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Arredondo 8/29/13 VRNS 150 Chapter 6 Study Guide Culture and Ethnicity 1) What are the demographics for CA? What % speaks English? 47% White, 32% Latino, 11% Asian, 6% African-American: 60% speak English 2) What are the demographics for the U.S.? What is expected to happen by 2050? 61.5% White, 12.5% Latino, 12.3% African-American, 4.3% Asian-American, 8.5% other, 0.9% NativeAmerican. By 2050 it is estimated that the White population will decrease to 47%, so no single race majority in the U.S. 3) What are the current majority of Americans? What impact does this have on todays population? White Anglo-Americans=ancestors are from England or Western Europe. This produces the set of common U.S. cultural characteristics shown in Box 6-1 such as; speak English, bathe daily, are Christian etc 4) What is culture? Where is it learned? Is it dynamic or static? It is learned behaviors (values, beliefs, and practices) that develop over time as a result of social, religious, and intellectual influences in ones environment. It is learned from birth from both instruction and immersion into the environment. It is dynamic, ever changing to meet the needs of its members. Also changes when members immigrate and adapt to new cultures from host countries. This is called enculturation or socialization. 5) What does culture include? Language, communication style, traditions, religion, definition of beauty, modes of dress, health beliefs/practices, food preference, tolerance for space, family roles, desirable education levels. Culture encompasses every aspect of an individuals life. 6) What is race? Physical characteristics including; skin color, eye shape, hair texture, etc 7) What is minority status? The people who differ from the dominant group, but not necessarily being fewer in number. Less power and control then the dominant group. 8) What is ethnicity? Identity based on geographical locations that are places of birth or ancestral origins. Ex. Italian-Americans, Irish Americans, etc Can occur in people who have never lived in the area. Grauso=Hawaii 9) What are stereotypes? They are preconceived ideas about people based on race, culture, ethnicity, gender, sexual orientation or any other factor, ex: employment-like being a garbage man or being a priest etc. 10) What is generalizing? Why do we use it?

P. Arredondo 8/29/13 Supposition that a person shares cultural characteristics with others of a similar background. It is used to predict common cultural characteristics. They are only good guesses any 1 member of a culture may differ. 11) What is ethnocentrism? The belief that ones own culture or ethnicity is superior to others. 12) How is healthcare heavily impacted by culture? There are 2 reasons. -Those who receive healthcare services are multicultural -Those who provide healthcare services are multicultural 13) What is culturally sensitive care (CSC, transcultural nursing)? What criteria need to be met in order to provide CSC? Providing care within the context of anothers culture. One must obtain knowledge & understanding of clients culture, accept and respect cultural differences, accept each client as an individual, have knowledge of health problems that affect particular cultural groups, adapt with them in a way that is congruent with their culture. 14) What are some aspects of a cultural assessment that a nurse should know? Some aspects included but not limited to are; language & communication style, hygiene & modesty, special clothing or ornamentation, religion, family & gender role beliefs, dietary practices & restrictions, eye contact beliefs, space, touching, health beliefs and practices. 15) Do non-English speakers get an interpreter? Who is not eligible for an interpreter? Yes they are entitled by law (Title IV and JCAHO). It is illegal to use kids, and there are risks when using family members. 16) Explain how to communicate with Hispanics. It is ok to sit close, command English may be limited, hesitant to ask questions look for signs, men protective and authoritarian about women and children, men expect to be consulted in family decisions. 17) Explain how to communicate with African-Americans. May be distrustful of healthcare system due to Tuskegee experiment (1932-72), may have been disrespected and discriminated against in healthcare settings, need to be respectful, use surnames, ask open-ended questions, respond quickly and cheerfully to requests. 18) Explain how to communicate with Asians. They value simplicity so expect short answers, respect for harmony and authority figures may lead them to not openly disagree with orders or medical personnel which can conceal a disagreement and lead to noncompliance. 19) Explain how to communicate with Native-Americans. They tend to be private and hesitate to share personal info with strangers, may see questioning as prying, may be fearful of people who write down what they say, may see impatience of the nurse as disrespectful, view sustained eye contact as invasion of privacy and disrespectful. 2

P. Arredondo 8/29/13 20) What are some general principles for communicating with non-English speaking clients? When using an interpreter; select one of same gender and age, look at the client not the interpreter, avoid technical terms, ask questions with yes/no answers, use nonverbal communication (body language). 21) What are some cultural practices regarding the social interactions and beliefs about health and illness for: -Anglo-Americans? Make eye contact while speaking, prefer ~2ft of space, prefer strong handshakes, freely express emotions, believe disease caused by microorganisms=biomedical or scientific perspective. -Hispanics? Men may no express emotion to maintain machismo(manliness), believe in hot/cold beliefs (naturalistic or holistic perspective) says illness is cause by an imbalance of these and adding or withholding may restore health. -African Americans? They freely express emotion, believe disease is caused by microorganisms=biomedical or scientific perspective. However, Creoles are an African-American sub culture and may believe that supernatural forces are responsible for illness or health=magico-religious perspective. -Asian Americans? They view prolonged eye contact as an invasion of privacy and disrespectful, prefer more than an arms length of space, emotions and expressions of pain not feely expressed, may consider head sacred so should not be touched unless a close relative, female body cannot be touched by men from waist to knees unless by husband, believe in yin/yang (natural or holistic perspective) in which balance between forces determines health or illness. -Native Americans? Lingering eye contact viewed as invasion of privacy and disrespectful, strong handshakes are offensive; believe in naturalistic or holistic perspective. 22) What are some cultural practices regarding diet and diet restrictions for the following: -Jews? Kosher, no pork, dont mix meat and milk. -Catholics? Holy day restriction of meat. -Seventh Day Adventists? No meat. -Hindus? No meat. -Muslims? No pork or alcohol. 23) What are some cultural practices regarding time? Some cultures value punctuality Anglos Others are more laid back Hawaiians Americans tend to see time as useful work periods Other cultures like European and South American countries freely expand schedules to include a midday siesta. 24) What tare some biologic and physiologic variations that concern nurses? Differences in certain physiologic enzymes. LOOK AT SLIDES 44-46 IN GRAUSOS POWERPOINT FOR A GUIDE ON ASSESSING SKIN 3

P. Arredondo 8/29/13 25) What is hyperpigmentation? Give an example. Excessive pigment. Mongolian spots are an example of hyperpigmentation. They are blue areas on lower back or buttocks of infants from East Asia, Turkey, East Africa, & Native Americans. They are present on the baby anywhere from birth to ~5 years of age. 26) What is hypopigmentation? Give an example. List treatment options. Deficient pigment. Vitiligo is irregular white areas on the skin due to absence of melanin. Occurs in whites and nonwhites, affected areas are at higher risk of sun burn, and they may create emotional distress. Treatment options include: concealment with make-up, and bleaching unaffected areas to match like Michael Jackson. 27) Hair of non-whites may be curly which is harder to comb. What do you do in this situation? Use wide-toothed comb or pick, wet hair with water or lotion, and may place in brads to decrease tangles. 28) What diseases are linked to the following?: -African Americans? Sickle cell anemia. -Jews? Tay Sachs disease -Native Americans? Alcoholism 29) For African Americans, Hispanics, Asian Americans, and Native Americans, what diseases are leading causes of death? Heart disease and cancer= #1-2 for all CVA=#3-4 for all except Native American #6 for them Diabetes=#4-6 for all READ PAGE 82 FOR WAYS TO BECOME CULTURALLY SENSETIVE!