Many prefer to have family members with them at all times, leading to chaos and loss of control from the perspective of the nurses. The health care culture's value of efficiency often conflicts with patients' value of modesty. Many doctors and nurses find concern about keeping patients covered difficult when their primary focus is performing an appropriate procedure. The health care culture also values self-control. Many patients, however, come from cultures in which emotional expressiveness is the norm.
Cultural background is a major influence in how one perceives and reacts to pain.
People of some cultures are more expressive of their pain than those from others. Weather and degree of crowding are thought to affect the way people handle their pain and emotions. Hispanic, Middle Eastern, and Mediterranean backgrounds tend to be expressive, whereas Northern European and Asian backgrounds tend to be stoic. Ethnicity, alone, does not predict accurately how a person will respond to pain. Some individuals tolerate even the most severe pain with little more than a clenched jaw and frequently will refuse pain medication.