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CULTURE, CULTURAL INFLUENCES, BELIEF VALUES and NORMS
OBJECTIVES
•Discuss concept of sociology and anthropology and their importance in medicine.
•Describe culture and subculture and their influences.
•Discuss evolution of culture as dynamic processes.
•Discuss concept of Belief values and norms and their impact on clinical practice.
•Evaluate the attitude of physicians toward culture.
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Behavioural Sciences
Study of human behaviour using the principles of psychology, sociology and anthropology
and conditions of health and disease.
PSYCHOLOGY:
Study of human mind and the role played by its various functions such as emotions,
thoughts, cognitions, motivations, perceptions and intelligence taking part in the
health and disease.
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Sociology and Anthropology
Sociology and anthropology provide the knowledge base for the sub-part of Environment.
Included as an essential element in the understanding and practice of holistic medicine.
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SOCIOLOGY
Sociology is the scientific study of society.
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A society, is a group of people related to each other through persistent relations, or a large
social grouping sharing the same geographical or virtual territory, subject to the same
political authority and dominant cultural expectations.
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The role of family, gender issues, social classes, socioeconomic circumstances, housing,
employment, social support in maintaining health or causing this disease is studied in this
domain.
Anthropology
Is the study of effects of evolutionary history of human beings, their cultural history, racial
classification, geographical distribution.
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Anthropology means not only looking out at other cultures, but looking back at our origins
and what it means to be human.
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Why to know about sociology and anthropology?
Holistic approach rather than traditional approach.
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These factors influences the body, mind and spirit of an individual, in the process of health.
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The basic phenomena's include , culture, beliefs, values, norms, health belief models,
family, child rearing practice, social barriers to health care, social classes, gender roles,
ethnicity and other social phenomena.
What is Culture?
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Culture is the outcome of the man-made part of our environment.
Culture is always a dynamic process, and therefore, continues to evolve.
The culture is viewed in people’s language, art, architecture, religion, norms, values and
health care beliefs.
People in culture have a shared view of value orientation and hold a peculiar world view.
World view is shown in form of language, art, architecture, religion,, norms , values and
health care beliefs.
It is not biologically inherited instead learnt from environment ….. So can change.
It provides one with a sense of identity, encourages a group survival and gives a useful
picture of the world.
Subcultures
Subcultures may develop within a culture resulting in distinctive set of standards and
behavior patterns by which a group within a larger society operates. E.g. four provinces,
people living around shrines.
The typical example of sub-culture relevant to health are language learnt acceptable
behaviour patterns.
Three related factors for fabric of society
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BELIEFS
VALUES
NORMS
Beliefs
Beliefs are views with a shared meaning in a culture that are held to be true e.g. in most
Islamic cultures, the benevolent role of God in the healing processes an established belief.
Values
The values are those aspects of a culture that are held in high regard, are desirable and
therefore worthy of emulation e.g.' a doctor is never commercial and business like in his
dealings with patients, elders always know better.
Norms
Norms refer to principles of right and wrong action and the rules and laws that govern the
acceptable and unacceptable behavior e.g. abortions, euthanasia, and intake of alcohol,
cannabis and heroin are all considered against the norms.
A doctor needs to have a flexible approach regarding his patient’s beliefs, values and norms
and do not try to pass judgment on them.
Importance for Physicians !
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Rates of diseases
Preventive strategies
Pathways taken to health care facilities
Choices, option for treatment
Compliances or treatment adherence
Understanding of the disease phenomena
Efficacy of treatment
Illness behavior
Utilization of health services
Conducting psychosocial assessments
WHY to know about other cultures?
It is important to understand that individual consider their culture superior to others. So
physicians should avoid confronting.
To build a professional doctor patient relationship.
Attitude of Physicians towards culture could be
It is addressed by following strategies:
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Physician can not solve but help to solve their problems
Behave as if they are no Trans-cultural differences and it is not barrier in Dr. Pt.
relationship
Diversity of behavior should be acceptable and will be respected
Learn after any mistake: try to learn about that culture and do not repeat the
same
Role of Doctor/ Physician
1. Cultural Competency
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Cultural competency refers to possessing knowledge, awareness, and respect for other
cultures
Physicians must respectfully elicit needed information from patients from various
cultures to make accurate diagnoses and negotiate acceptable treatment goals
2. Views of Disease Causation
•A person’s worldview (i.e., basic assumptions about reality) is closely linked with his or her
cultural and religious background and has profound health care implications.
•(Asian patients believe that germs play a role in disease, but that hot-cold imbalances make a
person susceptible to illness)
•Physicians should respectfully explore a patient’s beliefs within the context of the patient’s
religion and culture.
•Patients may lose confidence in their physicians if they do not receive prompt, culturally
comprehensible diagnoses.
•Clinical success often depends on communicating with these healers and prioritizing tests and
treatments.
3. Cross-Cultural Interview
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The cross-cultural interview requires time and patience
•Establish trust
•use a patient’s formal name
•persons from some Islamic sects do not allow opposite-sex touching (even
hand shaking)
•Language barriers can create misunderstandings
•directly (An interpreter is necessary if the physician and patient do not
speak the same language fluently)
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Explain the different treatment options and find a mutually acceptable treatment plan.
Take home message
Efforts directed toward instituting more culturally relevant health care enrich the physicianpatient relationship
Improve patient rapport
Adherence
Outcomes of health care
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