Cultural Diversity Test

Acculturation/Cultural Assimilation

When an individual shifts his or her identity from the minority group to the dominant group and adopts the values, attitudes, and behaviors of the dominant culture. Losing the cultural characteristics that once made the minority group different.

Beliefs

How a person perceives situations and other people which are influenced by: cultural beliefs, social beliefs, religious beliefs, and personal connections.

Cultural diversity

A group of people whose members are characterized by a wide range of distinctions.

What are distinctions of cultural diversity?

Race, national origin, religion, language, physical size, gender, sexual orientation, age, disability, socioeconomic status, occupational status, geographical location.

Culture

A shared system of beliefs, values, and behavioral expectations that provide structure for daily living. It influences people’s roles and interactions with others and is revealed in the attitudes, customs, and institutions unique to particular groups.

What is culture influenced by/rooted in?

Aspects of human society, including: beliefs, habits, likes, dislikes, customs, rituals.

Culture shock

Feelings of psychological discomfort or disturbance caused by living in a dominant culture that differs from one’s own. Often produces feelings of stress, foolishness, fear, inadequacy, embarrassment, humiliation, inferiority, frustration, anxiety, and low self-esteem.

Dominant group

The group within a society that tends to control that society’s values, and while it is usually the largest group in the society, it does not have to be.

Ethnicity

A sense of identification with a group based on a common heritage. Belonging to it means being born into it or adopting the group’s characteristics.

What are characteristics i people within the same ethnic group?

Language and dialect, religious practices, literature, folklore, music, political interests, food preferences.

Ethnocentrism

The belief or assumption that a particular social or cultural group is superior in some way.

Folk medicine

A form of prevention and treatment that uses old-fashioned remedies and household medicines handed down from generation to generation within a particular culture.

Hereditary

Inherited genetically; being more prone to developing particular diseases, characteristics, and conditions, sometimes based on racial or ethnic groups.

Immigrate

Settling in a new country.

Minority group

Usually has some physical or cultural characteristics that identify the people within it as different from the dominant group, such as: race, religion, beliefs, customs or practices.

Race

Normally based on specific physical characteristics, such as skin pigmentation, body stature, facial features, and hair texture.

Subculture

A group of people who are members of a larger cultural group, but whose attitudes and behaviors reflect different beliefs and values from those of the larger culture.

Stereotypes

Mistaken perceptions that are typically rooted in strong feelings and lack of knowledge.

Name examples of ethnicities

African American, Asian American, European American, Hispanic American, Middle Eastern/Arabic American, Native American

What is the importance of cultural competency?

Health care workers need to be aware of, and sensitive to, cultural diversity, life situations, and other various factors that shape a person’s identity.

Is it possible to erase all biases?

No it is not possible. But they can be set aside for the purpose of the medical case.

What is cultural competency?

An ability to interact effectively with people of different cultures.

What is bias?

A preference that inhibits impartial judgment of others.

Territorial space

The distance people require to feel comfortable when interacting with others.

Difference between spirituality and religion

**Spirituality is based on one’s own beliefs and has no rules but religion is group based and has rules.**

What is a nuclear family?

**A nuclear family is a family with a mom and dad with children who are usually in a middle-income home.**

Give an example of a non-nuclear family

Examples: two women/men with a child/children, single mother/father, two people with no kids

What is holistic care?

The treating of both the mind and body through medicine.

List 3 ways to overcome bias, prejudice, and stereotyping.

Understand that all people are different, educating yourself, interact with other cultures

What is prejudice?

Preconceived opinion that is not based on reason or actual experience.

What is sensitivity?

Understanding a person’s perspective when it comes to certain topics.

Compare and contrast “Western” or biomedical health care and alternative medicine.

Western medicine is more focused on healing the body but alternative medicine is more focused on healing the mind

What is an atheist?

A person who does not believe in any deity or higher power.

True or False: Maintaining direct eye contact always is a sign of respect

False: In some cultures, maintaining direct eye contact is seen as rude and disrespectful. Some cultures which believe in the evil eye see it as a curse to look a baby in the eye.

True or False: Traditional Muslim culture permits women to wear whatever they choose and not wear a head covering

False: In traditional Muslim culture, while it is not forced, it is encouraged to wear the hijab or burqa and wear modest clothing.

True or False: Many Latin American cultures believe in the need to keep the body in balance

True

True or False: Culture is defined as the thoughts, beliefs, and values of a social group

True

True or False: As a nursing assistant, you will typically work only with coworkers of the same culture and religion as you

False: A nursing assistant will work with people of all religions and cultures.

True or False: Nursing assistants need to provide care for patients and residents and if they are modest, they just need to get over it so you can get your job done

False: No, modesty should try to be maintained to its fullest capacity such as not taking off the hijab or allowing something to be worn under the hospital gown.

True or False: When speaking to patients or residents, it is a good idea to use slang term or jargon because it helps develop rapport 

False: No because there is no guarantee that the person will understand what is being said.

True or False: Having a family member translate what you are saying is a great way to communicate

False: It is not the best way because there is no guarantee that they are saying the correct thing

True or False: Telling jokes are a fun way to break the ice with patients and family members of a different culture

False: Some cultures could be offended by this as they are dealing with health issues at the moment

True or False: Ablution is the practice of praying at regular times during the day

False: No it is the practice of washing oneself

True or False: Spirituality is an organized system of belief in a higher power

False: Spirituality is more individual not group based

True or False: People who do not speak English are mentally confused

False: Just because a person does not speak english does not mean they are mentally confused

True or False: Every culture and religion believe that conducting an autopsy of the deceased is necessary

True

True or False: The Sacrament of the Sick may be administered to Christian Scientists who are very ill or just before death

False: No this is for roman catholics

True or False: Some patients or residents may not have formal religious affiliations; however, they may still have spiritual needs 

True

True or False: A prayer rug is special to the Islamic, who pray multiple times a day in the direction of Mecca. However, in the hospital, they will not be permitted to continue this practice

False: They are able to continue practicing in the hospital

True or False: Using gestures like “thumbs up” can be an effective way to communicate

True

True or False: Even though a person may be part of an identifiable culture, he or she should still be recognized as a unique individual

True

True or False: If the clergy is visiting with a patient or resident, you should continue with your care or tasks with that person.  

False: No, giving the patient time with the clergy is best since they are trying to spiritually connect with their religion.

True or False: Although some religious groups may avoid certain types of food, that is something that can only be maintained at home, not in an acute or long term care setting

False: No, adjustments can be made such as providing them with vegetarian options or allowing other people to bring food in for the patient.

True or False: Some cultures use amulets, which are charms used to ward off evil

True

True or False: Attitudes about death are closely related to religion

True

True or False: Touch is a sign of affection and people of all cultures love to be touched

False: Not all cultures like to touched some do not liking touching between different sexes

True or False: A patient from another culture may answer “yes” to all questions

True

True or False: If a person does not understand English, it may be helpful to speak very loudly 

False: Speaking loudly does not rid the fact that they can’t understand you.

True or False: A picture board may be used as a communication tool with people who do not speak English

True

True or False: The nursing assistant should share their own religious beliefs with their patients and residents as it will help to develop a deep bond

False: Sharing their personal beliefs should not be done as it is not the patient’s business and they may not agree with the beliefs.

True or False: In some cultures, the left hand is used for eating and the left hand is always used for personal hygiene after using the toilet

False: It is actually the right hand for eating  not the left hand that is used.

True or False: An interpreter is a communication specialist who can mediate between speakers of different languages

True

The home health nurse prepares to teach a Hispanic patient who neither speaks nor reads English how to measure and administer insulin. The most helpful teaching tools would be:  

An alarm clock, magazine pictures showing sunrise and sunset, several clean insulin syringes, and insulin bottles filled with colored water.

The nurse is cleaning the bedside area to give a bed bath to a Muslim woman the day after a cesarean  section. The culturally sensitive nurse would:

Be especially protective of her modesty.

A severely injured adult male is brought into the ER following an auto accident and is given 2 units  of O negative blood while waiting for a crossmatch to be completed for the other 4 units of blood that the doctor has ordered. The nurse discovers a card identifying the man as a Jehovah's Witness, The nurse should:

Inform the doctor that the patient is a Jehovah's Witness

A nurse leading a discussion group of Jewish long-term care facility residents to discuss dietary law and other religious practices anticipates that the most prominent need of these patients would be  

Having a quiet time for prayer provided before and after all meals

A Filipino man is admitting his elderly mother to a long-term care facility for custodial care During the intake interview, the man is alternately tearful and defensive. The culturally competent nurse assesses the labile behavior as being related to the Filipino belief that.  

families should care for the elderly at home.

A patient of Chinese descent is in the community clinic for treatment of his arthritis The patient tells the nurse that his disease is a hot disease. The nurse assesses that he is referring to the 'hot-cold theory, which holds that hot diseases are caused by:  

Excess of blood and yellow bile.

The nurse has scheduled a specific time for a group of Latino diabetics to come for diabetic teaching, but the group does not come until almost an hour later The culturally competent nurse is aware that  

their culture places little significance on time concepts

Transcultural nursing care is expected for every patient. To provide this type of care, the nurse needs  to understand the practices of the predominant cultures of those groups in the health care geographic area that would require the nurse to be aware that:  

Culture influences beliefs about health, illness, and health practices

As breakfast trays are served, a Catholic patient asks the nurse to take it away, because a priest is coming to administer Communion.  The response by the nurse should be:

"I will leave the tray in the kitchen and you may call me to bring it back when it is time"

A practicing Hindu patient is dying, but has orders for a full diet, however, the patient will accept  only soups. The nurse should order which of the following from the  kitchen?  

Puréed tomatoes, carrots, celery, and potatoes in a vegetable stock

Buddhism

Beliefs: Spiritual enlightenment through conscious living and meditation

Death: Avoid mind altering drugs, chanting, state of mind at death influences rebirth (calm and peaceful)

Diet: Usually vegetarian, No alcohol, tobacco or coffee

Health: Mental cures are important

Pregnancy: Artificial insemination and birth control are acceptable

Rituals:Ceremony around baby blessings, marriage, and death.  Monthly atonement ceremony on the full moon

Clinical Issues: blood products are acceptable.  Avoid mind altering drugs

Christian Science

Beliefs: Bible based christian religion 

Christian Scientists generally view disease and illness as a mental error, not a physical problem

Death: No church policy on burial, but body should be prepared for burial by same sex

Diet: Avoid tobacco, alcohol and sometimes caffeine

Health: Spiritual means for preventing and healing diseases

Pregnancy:

Rituals: Praying

Clinical Issues: Usually do not seek immediate medical care

Church of Jesus Christ of Latter-day Saints

Beliefs:Daily prayer and reading of holy book. Family oriented

Death:Autopsy ok, believes in resurrection, euthanasia is not allowed, organ donation permitted

Diet: Fasting once a month, ill people not required, alcohol, coffee, tea and tobacco are discouraged

Health: Blood and blood products ok

Pregnancy: Abortion forbidden except in rape or mothers life in danger, artificial insemination OK, Birth control is for couples to decide.

Rituals: 2 elders are required for blessing of sick

Clinical Issues:Known for healthy lifestyles

Hinduism

Beliefs:Karma, Duties to god, parents, society and teachers

Death: Must be peaceful,autopsy and burial ok,cremation is common day of death, euthanasia forbidden,family wash body immediately after death,prefer to die at home

Diet: Fasting on holy days,right hand used for eating, left hand toileting

Health: Bathing after meal could cause stomach upset,Blood and products ok,patriarch, hot water to cold but cold can’t be added to hot, daily bath

Pregnancy:anti abortion unless mothers life in danger, circumcision is uncommon, may bot name immediately, exact time of birth important

Rituals:Several holy days, sit at lower elevation than the deity image, barefoot during worship, meditation, respect for elders, 10 -11 days priest performs naming ceremony Look at elders feet for respect

Islam

Beliefs: Submission to God, Muhammad God’s messenger,Pray 5 times a day,life after death,Pilgrimage to Mecca at least once,Ramadan, One God is Allah

Death: Autopsy for legal reasons,euthanasia prohibited, organ donation ok, prayer for deceased led by male within 72 hours of death

Diet: Children, ill and pregnant women exempt from fasting, eat with right hand, use only vegetable oil

Health:Handshakes or any contact between genders is usually not allowed, Females may want a female provider

Pregnancy:Abortion is situationally prohibited

Rituals: Fridays are the holiest days (prayer at noon). Prayer 5 times a day facing Mecca. Wash feet, face and hands before prayer

Clinical Issues: Women may wear a hijab or a burqa. Respect modesty

Judaism

Beliefs:Torah is religious book, pray 3 times a day

Death:life after death, burial as soon as possible, family may want to stay with body,

Diet:kosher certified food

Health: amputated limb buried in ground, sick exempt from fasting

Pregnancy:abortion to save mother,may not believe in birth control

Rituals: Married women may wear wig

Roman Catholic

Beliefs:Emphasis on sacraments including baptism and anointing of the sick

Death:Life after death,Last Rites by priest

Diet: Lent, no meats on Fridays, fast before communion

Health:Blood and blood products is ok

Pregnancy: Natural birth control only, no abortion

Rituals: Daily communion and prayer with priest, confession with priest,rosary

Seventh Day Adventist

Beliefs:Body is temple of God and should be kept healthy

Death:Death is a state of unconsciousness with a return to consciousness

Diet:May practice fasting, alcohol, coffee, tea is personal choice,Usually vegetarian

Health: Rehab and therapeutic encouraged, avoid narcotics or stimulants, Sat is sabbath

Pregnancy:Abortion is discouraged, no baptism

Rituals:Ill anointed with oil

Sikhism

Beliefs:Reincarnation is a cycle of rebirth,

Death:Body is bathed, dressed and then cremated, floor is washed and covered with white sheets; no shoes worn in the room

Diet:No restrictions

Health:May not cut hair on any part of body

Pregnancy:Drop of honey to newborn to give character later in life

Rituals:turban may be worn as responsibility to others

Clinical Issues:hair removal for surgery may be an issue

Jehovah’s Witnesses

Abortion is opposed, eat nothing to which blood has been added, can eat animal flesh that as been drained of blood, autopsy a private matter to be decided by the persons involved, cremation is acceptable

Can Jehovah’s witnesses accept blood?

Absolutely opposed to blood transfusion, whole blood, platelets, fresh & frozen plasma