Culture diversity
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Khalifa Abdul Hakim requests female healthcare practitioners for his wife
Muslim culture deems it immodest for a married woman's body to be seen by any male other than her husband
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Learning outcomes of the class
Explain concepts of cultural diversity
Describe influences on culturally competent healthcare
Discuss examples of diversity in health and illness care
Discuss factors that facilitate or impede culturally competent nursing care
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Definition of culture
Shared system of beliefs, values, attitudes, languages, symbols, and behavioral expectations
Provides social structure and defines roles and interactions
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Culture is socially acquired and learned
Guides acceptable behavior and lends identity
Influences perceptions and worldview
Develops over time and is resistant to change
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Ethnicity is a cultural group's perception of itself
Sense of identification with a collective cultural group
Based on common heritage and day-to-day life with family and friends
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Examples of ethnicities: African American, Asian American, European American, Hispanic American, Middle Eastern/Arabic American, Native American
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Race is the grouping of people based on physical or biological similarities
Social classification, not culture
Involves multiple cultures and ethnic groups
Based on characteristics like skin pigmentation, body structure, facial features, and hair texture
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Stereotyping assumes all members of a culture or ethnic group act alike
Can be positive or negative
Negative stereotyping includes ageism and sexism
Positive stereotyping includes beliefs of superiority leading to discrimination
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Subculture is a large group with characteristics not common to the larger culture
Examples: nursing as a subculture of healthcare, teenagers and older adults as subcultures of the general population
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Cultural assimilation is accepting cultural practices of the prevailing culture
Minorities lose their differences and adopt the values of the dominant culture
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Acculturation is adapting to an adopted culture through contact with another group or individual
Example: immigrants moving closer to the dominant culture through work, school, and language learning
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Cultural imposition is when one culture forces its values on another culture or subculture
Example: French schools in Africa promoting French culture, nurses recommending vaccinations based on their beliefs
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Ethnocentrism is the belief that one's own ideas, beliefs, and practices are superior to others
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Cultural blindness ignores differences and acts as if they don't exist
Common in the healthcare system regarding nontraditional methods of care
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Culture conflict occurs when people become aware of differences and feel threatened
Respond by ridiculing the beliefs and traditions of others to feel more secure about their own values
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Cultural diversity results from racial, ethnic, and cultural factors
Essential in health and illness care
Must be considered when providing healthcare
Healthcare providers must recognize and appreciate the characteristics of all patients
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Nurses must be aware of and sensitive to the needs of culturally diverse patients
Interpret behaviors based on their own culture
Patient and healthcare provider evaluate each other's behavior
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Cultural influences on healthcare
Physiological variations, reactions to pain, mental health, gender roles, language and communication, food and nutrition, orientation to space, socio-economic factors
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Examples of common health problems in specific populations
Heart disease, diabetes, cancer, etc. in different ethnic groups
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Different cultures view variables in healthcare differently
Definition of health, etiology of disease, health promotion and protection, practitioners and remedies
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Examples of cultural views on health from different cultures
South African, Asian, European perspectives
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Examples of cultural views on health from Hispanic, Middle Eastern/Arabic, and Irish cultures
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Examples of cultural views on health from Italian culture
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Culture shock is the discomfort or disturbances experienced when placed in a different culture perceived as strange
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Culturally respectful nursing care is planned and implemented in a way that is sensitive to the needs of diverse populations
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Cultural competency is awareness, sensitivity, knowledge, and skill in working with culturally diverse populations
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Four levels of cultural competence: unconscious incompetence, conscious incompetence, conscious competence, unconscious competence
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Explanation of the four levels of cultural competence
Page 30: Cultural Humility / Competence
Cultural humility/competence is a core competency for all registered nurses.
It requires lifelong learning.
Acquired through three stages: culturally incompetent, culturally sensitive, and culturally competent.
Each stage has three dimensions: cognitive (thinking), affective (feeling), and psychomotor (doing).
Page 31: Client Cultural Assessment
Categories of information necessary for a comprehensive cultural assessment of a client are:
Ethnic or racial background.
Language and communication patterns.
Cultural values and norms.
Religious beliefs and practices.
Health beliefs and practices.
Page 32: Culturally Appropriate Care
Respect clients for their different beliefs.
Be sensitive to behaviors and practices different from your own.
Accommodate differences if they are not detrimental to health.
Listen for cues in the client's conversation that relay a unique ethnic belief about etiology, transmission, prevention, etc.
Teach positive health habits if the client's practices are deleterious to good health.
Page 33: Avoid Stereotyping
Each individual has a unique personal history, belief system, communication style, and health status.
People from the same country could still be different.
Stereotyping can lead to misconceptions about the individual seeking care.
Page 34: Developing Cultural Competence
Cultural awareness.
Cultural knowledge.
Cultural skill(s).
Page 35: Barriers to Cultural Competence
Cultural conflict.
Cultural shock.
When health professionals assume they have the right to make choices and decisions for patients, patients may respond in the same way that minority cultures often respond to such an attitude by the dominant culture: by becoming passive, resistive, angry, or