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Cultural Diversity
By: Cindy Quisenberry
Definitions
Culture – the values, beliefs, attitudes, languages,
symbols, rituals, behaviors, and customs unique to a
particular group of people and passed from one generation
to the next
Ethnicity – a classification of people based on national
origin and/or culture
Race – a classification of people based on physical or
biological characteristics such as color of skin, hair, and
eyes; facial features; blood type; and bone structure
Definitions
Bias– a preference that inhibits impartial judgment (ie:
individuals who believe in the supremacy of their own ethnic
group)
Can you think of other bias?
Prejudice – a strong feeling or belief about a person or
subject that is formed without reviewing facts of information
(Prejudiced individuals regard their ideas or behavior as
right and other ideas or behavior as wrong.)
Stereotyping – occurs when an assumption is made that
everyone in a particular group is the same
Definitions
What is a nuclear family?
What is an extended family?
Definitions
Personal Space – often called territorial space; the
distance people require to feel comfortable while
interacting with others
Close Contact Cultures
Arabs
French
Latin Americans
Hispanic Americans
Asian Americans may stand close but do not touch (kissing or hugging never
done in public
Definitions
Monotheist – believe in one God
Polytheist – believe in many gods
Atheist – does not believe in any deity
Agnostic – believes that the existence of God cannot be
proved or disproved
Respecting Cultural
Diversity
The key to respecting cultural diversity is to regard each
person as a unique individual. Healthcare workers must
learn to appreciate and respect the personal
characteristics of others by:
Listen to patients as they express their beliefs.
Appreciate differences in people.
Learn more about the cultural and ethnic groups that you see
frequently.
Recognize and avoid bias, prejudice, and stereotyping.
Ask questions to determine a person’s belief.
Evaluate all information before forming an opinion.
Respecting Cultural
Diversity
Allow patients to practice and express their beliefs as much as
possible.
Remember that you are not expected to adopt another’s beliefs,
just accept and respect them.
Recognize and promote the patient’s positive interactions with
family.
Be sensitive to how patients respond to eye contact, touch, and
invasion of personal space.
Respect spirituality, religious beliefs, symbols, and rituals.
Common Ethic
Groups
African American – Central & South African countries,
Dominican Republic, Haiti, and Jamaica
Asian/Pacific American – Australia, Cambodia, China,
Guam, Hawaii, India, Indonesia & Pacific Island countries,
Japan, Korea, Laos, New Zealand, Philippines, Samoa,
Taiwan, Thailand, and Vietnam
European American – Austria, Czech Republic,
Denmark, England, France, Germany, Greece, Hungary,
Ireland, Italy, the Netherlands, Norway, Poland, Portugal,
Russia, Scotland, Sweden, and Switzerland
Common Ethic
Groups
Hispanic American – Cuba, Mexico, Puerto Rico, Spain,
and Spanish-speaking countries in Central and South
America
Middle Eastern/Arabic Americans – Egypt, Iran, Iraq,
Israel, Jordan, Kuwait, Lebanon, Saudi Arabia, Syria,
Turkey, Yemen, and other North African and Middle
Eastern countries
Native American – more than 500 tribes of American
Indians and Eskimos such as Apache, Choctaw,
Cherokee, and Navajo
Definitions
Personal Space – often called territorial space; the
distance people require to feel comfortable while
interacting with others
Distant Contact Cultures
European
African Americans (2-4 feet)
Cambodia – members of the opposite sex may never touch in public
Vietnamese allow only the elderly to touch the head of a child because the
head is considered sacred
Native Americans
Middle Eastern – men may not touch female individuals who are not immediate
family members
Definitions
Eye Contact
European Americans – indicative of interest and trustworthiness
Asian Americans – considered to be rude
Native Americans – may use peripheral vision and avoid eye
contact (may regard direct stares as hostile and threatening)
Hispanic and African Americans – may use brief eye contact, but
then look away to indicate respect and attentiveness
Muslim women – may avoid eye contact as a sign of modesty
India – different socioeconomic classes may avoid eye contact with
each other
Definitions
Gestures (head up and down for “yes”, side to side for
“no”, etc.)
Can mean an exact opposite in some countries
Asian and Native Americans, pointing can represent a strong
threat
“OK” can be insulting to some Asians
Baptist
Some believe in the healing power of “laying on of hands”
Physician is instrument for God’s healing
No last rites
Oppose abortion
Birth control is an individual’s decision
Buddhism
Suffering is inevitable
Illness is the result of negative Karma
Cleanliness is important to maintain health
May refuse medications that affect mental alertness
(mindful awareness is essential)
Oppose abortion
Birth control is an individual’s decision
Believes in reincarnation
Buddhist priest must be present at death
Limited touching during during the process of death
Last rites chanted at bedside right after death
Hinduism
Some believe illness is punishment for sins
Some believe in faith healing
Will accept most medical interventions
Naming ceremony is performed 10-11 days after birth to
obtain blessings form gods and goddesses
Abortion allowed only to save the life of the mother
Birth control allowed, but the duty of having a family is
stressed
Hinduism
Believe in reincarnation
Priest ties thread around the neck or wrist and may pour
holy water in the mouth of the deceased
Only family and friends may touch and wash the body
Organ donation discouraged
Cremation preferred
Some do not eat meat
Lutheran
Communion often administered by clergy to sick or prior to
surgery
Birth control allowed
Abortion discouraged
No last rites
Methodist
May request communion before surgery or while ill
Birth control allowed
Abortion discouraged
No last rites
Presbyterian
Prayer and counseling an important part of healing
May request communion while ill or before surgery
Birth control allowed
Abortion discouraged
No last rites
Seventh Day Adventist
May avoid OTC medications and caffeine
May anoint body with oil
Use prayer for healing
Some believe only in divine healing
Will accept required immunizations
Birth control is individual’s decision
Therapeutic abortions permitted as an individual’s decision
No last rites
Sabbath worship is sunset on Friday to sunset on Sat.
Encouraged to practice a vegetarian diet
Episcopal
May use anointing of the sick with oil as a healing
sacrament
Abortion opposed
Birth control is an individual’s decision
Some observe last rites by priest
Roman Catholic
Sacrament of the Sick and anointing with oil
Life is sacred; abortion and contraceptive use prohibited
Believe embryos are human beings and should not be
destroyed or used for research
Infant baptism mandatory
Baptism necessary for salvation (any baptized Christian
may perform an emergency baptism)
Sacrament of the Sick (last rites) performed by priest
May avoid meat at certain times
Islam (Muslim)
Illness is atonement for sins
Face city of Mecca 5 times a day to pray to Allah
Ritual washing before and after prayer
Must take meds with right hand since left hand is
considered dirty
At birth, the infant should hear “There is no God but
Allah, and Mohammed is His prophet”
Circumcision before 7 days old
Abortion forbidden
Family must be with dying person
Dying person must confess sins and ask forgiveness
Islam (Muslim)
Only family touches and washes body after death
Body is turned toward Mecca after death
Cremation not permitted
Avoid pork and shellfish
Usually do not consume alcohol
During holy month of Ramadan, all-day fasts are required
for those who are able.
Judaism
May refuse surgical procedure or diagnostic tests on
Sabbath or holy days
Family may want surgically removed body parts for burial
Ritual handwashing upon awakening and prior to eating
Male circumcision on 8th day after birth by child’s father or
Jewish physician
Birth control allowed
Abortion permitted only in specific circumstances
Person should never die alone
Body is ritually cleaned after death
Judaism
May bury dead before sundown on day of death and
usually within 24 hours
Organ donation permitted only after consultation with
rabbi
Sabbath is sunset Friday to sunset Saturday
Fast during some holy days
May observe certain dietary laws called “kosher” diets
Jehovah’s Witness
Prohibited from receiving blood and blood products
Elders will pray and read scriptures to promote healing
Medications okay if not derived from blood products
Birth control personal decision
Abortion allowed only to save the life of the mother
No last rites
Organ donation discouraged due to transmission of blood
(All organs and tissues must be drained of blood before
transplant)
Russian Orthodox
Holy Unction and anointing body with oil used for healing
Will accept most medical treatments but believe in divine
healing
Birth control prohibited
Abortion prohibited
List rites by ordained priest mandatory
Arms of deceased are crossed
Organ donations not encouraged
May wear a cross necklace that should not be removed
Mormon (LDS)
May believe in divine healing with “laying on of hands” or
blessing by the church elders
Anointing with oil can promote healing
Infant blessing by clergy in church ASAP after birth
Baptism at 8 years of age
Abortion prohibited
Birth control individual’s choice
May want church elders present at birth
No last rites
Mormon (LDS)
Special undergarments may be worn and should not be
removed unless necessary
Fast on first Sunday of each month
Avoid medications containing alcohol and caffeine
Avoid coffee, tea, caffeine-containing beverages and
alcoholic beverages
Amish
May give birth at home
Birth control not forbidden – but most do not use (large
families are a gift from God)
Prohibit abortion
No last rites
Cremation not used
Do not buy health insurance – church has mutual aid fund
May refuse prescription meds (use herbal remedies)
Christian Scientist
Illness can be eliminated through prayer and spiritual
understanding
May not use medicine or surgical procedures
May refuse blood transfusions
Most will accept mandated immunizations
Abortion discouraged
Birth control individual’s decision
No last rites
Organ donation discouraged
Most do not drink alcohol, coffee, or tea