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 Healers—cont’d • 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, belief’s, 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 Assessment—cont’d • 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 patient’s values and practices. • Cultural care perspective or maintenance • Cultural care accommodation or negotiation • Cultural care repatterning or restructuring