widely different backgrounds, ages, cultures, and values.•Each of us perceives and interprets the world based on our own experiences and values, so we may interpret words and behavior very differently from others. •Different social, cultural, and sex/gender standardscan lead to very different understandings. •Men and women may perceive behavior or situations differently. Western Tradition •Identity found in individuality•Values: oAutonomyoIndependenceoSelf-reliance•Mind and body are separate entities not holistic•Disease has a cause and treatment is aimed at the cause•Time is linear keeps moving forward•Success is obtained in preparing for the future•Clinical application = privacy and confidentialityEastern Tradition •Family basis: clan (same last name) for identity, or origin, collectivism•Body-Mind-Spirit:one entity•Time is circular and recurring reincarnation•Idea of balancing and nature and nurture•Born into a fate and a duty to comply•Disease caused by fluctuations in opposing forces (not balanced)•Clinical implication = family’s and senior’s decision(s)
Indigenous Culture •Places significance on place of humans in a natural world•Basis of identity is the tribe•Person is an entity only in relation to others•Disease is caused by lack of harmonybetween individual and environment•Clinical implication = feeling, coherence to natureCultural Awareness •Examine & Assess: beliefs, values, and practices of own culture•Recognize that during a cultural encounter, three cultures are intersecting oPatient + Nurse + Setting Cultural Barriers to Mental Health Services •Communication barriers/language•Stigma of mental illness•Misdiagnosis•Cultural Concepts of Distress: cultural bound syndrome•Genetic variation in pharmacodynamics (CYP) enzymesWhat Kind of Asian are you? Populations at Risk of Mental Illness and Inadequate Care •Immigrants: limited English proficiency, limited jobs, high need to adjust•Refugees: loss of family, homeland, vulnerable to suffer from psychiatric disorders including depression and post-traumatic stress disorder•Cultural “minorities”: frequent victims of bias, discrimination, and racism. They often feel excluded and marginalized, such as homeless, LGBTQ, etc. Model of Cultural Competence Care: Dr. Campinha-Bacote •Cultural Awareness •Cultural Knowledge •Cultural Encounter oKey component: amount of encounters •Cultural Skill •Cultural Desire
Dr. Madeleine M. Leininger’s Sunrise Model •Cultural Care Diversity & UniversityCultural Sensitivity •Being aware that cultural differences and similarities between people exist without assigning them a value – positive or negative, better or worse, right or wrong. Cultural Humility •The ability to maintain an interpersonal stance that is other-oriented in relation to aspects of cultural identity that are most important to the person.