Health care professionals need to attatin appropriate skills in order to embrace diversityand practice completely with diverse group
What is Culture?
A shared pattern of values and behaviours shared over time to guide the decision and actions of a group
Culture can be: Visivle or Invisible
Spirituality and Religous belief
Childhood or life Experiences
What is Minority?
The smaller number or part, esp. a number that is less than half the whole number.
Mathematical perventage- meaning existing in proportionately smaller numbers
- Referring to groups who have limited access to opporunity, power and resources including healthcare
- Most often refers to race, ethnicity, religion, gender, or sexual orientation.
What is Xenophobe?
Intense or irrational dislike or fear of people from other countries.
What is Invisible Culture?
Not easily seen or less observable
What is Enculturation?
Socialization into one's primary culture as a child
What is Assimilation?
Adopting and adapting to characteristics a new culture
What is Acculturation?
Result when people give up thier ethnic identity in favor of the dominat culture
What is Multiculturalism?
Many culture existing within society
What is Ethnocentrism?
Belief in the superiority of one's own ethnic group.
What is Ethnicity?
Refers to groups who members share a social and cultural heritage
Members feel a sense of common identity(Ex. common values, language, history, physical characteristics, geographical space)
What is Discrimination?
The unjust or prejudicial treatment amongst different categories of people or things, esp. on the grounds of race, age, or sex.
What is Collectivism?
Focus on family or the group
Children grow within the family unit
Emphasis placed on:
–Interdependence within the family
Purpose of Communication
Using hands, heads and other body parts to communicate
93% of all communication is non-verbal
Non-verbal aspects can convey stronger messages than verbal
Can include the following:
Communication and language
In Canada, 4 populations face barriers to healthcare access including:
-People who used sign language
-People who speak one of Canada's official languages, but live in an area where the other language is prominent (Ex. French/English)
Working with people who have limited English Proficiency(LEP)
The first step in effective communication is a commitment to mutual communication
See handout for common use of expressions and how they may be understood.
Strategies of working with people who have limited English proficiency(LEP)
Speak slowly, not loudly
Face the person and use non-verbal communication
Avoid difficult and uncommonwords
Be aware of frequently misunderstood words(ex. anxiety,depression) and words that describe sensation(ex. pins and needles)
Don't complicate communication with unnecessary words or information
Organize what you say for easy access
Repeat when you have not been understood
Rephrase and summaries often
Don't ask questions that can be answered with yes or no
Greet the client in the clients own language to establish reapport
Area around the person's body and the objects within that area
Intimate Zone - 11/2 feet
-Allows adults bodily contact for perception of breath and odour
Personal distance - 11/2 - 4 feet
-"bubble" of space around the body, no visual distotion
-voice may be moderate, body odour not apparent
Social distance - 4-12 feet
- Reserved for impersonal business transaction
Public distance - 12 feet or more
-Impersonal interaction, voices projectied, subtle facial expressions maybe lost
A state of complete physical, mental and social well-being, and not merely the absense of disease or infirmity
The balance of the person, both within ones being - physical,mental and spiritual.
Subjective experience of loss of health
Imbalance of one's being-physical, mental, and spiritual
-Studies show that pain threshold or tolerance levels vary within individuals, not base on culture or ethnicity
Pain Management: Pain
A universal experience
However, there is a different in how it is -Perceived(become aware of), interpreted, Treated
Pain Management: Threshold
Level where described as painful
Traditional health Protection
The protection of HEALTH rests in the ability to understand the cause of a given illness or set of symptoms
The traditional beliefs regarding the causation of illness differ
Health Protection: Traditional practices
The use of protective objects - worn, carried, or hung in the home
The use of substances that are ingested in certain ways and amounts or eliminated, and substances worn or hung in the home
The practices of substances of religion, such as the burning of candles, the rituals of redemption, and prayer
Small beaded bracelet
Items that maybe carried in a person's pocket
Thousand Year Eggs
The islamic prayer
Health Traditions: Small beaded bracelet
Has a deer's eye with image of the virgin of Guadalupe and a red pom-pom
Is placed on an infant to protect its health
Health Traditions: Glass eye
May be pinned on clothing, pinned on a crib or bed, or hung in the home to protect the health of the person or family
Health Traditions: Items that may be carried in person's poket
These items were conatined in a small pouch that could be carried by a coyote, a person leads people across the United States/Mexico border. It contain the coyote tooth, a chachayotel(large seed), red strings and a crystal
All items believe to protect the person and bring good luck
Health Traditions: Rosary beads
symbolized prayer and mediatation methods used in both the spiritual maintainance and restoration of health.
Health Traditions:Thousand year Eggs
Represent traditional foods that maybe eaten daily to maintain physical health.
Health Traditions: Nature
Depicts the notion that the enjoyment of nature, the environment, maybe universal way to maintaining mental health
Health Traditions:The Islamic Prayer
Frm East Jerusalem
Shows the prayer may be a way of maintaing spiritual health
Health Traditions: The Red String
From the Tomb of Rachel in Bethlehem
Israel s a place where a Red string that may be worn to protect physical health maybe secured.
Health Traditions: Eye
Represent the plethora of eye-related object that maybe worn or hung in the home to protect the mental health of people
Health Traditions: The Thunderbird
From the Hopi Nation
Maybe worn for spiritual protection, nte the "eye"
The Evil Eye
From Southern Europe, Middle East, North Africa
Illness often related to the "Evil Eye"
A belief or a superstition where harm can be projected by gazing or glaring at another person or thier property
Maybe seen as religion
The Evil Eye
The power emenates(spread out) from the eye(or mouth) and strickes the victim
The injury, illness or other misforutne is sudden
The person who cast the "Evil eye " may not be aware of having this power
The afflicted person may or may not know the source of eveil eye
The injury cause by the Evil eye maybe prevented or cured with rituals or symbols
This belief helps to explain sickness and misfortune
Proficiency in 2 language
In Canada refers to English/French
Generally refers to written communication because translators deals with words
Involves the spoken work and refers to the process of verbal interaction between people who speak two different language
Kinds of Interpreters
Multilingual healthcare provider
Involves three parties, i.e., the two clients and the interpreter
With Triadic Interpretation, Attention should be given to;Emphasis on meaning and understanding
Unobtrusive posturing and eye contact by the interpreter
Strategies to maximize provider clt interaction
Use of first person voice
Control of health care provider
**Confidentiality must be stressed
General Guidlines when Working with Cultural Interpreters
Allow extra time for the session
Use trained bilingual/bicultural interpreters
Never use children as interpreters
Consider the gender, ethnicity, language/ dialect ect.
Beware of common issues:-Words that can't be translate
-jargon or teminology
-Interpreter answer for the client
-conflict between the interpreter and clt(stop session)
Verify to avoid misunderstandings, mistakes and distortions
The traditional belief and practice concering the activities, such as the use of folk remedies and traditional healer that must be used to restore HEALTH.
Restore Health as following:Physical
Restore Health: Physical
Countless traditional remedies such as herbal teas, liniments, special foods and food combinations, massage and other activities
Restore Health: Mental
The use of various technique such as exorcism, calling on traditional healers, using teas or massage, and seek family and community support
Restore Health: Spiritual
Religious healing rituals, th use of symbols and prayers, meditation, special prayers and exorcism
Health Care Choices
Allophatic- Modern care or Conventional care
Homeopathic - Traditona or Folk
Health care that is practiced by M.D.s and allied health professionals such as registered nurses, Physical thereapist, and psuchologist.
By Dr. Still in Kirksville
The art of curing withour excessive use of sugery drugs
Attempts to discover and correct all mechanical disorder in the human machine and to direct the recuperative power of nature that is within the body to cure the disease
Osteopathsare fully qualified physicians - practice in all areas of medicne and surgery
What is Acupuncture?
Originated in China
Acupuncture involves the insertion of very thin needles through the patient's skin at specific points on the body - the needles are inserted to various depths.
Regulated in most provinces except Nova Scotia
Accupunction Benefits and Condition in can help:
Benefits and Condition it can help:
Neck or Cervical Pain
Lower Back Pain
Anxiety & Depression
Headaches & Migraines
Chronic Fatigue Syndrome
Arthritis & Arthritic Pain
Jaw and Face Pain
Irritable Bowel Syndrome
Menstrual & PMS Problems
Smoking & Addiction
Obesity & WeightControl
AccupunctureRisks and disadvantages:
Risks and disadvantages:
A small amount of bleeding may appear at the needle site and is more likely to occur in those patients taking aspirin. Bleeding will usually stop within minutes after removing the needle.
A small bruise
Fatigue has been observed to occur follow acupuncture treatments
Pain while needle is in place
Biologically Based Therapies: Traditional or Ethno-Cultural(ethnic group that has a distinct culture) HEALTH Care
Four thousand-year-old method of healing originatinf in India
Most acient existing medical system
Uses diet, natural theaoies and herbs
Form of Chinise traditoinal medicine
Combines movemet, meditation and regulation of breathing
Enchance immne system
A religion that is combination of Christianityand African Yoruba religiousbelief
Uses diet, natural therapies and herbs
Voodo Dools - belief to have originated in the fon people of present day Benin
Voodo religion was created in slave quarters inHaiti and Louisiana when the faiths of various prople began to intermingled
The End of life Care
Rituals surounding funerals and mourning
End of Life: ABC approach
Using this approach can promote knowledge and skills necessary to provide culture competent end-of-life care
Communicaiton is important
End of Life in 4 F's
Death Rites for Select Groups
Bangladesh–Muslim rites: body remains at home – cared for, washed, wrapped in white cloth
China –Initial burial in coffin; after 7 years, body exhumed and cremated,urn reburied in a tomb.
Egypt –Muslim rites
Death Related Objects
Masks—used to hide from “Angel of Death”or placed on face of deceased
–American Indian mask
Jade stone- from China, is placed in orifices(An opening, as of a pipe or tube) of the body to block the entrance of the evil spirits after death.
Ghost money-from China, is burned to send payments to a deceased personand to ensure hisor her well-being in the afterlife.
What is Deaf Culture?
Status within the culture does not depend on the level of hearing loss, but theattitude towards it.
Conflict occurs when the hearing society views deafness as a medical deficiency whichmust be "fixed“.
- loss of hearing functional and dependence upon visual communication.