Cultural Competency - Multicultural Health Generalizations: Cultural Themes
Korean-Americans
- Korean-American Health Beliefs and Practices
- Koreans in the United States
- An Introduction to Korean Culture
Cultural Barriers to Healthcare among Arab-Americans:
- Medical care and providers:
- An Arab-American patient seeing a doctor may expect to receive medication and have relief from pain during the first visit. Such patients may need an explanation for not receiving medication or lab testing.
- When Arab-Americans suffering from mental distress seek medical care, they could be likely to present with a variety of vague complaints. Patients often expect and prefer somatic treatment. Hospitalization is resisted because such placement is viewed as abandonment.
- Privacy:
- Some patients may not disclose detailed information about themselves or their families, especially to strangers.
- Women may not want to talk about their private lives. However, they may feel more comfortable talking with female doctors.
- Sexual problems and venereal diseases can be a difficult topic for patients to discuss.
- Diet:
- Muslims might eat only Halal meat (meat from animals slaughtered according to Islamic tradition).
- During Ramadan (10/5/05-11/4/05), Islamic patients might not take medications, eat or drink from sunrise to sunset.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural Health Care: A Culturally Competent Approach. Philadelphia, PA: F. A. Davis Company.
Hmong Customs
- Looking one in the eye can be considered rude.
- A smile is a sign of greeting and welcome.
- The head may be considered sacred because the soul lives there. Thus, patting a child’s head would not be appropriate for it could startle the soul out of the body.
- Children might wear tiny charms or strings on their wrists, waist, and/or neck to keep away evil spirits.
- Some might believe that evil spirits can cause illnesses and if the correct animal is sacrificed, the victim will recover.
- Some might believe in animism - the belief that natural phenomena or inanimate objects possess spirits.
- Status in the family and clan is very important. The last name denotes membership in a clan (Yang, Xiong, Vang, Lee).
- The household/family is very important. Several families may live together, but they are usually of the same clan. The male is the head of the family or household and might need to be addressed first.
Source: University of Wisconsin - Extension. Hmong Educational Project handout. Winter 2002.
Female Modesty as an Islamic Practice
- As defined in the Quran, conservative Muslim women dress to show no more than their faces and hands to anyone other than very close relatives.
- Some Muslim women abstain from shaking hands with men they do not know.
- Same gender care is an effective way to ensure female modesty. Therefore, Muslim women might require a female provider.
- Modesty in the examination room can be achieved by:
- Providing a long-sleeved gown, ankle-length robe, or bath blanket to conservatively cover the body.
- Asking permission of Muslim women before examining any covered body part, and allowing them to pull clothing aside as necessary (i.e. hijab/headscarf).
- Being understanding if husbands or relatives are present for support.
Sources: "Islam". Ethnic Resource Guide, 3rd. Edition, Copyright Fall 1999. p.73. Workforce Development and Diversity Strategies Division, Corporate Human Resources, Henry Ford Health System.
Culture Sensitive Prenatal Care for a Muslim Woman. Sigma Theta Tau International, Nursing Honor Society. (Online). http://buddhism.about.com/library/bleightpath.htm (2004, Aug. 30) (disabled)
Alternate source: Maqsood, Ruqaiyyah Waris. Thoughts on Modesty. Islam For Today. http://www.islamfortoday.com/ruqaiyyah05.htm
Santería : A Religion Practiced in Cuba
Although Catholicism is the primary religion of Cuba, Santería , an African Voodoo type religion, is practiced by some Cubans of middle and upper-class backgrounds and some with less education. Based on beliefs of the Yoruba African people, Santería incorporates Yoruba gods/ orishas (the "Seven African Deities") and variations on Catholic rituals. When modern medicine and the Church fail to heal, some Cubans seek assistance from Santería Santeros (priests). Santeros intervene in both physical and mental illnesses but seldom operate in conflict with biomedical treatments. When treating mental illness, Santeros may ascribe the problem as a special attribute or strength of the person being treated. A few healing rituals conducted by Santeros include herbal formulations, prayer, and santiquo /blessing rituals (the supplication to a Yoruba god and the corresponding Catholic saint). Spells, magic, and animal sacrifices can also be common in this religion, and most ceremonies are conducted at home.
Sources: Cuban Refugees. (Online). Baylor University. http://www3.baylor.edu/~Charles_Kemp/cuban_refugees.htm (2002, January 13).
Lipson, J. G., Dibble, S. L., Minarik, P. A., & Varela, L. (1996). Cubans. Culture and Nursing Care: A Pocket Guide. San Francisco: UCSF Nursing Press.
Korean Norms about Meeting/Greeting
- When understanding Korean norms about meeting/greeting, you may want to consider the following:
- Sustained direct eye contact should not necessarily be expected.
- When first meeting, a patient may frequently look at you when you are not looking to become more comfortable.
- Handshakes are appropriate between men.
- Women do not shake hands.
- Respect is shown to authority figures by giving a gentle bow.
Please also keep in mind that cultural differences are based on age, ethnic group, generation, migration wave, and length of time away from Korea.
Source: Culture clues: Communicating with your Korean patient. (Online). University of Washington Medical Center. http://depts.washington.edu/pfes/pdf/KoreanCultureClueDec00.pdf (2005, Feb. 24)
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.
Russian Family Relationships
- The composition of a Russian family includes the extended family and is structured to have strong family bonds and great respect for elders.
- Decision-making and role of spokesperson is the responsibility of the father, mother, eldest son, or eldest daughter.
- The whole family often pulls together during a crisis for support and strength.
- No major gender issues exist. Although a husband and wife might consult with each other, the wife might eventually give way to her husband's opinion. The more dominant personality usually prevails.
- Children, adults, and the elderly are all expected to care for ill family members.
- Adults are expected to accept their parents into their home and provide care.
- Friends are also expected to visit the ill in the hospital to provide strength and support.
Source: Evanikoff, L. J. (1996). Russians. Culture and Nursing Care: A Pocket Guide . San Francisco, CA: University of California.
Puerto Rican Family Roles and Priorities
- La familia - the family - is the nucleus of the Puerto Rican community and society.
- Family unity is valued.
- Family members include grandparents, great grandparents, married children, aunts, uncles, cousins, and even divorced children with their children.
- Two families may live in the same household.
- After marriage, children live away from their parents but are expected to maintain very close ties with their families, especially women.
- Because children are the center of the family, close and extended family members are expected to participate in the care of children, give support, and encourage the maintenance of cultural and religious traditions.
- Grandparents assume an active role in rearing grandchildren and supporting the family. These activities include babysitting, teaching traditions, disciplining, and enforcing educational activities.
- Dependent elders are expected to live with their children and be cared for emotionally and financially. All members of the family provide support for financial and physical labor needed to keep the elderly at home.
- Placements in nursing homes and extended-care facilities may be seen as inconsiderate to the elderly, and family members who must use these facilities may feel guilty.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural Health Care: A Culturally Competent Approach . Philadelphia, PA: F. A. Davis Company.
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