Chapter_13.pptx

Chapter 13: Diversity & Difference in Health Care Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Cultural Diversity What is cultural diversit y in your own words? • Race • National origin • Religion • Language • Physical size • Gender • Sexual orientation • Age...

Chapter 13: Diversity & Difference in Health Care Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Cultural Diversity What is cultural diversit y in your own words? • Race • National origin • Religion • Language • Physical size • Gender • Sexual orientation • Age • Disability • Socioeconomi c status • Geograph ic location Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Personal Beliefs • Cultural beliefs • Social beliefs • Religious beliefs • Personal convictions How a person perceives a situation and other people is greatly influenced by their beliefs? Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural and Ethnic Difference s What is Culture? • A shared system of beliefs, values, and behavioral expectations that provide structure for daily living Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Beliefs Habits Factors Influencing Culture Likes Dislikes Customs Rituals Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Provides shared identity for cultural group Facts About Culture Influences member’s view of: • Self • Expectations • Behavior Is shaped by social & physical environment Is transmitted via language, formal teaching, & observation of elders Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Shared Characterist ics of an Ethnic Group • Language & dialect • Religious practices • Literature • Folklore • Music • Political interests • Food preferences Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Characterist ics Distinguishi ng Minority Group • Race • Religion • Beliefs • Customs or practices Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Physical Characteristi cs: Genetically Inherited Diseases • Tay-Sachs disease • Keloids • Lactase deficiency & lactose intolerance • Sickle Cell Anemia Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Psychologic al Characteris tics • Consider patient’s perspective & concerns • Remember that different cultures & individuals interpret behaviors differently Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Reactio ns to Pain & Other Health Issues • Response to pain is culturally influenced • Patient in pain may not show it • Listen to patients who freely express their discomfort • Recognize influence of cultural & individual beliefs about health • Respect patient’s right to react to health care issues any way he wants to • Don’t stereotype a patient’s perceptions or responses based on culture Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Western Cultures (United States, Europe, etc.): • There is often an emphasis on expressing pain openly and seeking medical treatment promptly. • Pain is typically assessed using standardized pain scales, and individuals are encouraged to communicate their pain levels to healthcare providers. • The use of pain medications is common, and there is a strong emphasis on pain relief. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Asian Cultures (China, Japan, India, etc.): •Individuals may be more reserved in expressing pain and discomfort, as stoicism is valued. •There may be a reluctance to burden others with complaints, leading to underreporting of pain. •Traditional healing methods, such as acupuncture and herbal remedies, may be sought in addition to or instead of Western medicine. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Middle Eastern Cultures (Arab, Persian, etc.): • In Middle Eastern cultures, modesty and privacy are highly regarded. • Patients may express pain indirectly or through non-verbal cues rather than openly discussing it. • The role of the family in caregiving is significant, and family members may be involved in pain management decisions. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins African Cultures: •Are diverse, but some may place a strong emphasis on communal and spiritual aspects of pain management. •Traditional healers and rituals may be involved in pain relief. •There can be a strong connection between physical pain and spiritual or emotional well-being Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Indigenous Cultures: •Often have unique perspectives on pain and healing. •Traditional practices, such as the use of medicinal plants, ceremonies, and rituals, may play a vital role in pain management. •There may be a holistic approach to health, addressing the mind, body, and spirit. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Religions (Christianity, Islam, Buddhism, Hinduism, etc.): • Religious beliefs can influence how pain is perceived and managed. • Some religions may encourage prayer and spiritual coping strategies to alleviate suffering. • Religious rituals and traditions may be integrated into the patient's pain management plan. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Gender Roles • Dominant male role in many cultures • Recognize who is culturally dominant member of family • LGBTQIA2S+ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins LGBTQIA2S+ • L: Lesbian - Refers to women who are romantically and/or sexually attracted to other women. • G: Gay - Commonly used to describe men who are romantically and/or sexually attracted to other men. It is also sometimes used more broadly to include both men and women in the LGBTQ+ community. • B: Bisexual - Refers to individuals who are romantically and/or sexually attracted to people of both their own gender and other genders. • T: Transgender - Describes individuals whose gender identity differs from the sex assigned to them at birth. Transgender people may identify as a gender other than the one they were assigned at birth. • Q: Queer or Questioning - "Queer" is a term that has been reclaimed by some in the LGBTQ+ community and is used to describe sexual orientations and gender identities that do not fit traditional categories. "Questioning" is used to indicate that an individual may be exploring or uncertain about their sexual orientation or gender identity. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins LGBTQIA2S+ (cont’d) • I: Intersex - Intersex individuals are born with variations in their physical sex characteristics that do not fit typical definitions of male or female. Intersex people may have a combination of male and female characteristics or other variations. • A: Asexual - Refers to individuals who experience little or no sexual attraction to others or have a lack of interest in sexual activity. Asexuality is a valid and legitimate sexual orientation. • 2S: Two-Spirit - A term from Indigenous cultures in North America that describes a person who embodies both masculine and feminine qualities or has a unique spiritual role within their community. It is specific to certain Indigenous cultures. • +: Plus - The plus symbol acknowledges that the LGBTQ+ acronym is not exhaustive and that there are numerous other identities, such as asexual, pansexual, genderqueer, non-binary, and more, that are part of the diverse spectrum of human sexuality and gender. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Communication and Language & Gender Roles • Gender-sensitive language and communication are essential. Using inclusive terminology and preferred pronouns can foster trust and comfort. • Ask open-ended questions to understand patients' experiences and concerns related to their gender identity or roles. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Reproductive and Sexual Health & Gender Roles Gender roles can influence decisions related to reproductive health, family planning, and sexual practices. Healthcare professionals must be non-judgmental and provide unbiased information and services, regardless of patients' gender or sexual orientation. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Gender roles can contribute to Mental Health mental health challenges, such as depression, anxiety, and Gender and body image issues. Roles • Healthcare providers should address the psychological impact of gender roles and offer support and resources as needed. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Time Orientation • U.S. punctuality is important • Time orientation, the way individuals and societies perceive and value time, is deeply influenced by cultural and religious beliefs and practices. Different cultures and religious groups have distinct approaches to time, which can impact various aspects of life, including daily routines, social interactions, and even healthcare practices. Let's explore how time orientation varies among different cultural and religious groups: Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Monochronic Cultures • In cultures with a monochronic time orientation, such as many Western cultures, time is viewed as linear and segmented into discrete units. Punctuality and adherence to schedules are highly valued. People tend to focus on one task at a time and prioritize time efficiency. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Polychron ic Cultures: • In contrast, polychronic cultures, often found in many Asian, African, and Latin American societies, have a more flexible approach to time. Multiple activities may occur simultaneously, and people often prioritize relationships and social interactions over strict adherence to schedules. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Past, Present, and Future Time Orientatio n: Past-Oriented Cultures: Some cultures emphasize the past and tradition. The past is seen as a source of wisdom, and preserving cultural heritage is highly valued. Decisions are often made based on historical context. Present-Oriented Cultures: In presentoriented cultures, the focus is on the here and now. Immediate gratification and enjoying the present moment take precedence over long-term planning. Spontaneity is often encouraged. Future-Oriented Cultures: Futureoriented cultures emphasize planning, goal-setting, and investment in the future. Delayed gratification and longterm thinking are key values. Education and career planning are prioritized. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Religiou s Influenc e: Abrahamic Religions (Christianity, Islam, Judaism): These religions often have a strong future orientation, as they emphasize concepts of salvation, the afterlife, and preparing for the future. Time management and punctuality are emphasized in religious practices, such as prayer times. Eastern Religions (Buddhism, Hinduism): Eastern religions often have a cyclical view of time, with concepts of reincarnation and karma. Spiritual development and enlightenment are pursued over lifetimes, emphasizing patience and long-term growth. Indigenous and Animistic Religions: Many indigenous and animistic belief systems are deeply connected to the natural world and cycles of nature. Time is often viewed as cyclical, tied to seasons, and marked by rituals and ceremonies. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Healthcare Practices: •Time orientation can impact healthcare practices. In monochronic cultures, healthcare appointments are expected to start and end on time, and patients may value efficiency and quick access to care. In polychronic cultures, flexibility in appointment times and longer consultations may be more acceptable. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural Awareness in Healthcare: • Healthcare professionals must be culturally sensitive and adaptable. Understanding patients' time orientation, along with their cultural and religious backgrounds, can enhance the effectiveness of healthcare delivery and patient-provider relationships. • In summary, time orientation is a fundamental aspect of culture and religious beliefs, impacting various aspects of life, including how individuals prioritize and allocate their time. Recognizing and respecting different time orientations is essential for promoting cultural competence and providing patient-centered care in healthcare and other professional settings. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Food and Nutrition • Culture influences food preferences • Certain cultures have particular staple foods • Take cultural food differences into account when teaching about diet Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Food and Nutrition Related to Culture and Religious Competence in Healthcare • Food and nutrition are integral parts of culture and religion, influencing what people eat, how they prepare and consume meals, and the significance they attach to different foods. Healthcare professionals need to be culturally and religiously competent when addressing patients' dietary needs and preferences. Here's how food and nutrition intersect with cultural and religious competence in healthcare: Cultural Dietary Practices: • Traditional Diets: Many cultures have traditional dietary patterns rooted in historical, geographical, and agricultural factors. These diets often include specific foods and cooking methods unique to the culture. • Meal Structure: Cultural norms may dictate meal timing, portion sizes, and the order of dishes. For example, some cultures emphasize family-style dining, while others prioritize individual plates. • Food Taboos: Certain cultures have food taboos related to religious beliefs or cultural traditions. These taboos may prohibit the consumption of certain animals or specific types of foods. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Religious Dietary Restrictions: Halal: In Islam, halal dietary laws dictate what is permissible to eat. Halal foods must be prepared in accordance with Islamic guidelines, and the consumption of pork and alcohol is prohibited. Kosher: In Judaism, kosher dietary laws outline which foods are considered clean or unclean. Kosher foods must be prepared under rabbinical supervision, and the mixing of meat and dairy is typically avoided. Vegetarianism and Veganism: Some religious groups, such as Buddhists and Jains, may follow vegetarian or vegan diets as part of their spiritual beliefs. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Difference s Among Individual s Socioeconomic Factors • Family income affects health & access to health care • Upper income groups live longer & have fewer disabilities • Poverty often leads to inadequate care of infants & children • Poor housing conditions affect health Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Difference s Among Individual s (cont’d) Age • Children & older adults less able to communicate symptoms, medication responses • Different health needs in young vs. old • Don’t make assumptions based on age of patient alone Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Differences Among Individuals (cont’d) Religion • Be sensitive to each patient’s values & beliefs Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Diversity in Health Care Practices Folk Medicine • Cutaneous stimulation • Therapeutic touch • Acupuncture • Acupressure Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Diversit y in Health Care Practic es (cont’d) • Natural Remedies • Herbs • Be aware of possible interactions with prescriptions • Keep personal opinions & biases to yourself Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Diversit y in Health Care Practic es (cont’d) • Complementary or Alternative Medicine • Healing through: • Nutrition • Exercise • Relaxation • Emphasis on preventive medicine • Often borrowed from the practice of ethnic or cultural groups Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Diversity in Health Care Practices (cont’d) Acupuncture: a healing practice that originated in China Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins