Cultural Competency - Multicultural Health Generalizations:
African-American
African Americans and Death & Dying
- Faith or spirituality can play an important role in the life and death of many African Americans.
- One reason why some African Americans might be resistant to completing written advanced directives is historical mistreatment, and thus mistrust of the medical system.
- Among the younger generations of African Americans, some are giving more consideration to hospice.
- Palliative care is an option acceptable among some African Americans.
- A dying African American patient or family member might request the presence of a spiritual leader at the bedside.
- Many African Americans and their friends may have a desire to mourn together at the death of a loved one.
Sources:
1. Edwards, G. (2006). Program for Multicultural Health, University of Michigan Health System.
2. Andrews, J.D. (2005). African Americans. Cultural, Ethnic, and Religious Reference Manual for Health Care Providers. (3rd edition). JAMARDA Resources, Inc. Winston-Salem, NC.
3. Barrett R.K., Heller K.S. (2001). "Death and dying in the black experience: An interview with Ronald K. Barrett." Innovations in End-of-Life Care. 3(5), http://www.edc.org/lastacts (accessed 2/2006)
4. Crawley, L., Payne, R., Bolden, J., Payne, T., Washington, P., & Willaims, S. (2000). "Palliative and End-of-Life Care in the African American Community" JAMA. 284(19):2518-2521
African-American Health Beliefs
- Some African Americans believe in a direct connection between their health and God's plan.
- Good health is the product of keeping spiritual harmony between mind, body and soul.
- Illnesses can be treated not only with medical intervention but also with spiritual approaches such as prayer and supportive visits from church ministers and members.
- Asking patients what they think caused their illness and what treatments they plan to or have already used can help with understanding their health beliefs and practices.
Source: Diversity and Health Care Resource Center (1999). Culture-Sensitive Health Care: African Americans. http://www.diversityresources.com/health2k/health/indexaf.html (disabled) (2004, Feb. 2) Redirected to: http://www.diversityresources.com/rc_sample/african.html (disabled)Redirected on 2/06 to: http://depts.washington.edu/pfes/pdf/AfricanAmericanCultureClue4_05.pdf
African Americans and Folk Healers
Many types of folk healers are found in African American communities. Some, such as the granny or herb doctor, work in their homes or have store fronts, yet others may practice in a religious setting. While some folk healers limit themselves to a specific type of illness or problem, other healers' intent is to heal every type of illness. Healers may refer to themselves as herb doctors, root doctors or root workers, readers, advisors, spiritualists, or conjurors. Healers may also prefer kinship terms such as Sister, Brother, Mother, Reverend, Prophet, Evangelist, Madam, Princess, King, or Queen when referring to themselves. Some believe that their healing power is a gift from God. For fear of disapproval, many patients who use folk healers may not admit this to their healthcare provider. Hence, when providing care, it could be helpful to ask the patient about any treatments or remedies that have been tried in order to develop an effective treatment plan. In sum, learning about patients' folk beliefs and remedies can add to the effectiveness of the healthcare received.
Sources: Culture-Sensitive Health Care: African American. (Online). Diversity Resources. <http://www.diversityresources.com/health2k/health/african.html> (disabled) <(2004, Feb. 2) Redirected to: http://www.diversityresources.com/rc_sample/african.html (disabled). Redirected on 2/06 to:
http://www.unc.edu/courses/2005spring/nurs/095/001/cultural_competence/ppts/AAfolkmed.ppt
African-American Illness Beliefs
Some African-Americans may have some of the following illness beliefs:
- Causes of physical illness:
- Natural causes
- Improper diet and eating habits
- Exposure to cold air/winds
- Supernatural causes: God's punishment for improper behavior or not living according to God's will
- Home and folk remedies:
- Teas, herbs, warm medicated compresses to the chest for colds
- Advice/prescriptions from folk healers who are stable, respected and powerful resources
Source: Locks, S. and Boateng, L.A. Black/African Americans. In Lipson, J.G., Dibble, S.L. and Minarik, P.A., eds. (1996). Culture and Nursing Care: A Pocket Guide. San Francisco, CA: University of California San Francisco Nursing Press
