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Cultural Humility: Eastern Europe

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Susan Botarelli

on 24 August 2013

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Transcript of Cultural Humility: Eastern Europe

Cultural Humility: Eastern Europe
Overview
Susan Botarelli
Presenters
The Countries of Eastern Europe
Russia
Czech Republic
Poland
Hungary
Romania and Moldova
Croatia
Lithuania, Latvia, and Estonia
Slovenia
Slovakia
Bulgaria
Ukraine and Belarus
Serbia
Montenegro, Bosnia and Herzegovina
Albania, Kosovo, and Macedonia

History of the Region
Russian Civil War 1917-1921
Estonian Liberation War 1918-1920
Latvian War of Independence 1918-1920
Hungarian-Romanian War of 1919
Czechoslovakia-Hungary War 1919-1920
Polish-Soviet War 1919-1921
Polish-Lithuanian War 1920
World War II 1938-1945
Hungarian Revolution 1956
Soviety invasion of Czechoslovakia 1968
Romanian Revolution 1989
Fall of the Berlin Wall 1989 becomes the fall of Communism
Croatian War of Independence 1991-1995
Bosnian War 1992-1995
Kosovo War 1989-1999
Iraq & Middle Eastern Wars 2001 to present
Russia-Georgia War 2008
Religions of the Region
31% Western Christian (Roman Catholic, Protestant)
44% Orthodox Catholic (Russian, Albanian)
16% Muslim
Julia Allen Chew
Susan Botarelli
Rhonda Edds
Stefanie Eymar
Kerri Rouze
Values of the Eastern Europeans
Toughness
Maintaining their cultural and regional traditions
Focusing on their families
Working hard for the betterment of their families
Well connected to their history
Hospitality toward all: good manners & kindness
Value the pursuit of education and educational goals
Successful in life on all levels
Inter-generational communication and contact
Autonomy entering into adulthood
World View
Have a stirring and stormy history
The Effects of World War II
The Effects of Communism
Living in a social-institutional system
Changes after 1989
Stefanie Eymar
World View: Current View
High importance placed on:
Group collectivism

Middle importance:
Humane orientation
Institutional collectivism
Performance orientation

Low importance:
Uncertainty performance
Future orientation
High/Low Context in Communication
Auxiliary words tend to be unstressed and incorporated into single phonetic group with an autonomous stressed word

Exuberant use of diminutives and metaphoric figures marks the Slavic tradition

Many two way contrasts in phrasing recalling the Iranian influence of a dualistic view of the world

Tendency towards analytic expression

Verbal and Non-verbal
Rhonda Edds
Prefer being addressed by title or surname – no first names until they suggest it

Will say “yes” even if don’t mean it because they value relationships

Prefer quiet speaking

Even if younger people speak more fluent English, address comments to older people

Women who speak in a forthright manner may meet resistance

O.K. sign (thumb and forefinger in circle) and shaken fist are considered vulgar

Rude to talk to someone with hands in pocket or while chewing gum

Do not shake hands with an Eastern European unless she offers her hand first
Use of Time and Space
Not uncommon for people to be 1-2 hours late for a meeting

Takes a long time to process information and provide an answer

Meals and meetings tend to last for several hours

Do not require as much personal space as Americans

Used to having many people in small spaces

Social Institutions
Julia Allen Chew
•Government
•Economy
•Family
•Religion
•Education
•Medicine
Government
Predisposed against speaking out
May be stoic
May not ask for help
Seek care when illness has progressed
Accustomed to hierarchy and may be reluctant to trust
Economy
May not seek care
Families may struggle with schedules
Children and adults may not engage in preventive care
Implications for Health & Wellness
Family
Potential issues accessing care
Fine balance of new schedules & working parents
New balance of family roles
Increase in environmental exposures and safety hazards
Increase in personal freedoms
Recognizing mental health issues with transformational changes Traditionally strong family connections and healthcare decision making
Religion
Lack of trust in organizations
Coping ability may be weakened
Education
Growing disparity between educational levels in the population may create distrust or communication barriers
Medicine
Increased acuity of diseased states
Delay in services
Use of traditional herbal remedies
Patients may not fully disclose health information Trust is key
Implications for Practice
Kerri Rouze
•Eastern Europeans are very stoic --> they seek out care when they are fairly ill

•In the Eastern European countries healthcare is free versus commercial insurance in the United States

•Common & consistent health problems: tooth decay, intestinal parasites, and respiratory diseases

•Former occupants of refugee camps may present with post traumatic stress disorder and high rates of
sexually transmitted infections.

•Women will seek prenatal care

Plan of Care
•Same gender healthcare provider preferred along with age maturity
•Using a translator: request specific dialect and same sex translator
•May be very quiet and slow to respond to questions
•Women may not look a male provider in the eye
•Awareness of cultural practices of male and female circumcision
•Cultural shame tied to loss of virginity prior to marriage--> extreme sensitivity in cases of rape
•Familial shame potentially associated with a disabled/mentally ill family member
•Embarassed to be offered financial assistance (Medicaid)
•Heightened anxiety with hospitalization of a loved one
•They do not desire use of artificial means for preservation of life-->discussion of DNR status

Questions?
Thank you for your time and attention!
References

Backasci, G., Sandor, T., Andras, K., Viktor, I. (2002). Eastern European cluster: Tradition and

transition. Journal of World Business, 37, 69-80.

Berend, I.T. (2007) Social shock in transforming Central and Eastern Europe.

Communist and Post-Communist Studies, 40(3), 269-280. Retrieved from

http://dx.doi.org.dml.regis.edu/10.1016/j.postcomstud.2007.06.007

Encyclopedia Britannica: Slavic languages. Retrieved from:

http://www.britannica.com/EBchecked/topic/548460/Slavic-languages

Freidlmeier, M. (2012). Continuity and change in family structures, family relations and

values in Eastern European countries after the collapse of communism. Cognitie, Creier,

Comportament, 16(2), 165-170.

Geovarghin, M. (2013, August 9). Personal interview: American citizen born in Armenia.

Mackenbach, J.P. (2013). Convergence and divergence of life expectancy in Europe: A

centennial view. European Journal of Epidemiology 28, 229–240.

Morrison, T., & Conaway, W. A. (2006). Kiss, bow or shake hands. Holbrook, MA: Adams

Media Corporation.

Purnell, L. D. and Paulanka, B.J. (2005). Guide to culturally competent health care.

Philadelphia: F.A. Davis.

Wallace, C., Pichler, F., & Haerpfer, C. (2012). Changing patterns of civil society in Europe and

America 1995-2005: Is Eastern Europe different?. East European Politics & Societies,

26(3), 3-18. Retrieved from http://eep.sagepub.com/content/26/1/3

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