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Working with Diversity: An Overview of Diversity in Contemporary Society and the Effect of This on Healthcare Situations

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Spirituality in Healthcare: Perspectives for Innovative Practice

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Abstract

In this age of digital and social media, there is a need for a consideration of individual spiritual needs within the infinite forms of diversities found within any population in today’s globalised world. Faced with the endless range of individualities, this chapter considers concepts, such as development of individual identities of culture, the dominant influences of cultural perception (such as media and politics) and the personal experience of intersectional processes in shaping personal needs, wants and notions of spirituality.

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Notes

  1. 1.

    ‘Others’ here represents anyone who we see differently from our group we are operating within at that moment. Thus, it could be personal, professional, ethnic, nationalistic, etc.

Abbreviations

BAME:

Black and Minority Ethnic Groups

UK:

United Kingdom

UNHCR:

United Nations High Commission for Refugees

WHO:

World Health Organization

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Author information

Authors and Affiliations

  1. Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK

    Gayatri Nambiar-Greenwood

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  1. Gayatri Nambiar-Greenwood
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Correspondence to Gayatri Nambiar-Greenwood .

Editor information

Editors and Affiliations

  1. School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland

    Fiona Timmins

  2. Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal

    Sílvia Caldeira

Appendix: Scenarios

Appendix: Scenarios

12.1.1 Travelling Family

Milly Smith is a 66-year-old woman who has just arrived in the A&E department with an exacerbation of her long-term chronic lung condition (chronic obstructive pulmonary disease), with a high temperature and dangerously low oxygen saturation levels (a pyrexia of 38.7 and saturated oxygen of 88%). She requires admission, for IV antibiotics and further care and investigations. Milly has been a heavy smoker (20–30 cigarettes a day) since the age of 10. She was diagnosed with this terminal condition approximately 10 years ago, and it has been recommended by a number of previous consultants that she access end-of-live palliative care services. Due to the transient nature of their lives, Milly has been unable to do so.

A devout Catholic, Milly was born into a travelling community and has moved around the United Kingdom and Western Europe throughout her lifetime. She and her family are currently based on an illegal campsite in the North West of England, and the local council is trying to evict the community from here in the next few days. She has 15 supportive adult children, between the ages of 24 and 51, the first child being born when Edna was 16. A widow of 4 years, Milly is very much a matriarch within her family and local community. She is accompanied in A&E by five adult daughters who are very concerned about their mum but express concern about her being admitted as it is likely that they will be moved on by the council in the next day or two. She is also distressed as they worship together on Sundays, in a shared communal way. The eldest daughter explains that her father died in hospital and the family experienced negative and racist treatment from the hospital staff.

  1. 1.

    What are the main issues that individuals and families who choose not to have a permanent address face in accessing healthcare? What can be done to facilitate her spiritual needs in this instance that makes her feel valued?

  2. 2.

    What are the differences between Gypsies, Roma, Travellers and New Age Travellers?

  3. 3.

    What issues may inhibit or limit how freely Milly and her family communicate with you?

  4. 4.

    How do programmes like ‘My Big Fat American Gypsy Weddings’ or other programmes that denigrate gypsy and traveller families influence our unconscious bias regarding Milly and her family?

12.1.2 Jewish Community

Joel Abrahams is a 48-year-old Orthodox Jewish man who has been admitted to a local psychiatric inpatient service due to an exacerbation of his enduring episodes of clinical depression. The nurses are reporting him not to be cooperative with any organised group work as he does show any interest in taking part in the activities provided by the unit, such as watching movies, playing pool or the weekly exercise group. He is also particularly uncomfortable in taking part in any mixed gender group activity.

Joel has, during one of his previous admissions, mistakenly been diagnosed as having obsessive-compulsive disorder due to the psychiatrist not appreciating his religious practice of the concept of ‘scrupulosity’ and his desire for repetitive prayer throughout the day, accompanied by chanting and swaying. He also only dresses in the traditional religious manner of his community.

  1. 1.

    What are the factors that may reduce Joel’s ability to communicate freely and effectively with health and social care staff?

  2. 2.

    What actions can be taken in relation to balancing Joel’s religious or spiritual needs and the needs for the service for him to engage in activities that are alien to him and his daily life, his privacy and his dignity?

  3. 3.

    How does knowing about Joel’s previous diagnosis of obsessive-compulsive disorder influence our unconscious behaviour/bias towards him?

  4. 4.

    What are the intersectional factors from Joel’s perspective that influence his health?

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Nambiar-Greenwood, G. (2019). Working with Diversity: An Overview of Diversity in Contemporary Society and the Effect of This on Healthcare Situations. In: Timmins, F., Caldeira, S. (eds) Spirituality in Healthcare: Perspectives for Innovative Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-04420-6_12

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