The Appalachian and Arab heritage related to their healthcare beliefs

/in /by

People of Appalachian Heritage.

People of Arab Heritage.

Read chapter 8 and 9 of the class textbook and review the attached Power Point presentation.  Once done, answer the following questions;

1.  Give an overview of the Appalachian and Arab heritage related to their healthcare beliefs and mention if there is any similarity in both cultures.  Give an example.

2.  How the Appalachian and Arab heritage view the process of death and explain if there is any similarity in any of them?

3.  Explain is there is any similarity in the healthcare beliefs of the Appalachian and Arab heritage with the evidence based nursing care that is provide. The Appalachian and Arab heritage related to their healthcare beliefs

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard title “Week 4 discussion questions”.  A minimum of two evidence based references no older than 5 years old  besides the class textbook are required.  Two replies sustain the proper references to any of your peers and a minimum of 500 words are required.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

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Appalachians 
Larry Purnell, PhD, RN, FAAN

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview

  • Heritage from England, Wales, Scotland, Ireland, France, and Germany
  • Came to the United States for religious freedom and better economic opportunities
  • Purposely isolated themselves in the mountains to live and practice their religions as they chose

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview Continued

  • Appalachia includes 410 counties in 13 states and extends from southern New York to northern Mississippi.
  • Continuous migration from the country to the city and vice versa
  • High proportion of aging in Appalachia
  • Farming, mining, textiles, service industries, etc. The Appalachian and Arab heritage related to their healthcare beliefs

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview Continued

  • High poverty and unemployment rates
  • Originally most educated group in America, now some of the least educated due to isolation
  • Area still lacks infrastructure

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications

  • Carry over from Elizabethan English
  • Spellin for spelling
  • Warsh for wash
  • Badder for bad

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Ethic of Neutrality

  • Avoid aggression and assertiveness
  • Do not interfere with others’ lives
  • Avoid dominance over others
  • Avoid arguments and seek agreement
  • Accept without judging—use few adjectives and adverbs, resulting in less precise description of emotions and thoughts

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications

  • Sensitive about direct questions and personal issues
  • Sensitive to hints of criticism. A suggestion may be seen as criticism.
  • Cordiality precedes information sharing so “sit a spell” and chat before doing business, which is necessary for developing trust

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communication Continued

  • A few may avoid direct eye contact because it can be perceived as aggression, hostility, or impoliteness
  • More being than doing oriented, more relaxed culture and being in tune with body rhythms
  • Be formal with name format until told to do otherwise.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communication Continued

  • Healthcare provider must be flexible and adaptable
  • Come early or late for an appointment and still expect to be seen
  • Family lineage is important
  • Formality with respect—Miz Florence or Mr. John

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family

  • Varied decision-making patterns but the more traditional Appalachian family is still primarily patriarchal
  • Women make decisions about health care and usually carry out the herbal treatments and folk remedies
  • Women marry at a young age and have larger families than the other white ethnic groups.  The Appalachian and Arab heritage related to their healthcare beliefs

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Continued

  • Children are accepted regardless of what they do
  • Hands-on physical punishment is common
  • Motherhood increases the status of the woman in the eyes of the community
  • Take great pride in being independent and doing things for oneself

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Continued

  • Family rather than the individual is the treatment unit
  • Having a job is more important than having a prestigious position
  • Consistent with the ethic of neutrality, alternative lifestyles are accepted, they are just not talked about
  • Extended family is the norm

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Biocultural Ecology

  • High incidence of respiratory conditions due to occupations
  • Increase of parasitic infections due to lack of modern utilities in some areas
  • High incidence of cancer, otitis media, anemia, obesity, cardiovascular disease, suicide, accidents, SIDS, and mental illness

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

High-Risk Behaviors

  • Tobacco is a main farming crop in some areas of Appalachia
  • Smoke at a young age
  • Alcohol use at a young age—binge drinking
  • Believe in the mind, body, spirit connection

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Ten Steps in Seeking Health Care

  • Use self-care practices learned from mother or grandmother
  • Call mother or grandmother if available
  • Then trusted female family member, neighbor, or a nurse
  • Then go to OTCs they saw on TV
  • Then use a neighbor’s prescription medicine

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Ten Steps in Seeking Health Care Continued

  • Pharmacist or nurse for advice
  • Physician or Advanced Practice Nurse
  • Then to a specialist
  • Then to the closest tertiary medical center
  • DO NOT BE JUDGMENTAL, if you want to keep them in the system

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

  • Food may be synonymous with wealth
  • Wide variety of meats, do not trim the fat—low-fat wild game is also eaten
  • Organ meats are common
  • Bones and bone marrow used for making sauces
  • Preserve with salt

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

  • Lots of frying (using lard or bacon grease) and pickling
  • Anytime is the time to celebrate with food, especially in the rural areas
  • Many teens have particularly poor health
  • Status symbol to have instant coffee and snack foods for some

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

  • Early introduction of solid foods
  • May feed babies teaspoons of grease to make them healthy and strong
  • Diet is frequently deficient in Vitamin A, iron, and calcium

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Childbearing Family

  • Must eat well to have a healthy baby
  • Do not reach over your head when pregnant to prevent the cord from wrapping around the neck of the fetus
  • Being frightened by a snake or eating strawberries or citrus can cause the baby to be marked
  • Use bands around the belly and asafetida bags. The Appalachian and Arab heritage related to their healthcare beliefs

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Death Rituals

  • Must stay with the dying person
  • Family should not be left alone
  • Funerals with personal objects at the viewing and buried in their best clothes
  • May take the deceased for viewing at home
  • After the funeral there is more food and singing and for some a “wake” to celebrate life

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Death Rituals Continued

  • Flowers are more important than donations to charity
  • Particularly good at working through the grieving process
  • Funeral directors are commonly used for bereavement
  • Cremation is acceptable and ashes may be saved or dispersed on the “land”

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality

  • Baptist, Pentecostal, Episcopalian, Jehovah’s Witness, Methodist, Presbyterian
  • Each church adapts to the community
  • Most are highly religious even though they do not attend church
  • Common to attend Sunday and other days
  • Preacher has a calling to “preach”
  • Ministers are trained

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality Continued

  • Meaning in life comes from the family and “living right with God,” which varies by the specific religious sect
  • Nature is in control—fatalism
  • Religion and faith is important in a hostile environment
  • I will be there if the “creek does not rise” or if “God is willing”—fatalism

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices

  • Good health is due to God’s Will
  • Self-reliance fosters self-care practices
  • Family important for health care
  • May be very ill before a decision is made to see a professional resulting in a more compromised health condition
  • Direct approaches are frowned upon

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices Continued

  • Herbal medicines, poultices, and teas are common
  • See Table 8–1 in the textbook; these practices are still alive and well
  • Folk medicines used in conjunction with biomedical treatments

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Barriers

  • Fatalism
  • Self-reliance
  • Lack of infrastructure
  • Health profession shortages
  • Culture of “being”
  • Poverty and unemployment
  • Care not acceptable from outsiders

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Responses to Health and Illness

  • Take care of our own and accept the person as whole individual
  • Not mentally ill, the person has “bad nerves” or are “odd turned”
  • Having a disability with aging is natural and inevitable—if you live long enough
  • Must establish rapport and trust

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Responses to Health and Illness Continued

  • Pain is something that is to be endured
  • Some may be stoical
  • Pain legitimizes not working or fulfilling one’s responsibilities
  • Withdraw into self when ill
  • Culture of being works against rehabilitation

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practitioners

  • Lay and trained nurses and midwives still provide much of the care in some parts of Appalachia
  • Breckenridge Frontier Nursing Service
  • Prefer people known to the family and community —the insider versus outsider concept

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practitioners Continued

  • Culture of “being” says the healthcare provider should not give the perception of being rushed
  • Physicians may not be trusted due to outsided-ness, not to being foreign
  • Must ask the clients what they think is wrong. The Appalachian and Arab heritage related to their healthcare beliefs