GEE 12

Workforce Issues

Differences and conflicts that exist in a homogeneous culture may be intensified in a multicultural workforce.Factors that affect these issues include language barriers, degree of assimilation and acculturation, and issues related to autonomy.

Dominant Language and Dialects

The health-care provider must be aware of the dominant language and the difficulties that dialects may cause when communicating in the client's native language.

Parallelism

The independent development of a culture characteristic in two widely separated cultures.

Elicit

The patient's health beliefs are elicited as they pertain to: the health condition the reason for the visit the patient's expectations

Artifacts

The physical things that the members of a society make when they apply their technology to the physical environment

Norms

The rules of culture that tell the members of a culture how they are expected to behave in a given situation

Health

is a state of wellness as defined by the individual within his or her ethnocultural group. Health generally includes physical, mental, and spiritual states because group members interact with the family, community, and global society.

Soul loss

is believed that for some reason, such as being frightened, hit on the head (where the soul resides), sneezing or experience troubled sleep, the soul leaves the body and is unable to return. It is thought that when a person has lost his individual soul, he will become sick

Listen

is most important part of effective communication: Identify and greet family or friends of the patient; Ask patient with English as a second language if they would like an interpreter; Start interview with an open-ended question; Do not interrupt the patient as s/he speaks

Family

two or more people who are emotionally connected. They may, but do not necessarily live in close proximity to each other.

Explanations

Check often for understanding. Use verbal clarification techniques

L.E.A.R.N model

A model for culturally effective communication

recommend

A plan of action is recommended with an explanation why the specific recommendations are being made, for example, treatment dates, times, duration, interventions

Fission

A process that can be traced historically when a long established society breaks up into two or more independent units.

Language

A system of patterned sounds, that the members of a society use to communicate their thoughts and feelings to one another

Cultural Ethnocentrism

Admiration of other culture Belief that one is superior

awareness

Admitting personal biases, steroetypes, and prejudices. Becoming aware of cultural norms, attitudes, and beliefs. Valueing diversity

Support

Ask about and try to understand barriers to care and compliance. Help the patient overcome barriers.Involve family members if appropriate. Reassure the patient you are and will be available to help

Partneship

Be flexible with regard to issues of control. Negotiate roles when necessary. Stress that you will be working together to address medical problems

Developing awareness Acquiring knowledge Proper attitude Developing cross-cultural skill

Becoming Culturally Competent

Rapport

Connect on a social level o Seek the patient's point of view. Consciously attempt to suspend judgment. Recognize and avoid making assumptions

cultural determinism

Culture dictates who we are today. • Pros & Cons

Cultural Competence

Respect the patient and his or her culture and beliefs. Understand that the patient's view of you may be identified by ethnic or cultural stereotypes

Values

Elements of Culture, Cultural standards or judgements of what is right, good or desirable

Symbols

Elements of Culture, anything that has been given representational meaning by members of a cultural group

Individualism VS Collectivism

In-groups VS out-groups

Uncertainly avoidance

Index measures the extent to which a society feels threatened by uncertain or ambigious situations

Power Distance

Index use to measure the degree of inequality in a society. How people accept the unequal distribution of power ❖ Higher value means distance is very far, needs of the common lack representation. ❖ Lower value means distance is very minimal, equality is very strong

Assess

Investigate potential attributes and problems in the person's life that may have an impact on health and health behaviors.

Conditioning

It is reinforced by a system of reward and punishments found in the cultural system

Diffusion

It is the much more common process of patterns and traits passing back and forth from one culture to another.

Acquiring Knowledge

Knowing how your culture is viewed by others. Attending classes, workshops, and seminards about other cultures. Reading about the cultures

Corporate, Social Class, Generation, Regional, National

Levels of Culture

Developing Cross-cultural Skills

Making friends with people of different cultures. Establishing professional and working relationships with people of different cultures. Learning another language

Symbols

Manifestation of Culture, words, getures, pictures, or objects that carry a particualar meaning

Values

Manifestation of culture, the way people act under different circumstances (honesty, bravery, loyalty)

Symbols, heroes, rituals, values

Manifestations of Culture

cultural relativism

No culture is superior. Truth is relative not absolute. the practice of judging a culture by its own standards.

Taboos

Norms so strongly held by the members of a society that to violate them is virtually inconceivable

Mores

Norms that carry a strong social sanction if violated because adherence to them is essential to the well-being of the society

Folkways

Norms that carry only a weak social sanction if violated because adherence to them is essential to the well-being of the society

Laws

Norms that the governing body of a society officially adopts to regulate behavior

convergence

The fusion of two or more cultures into a new one which is somewhat different from its predecessors.

Purnell Model for Cultural Competence

Provides a comprehensive, systematic and concise framework for learning and understanding culture. This can assist healthcare providers, managers and administrators in all health disciplines to provide holistic etc.

Cultural competency

Refers to an ability to interact effectively with people of different cultures. In the health care profession, it means the establishment of a relationship to patients/clients with respect to the various culture they possess to efficiently and effectively deliver medical intervention

Empathy

Remember that the patient has come to you for help. Seek out and understand the patient's rationale for his or her behaviors or illness. Verbally acknowledge and legitimize the patient's feelings

Trust

Self-disclosure may be an issue for some patients who are not accustomed to Western medical approaches. Take the necessary time and consciously work to establish trust

Subculture

Subgroups of people who don't think/behave alike. They share most of society's norms, values, beliefs but they change some of society's ideas to reflect more closely to their own needs.

Technology

The body of knowledge that members of a society apply to their physical environment to meet their survival needs

Healthcare Practices

The focus of health care includes traditional, magicoreligious, and biomedical beliefs; individual responsibility for health; self-medicating practices; and views toward mental illness, chronicity, rehabilitation, and organ donation and transplantation

Breach of taboo

This explanation sees sickness as punishment by the gods for the breach of religious prohibitions or social taboos that have divine sanction

Spirit Intrusion

This explanation takes the view that sickness is due to the presence on the body of evil spirits

Sorcery

This interpretation considers sickenss to be the result of the manipulations by persons skilled in magic or having supernatural powers

Indoctrination

This may take the form of formal teaching or training which may take place anywhere the individuals finds himself interacting with his fellow humans

Masculinity VS Feminity

Weak vs strong values

Negotiate

When the recommended plan is not readily agreed upon, negotiate a plan of action that is agreed upon by the patient and the provider.

Family roles and organization

affects all other domains and defines relationships among insiders and outsiders. This domain includes concepts related to the head of the household, gender roles, family goals and priorities, developmental tasks of children and adolescents etc.

Social Class

associated with educational opportunities and differences in occupation

Regional

associated with ethnic differences within a nation

Generation

associated with the differences between parents and children

National

associated with the nation as a whole

Corporate

associated with the particular culture of an organization

Culture shock

believe that their own way is the only right way only to find out that it is not at all the same

Person

biopsychosociocultural being who is constantly adapting to her or his community.

Rituals

collective activities that are socially essential (ways of greeting, religious and social ceremonies, etc.)

Johnson's research (2000)

found that barriers to exercise among South Asians included unsafe neighborhoods and lack of gender-specific facilities.

Spirituality

involves more than formal religious beliefs related to faith and affiliation and the use of prayer. For some people, religion has a strong influence over and shapes nutrition practices, health-care practices, and other cultural domains.

Community

group of people having a common interest or identity and living in a specified locality. This includes physical, social and symbolic characteristics that cause people to connect. Sharing a specific language or dialect, lifestyle, history, dress, art, or musical interest are symbolic characteristics of a community.

Biocultural ecology

identifies specific physical, biological, and physiological variations in ethnic and racial origins. These variations include skin color and physical differences in body habitus; genetic, hereditary, endemic, and topographic diseases; psychological makeup of individuals; and differences in the way drugs are metabolized by the body.

Object intrusion

in a concrete way, sickness is interpreted as the result of intrusion of certain undersirable objects, such as tiny bones, bits of leather, coagulated blood, insects, or hairs

Culture lag

inability of a given society to adapt to a culture immediately

High-risk behaviors

include use of tobacco, alcohol, or recreational drugs; lack of physical activity; increased calorie consumption; unsafe driving practices; failure to use seat belts and helmets; failure to take precautions against HIV and STIs; and high-risk recreational activities.

Overview, inhabited localities, and topography

includes concepts related to the country of origin, the current residence, the effects of the topography of the country of origin and current residence on health, economics, politics, reasons for migration, educational status, and occupations.

Pregnancy and childbearing practices

includes culturally sanctioned and unsanctioned fertility practices; views toward pregnancy; and prescriptive, restrictive, and taboo practices related to pregnancy, birthing, and the postpartum period.

Death rituals

includes how the individual and the society view death and euthanasia, rituals to prepare for death, burial practices, and bereavement. Death rituals of ethnic and cultural groups are the least likely to change over time and may cause concerns among health-care personnel.

Nutrition

includes more than having adequate food for satisfying hunger. This domain also comprises the meaning of food to the culture; common foods and rituals; nutritional deficiencies and food limitations; and the use of food for health promotion and wellness, illness and disease prevention, and health maintenance and restoration.

Health-care practitioners

includes the status, use, and perceptions of traditional, magicoreligious, and biomedical health-care providers. It is interconnected with communications, family roles and organization, and spirituality.

Global Society

includes world communication and politics; conflicts and warfare; natural disasters and famines; international exchanges in education, business, commerce etc ; advances in health sciences, space exploration and the expanded opportunities for people to travel around the world and interact with diverse societies.

imitation

individual imitate the things around him

Respect Model

model of cross cultural communication

Heroes

persons, past or present, real or fictitious, who possess characteristcs that are highly prized in a culture

Cultural dualism

possess dual culture that was adopted from influences of other culture

Illness

refers to how patients think, react, and cope when they suffer from illness. It includes how they perceive and understand their sickness, seek help for their health problems, utilize health care systems, and how they benefit from healthcare

Health

refers to how people behave to maintain their health. This may include how people follow guidance on food intake, exercise, hygeine, preventive examinations, and so on

Culture

represents the values, norms, and traditions that affect how individuals of a particular group perceive, think, interact, behave, and make judgements about their world.