How Important is Cultural Diversity in Healthcare? PDF

estimated 20 million people in the U.S. do not speak or understand How important is cultural diversity in healthcare? Could a lack of English. About 9 percent of the U.S. population is at risk for adverse diversity truly harm patients events due t...

estimated 20 million people in the U.S. do not speak or understand How important is cultural diversity in healthcare? Could a lack of English. About 9 percent of the U.S. population is at risk for adverse diversity truly harm patients events due to language barriers, the Agency for Healthcare Research and Quality (AHRQ) said. Complicating the matter more are the culturally specific terms, metaphors, and expressions used to If the goal is to have a diverse group of healthcare providers that describe pain and distress that do not cross language barriers. reflects the varying cultures, races, and ethnicities of patients they serve, many medical facilities are still falling short. “Currently, the state of diversity in healthcare still has a long way to go to be “When clinicians lack the linguistic and cultural skills needed and representative of the general populations that we serve,” says Dr. Luz interpreters are not available, patients may have to rely on medically Claudio, professor of environmental medicine and public health. inexperienced, bilingual relatives or non-medical staff, compromising the quality of care and worsening health outcomes for migrant communities,” researchers said in, “Overcoming language barriers in Even though the United States is growing more diverse by the day, healthcare: A protocol for investigating safe and effective only 17 percent of physicians are Asian, 5.8 percent are Hispanic, communication when patients or clinicians use a second language.” five percent are Black, and 0.3 percent are American Indian or Alaska Native and the majority are White 56.2 percent.1 These numbers aren’t likely to see a drastic change anytime soon. Figures from the Family nurse practitioners (FNPs) work with diverse groups of Association of American Medical Colleges (AAMC) show that 46.8 patients, breaking down barriers to provide inclusive healthcare percent of medical school applicants are white. Though some areas services and meeting the nation’s medical needs. Healthcare of the medical field are showing increased diversity, researchers have professionals agree that diversity in nursing, including in the FNP found that the majority of people of color working in healthcare hold field, promotes a deeper understanding of the components that entry-level, lower-paying jobs.2 impact a patient’s well-being. The move to a diverse FNP workforce has grown in a positive direction, said Joyce Knestrick, president of the American Association of Nurse Practitioners (AANP). “Diversity “One of the main reasons diversity is slow to increase in healthcare is gives NPs a stronger voice to influence healthcare. Our strong voice because it is dependent on how diversity changes in the education of and our collective experiences working with and within diverse healthcare professionals,” says Dr. Jenna Liphart Rhoades, advisor at populations can improve healthcare for all of our patients". NurseTogether.com. “For example, there won’t be an increase in the diversity of nurses if there isn’t an increase in diversity during their education.” Diversity is expressed in many ways, including gender, sexuality, race, religious beliefs, age, physical ability, gender identity, political views, and socioeconomic status. Numerous countries are now recognizing the need to address the diversity of their society which includes the client base, the provider base, and the organization. Communities that used to be culturally homogeneous, such as Portugal, Norway, Sweden, Korea, and selected areas in the United States and the United Kingdom, are now Religions and Dietary Preferences facing significant internal and external migration, resulting in Buddhism ethnocultural diversity that did not exist before, at least not as much Alcohol is usually prohibited. as it does at present. Many European countries started to develop Many are Lacto-ovo vegetarians. national programs to address the value or importance of cultural Some eat fish, and some avoid only beef. competence in reducing health disparities as commissioned by the U.K. Presidency of the European Union (Health Inequities: A Church of Jesus Christ of Latter-day Saints (Mormon) Challenge for Europe, 2005). Alcohol, coffee, and tea are usually prohibited. Consumption of meat is limited. Whether people are internal migrants, immigrants, or vacationers, The first Sunday of the month is optional for fasting. they have the right to expect the healthcare system to respect their personal beliefs, values, and healthcare practices. Culturally Eastern Orthodox competent health care from providers and the system, regardless of During Lent, all animal products, including dairy products, the setting in which care is delivered, is becoming a concern and are forbidden. expectation among consumers. Diversity also includes having a Fasting occurs during Advent. diverse workforce that more closely represents the population the Exceptions from fasting include illness and pregnancy; organization serves. children may also be exempt. Hinduism Health-care personnel provides care to people of diverse cultures in Many are vegetarians; those who eat meat do not eat long-term-care facilities, acute-care facilities, clinics, communities, beef or pork. and clients’ homes. All healthcare providers—physicians, nurses, Fasting rituals vary. nutritionists, therapists, technicians, home health aides, and other Children are not allowed to participate in fasting. caregivers— need similar culturally specific information. Islam Influences/Barriers to Nursing Care Pork, birds of prey, alcohol, and any meat product not ritually slaughtered are prohibited. One of the leading causes of medical errors in the United States is During the month of Ramadan, fasting occurs during the miscommunication between patients and providers. When patients daytime; some individuals, such as pregnant women, may with limited English proficiency cannot adequately communicate their be exempt from fasting. needs, they are less likely to comply with medical instructions and Jehovah’s Witnesses receive vital services. Any foods to which blood has been added are prohibited. They can eat animal flesh that has been drained. Judaism As primary care providers, family nurse practitioners (FNPs) are Orthodox believers need to adhere to dietary kosher laws: responsible for communicating with patients about their health. But an  ○ Meats allowed include animals that are Stopping medical treatment is against the will of Allah vegetable eaters, cloven-hoofed animals (Arabic word for God). (deer, cattle, goats, sheep), and animals that Grief may be expressed through slapping or hitting the are ritually slaughtered. body. ○ Fish that have scales and fins are allowed. If possible, only a same-sex Muslim should handle the ○ Any combination of meat and milk is body after death; if not possible, non-Muslims should prohibited; fish and milk are not eaten wear gloves so as not to touch the body. together. During Yom Kippur, 24-hour fasting is observed. Judaism Pregnant women, children, and ill individuals are exempt A client placed on life support should remain so until from fasting. death. During Passover, only unleavened bread is eaten. A dying person should not be left alone (a rabbi’s Pentecostal (Assembly of God) presence is desired). Alcohol is usually prohibited. Autopsy and cremation are usually not allowed. Members avoid consumption of anything to which blood has been added. Hinduism Some individuals avoid pork. Rituals include tying a thread around the neck or wrist of Roman Catholicism the dying person, sprinkling the person with special water, They avoid meat on Ash Wednesday and Fridays of Lent. and placing a leaf of basil on the person’s tongue. They practice optional fasting during Lent season. After death, the sacred threads are not removed, and the Children, pregnant women, and ill individuals are exempt body is not washed. from fasting. Buddhism Seventh-Day Adventist (Church of God) A shrine to Buddha may be placed in the client’s room. Alcohol and caffeinated beverages are usually prohibited. Time for meditation at the shrine is important and should Many are lacto-ovo vegetarians; those who eat meat be respected. avoid pork. Clients may refuse medications that may alter their Overeating is prohibited; 5 to 6 hours between meals awareness (e.g., opioids). without snacking is practiced After death, a monk may recite prayers for 1 hour (need not be done in the presence of the body) Religion and End-of-Life Care Cultural Awareness includes learning about the cultures of clients Christianity with whom you will be working; also, ask clients about their health care practices and preferences. Cultural practices/traditions Amish influenced health care decisions. Culture can greatly affect client Funerals are conducted in the home without a eulogy, health, as well as their reactions to treatments and care. flower decorations, or any other display; caskets are plain and simple, without adornment. At death, a woman is usually buried in her bridal dress. I. African Americans One is believed to live on after death, with either eternal reward in heaven or punishment in hell. Descriptions: Citizens or residents of the United States who may have origins in any of the black populations in Catholic and Orthodox Africa. A priest anoints the sick. Communication Other sacraments before death include reconciliation and 1. Competent in standard English Holy Communion. 2. Head nodding does not always mean agreement. Church of Jesus Christ of Latter-day Saints (Mormons) 3. Prolonged eye contact - may indicate A sacrament may be administered if the client requests it. rudeness or aggressive behavior. 4. Rely on fewer words and use more nonverbal Protestant messages than what is spoken No last rites are provided (anointing of the sick is 5. African American speech is dynamic and accepted by some groups). expressive. Body movements are involved Prayers are given to offer comfort and support. when communicating with others. 6. Nonverbal communication may be important. Jehovah’s Witnesses 7. Express their feelings to their trusted family or Members are not allowed to receive a blood transfusion. friends. Members believe that the soul cannot live after the body Time Orientation and personal spaces preferences has died. 1. Time orientation varies according to age, socioeconomics, and subcultures and may Islam include past, present, or future orientation. Second-degree male relatives such as cousins or uncles 2. Members may be late for an appointment should be the contact people and determine whether the because relationships and events that are client or family should be given information about the occurring may be deemed more important client. than being on time. The client may choose to face Mecca (west or southwest 3. Members are comfortable with close personal in the United States). space when interacting with family and The head should be elevated above the body. friends. Discussions about death usually are not welcomed. Social Roles  1. Large extended-family networks are 4. Marriage outside the faith is not usually important; older adults are respected. allowed; unmarried women remain under the 2. Many households may be headed by a authority of their fathers. single-parent woman. Health and Illness 3. Religious beliefs and church affiliation are 1. Most Amish need to have a church (bishop sources of strength. and community) permission to be hospitalized Health and Illness because the community will come together to 1. Religious beliefs profoundly affect ideas about help pay the costs. health and illness. 2. Usually, the Amish do not have health 2. Food preferences include such items as fried insurance because it is a “worldly product” foods, chicken, pork, greens such as collard and may show a lack of faith in God. greens, and rice; some pregnant African 3. Some of the barriers to modern health care American women engage in pica. include distance, lack of transportation, cost, Health Risks and language (most do not understand 1. Sickle cell anemia scientific jargon). 2. Hypertension Health Risks 3. Heart disease 1. Genetic disorders because of intermarriage 4. Cancer (inbreeding) 5. Lactose intolerance 2. Nonimmunization 6. Diabetes mellitus 3. Sexual abuse of women 7. Obesity Nursing Interventions Nursing Interventions 1. Speak to both the husband and the wife or the 1. Assess the meaning of the client’s verbal and unmarried woman and her father regarding nonverbal behavior. health care decisions. 2. Be flexible and avoid rigidity in scheduling 2. Health instructions must be given in simple, care. clear language. 3. Encourage family involvement. 3. Teaching should be focused on health 4. Alternative modes of healing include herbs, implications associated with prayer, and laying on of hands practices. non-immunization, intermarriage, and sexual abuse issues. II. Amish III. Asian Americans Description 1. Known for simple living, plain dress, and Description: Americans of Asian descent; can include reluctance to adopt modern convenience, and ethnic groups such as Chinese Americans, Filipino can be considered a distinct ethnic group. Americans, Indian Americans, Vietnamese Americans, Various Amish church fellowships are Korean Americans, Japanese Americans, and others Christian religious denominations that form a whose national origin is the Asian continent. very traditional subgrouping of Mennonite Communication churches. 1. Languages include Chinese, Japanese, 2. Cultural beliefs and preferences vary Korean, Filipino, Vietnamese, and English. depending on specific Amish community 2. Silence is valued. membership. 3. Eye contact may be considered inappropriate 3. In general, they have fewer risk factors for or disrespectful (some Asian cultures interpret disease than the general population because direct eye contact as a sexual invitation). they practice manual labor, diet, and rare use 4. Criticism or disagreement is not expressed of tobacco and alcohol; the risk of certain verbally. genetic disorders is increased because of 5. Head nodding does not always mean intermarriage (sexual abuse of women is a agreement. problem in some communities). 6. The word “no” may be interpreted as 4. Diabetes Mellitus can become a health issue disrespect for others. later in life and is related to obesity. Time Orientation and personal spaces preferences Communication 1. Time orientation reflects respect for the past 1. Usually, speak a German dialect called but includes emphasis on the present and Pennsylvania Dutch; the German language is future. usually used during worship. 2. Formal personal space is preferred, except 2. English is usually learned in school. with family and close friends. Time Orientation and personal spaces preferences 3. Members usually do not touch others during 1. Members generally remain separate from conversation. other communities, physically and socially. 4. For some cultures, touching is unacceptable 2. They often work as farmers, builders, quilters, between members of the opposite sex. and homemakers. 5. The head is considered to be sacred in some Social Roles cultures; touching someone on the head may 1. Women are not allowed to hold positions of be disrespectful power in congregational organizations. Social Roles 2. The roles of women are considered equally 1. Members are devoted to tradition. important to those of men but are very 2. Large extended-family networks are common. unequal in terms of authority. 3. Loyalty to immediate and extended family and 3. Family life has a patriarchal structure. honor are valued.  4. The family unit is structured and hierarchical. 5. Dramatic body language, such as gestures or 5. Men have the power and authority, and facial expressions, may be used to express women are expected to be obedient. emotion or pain. 6. Education is viewed as important. Time Orientation and personal spaces preferences 7. Religions include Taoism, Buddhism, 1. Members are usually oriented more to the Confucianism, Shintoism, Hinduism, Islam, present. and Christianity. 2. Members may be late for an appointment 8. Social organizations are strong within the because relationships and events that are community. occurring are valued more than being on time. Health and Illness 3. Members are comfortable in close proximity 1. Health is a state of physical and spiritual with family, friends, and acquaintances. harmony with nature and a balance between 4. Members are very tactile and use embraces positive and negative energy forces (yin and and handshakes. yang). 5. Members value the physical presence of 2. A healthy body may be viewed as a gift from others. the ancestors. 6. Politeness and modesty are important. 3. Illness may be viewed as an imbalance Social Roles between yin and yang. 1. The nuclear family is the basic unit; also, large 4. Illness may also be attributed to prolonged extended-family networks are common. sitting or lying or overexertion. 2. The extended family is highly regarded. 5. Food preferences include raw fish, rice, and 3. The needs of the family take precedence over vegetables. the needs of an individual family member. Health Risks 4. Depending on age and acculturation factors, 1. Hypertension men are usually the decision-makers and 2. Heart disease wage earners and women are the caretakers 3. Cancer and homemakers. 4. Lactose intolerance 5. Religion is usually Catholicism but may vary 5. Thalassemia depending on origin. Nursing Interventions 6. Members usually have strong church 1. Be aware of and respect physical boundaries; affiliations. request permission to touch the client before 7. Social organizations are strong within the doing so. community. 2. Limit eye contact. Health and Illness 3. Avoid gesturing with hands. 1. Health may be viewed as a reward from God 4. A female client usually prefers a female health or a result of good luck. care provider (HCP). 2. Some members believe that health results 5. Clarify responses to questions and from a state of physical and emotional expectations of the HCP. balance. 6. Be flexible and avoid rigidity in scheduling 3. Illness may be viewed by some members to care. be a result of God’s punishment for sins. 7. Encourage family involvement. 4. Some members may adhere to nontraditional 8. Alternative modes of healing include herbs, health measures such as folk medicine. acupuncture, restoration of balance with 5. Food preferences include beans, fried foods, foods, massage, and offering of prayers and and spicy foods. incense. Health Risks 9. Yin foods are cold and yang foods are hot; 1. Hypertension one eats cold foods when one has a hot 2. Heart disease illness, and one eats hot foods when one has 3. Diabetes mellitus a cold illness. 4. Obesity 5. Lactose intolerance IV. Hispanic and Latino Americans 6. Parasites Nursing Interventions 1. Allow time for the client to discuss treatment Description: Americans of origins in Latin countries; options with family members. Mexican Americans, Cuban Americans, Colombian 2. Protect privacy. Americans, Dominican Americans, Puerto Rican 3. Offer to call clergy because of the significance Americans, Spanish Americans, and Salvadoran of religious preferences related to illnesses. Americans are some Hispanic and Latino American 4. Ask permission before touching a child when subgroups. planning to examine or care for him or her; Communication some believe that touching the child is 1. Languages include primarily English and important when speaking to the child to Spanish. prevent “evil-eye.” 2. Members tend to be verbally expressive, yet 5. Be flexible regarding the time of arrival for confidentiality is important. appointments and avoid rigidity in scheduling 3. Avoiding eye contact with a person in care. authority may indicate respect and 6. Alternative modes of healing include herbs, attentiveness. consultation with lay healers, restoration of 4. Confrontation is usually disrespectful and the balance with hot or cold foods, prayer, and expression of negative feelings may be religious medals. impolite.  7. Treat each client and individuals 2. Obesity accompanying the client with respect and be 3. Heart disease aware of the differences and diversity of 4. Diabetes mellitus beliefs about health, illness, and treatment 5. Tuberculosis modalities. 6. Arthritis 7. Lactose intolerance V. Native Americans 8. Gallbladder disease Nursing Interventions 1. Clarify communication. Description: Term that the US government uses to 2. Understand that the client may be attentive, describe indigenous peoples from the regions of North even when eye contact is absent. America encompassed by the continental United States, 3. Be attentive to your own use of body language including parts of Alaska, and the island state of Hawaii; when caring for the client or family. comprises a large number of distinct tribes, states, and 4. Obtain input from members of the extended ethnic groups, many of which survive as intact political family. communities. 5. Encourage the client to personalize the space Communication in which health care is delivered; for example, 1. Linguistic diversity, depending on the origin encourage the client to bring personal items or 2. The use of a professional interpreter is objects to the hospital. important. 6. In the home, assess for the availability of 3. Silence conveys respect for the speaker for running water, and modify infection control some groups. and hygiene practices as necessary. 4. Some members may speak in a low tone of 7. Alternative modes of healing include herbs, voice and expect others to be attentive. restoration of balance between the person 5. Eye contact may be viewed as a sign of and the universe, and consultation with disrespect. traditional healers 6. Body language is important. Time Orientation and personal spaces preferences 1. Members are oriented primarily to the present. VI. White Americans 2. Personal space is important. 3. Members may lightly touch another person’s Description: Term used to include US Citizens or hand during greetings. residents having origins in any of the original people of 4. Massage may be used for the newborn to Europe, the Middle East, or North Africa; the term is promote bonding between the infant and interchangeable with Caucasian American. mother. Communication 5. Some groups may prohibit touching a dead 1. Languages include the language of origin body. (e.g., Italian, Polish, French, Russian) and Social Roles English. 1. Members are family-oriented. 2. Silence can be used to show respect or 2. The basic family unit is the extended family, disrespect for another, depending on the which often includes persons from several situation. households. 3. Eye contact is usually viewed as indicating 3. In some groups, grandparents are viewed as trustworthiness in most origins. family leaders. Time Orientation and personal spaces preferences 4. Elders are honored. 1. Members are usually future-oriented. 5. Children are taught to respect traditions. 2. Time is valued; members tend to be on time 6. The father usually does all work outside the and to be impatient with people who are not home, and the mother assumes responsibility on time. for domestic duties. 3. Some members may tend to avoid close 7. Sacred myths and legends provide spiritual physical contact. guidance for some groups. 4. Handshakes are usually used for formal 8. Most members adhere to some form of greetings. Christianity, and religion and healing practices Social Roles are usually integrated. 1. The nuclear family is the basic unit; the 9. Community social organizations are important. extended family is also important Health and Illness 2. The man is usually the dominant figure, but a 1. Health is usually considered a state of variety of gender roles exists within families harmony between the individual, family, and and relationships. environment. 3. Religions are varied, depending on their 2. Some groups believe that illness is caused by origin. supernatural forces and disequilibrium 4. Community social organizations are important. between the person and environment. Health and Illness 3. Traditional health and illness beliefs may 1. Health is usually viewed as an absence of continue to be observed by some groups, disease or illness. including natural and religious folk medicine 2. Many members usually tend to be stoic when traditions. expressing physical concerns. 4. For some groups, food preferences include 3. Members usually rely primarily on the modern cornmeal, fish, game, fruits, and berries. Western health care delivery system. Health Risks 1. Alcohol abuse  4. Food preferences are based on the origin; 5. “Social distance” is especially important to many members prefer foods containing maintain when interacting with Muslim carbohydrates and meat items. women. The difference may be obvious when Health Risks dealing with a woman from a more 1. Cancer conservative group. If she takes a small step 2. Heart disease backward it is indicative that, though 3. Diabetes mellitus interested in the conversation, she is 4. Obesity uncomfortable and it would be kind to respect 5. Hypertension her space. 6. Thalassemia Social Roles Nursing Interventions 1. Arab Muslim families are characterized by a 1. Assess the meaning of the client’s verbal and strong patrilineal tradition. Women are nonverbal behavior. subordinate to men, and young people are 2. Respect the client’s personal space and time. subordinate to older people. Muslims are very 3. Be flexible and avoid rigidity in scheduling particular about showing respect for elders. care. 2. Within the larger extended family, the older 4. Encourage family involvement male figure assumes the role of decision-maker. VII. Arabs 3. Islam encourages Muslims to dress modestly. Muslim women from diverse backgrounds observe modesty in their way and that Description explains the variation in their dress codes 1. Arabs trace their ancestry and traditions to the across cultures. Wearing the Hijab (head nomadic desert tribes of the Arabian covering) is a mark of devotion and Peninsula commitment to Faith. 2. Arab Americans are defined as immigrants 4. Child-rearing patterns also include great from the 22 Arab countries of North Africa and respect toward parents and elders. Children Southwest Asia: Algeria, Bahrain, Comoros, are raised to not question elders and to be Djibouti, Egypt, Iraq, Jordan, Kuwait, obedient to older brothers and sisters Lebanon, Libya, Mauritania, Morocco, Oman, Health and Illness Palestine, Qatar, Saudi Arabia, Somalia, 1. Arabs associate good health with eating Sudan, Syria, Tunisia, United Arab Emirates, properly, consuming nutritious foods, and and Yemen fasting to cure disease. Communication 2. illness is viewed as an imbalance between the 1. humors—black bile, blood, phlegm, and They share a common language, Arabic, and yellow bile—and the primary attributes of most are united by Islam, a major world dryness, heat, cold, and moisture religion that originated in 7th-century Arabia. 3. Concerns about amounts and balance among 2. The Arab person’s speech is likely to be food types (hot, cold, dry, moist) may be characterized by repetition and gesturing, traced to the Prophet Mohammed, who taught particularly when involved in serious that “the stomach is the house discussions. of every disease, and abstinence is the head 3. Arabs may be loud and expressive when of every remedy” (Al-Akili, 1993, p. 7). involved in serious discussions to stress their 4. Illness is related to excessive eating, eating commitment and their sincerity in the subject before a previously eaten meal is digested, matter eating nutritionally deficient food, mixing 4. Observers witnessing such impassioned opposing types of foods, and consuming communication may assume that Arabs are elaborately prepared foods. Conversely, argumentative, confrontational, or aggressive. abstinence allows the body to expel disease. 5. Maintaining eye contact when talking might 5. The condition of the alimentary tract has make Muslim women and the elderly priority over all other body systems in the Arab uncomfortable. perception of health. 6. Arabs need to develop personal relationships 6. Obesity is a problem for second-generation with healthcare providers before sharing Arab American women and children, most of personal information. whom report eating American snacks that are Time Orientation and personal spaces preferences high in fat and calories. 1. Throughout the Arab world, there is 7. Illness is considered a punishment for one’s nonchalance about punctuality except in sins. cases of business or professional meetings; 8. Mental or emotional illnesses may be otherwise, the pace of life is more leisurely attributed to the possession by evil jinn. than in the West. 9. Euthanasia and assisted suicide are forbidden 2. Social events and appointments tend not to because they believe in the sanctity of life. have a fixed beginning or end. 10. Spiritual beliefs and health-care practices for 3. Etiquette requires shaking hands on arrival Arab American Christians are similar to those and departure of the same sex/gender. of Orthodox or Catholics. 4. Touching someone of the opposite sex may Health Risks be carefully avoided. A Muslim woman may 1. Obesity be reluctant to shake hands with a man, even 2. Diabetes Mellitus as part of an introduction. 3. Cardiovascular Disease 4. Thalassemia  5. Asthma 3. They practice preventive health care, with 6. Tuberculosis routine physical, dental, and vision screening 7. Hepatitis A/B as well as a well-immunized population. 8. Lung and colorectal cancer 4. The older generation is still more likely to Nursing Interventions defer to medical authority, Jewish adults tend 1. A female client usually prefers a female health to want to participate in healthcare care provider. decision-making. 2. In emergency situations to save a life or 5. Many Jews understand the dietary laws as a prevent injury, it is acceptable to be treated guide to raising the act of eating to a spiritual and handled by the opposite gender. level, which is also true of the practice of 3. Encourage family involvement. washing one’s hands and praying before and 4. Be flexible and avoid rigidity in scheduling after eating. care. 6. The preservation of life is one of Judaism’s 5. Passing an item to someone with the left hand greatest priorities. Even the laws that govern may be considered rude by some Muslims the Sabbath may be broken if one can help 6. Alternative methods of healing include save a life. combining spiritual medicine, the performance 7. Taking medication that is not necessary to of daily prayers, and reading or listening to the preserve life on the Sabbath may be viewed Qur’an with conventional medical treatment, as “work” and is unacceptable. treating with the disease’s opposite: hot 8. To abstain from healing would be equivalent to disease, cold remedy, simple foods such as murder. dates, honey, salt, and olive oil. Health Risks 1. Lactase Deficiency VIII. Jewish 2. Tay-Sachs disease 3. Factor XI plasma thromboplastin antecedent Genetic (PTA) deficiency Description 4. Haemophilia C 1. Being Jewish refers to both a people and a 5. Phenylketonuria religion, not a race. 6. Myopia 2. The people are called Jewish, their faith 7. Hypercholesterolemia Judaism, their language Hebrew, and their 8. Breast Cancer land Israel. 9. Mental Health Problems (PTSD) 3. Judaism is both a religion and a culture. Nursing Interventions Communication 1. Some clients prefer health care providers of 1. English is the primary language of Jewish the same gender. Americans. 2. Nurses/healthcare providers should touch 2. Hebrew is the official language of the state of Hasidic men only when providing direct care. Israel and is used for religious prayers by all “Therapeutic touch” is not appropriate with Jews wherever they live. these clients. 3. Communication practices are more related to 3. During the week of Passover, no bread or their American upbringing than to their product with yeast may be eaten. religious practices. 4. Health teachings about the potential 4. Humor is frequently used as a coping life-threatening sequelae of their condition as mechanism and as a way to communicate well as the exceptions to Jewish law that with others. permit Time Orientation and personal spaces preferences them to take their medications. 1. Jews have never perceived time as 5. In view of the prohibition of work on the progressive, but rather as a fragmented line. Sabbath and holidays, special nursing 2. Hasidic Jewish men are not permitted to touch attention may be given to the observant a woman other than their wives. They often Jewish patient by nursing staff during Sabbath keep their hands in their pockets to avoid and biblical holidays. Jewish practice prohibits touch. using electricity on these days some patients 3. Non-Hasidic Jews may be much more will not turn lights informal and may use touch and short spatial on or off, adjust the bed, use the call button distance. or do anything with the telephone or Social Roles television. 1. The family is the core of Jewish society. 6. Do not discharge on the Sabbath or biblical 2. Modesty involves humility. Jews are holidays. encouraged not to “show off” or try to impress others. 3. Social action, volunteerism, and involvement Transcultural nursing is how professional nursing interacts with the in helping others are common vocations. concept of culture. It is a specific cognitive specialty in nursing that 4. Man is traditionally considered the focuses breadwinner for the household, and the on global cultures and comparative cultural caring, health, and woman is recognized for running the home nursing phenomena. It was established in 1955 as a formal area of and being responsible for the children. inquiry and practice. Health and Illness It is a body of knowledge that assists in providing culturally 1. Good health is considered an asset. appropriate nursing care. 2. They give importance to keeping the body and mind healthy, Jewish are health conscious. Cultural aspects of care seem to be a feature of the overall nursing Philippine-Americans and Culture Care picture within a multicultural context of health care. Many participants claimed that Differences in cultural beliefs, values, and lifeways between they responded to the cultural needs of patients. Anglo-American and Philippine nurse immigrants have been Transcultural nursing is a comparative study of cultures to frequently identified in hospitals, clinics, and schools of nursing. understand similarities (culture universal) and difference These differences are, however, the source of tension, nurse burnout, (culture-specific) across human groups distrust, and other problems that limit nurses’ effectiveness (Leininger, 1991). Current issues and trends on the increasing numbers of culturally Japanese-Americans and Culture Care diverse individuals who are projected to need nursing care in the future: Japan is one of the world’s most creative and innovative societies. It Much effort are being made to explore the current trends in has one of the most rapid and modern transit systems in the world. transcultural nursing to produce various theoretical works Today, Japanese are living and working in many countries, but many through integrated culture reviews. The theoretical works related to still retain some traditional practices because of their coherence, transcultural nursing during the past 10 years was meaning, and relevance to their extended families and country. searched through multiple databases and reviewed to determine themes reflecting the current trends. Sustained efforts In the United States there are over 800,000 Japanese are needed to further develop the theoretical works related to living in the country and many Japanese Americans lived on the West transcultural nursing to reflect changes in this ever-changing Coast, Pacific Islands, and especially in Hawaii. Nurses are learning nursing world. traditional and current beliefs and lifeways so they can provide In dealing with the increasing numbers of culturally diverse individuals culturally congruent care to Japanese clients and their families. through a specialization, globally, there are some universities offering Transcultural Certificate For Nurses Through Mexican-American and Culture Care Distance Learning which focuses specifically on the cultural anomalies facing nurses working with patients from different cultures. But this is usually paired with the degrees in Hispanic Americans, also called Latinos, feminine Latinas, and BSN or MSN and clinical experience. This is designed for Latinxs, people living in the United States who are descendants of post-graduate, or advanced practice nurses. Spanish-speaking peoples. Since most Hispanics trace their ancestry to Latin America, they are also often called Latinos. The U.S. is home In the University of Northern Colorado, the Transcultural Nursing to the second-largest Mexican community in the world (24% of the Graduate Certificate Program (Non-Degree) is being entire offered with 10-11 credits and prepares the nurse to provide Mexican-origin population of the world), second only to Mexico itself. culturally congruent and competent nursing care based upon qualitative analysis and other research methodology with field Taiwanese-Americans, Culture Care, Meanings and Expressions experiences The certificate option is designed for master's i nursing students, post-baccalaureate or post-master's students and Each year, thousands of immigrants from all over the world arrive in senior level undergraduate nursing students. the United States, and the Taiwanese are one of the large immigrant groups that have come to the United States. These immigrants have brought their homeland values, beliefs, and lifeways, including health and illness practices. Still today, Taiwanese immigrants practice their TELEHEALTH traditional cultural lifeways after long periods of residing in the United States. Such transcultural practices need to be studied and addressed by transcultural nurses. The future of transcultural nursing practice will likely be increasingly personalized — and patients may not even need to leave their homes to access care and be assessed. This applies Arab-Muslims Culture Care also to immediate family members that needs to be communicated and might be in rural locations. Already, virtual Caring for Arab Muslims poses a real challenge to most nurses today websites set patients/clients up with online sessions, since Western awareness to their unique cultural beliefs, values, and allowing them to access therapeutic support they otherwise might not lifeways is just beginning to develop. Muslim religious values and the receive. worldview of Islam are markedly different from the values that underpin life in the Western world. Understanding these values The number of Philippine immigrants to the United States has requires that nurses learn about the religious and cultural factors, steadily increased since World War II, and among them are Philippine social structure features, and health care features, as well as their nurses who are one of the largest groups of foreign-born nurses own cultural background. The central and important goal of practicing in the United States. With the increase of Philippine nurses transcultural nursing necessitates learning about the culture and then in nursing service and educational contexts, there have been some developing care practices that are culturally congruent with the values signs of intercultural tensions and conflicts largely related to of the people. misunderstandings.