copyright © 2007 by mosby, inc., an affiliate of elsevier inc. 1 chapter 5 culture and health care

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 1

CHAPTER 5

CULTURE AND HEALTH CARE


Culture Overview

Importance of cultural values and connections on health care Patient’s culture Health care worker’s cultural background

Culture Act of belonging to a designated group “Colo”

• Latin – to cultivate Effect is unconscious


Culture Is Reflected in Many Aspects of Life

Eating habits Language Dress Hobbies Living patterns Occupational choices Education Religious affiliations Political points Interpersonal relationships


Acculturation

Learning cultural behaviors from one group or person Evolves slowly Always occurring Subcultures within each large cultural group Can be broad and varied

United States Census Bureau Collects data on U.S. population every 10 years


Table 5-1


Ethnography

Branch of anthropology Studies and records human cultures Ethnographic studies provide information to

teach cultural competence


Cultural Impact on Health Care

Every interaction with a patient has cultural implications


Wellness and Health Prevention

Various cultures have different views on preventive medicine Exercise Preventive doctor visits Immunizations


Touch and Physical Space

Differing views on close touching and human contact

As a health care worker:Always ask permission before touching any

patient, regardless of cultural differencesBe alert to positive or negative signs


Communication

Vital to our survival Language

Language barriers affect communication Language is a form of cultural connection

Assimilation Process of accepting and exchanging cultural

information


General and Invasive Procedures

Important for the health care worker to be sensitive to patients who are not comfortable in removing clothing for examinations or who fear invasive procedures.

All health care team members should announce their arrival and wait a few moments before entering a room.


Dietary Needs

Social tool and biological need Many ethical and religious implications with

food All attempts should be made to meet the

patient’s nutritional needs and preferences


Box 5-1 Yin and Yang Foods


Spirituality

Essential for recovery and strength for many ethnicities

Belief should be accepted and assistance offered when requested

Using incorrect terminology is a sign of great disrespect


Death

Views vary greatly Rituals vary greatly Deaths from suicide have many cultural

implications


Medications

Actions and side effects vary based on patient ethnicity FDA and ISMP studies

• Antilipemic drugs

• BiDill

• Drug dosage


Pain Management

Beliefs about pain vary Important for the health care worker to use

listening and assessment skills to look for nonverbal cues of pain


Other Cultural Differences That Have an Impact on Health Care

Refusal to give blood or get blood transfusions

Refusal to donate or receive organ transplants

Refusal to place aging parents into nursing home

Fertility control Mental illnesses


Signs of Cultural Barriers

Important to listen to the patient closely and look for nonverbal cues

Signs that cultural barriers exist: Resistant to change Uncooperative Argumentative Overly agreeable and flaccid Noncompliance after multiple teaching attempts


Obstacles to Cultural Competence

Ethnocentrism Belief that one’s own culture is superior to another

• Often unconscious

• Seen in many daily activities

Health care provider cannot allow this to interfere with providing care


Obstacles to Cultural Competence (Continued)

Stereotyping Seeing or viewing patients in one ethnic group all

molded together as one• Assumes conformity

Patients need to feel trusted and safe Prejudice and discrimination

Stereotyping can lead to prejudice, which leads to discrimination


All health care providers must agree to care All health care providers must agree to care for patients regardless of race, age, color, sex for patients regardless of race, age, color, sex

or ethnic origin.or ethnic origin.


Overcoming Obstacles

Explore personal ideas and perceptions about different cultures

Learn as much as you can about local cultures

Always use the patient’s family name unless given permission to use first name only

Be aware of eye contact


Overcoming Obstacles (Continued)

Encourage patients to talk about their illnesses and look for areas of misunderstanding

Look for confusion and fear Treat all patients with respect, concern, and

compassion Recognize that other cultures are not as time

sensitive as Americans Respect spirituality

copyright © 2007 by mosby, inc., an affiliate of elsevier inc. 1 chapter 5 culture and health care

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