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Nov 2, Fundamental concepts about culture and family dynamics should be understood by providers so they may best address how the unique family experience of an individual patient affects decision-making, compliance, and successful treatment outcomes.
Interdependence Cultures differ in how much they encourage individuality and uniqueness vs. Individualistic cultures stress self-reliance, decision-making based on individual needs, and the right to a private life. Extended Family Models In western cultures, and particularly in European American culture, families typically follow a nuclear model comprised of parents and their children.
When important health care-related decisions must be made, it is usually the parents who decide, though children are raised to think for themselves and are encouraged to act as age-appropriate decision makers Dynamic and culture well.
Upon reaching adulthood, when parental consent is no longer an issue, young American adults may choose to exercise their right to privacy in health care matters.
This is markedly different from collectivist cultures that adhere to an extended family model. In cultures such as American Indian, Asian, Hispanic, African, and Middle Eastern, individuals rely heavily on an extended network of reciprocal relationships with parents, siblings, grandparents, aunts and uncles, cousins, and many others.
Many of these people are involved in important health care decisions, including some who are unrelated to the patient through blood or marriage. For example, in some Hispanic families the godparents play a critical role.
Multi-generational Households It is very common for families in collectivist cultures to establish multi-generational households. This is less true when a family becomes acculturated in the United States or other western countries where privacy is more highly valued and in cases where socio-economic gains create opportunities for greater independence.
In most multi-generational households, there are at least three generations living together; the grandparents are expected to live under the same roof as their adult children and grandchildren.
This is the reverse of how European American family households usually function. In traditional Asian families, it is the oldest male in the family who brings his bride to live with his parents.
The daughter-in-law is often expected to be submissive to her mother-in-law who rules the roost.
In Hispanic families, grandparents from either side may live under that same roof as their children and grandchildren. Mothers often gain a great deal of support from the grandmothers in domestic matters, but this varies depending on the dynamics unique to each family.
Who are the authority figures? In Asian and Hispanic traditional families, the father is the main authority figure. He will most often make decisions about matters outside the home, speaking for the family in public settings and signing consent forms.
It is usually a female figure who takes charge of domestic life. In unilineal cultures, family membership is traced either through a male or female ancestor. Thus it makes sense that a Navaho maternal uncle might bring his nephew into the hospital expecting to be empowered to sign an informed consent.
Similarly, in both American Indian and African American families, role flexibility can be an important issue. It is not uncommon for Native American grandparents to raise grandchildren while the parents leave the reservation to find work.
In African American families, the mother sometimes plays the role of the father and thus functions as the head of the family. In addition, older children sometimes function as parents or caretakers for younger children.
The concept of role flexibility among African American families can be extended to include the parental role assumed by grandfather, grandmother, aunts, and cousins. Boyd-Franklin It is a good idea to determine if older children will be involved in patient care and to include them when possible in patient care training.
This is important to consider for all multi-generation households. Family Dynamics and Acculturation Finally, it is important to consider the enormous stresses families encounter in the process of acculturation due to sudden and radical shifts in family dynamics.
Parents in a recently migrated family often are aligned with the culture of the country of origin, while their offspring are likely to adapt to the dominant culture more rapidly.
This often leads to intergenerational conflicts. For example, a father may lose his traditional role as the head of the family if his wife begins to work outside the home, earning income and greater independence.
Similarly, if his children quickly adopt the attitudes and values of the new dominant culture, he may find it harder to communicate with them.
Both parents and grandparents may feel a loss of status due to language barriers, especially if their children learn the language of the dominant culture more quickly. This can be especially problematic in healthcare settings where responsibility is shifted to younger family members who can navigate the health care system better than their parents can.
In cases where children are able to communicate with health care workers in English, they may be asked to interpret for their parents. This leads to a host of potential problems for the family, including feelings of shame and betrayal that children would relay information of a personal nature to someone outside the family.
This is one of the main reasons children should not be used as interpreters. Summary Because cultures adapt and change, making assumptions about family dynamics is problematic; families in the United States today from all cultures display a variety of configurations. One can, however, expect that families from more traditional cultures not acculturated in U.
There are many aspects of culturally-based family dynamics not addressed within the scope of this newsletter article. Some of the best resources for learning more about cross-cultural family dynamics come from the mental health and child development fields.Cross-cultural comparison is a critical method by which we can examine the interaction between culture and psychological processes.
However, comparative methods tend to overlook cultural dynamics – the formation, maintenance, and transformation of cultures over time. The present article gives a. However, because culture is adaptive and dynamic, once we recognize problems, culture can adapt again, in a more positive way, to find solutions.
ETHNOCENTRISM AND THE EVALUATION OF CULTURE. The diversity of cultural practices and adaptations to the problems of human existence often lead some to question which practices are the best.
The dynamic ecosystem/culture is subject to a never-ending deluge of new elements. Every time you sign a new client, hire a new teammate, promote someone or implement change of any sort, your. Culture is dynamic and heterogeneous means that culture changes.
A person who grows up in one culture is not tied down to that culture. If that person moves to a completely different area and takes on all the cultural values therein, he/she can be viewed as a part of that new culture.
Culture is dynamic and thus complex. Culture is fluid rather than static, which means that culture changes all the time, every day, in subtle and tangible ways. Because humans communicate and express their cultural systems in a variety of ways, it can be hard to pinpoint exactly what cultural dynamics .
Dynamic refers to the variability of culture. Culture is formed by people who have different values, beliefs, and religions. We mix them together in order to live peacefully. With the inclusion of.