Cultural Diversity in Medical Care Essay Example

not a task that a nurse can become proficient in overnight, but like most aspects and skills in nursing, something he or she will become more sufficient in over time. I have decided to write on what I believe to be two very different cultures. I have found both of these cultures to be very interesting and much different from my own American culture. I will be discussing the African-American and Japanese cultures, including ways they are similar and different in each aspect of their culture.

Communication

The African American culture primary speaks English. There are some dialects spoken in the coastal areas of South Carolina, northern Florida, and Louisiana. Vernacular Black English is a expressive dialect that refers to a nonstandard varieties of English spoken by this culture of any educational or social level. They address each other as “Mr.” or “Mrs.” Or by last name. Most Women greet each other with a hug or kiss on the cheek whereas the men greet each other with a modified handshake hug. When greeting a stranger a handshake is acceptable unless indicated otherwise. When speaking to each other, the conversations are very load and with lots of body movement. Their tone of voice can be low or high pitched in positive or negative encounters. Their style is very direct but depends on the age, and at times conversations can be very lengthy. The Japanese culture, Nisei are usually bilingual, but later generations speak English only. Newly immigrated Japanese usually can understand and speak some English. Most Japanese visitors have difficulty communicating in English. Also in the Japanese culture, they use surnames with a small bow this is more

common in the older generations whereas in the younger generation, a simple hand shake is more common. Traditionally, this culture is very careful of feelings and they adjust their speech to the other persons age, gender and social status. Avoiding direct expressions or disagreement or conflict is huge in this culture, and in general they ask very few questions about their treatment or care deferring to the clinician’s authority. Most Japanese avoid direct eye contact, and have a low-touch preference.

Family Roles & Organization

In the African-American culture, the father ultimately has the final say so in the decision making role, he is head of the house hold and speaks for the family while the women makes the health care decisions. Women are viewed as equal and both the men and women cook, clean, and share child care and also work inside and outside of the home. The wife or eldest female sibling takes on the caretaker role, while the sons often take care of the parents. Children are expected to help with household chores and complete school. Discipline and good behavior are also emphasized. Depending on religious beliefs, an unwed women who becomes pregnant maybe counseled by a pastor or someone in their church. In the Japanese culture, they are more family oriented and their values include importance of family as a unit. Women, are involved in the decision making whereas the male is more of the family spokesperson. Women are the primary caregivers for the family, even if the women are sick they still continue the care taking role. Men are more pampered. The children are taught to be polite, shy and humble and emotional

outburst are discouraged. In this culture, educational achievement leading to a valued or respected occupation such as medicine, pharmacy or law is greatly emphasized. The Japanese expect a couple to be married if they become pregnant and frown upon sexual activity outside of marriage.

Biopsychosociocultural Aspects

In the Japanese culture, modesty is very important especially to women. It is in their belief that one must purify the body to restore their health. Hair washing and daily showers are preferred. Women prefer to have their hair professionally washed and styled weekly. Nails are usually short and clean with a preference of a manicure and pedicure. As for privacy, primarily they toilet in the bathroom and wash after each toileting. When it comes to special clothing they may use prayer beads depending on religion. The two challenges the Japanese culture faces is alcohol abuse and tobacco use. In the African-American culture, when it comes to modesty both genders prefer a respectful approach. Daily skin care and hygiene are important. It is common for African-Americans to have dry skin, so it is very important to them to have a good moisturizing lotion to use daily. They shampoo their hair every 7-10 days because of the texture and it is also very dry so they use oils that they apply daily. Both genders typically prefer short toe nails but the women prefer to have them painted. Manicures are a matter of personal choice but women prefer to have some length with decoration. Providing privacy is important when it comes to toileting, also hand washing and washing of the genital area after toileting is essential. For both genders, dressing in their church

clothes for services is not complete without a hat of some kind. Self-care is preferred, but when assistance is needed they show appreciation. Sexual transmitted infections and drug use are high risk behaviors in this culture.

Nutrition

African-Americans eat three meals a day often with a large meal eaten in the late afternoon or after church. Special utensils are not commonly used in this culture. Their preference is cooked foods with a usual diet consisting of hearty meals with meat, fish, greens and starches. Prefer home cooked foods to processed and fast foods. For religious reasons, pork is not usually eaten, but all leafy greens are eaten for good health and maintaining bowel function. In the Japanese culture, they eat three meals a day with snacks between meals. Rice is eaten with most meals, especially dinner. Chopsticks are the preferred utensil depending on the setting. The usual diet is low in fat, animal protein, cholesterol, and sugar with a high salt content. Traditional protein source is fish, soybeans and vegetables. They believe that if combining certain lactose foods will cause illness. When ill they prefer to drink hot tea and eat pickle plums to maintain normal bowel function.

Pregnancy and Childbearing Practices

Traditionally, Japanese value pregnancy as a woman’s destiny. Mothers to be are pampered and instructed to eat properly, avoiding foods and drinks that may harm the baby. The Japanese prefer the male children to inherit the family assets and take responsibility for parents and siblings. During labor women may be assertive and express her wishes and needs. During Labor the Japanese still view modesty as very important. The Father has an active role and are usually present

during labor and delivery. At least two children are desirable for most families but if the first two children are girls, they will typically keep trying for a boy. In the African-American culture, partners are actively involved in pregnancy care. They have no limitations on activities during pregnancy and continue to work up until time of delivery. Emotion is fully acceptable during the labor process while there is no preference in the gender. The ideal family size is typically two children, but families with many children are viewed as healthy and blessed.

Death Rituals

In Japan, death is openly discussed. When the family knows that their family member is terminally ill or dying, they normally avoid talking about it with each other. A DNR is a very difficult choice for this culture and when the decision is made, the entire family decides. In terminally ill cases, they prefer to die at home. Women openly grieve , while men remain quiet. It is important that the body remain clean and that dignity and modesty are preserved for viewing. The Japanese strongly agree that the body should remain intact and seldomly agree to organ donation or an autopsy. African-Americans consider death inevitable, and as a natural part of living. They grieve expressively and strongly and believe that although death is a part of God’s will, life support measures should not be withdrawn as this is viewed as an extension of God’s gift. They prefer death at home with an adequate amount of time needed to inform all family members including the ones that live far away. African-Americans have no specific death ritual, but some believe that death at home

brings bad luck. Family members usually want professionals to prepare and clean the body unless a religious ritual was requested. They show respect for the deceased and avoid cremation, and also view organ donation as disrespectful.

Spirituality

African-Americans are religious and have strong church affiliations. Catholicism, and Islam are the primary affiliations. The typical spiritual practices include going to church on Sundays, praying, singing and visiting with the preacher of the church. They may use faith and herbals along with biomedical resources but do not commonly use these practices, as they prefer primary health care providers. Christianity accounts for the largest group among the Japanese culture. Immigrants most commonly practice Buddhism and Shintoism. Japanese join churches of any religion as church has been and continues to be, a place for socializing and cultural change. The Japanese pray and make offerings in small shrines at home, they also combine prayer with traditional Western medicine.

Health Care Practices

The Japanese culture believe that natural causes like being out of balance from lack of sleep or poor diet have an impact on physical illness. They also believe that chronic illness are caused from a result of bad behavior in this life or in a past life. When it comes to mental health, families believe that the mentally ill member do not try hard enough to deal with the situation. They do not view mental illness as a real illness and avoid seeking professional help. Genetic defects are viewed as a punishment for parents of bad behavior, and also view disabilities as a punishment for something one has done in their life or for something a family member has done. Women primarily care

for the sick and assume a passive role. Most Japanese use herbal medicine to cure a topical site, but are compliant with western medication which they use in conjunction with folk remedies. Blood transfusions and donations are acceptable in this culture, but organ transplants are not due to the belief’s of maintaining the integrity of the body. Many Japanese try home remedies before seeking medical help and often do not respond to illness until it has advanced. Some Japanese have a high pain threshold while others refrain from asking for medication. They accept oxygen but less likely to accept a narcotic. They get embarrassed when they lose control of bodily functions and get very uncomfortable when bowel routine is interrupted. Generally the Japanese tolerate fatigue well and resort to foods that they think will relive it. The Japanese do not accept gay relationships and view them as shameful. They have strong expectations that women and men assume their gender roles. Abortion is unacceptable and expect the parents to be married. Birth control is only acceptable within a marriage. Menopause is regarded as normal however, symptoms are not to be openly discussed.

African-Americans believe physical illness is a result of natural causes, improper diet, exposure to extreme weather or supernatural causes. Mental illness is viewed as a spiritual imbalance as they mask the issue, they still seek help from loved ones and professionals. Genetic defects are considered God’s will as are disabilities. While sick, they expect attention from family and relatives and acknowledge that one cannot perform their usual role. They include home remedies with teas, herbs, and compresses on the chest for colds. All forms of

medications are accepted and typically taken as prescribed. Surgeries, blood transfusions and organ transplants are all accepted. Expression of pain is very open in this culture. Oxygen and opiates are acceptable means for dyspnea. When nausea and vomiting occur, nonpharmacological methods are often preferred. When it comes to constipation they have an open attitude in reporting the symptom and prefer fruits and prunes as source of relief. Fatigue may be masked as depression and may take sleeping pills to foster sleep. All forms of birth control are acceptable. Abortion does occur but is uncommon. Homosexuality is not accepted, but they are not disowned by the family. Women are expected to be feminine and men are expected to be masculine, family may disown this individual if opposite to gender. Women have positive attitudes about menopause and view this as a normal life change.

Health Care Practitioners

African-American and Japanese cultures both rely on the use of folk healers and home remedies. Both cultures try home remedies and practices prior to seeking medical advice from a traditional health care practitioner. In the Japanese culture, they prefer to use practitioners of the same sex as the patient. It is important to take their traditions into consideration when treating the patient, even when they may wait too late to seek advice.

Conclusion

Cultural Competence plays a vital role in the nursing career field. It helps to ensure that you are providing quality, patient-centered care. Recognizing your own beliefs and understanding how they may vary from others is a very important step towards growing professionally in a field with such cultural and religious diversity. The African-American and Japanese vary in many aspects of their

cultures. The Japanese are a very proud culture. Their unique views on pain must be understood to provide quality care. African-Americans use more religious types of healing and treatment, so it is important that you respect their wishes. Learning different cultures and beliefs comes in time, educating yourself will make you a better nurse and prepare you to advocate fully for your patients.