Cultural Sensitivity

http://www.youtube.com/watch?v=v4IC7qaNr7I

Our goals: By the completion of this lesson students will:

● Identify and acknowledge their own cultural and spiritual heritage and how it may impact their attitude towards providing care by completing a non-biased questionnaire packet.

● Describe the various components in culture and spirituality during a class discussion

● Identify and demonstrate appropriate cultural and spiritual sensitivity in their approach to providing care by role-playing.

Skills Concept Context

As healthcare providers, we: ● Provide care to patients of different cultures● May be unfamiliar with various:

○ cultures ○ languages ○ Traditions○ spiritual backgrounds

Cultural Insensitivity ● Not usually intentional● Caused by not having the knowledge we need to understand other people● May be due to time constraints

○ not enough time to complete tasks and move to the next patient.

Cultural Insensitivity may cause:● Misunderstandings● Differing family expectations with

regards to care● Miscommunication● Difficulty providing care● Mistrust with patients● Inability for patients to be

vulnerable

Cultures Vary with their beliefs on medicine● Vary in their beliefs of prevention, cause, and treatment● Vary in their beliefs on death● Vary in their beliefs on life and birth

These differences mean healthcare providers need to adapt to the needs of the patient.

Examples: ● Filipino cultures allow the eldest male in the family to make decisions and be

the spokesperson● Asian cultures value harmony and avoiding conflict● Chinese cultures feel that mental illness, intellectual disabilities, or behaviors

lacking self control bring shame● India and Pakistan, are reluctant to accept a diagnosis of severe emotional

illness or an intellectual disability because it severely reduces the chances of other members of the family getting married

● Russians view U.S. medical care with mistrust. Russian medical practitioners are authoritarian and free exchange of information, and open discussion, is not typical

Examples: ● For Hispanic patients,illness can be seen as God’s will or divine punishment

brought about by previous or current sinful behavior. Hispanic patients may

prefer to use home remedies.

● Native Americans believe that a state of health exists when a person lives in

total harmony with nature. Illness is viewed as an imbalance between the ill

person and natural or supernatural forces

● For African-Americans, usually a key family member, or church member, is

consulted for important health-related decisions.

Interpreting other cultures● Too often we feel our culture is the “right” culture● It’s human nature to scoff at people for having beliefs that one views as

“wrong”

Example:A 27 year old vietnamese woman is in active labor. The baby is in distress, but the woman continues laboring on with her contractions; she is showing no signs of pain or discomfort except her look of concentration and her white knuckles on the sides of the hospital bed.

*Traditionally, vietnamese women believe that a woman must experience pain and discomfort as part of childbirth but expressing these feelings brings shame upon her. It can be highly upsetting for a vietnamese woman to progress through labor next to a highly vocal woman experiencing labor.

Language: Lack of understanding English

+

attempting to understand medical terminology about diseases and procedures

=

high stress levels

Knowledge: Our understanding of diseases varies tremendously from our patients

Examples:

● Diabetes may be just something that everyone in the family has and if one member doesn’t, they’re abnormal. It’s not seen as preventable.

● Lung cancer isn’t caused by smoking because the patient only smokes marijuana and not cigarettes.

Western Medicine: ● Treat patients as objects

○ Machines we put back into working order● For Families:

○ Taken from the familiarity of their homes○ Put into the sterile fearful world of the hospital

Western Medicine● PATIENTS SHOULD BE TREATED AS HUMAN BEINGS

THAT HAVE LIVES BEYOND THE MEDICAL WORLD OF DIAGNOSES, MEDICATIONS, TREATMENT, AND PROGNOSIS.

Meaning, DON’T BE LIKE HOUSE!

Cultural Sensitivity and competence:● Embodies attitude, knowledge, and skills● Permits individuals to respond with dignity and respect to all people● Is a continuum that encompases several stages

We don’t become culturally sensitive overnight!

It takes time and is a process of self-awareness!

Being culturally competent means:● Not imposing our personal values on someone else ● Asking questions about culture and spirituality respectfully● Not making assumptions● Respecting your patients decisions about their health care treatments

regardless of your view point, medical or personal● Celebrating differences● Recognizing similarities while still comprehending that differences are

differences and not defects.

Example:A 27 year old Arab man refuses to allow a male lab technician to enter his wife’s room to draw blood after she had just given birth. The staff was finally able to convince the man of the need for treatment, and he allowed the lab tech in after completely covering his wife, with no part of her showing other than her arm.

*For Arab families, honor is one of the highest values. Honor is based on female purity so extreme modesty and sexual segregation must be maintained at all times. Male nurses should not be assigned to traditional female muslim patients.

Cultural heritageUnderstanding one’s own cultural is the first step to becoming competent

Culture: The learned or shared knowledge, beliefs, traditions, customs, rules, art, history, folklore used to interpret experiences and generate social behavior.

Cultural Identity can include: Symbolic objects: Spiritual or religious items or clothing

Language: Slang terms, words that indicate status, level of intimacy

Topics and patterns of conversation: In many cultures it’s uncouth to begin a conversation with something serious

Tone of voice: Use a soft tone of voice and avoid criticism

Non-verbal cues: Gestures, facial expressions, body language, personal space

Cultural Identity can include: Concept of time: punctuality AND understanding past traditions

Family structure, composition, and authority: the way a family is constructed contributes to who makes the familial decisions

Cooking and dining: Is there a special time of day for the patient to eat? Special needs for meal preparations?

Spirituality and Religion: What are the effects of one’s religious beliefs on potential treatments? What about with regards to death or dying?

You are not expected to know everything!Being culturally competent does not mean knowing everything about every culture!

Instead, it means respecting differences, having an eagerness to learn about others, and having a willingness to accept that there are many ways view the world.

By incorporating cultural sensitivity into patient care, we are demonstrating respect and are reducing stress!