Chapter 9

Cultural Diversity in Health Care

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Objectives

Evaluate the use of concepts and principles important in healthcare diversity. Describe common characteristics of any culture.

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Objectives (contd)

Evaluate individual and societal factors involved in cultural diversity. Compare values and beliefs about illness that affect management of nursing care interventions involving patients from specific cultures.

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Case Study

Muslims are one of the fastest growing populations in the United States. El Gindy (2004) describes Muslim nurses dress requirements and the role of Islamic beliefs in their lives. A Muslim nurse wore her Hijab in the workplace while providing nursing care to her patients.

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Case Study (contd)

This nurse became frustrated because the Infection Control staff consistently asked her to wear short sleeves or roll up her sleeves. The Islamic dress code of wearing a Hijab is considered mandatory; it is a way of life to obey Allah.

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Case Study (contd)

Consider the impact of hospital policy on nursing staff dress codes. Consider sensitive or controversial issues that are often addressed by behaviors that represent coercion. Consider what role concepts about culture have in this case situation.

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Concepts and Principles

Culture:

Develops over time Is responsive to its members and their familial and social environments Is learned and shared by members Is essential for survival and acceptance Changes with difficulty

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Concepts and Principles (contd)

Cultural diversity:

Comprises a vast range of cultural differences among individuals or groups

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Concepts and Principles (contd)

Cultural background:

Is a fundamental component of ones external and internal distinctions

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

Concepts and Principles (contd)

Cultural sensitivity:

Involves affective behaviors in individuals Involves the capacity to feel, convey, or react to ideas, habits, customs, or traditions unique to a group of people

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

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Muslims and the Role of Islamic Beliefs in the Healthcare Workplace

For class, bring an annotated reference from the literature that describes persons of the Muslim faith and the role of Islamic beliefs in their lives. Based on the following slides, consider how coercive behaviors might occur with the Muslim nurses attire.

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

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Coercion in the Healthcare Workplace

Coercion:

Involves the use of power or status Is persuasion of a person to act in a specific way or to make a change Limits choices May lead to negative consequences (inequity of power or powerlessness) Can take many forms

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Coercion in the Healthcare Workplace (contd)

Cite some examples that might occur in the workplace. Consider the following factors: Coercion: direct or indirect? Responses to coercion

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

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External, Indirect Coercion in Relationship to Cultural Diversity

Negative biases toward a minority nurse Negative attitudes and their impact on nurses delivery of patient care

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

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External, Direct Coercion in Relationship to Cultural Diversity

Behaviors, either subtle or overt Actual occurrence or a perception Intentional or accidental

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Behavioral Responses to Coercion

What forms of coercive control or power are being exercised by whom in what role context?

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

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Negative Responses to Coercion

Frustration Anger Passive-aggressiveness Avoidance Manipulation Defensiveness Domination

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Negative Responses to Coercion

(contd)

Verbal retaliation Inflexibility Intolerance Uncooperativeness Unassertiveness Backlash effect

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Positive Behaviors to Effect Change in Use of Coercion

Cultural sensitivity Self-examination of ones personal and workplace values, beliefs, and prejudices Mutual communication

Respect for differences Honesty Integrative solutions (win-win)

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Positive Behaviors to Effect Change in Use of Coercion

(contd)

Richness of cultural differences requires deliberate effort. Cultural diversity is valued and celebrated within the nursing unit.

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

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Discussion

What might be some potential negative and positive behaviors occurring with the issue of the Muslim nurses wearing of the Hijab? What specific strategies might be used to address cultural attire within the nursing unit and with other departments?

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

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Evaluation
Write a brief evaluation about what you learned from this case study of a Muslim nurse to enhance knowledge about the following: Cultural diversity in the healthcare workplace Coercive behaviors and affecting change

Copyright 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

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