Cultural Competency - Multicultural Health Generalizations By Culture
American Indian Elders
- Indian Elder Caregiver
- Treating American Indians/Alaskan Native Elders
- Health and Health Care of American Indian and Alaska Native Elders
Native American Healing Practices
- Many Native American healing practices come from the belief that mind, body, spirit, and emotions must be balanced to be fully healthy.
- Some Native Americans believe that spirits of plants and animals sent by the Creator are sources for healing.
- Although healing beliefs may differ from tribe to tribe, various ceremonies are similar nationwide.
- Many tribes profess the burning of cedar leaves, sweet grass, or sage chases away negative energy, summons positive forces and cleanses the mind, body, spirit and emotions.
- Spiritual ceremonies and tribal counseling can also be used to treat physical illness.
Sources: Hall, Lori. "Health Center healing room is Michigan's first" Detroit Free Press. 11 June 1999:1.
Mehl-Madrona, Lewis, MD., Ph.D. Traditional (Native American) Indian Medicine. Center for Health and Healing Beth Israel Medical Center. http://www.healing-arts.org/mehl-madrona/mmtraditionalpaper.htm
Native American Family Relationships
- Family is broadly defined to include the immediate family as well as extended family members and fictive kin. "Family" is a matter of blood and spirit. Other members of the family's tribe may also be included as part of the family.
- Extended family relationships are important, especially during illness and death. Any illness concerns the entire family.
- Decision-making varies with kinship structure.
- Generally, individuals speak for themselves, but family members may speak on behalf of the person who is ill. Family spokesperson varies with kinship structure and culture. Spokesperson may not be decision maker.
- In many cases, extended family members, rather than the biological parents, may hold primary responsibility for the care of the children.
- In interactions with healthcare providers, these extended family members may act as advocates for the child and family in obtaining needed healthcare.
Sources: Andrews, J.D. (2005). "Native Americans." Cultural, Ethnic, and Religious Reference Manual for Health Care Providers. (3rd edition). Winston-Salem, N.C.: JAMARDA Resources, Inc.
Kramer, J. (1996). "American Indians." Culture and Nursing: A Pocket Guide. San Francisco: University of California.
Lynch, E. W., Hanson, M. J., (1997). A Guide for Working with Children and their Families: Developing Cross-Cultural Competence. (2nd ed.). Maryland: Paul H. Brooks Publishing Co.
Navajo Indians and Nutrition
- Food has major significance beyond nourishment in American Indian populations; it is offered to family and friends or may be burned to feed higher powers and those who have died (Discharry, 1986).
- Life events are celebrated with food. Food is the center of all dances and many healing and religious ceremonies.
- Sheep is a major source of meat, and sheep brains are considered a delicacy by the Navajo.
- In years past, it was taboo for the Navajo to eat chicken. This is no longer the case, and now chicken is an integral part of their diet. In fact, chicken is so popular that commercial fast-food chicken establishments have emerged on the Navajo reservation. A concurrent increased incidence of gallbladder disease is attributed to this dietary practice.
- American Indian diets may be deficient in vitamin D because many individuals suffer from lactose intolerance or do not drink milk.
- After some ceremonies, individuals may not eat salt or particular foods. For example, during initiation into some American Indian societies, young boys have a restricted diet. It is important for the healthcare provider to assess whether a ceremony has been recently performed and ask if there are specific food restrictions.
- Herbs are used in the treatment of many illness to cleanse the body of ill spirits or poisons.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural health care: A culturally competent approach. Philadelphia, PA: F. A. Davis Company.
Nonverbal Communication among Navajo Indian Patients
- Nonverbal communication styles have different connotations within each tribe.
- Navajo Indians, for example, may be comfortable with long periods of silence, and may not share inner thoughts and feelings with anyone outside their clan.
- Interest in what an individual says is shown through attentive listening skills.
- To establish a positive social relationship, the rule of silence is considered a serious matter that calls for caution, careful judgment, and plenty of time (Chisolm, 1983, as cited in Purnell and Paulanka, 1998).
- A person may be considered immature if answers are given quickly, or if he/she interrupts another who is forming a response.
- It is important to allow time for elderly Navajo to respond to questions. Not allowing adequate time for information processing may result in an inaccurate response, or no response (Wilson, 1987, as cited in Purnell and Paulanka, 1998)
- Navajo Indian family members may show support to family members during doctor appointments not through talking, but by simply being present. For Navajo Indians, silence is being supportive.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural health care: A culturally competent approach. Philadelphia, PA: F. A. Davis Company.
