Spiritual and Cultural Considerations in Primary Care - Assignment Example

? Spiritual and Cultural Considerations in Primary Care The essay aims to address a two-fold objective towit: (1) to identify the cultural and spiritual considerations of Hispanics in primary care; and (2) to review literatures explaining healthcare concerns and beliefs, family values, beliefs, and influence, decision makers within Hispanics culture, communication patterns, and general communication guidelines that should be used by a healthcare provider when caring for individuals of this culture. Spiritual and Cultural Considerations in Primary Care Overview of Hispanics Culture Hispanic refers to people from many countries including Puerto Rico, Cuba, Mexico, South America, Central America and Spain (O'Neill, 2002, p. 19). Hispanic Americans are very religious individuals. Hispanic Americans religion is Catholicism and views health as a reward from God or a result of good luck. Similar with the Asian American culture, Hispanic American also believe that health can be attained by maintaining balance between the hot and cold and the wet and dry forces. Illness results when God punished Hispanic Americans for their sin, when feeling of susto (fright) occur, when someone throws a mal ojo (evil eye), and envidia (envy)(De Laune, 2006, p. 394). Hispanic Americans used Spanish or Portuguese and other dialects in communication process. They are verbally expressive and used dramatic body language to express emotions and pain. However, Hispanic Americans view direct confrontation and expression of negative feelings as disrespectful. When communicating with a Hispanic American, one can observe the comfort in close proximity, overly tactile communication such as frequent handshakes and enbrace, and the value Hispanic Americans have for the presence of others. Hispanic Americans value modesty and politeness in speaking and are presently oriented. However, time for Hispanic American is flexible. The role of the family in the primary care might be used in dealing with Hispanic Americans as they prioritize first the need of the families before the individual needs. Nuclear family is the basic unit but highly regarded extended family. Gender roles are also evident in the Hispanic American culture and man performs the role of decision maker and breadwinner while the woman is the home maker and care taker. Review of Literature Healthcare Concerns and Beliefs Health care concerns and beliefs of many Hispanics have affected the predisposing diseases of their race and access to the use of health services. Hispanic diet, lack of health insurance, transportation, culture, and linguistic are some of the identified concerns of most researchers among Hispanics that needs to be addressed. Hispanic dietary preferences differ from other culture. Existing research suggests that Hispanic diet has greater percentage of carbohydrates, protein, and fiber, and lower percentage of total and saturated fat (Loria, Bush, Carroll, Looker, McDowell, Johnson, &Sempos, 1995, n.p.).Thus, Hispanics are more apt to meet the cholesterol education program. However, majority of the Hispanics suffer from obesity which is one of the most important health problems they are facing today. Aside from dietary preferences, Hispanics also lack sufficient access to health services particularly because of financial, structural, and personal barriers. Lack of health insurance and low income among Hispanics constitute the financial barriers. Structural barriers include proximity and transportation to the health providers and personal barriers include cultural and linguistic factors. In addition, Hispanics are less likely to consult a primary care’s advice primarily because Hispanics believe that having a disease is a punishment from God. For example, a child suddenly has fever after the parents brought the child to the park. Following Hispanic culture, this child was thrown a mal ojo (evil eye) by a stranger. Hispanics are known for being religious and spiritual-driven. Hispanics belief on God and evil forces are reflected on their everyday practices and these spiritual and cultural considerations affect their attitudes towards primary care. Family Values and Beliefs Familial and cultural considerations must be considered in dealing with primary care of Hispanics. This is because Hispanics viewed the family as the primary caregiver and source of social support during stress or illness. It is also in the family that the importance of religious institutions and healing were emphasized (Guarnaccia, Parra, Deschamps, Milstein & Argilles, 1992, p. 1). Among families of Hispanics, you will often hear them saying Si Dios quiere (If God wishes) or Que dios nos bendiga (May God bless us). These reflect their strong belief in terms of religion and their way of handling stress or illness. As minority groups, Hispanics family often feel stigmatized because ethnicity and social class affect health care delivery in the community. Studies suggested that primary care also depends on the interpretation of family members of presenting symptoms. The emphasis of the family placed upon direct- caregiving gave rise to the existence of family advocacy groups. These groups focus on the strengths and weaknesses of the client and how do illnesses can be managed with the help of the family members. Family members’ cultural preferences were also given consideration in conducting health education. Hispanics families are very emotional and verbally expressive (Guarnaccia, Parra, Deschamps, Milstein & Argilles, 1992, p. 3). Emotional affections are expressed through hugs and hand gestures as well as verbal expression of happiness or sadness. These were particularly evident during encounter of stress or illness. However, Hispanics family avoid direct confrontation because they believe that confronting and arguing other people are rude and disrespectful and reflects how bad a family had raised a child. In general, family values and beliefs centered upon the importance of family and religious influence of Hispanics culture. Influence and Decision Makers Major decisions among Hispanics family depends upon gender roles and familial importance. Men are the breadwinners of the family and takes control or dominance over family decisions. Women, on the other hand, are more of a mother instead of wife . Hispanics culture expected women to be submissive and sacrifice themselves for the families (Raffaelli and Ontai, 2004, p. 287). Family relationships also influenced major decisions among the Hispanics family. Hispanics viewed strong relationship with the family and importance of childbearing as the most integral part of family life and feminine gender role. Families have the obligation towards molding of children values and community priorities. Hispanic families also respect the role of the elderly in guiding future generation. Although most of the Hispanics families are nuclear in type, Hispanics culture strongly valued and regarded having an extended family. Communication Patterns and Guidelines As stated earlier, most of the Hispanics speak Spanish and Portuguese and these language preferences constitute the personal barriers such as linguistic factors and cultural preferences. Hispanics communication patterns significantly affect their access to primary care services. Language barrier becomes critical when a Spanish-speaking patient seeks medical care and encountered medical providers who do not speak Spanish or have no professional interpreters available in the institution. Thus, in order to deliver primary care services, effective communication between the patient and medical provider are necessary. For instance, instructions on health promotion and disease prevention among Spanish-speaking clients will not be accurate and well-understood by the client if Spanish language will not be used or if professional interpreters are not available. Nursing Implications when Dealing with Hispanic American Culture Health care providers are facing the challenge of delivering a culturally-competent care despite communication barriers among Hispanics. When dealing with minority populations, cultural variances directly affect how a health care provider especially the nurse could deliver a culturally-appropriate care. Berlin & Fowkes (1983) identified guidelines for healthcare practitioners in dealing with minority groups. These include listening with sympathy and understanding about the patient’s problem, explaining the problem, acknowledging and discussing similarities and differences, recommending treatment, negotiating agreement (p. 934). For instance, Hispanics believe in susto (fright). Nursing implications include educating the patient about the cultural context of susto and integrate biomedical explanation to the presenting symptoms. Hispanics also believe that illness is cause by the imbalance between hot and cold. Nursing implications include awareness of the health care provider about cultural identification of hot and cold so that health care adjustments particularly in diet must be made. Health care providers must not disregard the role of gender and family in decision-making. Since Hispanics viewed family as the primary caregiver and source of social support, nursing implications include the active participation of family members in then care plan of the patient. In this way, nurses were able to give a holistic care. During assessments and review of family history, it is important to note cultural health practices and language spoken by the client. Nursing implications include ease of facilitating assessments and nursing procedures ahead of time especially if the client needs an interpreter. Knowing the cultural health practices such as beliefs regarding folk healers and medicines will determine factors that may affect current health regimen and necessary adjustments needed. References Berlin, E.A. & Fowkes, W.C. (1983 December). “A Teaching Framework for Cross-cultural Health Care: Application in Family Practice.” Cross-cultural Medicine: The Western Journal of Medicine, 139(6): 934-938. De Laune, S.C. and Ladner, P.K. (2006). Cultural Diversity. Fundamentals of Nursing Standards and Practice (3rd ed.) (p. 308-407). New York: Delmar Learning. Guarnaccia, P.J., Parra, P., Deschamps, A., Milstein, G. & Argiles, N. (1992). "Hispanic Families Experiences of Caring for a Seriously Mentally Ill Family Member." Si Dios Quiere: Culture, Medicine and Psychiatry 16: 187-215. Loria, C.M., Bush, T.L., Carroll, M.D., Looker, A.C., McDowell, M.A., Johnson, C.L.&Sempos, C.T. (1995 May). "Macronutrient intakes among adult Hispanics: a comparison of Mexican Americans, Cuban Americans, and mainland Puerto Ricans." PubMed: American Journal of Public Health, 85(5): n.p. Retrieved on August 6, 2011, from http://www.ncbi.nlm.nih.gov/pubmed/7733429 O'Neill. P. (2002). Promoting Health in a Culturally-Diverse Older Adult Population. Caring for The Older Adult: A Health Promotion Perspective (p. 15-23). Philadelphia: SAUNDERS. Raffaelli, M. &Ontai, L.L. (2004). “Gender Socialization in Latino/a Families: Results from Two Retrospective Studies.” Sex Roles: A Journal of Research, 50: 287-299. Read More