Transcript Cultural Awareness - Amazon Web Services

 Descriptions
will be based on 2010 US Census
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White
Black or African American
American Indian and Alaska Native alone
Asian alone
Native Hawaiian and Other Pacific Islander Alone
Some other Race alone
Two or More Races
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Hispanic or Latino/Not Hispanic or Latino
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Minorities: a group differing, especially in race,
religion, or ethnic background, from the majority of
a population.
Cultural Awareness is the foundation of
communication and it involves the ability of
standing back from ourselves and becoming
aware of our cultural values, beliefs and
perceptions.
 What’s
in your head???
 Explicit stereotype, bias and attitude
 Implicit stereotype, bias and attitude
Man with Bag Video 1:
The external doesn’t
determine the internal:
The shopping video:
 Historically,
you could only have one race – it was
based on your external appearance.
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White
Black or African American
American Indian and Alaskan Native
Asian
Native Hawaiian and Other Pacific Islander
Now people can claim two or more races or other category.
 Race
is different from ethnicity.
 Race is biologically based and refers to an
individual’s physical
 Characteristics e.g. skin, hair, bone structure, eye
color etc.
 Ethnicity is sociological and refers to cultural
factors.
 Ethnicity
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(2010 US Census)
Hispanic or Latino
Not Hispanic or Latino.
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Nationality
Regional Culture
Ancestry
Language(s)
Belief System
Customs
Historical Perspectives
An ethnic group or ethnicity is a category of people
who identify with each other based on cultural
factors and it is usually an inherited status.
Total Population: 308,745,538
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White – 72.4%
Black or African American - 12.8%
American Indian and Alaska Native alone – 0.9%
Asian alone - 4.8%
Native Hawaiian and Other Pacific Islander Alone-0.2%
Some other Race alone -6.2%
Two or More Races -2.7%
Hispanic or Latino – 16.3%
Not Hispanic or Latino -83.7%
Total Population: 814,180
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White – 85.9%
Black or African American - 1.3%
American Indian and Alaska Native alone - 8.8%
Asian alone - 0.9%
Native Hawaiian and Other Pacific Islander Alone Some other Race alone - 0.9%
Two or More Races - 2.1%
Hispanic or Latino – 2.7%
Not Hispanic or Latino -97.3%
 33%
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of RH inpatients are Native American
What do they see when they walk in the hospital?
Our goal – include faces that look like them…
What do they think when they walk in the
hospital?
What are their fears – small pox blanket incident
General Amherst, July 8, 1763: “Could it not be
contrived to Send the Small Pox among those
Disaffected Tribes of Indians? We must, on this
occasion, Use Every Stratagem in our power to
Reduce them.”
Colonel Bouquet, July 13: “I will try to inocculate
the Indians by means of Blankets that may fall in
their hands, taking care however not to get the
disease myself.”
General Amherst, July 16: “You will Do well to try to
Innoculate the Indians by means of Blanketts, as well as
to try Every other method that can serve to Extirpate this
Execreble Race.”
Colonel Henry Bouquet, July 19: “..all your Directions
will be observed.”
Papers of Col. Henry Bouquet, ed. Stevens and Kent, ser.
21634, p. 161
The Tuskegee Syphilis Experiment was an infamous
clinical study conducted between 1932 and 1972 by the
U.S. Public Health Service studying the natural
progression of untreated study in rural African-American
men in Alabama under the auspices of receiving free
health care from the United States government.
- Cultural awareness becomes central when we have
to interact with people from other cultures.
- People see, interpret and evaluate things in a
different ways.
- What is considered an appropriate behavior in one
culture is frequently inappropriate in another one.
- Misunderstandings arise when I use my meanings to
make sense of your reality.
-If a patient, because of cultural “disconnect,” can’t appreciate what
we’re prescribing or why it’s necessary, or if the information is
delivered in a way that inadvertently frightens or offends the patient,
how can we fulfill our mission as health care providers?
-Core causes for cultural “disconnects” between health care providers
and patients include:
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VALUES
INDEPENDENCE
PRIVACY
SELF-CONTROL
TIME ORIENTATION
CULTURE
AFRICAN AMERICAN
HEALTH BELIEFS
-SOME BELIEVE DISEASE IS
DUE TO PUNISHMENT.
PRACTICES
-CULTURE HAS A RICH
TRADITION OF HERBAL
REMEDIES.
-RICH FOODS (RED) MAY BE
THOUGHT TO CAUSE HIGH
BLOOD PRESSURE
ANGLO-AMERICAN
-A PATIENT MAY PREFER TO
BE LEFT ALONE WHEN ILL.
-GENERALLY PREFER AN
AGGRESSIVE APPROACH TO
TREATING ILLNESS.
-GERMS ARE THOUGHT TO
CAUSE DISEASE AND
PATIENTS EXPECT
TREATMENT TO DESTROY
GERMS.
ASIAN
-IN CHINA AND KOREA,
COINING AND CUPPING
THERAPIES ARE
TRADITIONAL.
-AVOID THE NUMBER 4 AS
THE CHARACTER WORD
MEANS DEATH.
-MENTAL ILLNESS CAN BE
HIGHLY STIGMATIZING IN
ASIAN COUNTRIES.
PAIN
-EXPRESSIONS OF PAIN VARY
WIDELY.
-IT IS EQUALLY ACCEPTABLE
TO BE EXPRESSIVE OR STOIC.
-BIOMEDICINE IS PREFERRED,
ALTHOUGH MANY MAY USE
COMPLEMENTARY AND
ALTERNATIVE MEDICINE.
-PATIENTS TEND TO BE
STOIC.
-ALTHOUGH MOST WILL
WANT PAIN MEDICATION.
-ANTIBIOTICS ARE OFTEN
REQUESTED.
-MIDDLE CLASS PATIENTS
COMMONLY USE THE
INTERNET TO OBTAIN
INFORMATION.
-FEVERS ARE OFTEN TREATED
BY COVERING THE PATIENT IN
WARM BLANKETS.
-AVOID GIVING ICE WATER
WITHOUT ASKING IF THE
PATIENT PREFERS ROOM
TEMP. WATER.
-USE OF HERBS IS COMMON.
-STOICISM IS HIGHLY VALUED.
-PAIN MAY BE EXPRESSED
ONLY BY A CLENCHED JAW.
-FILIPINOS MAY BE
PARTICULARLY CONCERNED
ABOUT ADDICTION TO PAIN
MEDICATION.
CULTURE
HEALTH BELIEFS
HISPANIC/LATINO
-BELIEVE ILLNESS RESULTS FROM
AN UPSET IN BODY BALANCE.
PRACTICES
-AMONG THOSE FOLLOWING
TRADITIONAL CULTURAL
PRACTICES, FAT IS SEEN AS
HEALTHY.
PAIN
-PATIENTS MAY TEND TO BE
EXPRESSIVE (LOUD) WHEN IN
PAIN.
-ASK WHAT REMEDIES THE
PATIENT HAS TRIED BEFORE
COMING IN.
JEWISH
-THE HIGHEST JEWISH LAW IS
THAT YOU MUST DO EVERYTHING
YOU CAN TO SAVE A LIFE.
-OBSERVANT JEWS FOLLOW A
KOSHER DIET.
-FOR ORTHODOX AND
CONSERVATIVE JEWS, THE
SABBATH (SUNDOWN FRIDAY TO
SUNDOWN SATURDAY) IS FOR
REST AND RELIGIOUS
OBSERVANCE.
-EAT ONLY RITUALLY
SLAUGHTERED MEAT, NO PORK
OR SHELLFISH AND DO NOT MIX
MEAT AND DAIRY PRODUCTS.
MIDDLE EASTERN
-MAY NOT ALLOW ORGAN
DONATION.
-MAY NOT TAKE MEDICATIONS,
EAT OR DRINK FROM SUNRISE TO
SUNSET DURING RAMADAN.
-FAMILY MEMBERS ARE OFTEN
EXPECTED TO TAKE CARE OF
PATIENTS.
-INJECTIONS MAY BE
PREFERABLE TO PILLS.
-DAMP,COLD AND DRAFTS MAY
BE THOUGHT TO LEAD TO
ILLNESS.
-THE PATIENT MAY FEEL
SLIGHTED IF NOT GIVEN A
PRESCRIPTION.
-OBSERVANT MUSLIMS DO NOT
EAT PORK AND ARE EXPECTED
TO ABSTAIN FROM
ALCOHOL.(WHICH MAY BE IN
COUGH SYRUP)
-AN OPEN EXPRESSION OF PAIN
IS ACCEPTABLE.
-PATIENTS MAY BE MORE
CONCERNED WITH THE MEANING
AND REPERCUSSIONS OF WHAT IS
CAUSING THEIR PAIN THAN WITH
THE SENSATION ITSELF.
-PATIENTS TEND TO BE VERY
EXPRESSIVE ABOUT PAIN.
-PARTICULARLY IN FRONT OF
FAMILY.
-PAIN IS FEARED AND SHOULD BE
MINIMIZED.
-EXPLAIN THE SOURCE OF PAIN
AND THE PROGNOSIS TO
IMPROVE COPING.
CULTURE
HEALTH BELIEFS
RUSSIAN
-ELDERLY BELIEVE THAT
ILNESS RESULTS FROM COLD.
-THEY MAY NOT LIKE TAKING
A LARGE NUMBER OF PILLS.
PRACTICES
PAIN
-THEY MAY PREFER
NONPHARMACOLOGIC
INTERVENTIONS FOR
NAUSEA.
-PATIENTS TEND TO BE VERY STOIC.
-THOSE WHO PRACTICE
AYURVEDIC MEDICINE
(HINDUS, SIKHS, AND SOME
MUSLIMS) CLASSIFY FOOD IN
TERMS OF EITHER HOT OR
COLD.
-PATIENTS ARE GENERALLY STOIC, EXCEPT
DURING CHILDBIRTH.
-CUPPING OR COINING
-PATIENTS ARE GENERALLY STOIC.
ATTENTION TO NON-VERBAL INDICATIONS.
-FEAR OF DRUG ADDICTION, SO DISCUSS THE
IMPORTANCE OF PAIN MEDICATION.
-THEY MAY PRACTICE
CUPPING THERAPY.
SOUTH ASIAN
-USE OF HOME AND FOLK
REMEDIES IS COMMON.
-OBSERVANT HINDUS WILL
GENERALLY NOT EAT MEAT
OR FISH AND SOME MAY NOT
EAT EGGS.
SOUTHEAST ASIAN
-SOME HMONG BELIEVE THAT
WHEN PEOPLE ARE
UNCONSCIOUS, THEIR SOULS
CAN WANDER, SO
ANESTHESIA IS DANGEROUS.
-BELIEF THAT VERBAL
STATEMENTS CAN CAUSE
ILLNESS OR DEATH.
-FEAR OF BLOOD BEING
DRAWN BECAUSE IT MAY SAP
THEIR STRENGTH.
-GREAT CONCERN REGARDING DRUG
ADDICTION.
-ANTICIPATE THE NEED FOR PAIN
MEDICATION EVEN IF THE PATIENT DOES
NOT ASK FOR IT.
CULTURE
NATIVE AMERICAN
HEALTH BELIEFS
PRACTICES
-A MEDICINE BAG MAY BE WORN
BY THE PATIENT.
-FOOD THAT IS BLESSED MAY BE
THOUGHT TO BE HARMLESS.
-TOBACCO IS SACRED AND HAS
IMPORTANT CERMONIAL USE.
-TRADITIONAL HEALERS MAY BE
COMBINED WITH THE USE OF
WESTERN MEDICINE.
PAIN
-PATIENTS TEND TO BE STOIC.
-NOT EXPRESSING PAIN OTHER
THAN BY MENTIONING THEY DO
NOT FEEL GOOD.
-A TRADITIONAL RITUAL THAT
MAY BE USED FOR HEALING IS
THE SWEAT LODGE.
-Anecdotes or metaphors may be used by the patient to describe his or her own health.
-Long pauses of indicate that careful consideration is being given.
-Loudness and a firm handshake are associated with aggressiveness.
-A present time orientation is common.
White privilege (or white skin privilege) is a term for
societal privileges that benefit people identified as
white in Western countries, beyond what is commonly
experienced by non-white people under the same
social, political, or economic circumstances.
In order to reach out to minorities, we must understand
that experiences are different.
A person acts according to the values and norms of his or her culture;
another person holding a different worldview might interpret
his or her behavior from an opposite standpoint.
This situation creates misunderstanding and can lead to conflict.
NON -VERBALS
OTHER CULTURES
WESTERN CULTURE
Personal space is influenced by
status. A person of high status is
normally granted more space.
No status Discrimination.
Eye Contact is very brief, especially
with superiors or members of the
opposite gender
Generally engage in more eye
contact. Considered to be more
effective in communication.
Raised voices may simply imply an
exciting conversation.
Americans typically interpret raised
voices as a sign of anger or hostility.
SILENCE
Silence indicates respect, submit to
guidelines of elders.
Indicates thinking, sickness etc. Else
they feel uncomfortable with silence
conversation.
TOUCH
Touch with much greater frequency.
It is common for two men to hug and
hold hands. Touching by opposite
gender is considered uncomfortable.
Compared to other cultures,
Americans rarely touch each other
limiting themselves to handshakes
and occasional pats on the shoulder
or arms.
SMILE
Smile is used with greater frequency
to smooth over awkward or
embarrassing situations.
A smile is used with frequency to
communicate friendliness and
goodwill.
Facial Expressions may vary to
different situations like illness,
excitement, embarrassment etc.
Japanese have most control on their
facial expressions i.e. little to none
variation.
Time is not considered as important.
No respect of time.
Show respect of time by their
punctuality.
SPACE
EYE CONTACT
VOICE VOLUME
FACIAL EXPRESSION
TIME
 Officer
White Video One:
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We must get rid of stinking thinking
We must speak up for truth and injustice
Don’t tolerate it…don’t be wall flower
There is distrust because the majority don’t speak up for
the minority
It’s a common occurrence for minorities to be isolated
and treated differently – let’s change that culture.
Officer White Video Two:
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Respect for differences.
Walk down the hospital/clinic hall way…what do you see?
What are the ongoing solutions because they keep
changing??
It’s not about who is right or wrong but being strong
together (one will put to flight 1000, two 10,000).
 Don’t
 Give
be easily offended
the benefit of the doubt
 Forgive
 Laugh
 My
way is the only way (parochial stage)
 I know their way, but my way is better
(ethnocentric stage)
 My way and their way (synergistic stage)
 Our way (participatory third culture stage)
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Develop awareness- take a look at your own:
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Biases
Prejudices
Admit that you don’t know it all
 Suspend judgment
 Empathize
 Systematically check your assumptions
 Be comfortable with ambiguity
 Celebrate diversity
 Become aware of:
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Cultural norms
 Attitudes
 Beliefs
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 Developing
sensitivity and understanding of
other ethnic groups.
 It involves internal changes in terms of
attitudes and values.
Intentionally familiarizing oneself with
selected cultural characteristics, history,
values, belief systems and behaviors of the
members of another ethnic group.