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Understanding Cultural Differences – What Role Do They Play In Healthcare

Ramon Jimenez, chairperson of the diversity advisory board of the American Academy of Orthopaedic Surgeons could not have said it better, “Cultural competency will have to be on everybody’s radar screen for generations to come. When the day comes that the melting pot is truly a melting pot, then we won’t need this, but that day isn’t here yet.” Patients differ in many ways. Some of these differences are due to patient illness, personality, socioeconomic class, or education, but the most profound differences may be cultural. Many health professionals think that if they just treat each patient with respect, they will avert most cultural problems. That is not always the case. Some knowledge of cultural customs can help avoid misunderstandings and enable practitioners to provide better care.

Cultural generalizations will not fit every patient whom physicians see, but knowledge of broad patterns of behavior and belief can give physicians and other health professionals a starting point from which to provide a variety of ethnic and cultural different patients with the most appropriate care. Cultural Sensitivity & Competence for health care professionals is achieved through formal coursework, informal interaction, networking, and experience.

A few examples of why understanding differences is important :

A person of Chinese ethnicity was hospitalized and put in room number 4. In Chinese (and Japanese), the character for the number 4 is pronounced the same way as the character for the word “death.” Just as many American patients might not be comfortable in room 13—a number that is considered bad luck—many Chinese and Japanese patients would prefer not to be in a room called “death.” Even the most sensitive health care provider could not be expected to know the significance of the number 4 without some knowledge of these cultures or their languages.

Culture by *AagaardDS on deviantART

Lack of eye contact in American culture may indicate many things, most of which are negative. A physician may interpret a patient’s refusal to make eye contact as a lack of interest, embarrassment, or even depression. However, a Chinese patient may be showing the physician respect by avoiding eye contact. If the patient is female and from a Muslim country, and her physician is male, she may be trying to avoid sexual impropriety by not making eye contact. A Navajo patient may be trying to avoid soul theft or loss. Knowing the meaning of eye contact, or lack thereof, may help avoid misinterpreting a patient’s behavior.

Nurses are generally taught the importance of touch. Yet, if they are caring for a patient of the opposite sex and that patient is an Orthodox Jew, for example, it is important to know that, for that religion, contact outside of hands-on care is prohibited. A custom in many cultures, including Mexican, Filipino, Chinese, and Iranian, is for a patient’s family to be the first to hear about a poor prognosis, after which the family decides whether and how much to tell the patient. Members of such cultural groups may believe that it would be insensitive for a patient to be told bad news and that it could affect their prognosis for recovery.

Some groups share the belief that only God knows when someone will die naturally, so (according to the Hmong, for example) the only way a physician could know when someone will die is if that physician planned to kill the patient. Not all members of a group share these beliefs, so physicians should not automatically assume that every patient who is a member of one of these groups would want to be shielded from information. Nevertheless, a physician who is aware of such cultural differences could arrange to discuss with the patient, in advance, just who should be given information regarding the patient’s condition.

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About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

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