ethnicity. Concepts of Culture and Ethnicity. Culture – a set of values, beliefs & traditions that are held by a specific social group and handed down from generation to generation

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Concepts of Culture and Ethnicity

  • Culture – a set of values, beliefs & traditions that are held by a specific social group and handed down from generation to generation

  • Subculture – made up of people with a distinct identity, but who have certain ethnic, occupational or physical characteristics that are found in the larger culture

  • Dominant group – the group within the culture that has the authority to control the value system.

  • Minority group – usually has some physical or cultural characteristic that identifies the people within it as different

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  • The sense of identification that a cultural group collectively has, largely based on the group’s common heritage.

  • Race – Subculture of people characterized by specific characteristics.

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  • Culture Assimilation

    • AKA Cultural acculturation

    • When minority groups living within the dominant group loose the cultural characteristics that make them different.

    • Stereotyping – involves assigning characteristics to a group of people without considering specific individuality.

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  • Cultural Imposition – the belief that everyone should conform to the majority belief system.

  • Cultural conflict – when one ridicules others beliefs and traditions in an effort to make his or her own values more secure

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Cultural and Ethnic Influences on Health Care

  • Gender Roles – It is important to know who is the dominant figure in a family

  • Language and Communication – Some clients may not be able to speak the English Language

  • Orientation to Space and time – personal space

  • Food and Nutrition

  • Socioeconomic

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  • The culture of poverty- the highest risk families are headed by one income single females, fixed income elderly and future generations of those living in poverty

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  • Feelings of despair, resignation & fatalism

  • Day to day attitude toward life with no hope for the future

  • Unemployment and need for financial or government aid

  • Use of escape values such as alcohol and drugs

  • Unstable family structure with abusiveness and abandonment

  • Decline in self respect and retreat from community

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Effects of Poverty on Health Care

  • Lack of affordable and adequate housing

  • Crowded living conditions

  • The sick usually experience more complication

  • Recovery time is longer

  • Less likely to regain their preillness level of functioning

  • Lack of access to health care insurance

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Family Support

  • Some cultures have large extended families and are unable to share private information with anyone outside the family.

  • Some cultures have great respect for elderly and will not consider institutional care

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Physical and Mental Health

  • Physiologic Characteristics

    • Keloid formation – overgrowth of connective tissue that occurs during healing process of injury, surgery—African heritage

    • Lactose intolerance 0 lack of lactase to break down lactose during digestion - Hispanic, African, Chinese, Thai.

    • Sickle Cell Anemia – sickle shaped red blood cells. Most common in African or Mediterranean ethnic background.

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Tay Sacks Disease – a gene for a hereditary disorder – have very short life span – Eastern European, Jewish descent.

G6PD deficiency – enzyme deficiency. Red blood cells have no cell membrane they are easily destroyed , which leads to anemia and increased billirubin levels. - 10% of African American population

Thalassemia – genetic disorder effecting the Hgb in RBC function. Mediterranean, Asian, and African origin.

Sarcoidosis – formation of multiple tubercles or nodules on various parts of the body - African American population.

Gout – An increase of uric acid in the blood -males especially from Puerto Rican or Filipino descent.

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Psychological Characteristics

  • In most situations an individual will relate the behavior of another person to the individual’s own familiar culture.

  • It is important to remember that what may seem perfectly reasonable & important to a client may seem ridiculous and irrelevant to a nurse. The reverse perception may also exist.

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Culture Shock

  • Feelings an individual experiences when placed in a different and often strange culture and may result in psychological discomfort or disturbances.

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Cultural Imposition and Ethnocentrism

  • Cultural Imposition. – the tendency for health personnel to impose their beliefs practices and values of other cultures, because they believe that their ideas are superior.

  • Ethnocentrism – the belief that one’s own ideas, beliefs and practices are the best and superior.

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Providing Transcultural Care

  • Major Theme – Focus on caring practices of various cultures

  • Nursing Role – Understand the client’s needs and to adapt care to meet those needs.

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Cultural Assessment

  • Identify factors that effect behavior by cultural assessment

    • Values, religion, dietary practices, family lines of authority, family life patterns and beliefs and practices related to health and illness

    • See guidelines on pp 47-52

    • See table 3-1 on page 46-50

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Reaction to Pain

  • Reactions are culturally prescribed

    ……….. Let’s discuss

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Different Health Practices

Folk Healers

less expensive, more accessible and more understanding of cultural needs . Speak the client’s language

Traditional Folk Medicine


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Transcultural Nursing

  • Nursing care planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing diverse cultural populations.

  • The culture of health care: Assess:

    • the cultural background

    • expectations and beliefs about healthcare

    • Cultural context of the encounter

    • Degree of agreement between the 2 persons set of beliefs and values