Cultural Diversity in Healthcare

8/8/2019 Cultural Diversity in Healthcare

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Culture

Set of values, beliefs, attitudes,

languages, symbols, rituals, behaviors,customs of a group of people

Learned and shared

Dynamic and changing


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Ethnicity

Classification of people based on

national origin or cultureExamples: African American, Asian

American, European American, HispanicAmerican, Middle Eastern/ArabicAmerican, Native American


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Race

Classification of people based on

physical or biological characteristicsInvolves multiple cultures and ethnicgroups


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Cultural Diversity

Differences based on cultural, ethnic,and racial factors

Melting Pot or Salad Bowl approach

Must be considered when providinghealth care

Healthcare providers must recognizeand appreciate the characteristics of allpatients


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Holistic Care

Must be developed to include cultural

diversity of AmericaAddresses 3 aspects of well-being:mental/emotional, physical, and social


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Areas ofCultural Diversity

Family organization

LanguagePersonal space

Touching

Eye contact

Gestures

Health care beliefsSpirituality

Religion


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Cultural Diversity ImpactsBeliefsBirth

DeathHealth

Illness

Health Care


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Health

Varies Based on Cultural Background


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WorldHealth Organization

A state of complete physical, mental,

and social well-being, not merely theabsence of disease


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South African

Harmony with nature

Harmony of mind, body, and spirit


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Asian

Physical and spiritual harmony with

natureBalance of yin and yang


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European

Personal responsibility with diet, rest,

exercise, and prevention


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Hispanic

Good luck

Reward from GodBalance between hot and cold forces


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MiddleEastern/Arabic

Spiritual Causes

Cleanliness


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HealthfulHints from LongAgo

A sassafras root carried in the pocket

guards against illness. (superstition ofOld Saint Simons)

Asafetida worn on a string around theneck protects a child from manydiseases, and a buckeye carried in thepocket protects against rheumatism.(Blue Ridge and Great Smokey Mts.)


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A single, pierced nutmeg, worn

around the neck on a string, will protectyou from boils, croup, body lice, andvarious lung diseases. (New England)

A well-ventilated bedroom will preventmorning headaches and lassitude.(1914 Almanac)


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Illness

Abnormal functioning of a bodys

system or systemsCauses vary based on cultural/ethnicbackground


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South African

Spirits/demons

Conflicts in lifeGods punishment


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Asian

Imbalance of yin and yang

Supernatural forcesUnhealthy environment


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European

Sin

Outside sources: microorganisms,toxins


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Hispanic

Sins

FrightEvil Eye

Envy

Imbalance between hot and cold


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MiddleEastern/Arab

Sins

Evil EyeSpiritual causes


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Native American

Supernatural forces

Violation of a tabooImbalance between man and nature


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FolkRemedies

Beliefs and practices ethnically similar

Religion plays a role in perception of,interpretation of, and behavior in healthand illness

Women are usually the prime caregiversCan create delay in seeking professionalhelp


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Preventions

Jewish: camphor around the neck in

winter in a small cloth bag to preventmeasles and scarlet fever

Black and Native Americans: blackstrapmolasses

Black Africans (Ethiopia): eat hot & sourfoods i.e. lemons, fresh garlic, pepper


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Preventions

Germans: no sweets at meals, drink

glass of water at meals, cod-liver oil,plenty of milk, spring tonic (sulfuredmolasses)

Islam: dress properly for the season &weather, keep feet from getting wet inthe rain


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Preventions: Irish

Clean out bowels with senna for 8 days

Spring tonic of sulfured molassesOnions under the bed to keep nasalpassages clear

Bag of camphor around the neck duringflu season


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Preventions: Irish

Never go to bed with wet hair

Dont look in the mirror at night & closecloset doors (prevents evil spirits)

Eat lots of oily food

Take Father Johns Medicine every sooften


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Preventions: Italian

Garlic cloves strung on a piece of string

around neck of infants and children toprevent colds and evil stares

Red ribbon around neck of infant doesthe same thing

Never wash or bathe during period


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Preventions: Italian

Never wash hair before going outdoorsor at night

Keep a pair of open scissors undermattress of crib to prevent evil innewborn

Wrap a bandage around the baby fromthe waist to the feet for 1st6 months toprevent bowlegs


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Home Treatments: Jewish

Sore throat: find salted herring, wrap it

in a towel, put it around the neck, let itstay there overnight, gargle with saltwater

Boils: fry chopped onions, make acompress and apply to the infections


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Home Treatments: Blacks/N

ativeAmericansBloody nose: place keys on chain

around neckSore throat: suck yolks out of egg shell,honey and lemon, baking soda, salt ,warm water, onions around the neck


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Home Treatments: BlackAfrican

Evil Eye: put some kind of plant root on

fire and make the man who has the evileye smile and the man talks about hisillness


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Home Treatments: Germans

Coughs: honey & vinegar; boiled onion

water, honey, & lemon; hot water &Vicks

Swollen glands/mumps: put pepper onsalt pork and tie around the neck

Earache: few drops of warm milk in theear, laxatives when needed


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Home Treatments: Germans

Sty: cold tea-leaf compresses

Fever: mix whiskey, water, & lemonjuice to drink before bed (causes personto sweat and break fever)

Constipation: Ivory soap suppositories


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Home Treatments: Islam

Sore throat: gargle with vinegar and

waterIndigestion: baking soda and water

Sore muscles: alcohol and water

Rashes: apply corn starch


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Home Treatments: Irish

See doctor only in an emergency

Earache: heat salt, put in stockingbehind ear

Fever: spirits of niter on a dry sugarcube

Colds: hot lemonade and a tablespoonof whiskey; egg whites; ipecac


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Coughs: linseed poultice on chest;

flaxseed poultice on back; red flannelcloth soaked in hot water and placed onchest all night

Menstrual cramps: hot milk sprinkled

with ginger, glass of warm wine, hot-water bottle on stomach


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Nausea: castor oil, hot ginger ale, cupof hot boiled water

Sore throat: paint throat with iodine,honey and lemon, Karo syrup; paintwith kerosene oil with rag then tie sock

around the neck; paint with iodine orMercurochrome and gargle with saltwater, honey melted Vicks


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Home Treatments: Italian

Chicken soup for everything

Boils: cooked oatmeal wrapped in acloth (steaming hot) and applied todrain pus

Headache: kerchief with ice in itwrapped around the head

Cramps: crme de menthe


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Home Treatments: Italian

Acne: apply babys urine

To build up blood: eggnog with brandy;Marsala wine and milk

Backache: place a silver dollar on the sorearea and light a match to it, while the match

is burning put a glass over the silver dollarand slightly lift the glass, this causes suctionwhich lifts the pain out


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Healthcare Providers

Culture

Cultural Diversity in Health andIllness, Second Edition, p.70


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Beliefs

Standardizeddefinitions of health

and illnessThe omnipotence oftechnology


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Practices

The maintenance of health and theprevention of disease through suchmechanisms as the avoidance of stressand the use of immunizations

Annual physical examinations and

diagnostic procedures such as Papsmears


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Habits

Charting

The constant use ofjargon

Use of asystematic approach

and problem-solvingmethodology


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Likes

Promptness

Neatness and organizationCompliance


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Dislikes

Tardiness

Disorderliness anddisorganization


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Customs

Professional deference and adherenceto the pecking order found inautocratic and bureaucratic systems


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Customs

Handwashing


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Customs

Employment of certain proceduresattending birth and death


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Rituals

The physicalexamination

The surgicalprocedure

Limiting visitors and

visiting hours


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Cultural Beliefs Concerning

Epidemiology andPainMedical culture is in direct oppositionsometimes

Bacteria/viruses/carcinogens/pollutantsversus soul loss/spiritpossession/voodoo/witchcraft

Free, open expression of feelings versusnever revealing true feelings


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Examples ofCultural Clashes

Mr. Smith in room222 is the ideal

patient. He neverhas a singlecomplaint.


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Examples ofCultural ClashesMrs. Cohen in room223 is a real

complainer. She isconstantly asking forpain medication andputting on her light.


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Examples ofCultural ClashesMr. Chen in room225 says nothing. I

often wonder whathe is feeling.


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Healthcare Providers

Must change to accommodate othercultural beliefs and behaviors towardshealth and illness


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Religion andHealing

Vital role in perception of health andillness

Rites surrounding birth and death

Diet


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TraditionalEtiology:EvilEye

Power of eye strikes victim

Injury, illness, misfortune is suddenPerson with evil eye may not know it

Victim may not know source of evil

Prevented or cured by rituals/symbols,removal of spell or evil agent

Explains sickness and misfortune


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TraditionalMethods of

Prevention


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Protective Objects

Amulets

BanglesTalismans


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Protective Substances

Garlic

OnionsChachayotel

1000 year old eggs

Kosher foods


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ProtectiveReligious Practices

Social, moral, dietary practices

Burning candlesRituals of redemption

Prayer


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Examples ofSaintsforProtection

Blessing of the Throats on St. BlaiseDay

Virgin of Guadalupe

St. Anthony of Padua: barren women

St. Odilla: blindnessOur Lady of Lourdes: bodily ills


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Beliefs Affecting Therapy

Use of healers with divine powers

Natural products: herbs, berriesPurgatives

Blood-letting

Removal of person with evil eyeAvoidance of provocation of envy


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Forms ofSpiritualHealing

Spiritual healing

Inner healingPhysical healing

Deliverance or exorcism

Auric healingPilgrimages


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Healthcare Providers Must

Be Aware ofthe Multitude of

Sources Outside ofMainstream Medicine!

Embrace Diversity in Medicine. TeachTolerance to Healthcare Providers!

Cultural Diversity in Healthcare

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