"Culture Care Diversity: A Worldwide Nursing Theory" is a great example of a paper on social and family issues. The essay aims to address a two-fold objective to wit: (1) to perform a heritage assessment with families selected by the student from their local community; and (2) to discuss the usefulness of applying a heritage assessment to evaluate the needs of families and develop plans for health maintenance, health protection, and health restoration. Heritage Assessment Part I: Family Profile Performing a heritage assessment is essential to the attainment of individualized, culture-sensitive care. It is based on the concept that one’ s lifestyle or viewpoint towards his/her own health is grounded on their families’ cultures, beliefs, and practices It uses a heritage assessment tool which consists of questions relevant to the families ethnic, cultural, and religious heritage (Sagar, 2012, 82).
To further understand how this tool works, let us examine the heritage assessment profile of three families – Filipino, Arab, and American families while preserving anonymity. Client A is a twenty-five-year-old Filipino migrant in America for approximately 5 years. Her parents, together with other relatives, were born and resides in the Philippines.
She has two brothers and two sisters. She grew up in a rural area for twenty-years until she migrated and worked in the United States at the age of 22. Neither her father nor her mother was able to go to the United States, even a visit. However, Client A always made sure that she keeps constant communication with her families. As she is far from home, Client A can only visit her family at least twice a year. Client A also said that she has been living with her partner for two years now even if her Catholic beliefs forbid dwelling together of unmarried couples.
She finds it lucky that her neighbor understands their status; primarily because they belong to different religions. She is not an active member of the church because of a demanding schedules at work and only attend masses during special holidays. Despite the situation, Client A never forgets to praise and thank God most especially during the time of sickness. When there’ s time, she participates also in Filipino OFW gathering.
As she went to prestigious private schools in the Philippines starting from basic to higher education, Client A only used her native language. Meanwhile, Client B comes from an Arab family who puts a strong emphasis on the foundation, structure, and hierarchy of the family. His father and mother were born in the Kingdom of Saudi Arabia (KSA), as well as his grandparents. He has two brothers and one sister. Client B grew up in an urban area where parents raised female children in an authoritarian manner compared to males.
Client B’ s parents grew up in KSA and came to the United States for business when they were thirty years old. Client B was just 14 at that time and his siblings were so little. A few years passed, most of their relatives lived in the same vicinity and maintained constant communication with everyone. They did not change their original family name as they believe that names were a gift from Allah. Client B also emphasized that their partners should also be Islam followers because a family should always be united in religion.
He stated that he is an active member of Islam, pray at least five times a day, and religiously go to the mosque as scheduled. Even in the United States, mosque schools taught them to observe food etiquettes, fasting days, and foods to avoid during religious inclinations. Client B prefers Arabic when communicating as he finds it comfortable to use because his friends and family still communicate in this language. The third family being assessed is the family of Client C whose members were born and did grow up in the United States.
Her parents got divorced 2 years ago and she lives with her mother who is 43 years old. They lived independently, away from relatives and her father. Client C was not given the chance to visit her father or other family members due to geographical distance. Client C’ s family belongs to the Catholic religion, as well as her neighbors. Together with their neighbors, they attended weekly masses, celebrate religious holidays, and pray to God frequently. Most of her friends from private schools are Catholic and they use English (their native language) in communicating with each other. Part II: Health Maintenance, Health Protection, and Health Restoration The Heritage Assessment Tool has provided an in-depth view of the three families, particularly health concerns when dealing with different ethnic groups.
Caring for an American family might be different from those of Filipino and Arab families; thus, delivery of care must be unique and based on the ethnic needs of the family. The nurse, as an advocate, shall promote the physical, mental, and spiritual health of the family in each spectrum – health maintenance, health protection, and health restoration.
In this part, we will apply Spector’ s Model in comparing and planning health education for the three families based on what transpired from the interview. Physical Mental Spiritual Health Maintenance Client A self-medicate or delay treatment if she thinks that the illness is not serious; Client B tends to go initially to his religious leaders prior to access to healthcare providers; Client C highly valued her mother that she was the first to be consulted during the time of illness. Action: The nurse must never confuse resiliency to incompliance as families may seek initial care from significant others.
In this case, interview their significant others to gather more details about the client. The three families have different means of recreation. Client A prefers social gatherings from the same ethnic group; Client B reads books and magazines (except those forbidden by their religion) while Client C enjoys conversations with friends from the same church. Action: When planning recreational activities for this client, be sure to include materials or activities which are permitted by their religion.
Observe also personal space in social gatherings, especially among Arab clients. Hectic schedule at work and not geographic proximity lessens Client A’ s participation in spiritual responsibilities while Client B and C actively and frequently follow religious practices. Despite the differences, they make a point to develop spiritual connections. Action: The nurse must develop an awareness of how the client practices their religious inclinations. Since religious belief is highly valued by each family, respect to traditions and beliefs must be given accordingly. Health Protection At the height of illness, Client A used a blanket when she feels cold and loose clothing when she feels warm while Client B used the thobe no matter the weather is.
Arabs value hierarchy and the type/color of the thobe indicates hierarchy in the Arab system (Leininger & McFarland, 2006, 99). Just like Client A, Client C’ s clothes are patterned in congruence with the condition of the environment. Action: The nurse must know that some ethnic groups like Filipinos and Americans believe in the balance of the body with the environment to prevent diseases; meanwhile, the thobe used by Arabs might not be for protection but for hierarchy.
It is essential that respect must be accorded to Arabs when giving care. All three clients avoid intrusion of personal space. While Client C avoids eye contact and milk consumption, Clients A and B avoid foods that are forbidden during religious celebrations (e. g., meat during Easter). Action: Encourage clients to personalize their space during delivery of care. It is also important to remember that some clients might be listening even without eye contact (Delaune & Ladner, 2011, 387). In addition, study the client’ s religion. It will help a lot in planning for nutritional care. All three clients lean on religion in times of sickness by means of praying or going to their respective churches. Action: Realize the importance of religion.
Allow time for clients to pray, worship, or talk to their God. Do not discourage or disturb rituals as it gives them strength. Health Restoration Client A is resilient and tends to self-medicate; Client B seeks the healing powers of their religious leader while Client C finds comfort from her family. Action: Determine the nature of the role of the individual in providing care.
Discuss the participation of traditional healers or alternative medicines with the clients to identify a potential conflict with treatment. Client C preferred meat and blue cornmeal for health restoration while Client A preferred “ hot-and-cold” foods to balance body temperature. Action: Identify food preferences in meal planning. At present, only in the case of Client B that was folk/traditional healer is present because of their belief that families should be united and should stay in one place. Action: Identify the need for folk healers in order to lessen the anxiety of the client and get the rapport needed for the delivery of care.
DeLaune, S.C. & Ladner, P.K. (2011). Cultural Diversity. In Fundamentals of Nursing: Standards and Practice (4th ed.) (pp. 379-400). New York: Delmar, Cengage Learning.
Leininger, M.M. & McFarland, M.R. (2006). Globalization of Transcultural Nursing and Research. In Culture Care Diversity and Universality: A Worldwide Nursing Theory (2nd ed.) (pp. 83-114). Massachusetts: Jones and Bartlett Publishers, Inc.
Sagar, P. (2012). Rachel Spector's Health Traditions Model. In Transcultural Nursing Theory and Models: Application in Nursing Education, Practice, and Administration (pp. 79-94). New York: Springer Publishing Company, LLC.