1. Power and Cultural
Considerations
Ophthalmology Wiki Project
Karena Poupard
University of North Florida
EEX 5998 Healthcare Interpreting
Dr. Sherry Shaw
(Group Members: Erik Hoover, Holly Jackson, Karena Poupard, Michelle Theiss)

2. What is Power?
Definition: power relates to the status level of individuals
involved in a communication exchange in order to influence
behavior with or without resistance.
Education/Income/Background level indicates a sense of
status
Examples:
Doctor/Patient
Professor/student
Speaker/audience member
Doctor/Interpreter/Patient
Lawyer/plaintiff or defendant (Judge/Lawyer)
High Class/Middle Class/Lower Class

3. Cultural Considerations
Culture:
Diverse Ethnicities
Race
Religion
Socioeconomic status
Gender Identification
Non-dominant groups
Communication:
Use of Interpreters
Communication style
Personal Space
Eye Contact
Touch
Time Orientation
View of Healthcare professionals
Learning Styles

4. Diverse Ethnicities
Definition of Diverse: Diversity is a commitment to
recognizing and appreciating the variety of characteristics
that make individuals unique in an atmosphere that
promotes and celebrates individual and collective
achievement.
http://www.lib.utk.edu/diversity/diversity_definition.html
Definition of Ethnicity: of or relating to large groups of
people classed according to common racial, national, tribal,
religious, linguistic, or cultural origin or background
http://www.merriam-webster.com/dictionary/ethnic
Examples:
White
Hispanic or Latino and Non Hispanic or Latino
African American
Pacific Islander or Hawaiian
Asian
American Indian or Alaskan Native

5. Race
Definition: as “a human group defined by itself or
others as distinct by virtue of perceived common
physical characteristics that are held to be
inherent…Determining which characteristics
constitute the race…is a choice human beings
make.
http://plato.stanford.edu/entries/race/#RacVerEth

6. Examples:
Hispanic/Latino
A Hispanic patient brings his family to his
appointment. There is not enough room for the
family to join in the patient room. The doctor
allows for one family member to be present.
Family is valued within Hispanic culture and
consultation with family is important before making
any decisions.
Eye contact is important. It is a sign of respect but
do not stare as this is deemed as an invitation to
fight or quarrel.

7. African American
General “Good to Knows”
Non-verbal Communication:
Personal space needs can be hard to determine. Ask the
patient what is too far /too close. This helps avoid feelings that
you are “in {their} face” or “far away because I am black.”
Patient may be reluctant to make eye contact. Make special
efforts to seek and maintain eye contact and speak directly to
the patient
Verbal – Show respect :
Ask patient to self identify race to determine preference for
Black/African American/ Negro/etc…
Refer to patient as Mrs., Mr., Ms. or Miss unless requested to
use first name or other name.
To African American women in the northern parts of the U.S.,
use of the term “Ms.” may be offensive. Be certain to ask the
patient how she prefers to be addressed.
http://www.bcm.edu/mpc/special-af.html

8. Asian/Pacific Islander/Hawaiian
In collectivist societies, many decisions are not made by
individuals, but by families and groups, presumably with the
larger good in mind; for example, in focus groups in Hawaii,
physicians said they modified their approach to families on
the basis of their understanding of cultural decision making
norms. Unlike the custom among white people, for whom the
individual patient is the decision maker, many Japanese and
Chinese families assign decision-making duties to the eldest
son. In Pacific Islander families, it may be less obvious who
the decision maker is. A member may be designated as
decision maker, and others are assigned to other duties (for
example, bringing food, telling stories, and running errands).
Regardless of role, all family members customarily receive
the same level of detail about the patient's diagnosis,
prognosis, and treatment options.
http://www.thefreelibrary.com
/Asian+and+Pacific+islander+cultural+values%3a+considerations+for+heal

9. American Indian/Alaskan Native
Listening and observing is highly valued in this culture when
it comes to communication. It may take them longer to
respond to a question or make a decision. Sometimes they
may want to consult with their tribe before making any
decisions.
Emphasis on watching, listening and observing as opposed
to talking about what is going on in order to formulate a
response.
Deaf American Indian/Alaskan Native: Home signs may be
highly used between family members.
Humphrey J. & Alcorn B. (1994, 1995, 2001). So You Want to be an Interpreter: An
Introduction to Sign Language Interpreting. Interpreting with Native Deaf people, 3.23
– 3.24.

10. Religion
Definition: a set of beliefs concerning the cause, nature and
purpose of the universe, especially when considered as the
creation of a superhuman agency or agencies, usually
involving devotional and ritual observances and often
containing a moral code governing the conduct of human
affairs.
http://dictionary.reference.com/browse/religion

11. Example:
A person walks in to an Ophthalmology
appointment with a religious belief that does not
allow them to accept medication or treatment.
This could have an end result of visual impairment
if proper treatment is not obtained.

12. Socioeconomic Status
Definition: Socioeconomic status is commonly conceptualized as
the social standing or class of an individual or group. It is often
measured as a combination of education, income and occupation.
Examinations of socioeconomic status often reveal inequities in
access to resources, plus issues related to privilege, power and
control.
http://www.apa.org/topics/socioeconomic-status/index.aspx

13. Example:
Individuals who are earning an income below the National
poverty level are at risk of receiving poor quality treatment
based on insurance coverage such as Medicaid.
Specific testing is not covered, doctors are rushed and
inundated with patient care, and proper treatment is not
provided.

14. Gender Identification
Definition: Gender identity is defined as a personal
conception of oneself as male or female (or rarely, both or
neither).
This concept is intimately related to the concept of gender
role, which is defined as the outward manifestations of
personality that reflect the gender identity. Gender identity, in
nearly all instances, is self-identified, as a result of a
combination of inherent and extrinsic or environmental
factors; gender role, on the other hand, is manifested within
society by observable factors such as behavior and
appearance.
http://emedicine.medscape.com/article/917990-overview

15. Lesbian/Gay/
Bisexual/Transgender
Discrimination can be occur when an Ophthalmologists
harbors unintentional/intentional biases against patients who
identify as LGBT.
LGBT patients tend to avoid medical attention due to
discrimination factors.

16. Non-Dominant Groups
A category of people whose physical appearance or cultural
characteristics are defined as being different from the traits of the
dominant group and that result in their being set apart for different and
unequal treatment. This definition of a minority group takes into account
both race and ethnicity and can, indeed, subsume sex/gender, age,
religion, disability. http://cnx.org/content/m33866/latest
As diverse beings, there are times in which we may belong to the
dominant (or majority) group and there are times in which we belong to the
non-dominant (or minority) group. Therefore, we each experience
moments and situations in which we have power and privilege, and others
in which we may experience discrimination and oppression.
A variety of reactions occur associated with being a member of the non-
dominant culture/group: fear, anger, sadness, pride, helplessness,
excitement, rejected, blaming, challenged, respectful, empowered, etc.
These reactions can also impact how we view ourselves and how we
engage with others. We may become more isolated, we may experience
difficulties in finding success, and these could lead to anxiety and
depression. When we experience these challenges, it can be helpful to
look for others to connect with and to share our experiences. Conversely,
as a member of the non-dominant culture/group, we may feel motivated to
engage with others and affect change, thus helping to improve the
conditions for our community.
http://www.marquette.edu/counseling/diversity.shtml

17. Resources
Diverse Ethnicities
http://www.lib.utk.edu/diversity/diversity_definition.html
http://www.merriam-webster.com/dictionary/ethnic
Race
http://plato.stanford.edu/entries/race/#RacVerEth
Religion
http://dictionary.reference.com/browse/religion
Socioeconomic Status
http://www.apa.org/topics/socioeconomic-status/index.aspx
Gender Identification
http://emedicine.medscape.com/article/917990-overview
Non-Dominant Groups
http://cnx.org/content/m33866/latest
http://www.marquette.edu/counseling/diversity.shtml

18. Resources Continued
African American
http://www.bcm.edu/mpc/special-af.html
American Indian/Alaskan Native
Humphrey J. & Alcorn B. (1994, 1995, 2001). So You Want to
be an Interpreter: An Introduction to Sign Language
Interpreting. Interpreting with Native Deaf people, 3.23 – 3.24.