Chapter 5 - Cultural Awareness and Health Practices

African Americans
# Communication
# Competent in English
# Prolonged eye contact = rudeness or aggressive
# Nonverbal is important
# Personal question = can be intrusive
# Time orientations and personal space preference
# Variation according to the age = Past, present and future orientation
# Late for appointment = relationship is important
# Comfortable with personal space, family and friends
# Social roles
# Large extended-family
# Older adults are respected
# Households can be headed by single woman
# Religious beliefs are strength
# Health and Illness
# Religious beliefs affect ideas about
# Foods = Fried foods, chicken, pork, greens and rice
# Health risks
# Sickle cell anemia
# Hypertension
# Heart disease
# Cancer
# Lactose intolerance
# Diabetes Mellitus
# Obesity
# Interventions
# Asses verbal and nonverbal behavior
# Flexibility with scheduling and family involvement

Amish
# Communication
# German language + dialect + English learned at school
# Time orientations and personal space preference
# Remain separate from other communities
# Social roles
# Equality roles but man is authority
# Marriage outside the faith is not allowed
# Health and Illness
# Need to have church permission to be hospitalized
# Community will pay the coasts
# Not have health insurance = lack of faith in God
# Health risks
# Genetic disorders
# No immunization
# Sexual abuse on woman
# Interventions
# Speak with husband and wife / unmarried and father
# Simple and with clear language
# Bases on health risks
Asian Americans
# Communication
# Language include Chinese, Japanese, Korean, Filipino, Vietnamese and English
# Silence is value
# Eye contact = disrespectful
# Head nodding does not always mean agreement
# The word “no” = can be disrespect for others
# Time orientations and personal space preference
# Respect for the past but emphasis on the present and future
# Formal personal ins preferred
# Do not touch others during conversation
# Touching in opposite sex is unacceptable
# Head is sacred = do not touch
# Social roles
# Devoted to tradition
# Family is structured and hierarchical
# Man have the power and authority / Woman is obedient
# Education in important
# Religious include Taoism, Buddhism, Confucianism, Shintoism, Hinduism, Islam, Christianity
# Health and Illness
# Physical and spiritual harmony
# Positive (yin) and negative (yang) forces
# Health body = gift from the ancestors
# Foods = Raw fish, rice and vegetables
# Health risks
# Hypertension
# Hearth disease
# Cancer
# Lactose intolerance
# Thalassemia
# Interventions
# Request permission to touch
# Avoid gesturing with hands
# Limited eye contact
# Female client = Female Health Care Provider (HCP)
# Flexibility and avoid rigidity
# Encourage family involvement
# Alternative modes include herbs, acupuncture, massage, incense or some foods

Hispanic and Latino Americans

# Communication
# English and Spanish
# Verbally expressive
# Direct confrontation = disrespectful
# Expression negative feelings = impolite
# Dramatic body language
# Time orientations and personal space preference
# Oriented more to the present
# Late for appointment = relationship is important
# Comfortable in close proximity
# Value the physical presence of others
# Politeness and modesty are important
# Social roles
# Extended-family networks are common
# Needs to the family first
# Religious is usually Catholicism + Strong church affiliations
# Health and Illness
# Health = reward from God or result of good luck
# Illness = God’s punishment
# Some members use Folk Medicine
# Foods = beans, fried foods, spicy foods
# Health risks
# Hypertension
# Hearth disease
# Diabetes mellitus
# Obesity
# Lactose intolerance
# Parasites
# Interventions
# Allow time for family discuss treatment
# Protect privacy
# Offer to call Clergy
# Ask permission before to touch a child
# Be flexible and avoid rigidity in scheduling care
# Alternative modes include herbs, consult with lay healers, hot or cold foods, prayers

Native Americans (Indigenous people)

# Communication
# linguistic diversity
# Interpreter is importante = clear communication
# Silence indicates respect
# Eye contact can be sign of disrespect
# Body language is important
# Time orientations and personal space preference
# Oriented primarily to the present
# Massage in newborn = promote bonding between infant and mother
# Some groups prohibit touching of a dead body
# Social roles
# Members are family oriented
# Some groups = grandfather is family leader
# Elders are honored
# Religious is Christianity
# Community social organization is important
# Health and Illness
# Health = state of harmony between family, individual and environment
# Illness = supernatural forces or disequilibrium person X environment
# Foods = Cornmeal, fish, game, fruits and berries
# Health risks
# Alcohol abuse
# Obesity
# Hearth disease
# Diabetes mellitus
# Tuberculosis
# Arthritis
 # Lactose intolerance
# Gallbladder disease
# Interventions
# Clarify communication
# Client may be attentive even when eye contact is absent
# Attention in body language
# Encourage personal space
# Modify infection control and hygiene practices as necessary

White Americans
# Communication
# language of origins and English
# Silence can be respect or disrespect – depending on the situation
# Time orientations and personal space preference
# Usually future oriented
# Time is value – Be on time
# Handshakes are formal greetings
# Social roles
# The man usually is dominant figure
# Religious are varied
# Health and Illness
# Health = absence of disease
# Foods = carbohydrates and meat items
# Health risks
# Cancer
# Hearth disease
# Diabetes mellitus
# Obesity
# Hypertension
# Thalassemia
# Interventions
# Asses the meaning of verbal and no verbal behavior
# Respect personal space and time
# Be flexible and avoid rigidity
# Encourage family involvement
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End-of-life Care

Jewish = oppose prolonging life

Muslims = oppose autopsy but permit organ transplant
Amish = permit organ donation except Hearth
Buddhists = encourage organ donation
Mormon, Islamic, Jewish = prohibit cremation
Hindus = prefer cremation

African Americans
# Discuss problems with spouse or older family member
# Family is highly value
# Prefer to die at home

Asian Americans
# Often do not tell the client the diagnosis or prognosis
# Die at home = bad luck

Hispanic and Latino Groups

# Family makes decisions
# Extended family are involved
# Several family members may be at dying client bedside
# Mourning is acceptable and expected
# May refuse autopsy
# Die at home = bad luck

Native Americans
# Family meeting about end-of-life care and the type of treatments
# Some groups avoid contact with the dying
# May prefer di in the hospital
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Complementary and Alternative Medicine (CAM)

# Used in addiction to conventional treatment and focus on mind-body connection

# High risks therapies = invasive
# Low risks therapies = noninvasive
# National Center for Complementary and Alternative Medicine (NCCAM) = 5 categories:
# Whole medical systems
# Mind-body medicine
# Biologically based practices
# Manipulative and body-based practices
# Energy medicine
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Herbal Therapies

# Plant or plant parts for their therapeutic value in promoting health

# Can be toxic = consult HCP
# Herb-medication interaction can occur
# Client use = discuss with HCP before use
# Avoid use herbs to treat serious medical condition (Hearth disease)
# Avoid use if pregnant
# Do not give herbs to infant or young children
# If surgery, discontinue 2 to 3 weeks before
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Low-Risks Therapies

# No adverse effects
# Meditation and relaxed practices
# Imagery
# Music therapies
# Massage
# Touch
# Laughter and humor
# Spiritual measures, such as prayer