Family traditions

Family traditions

Instructions: 

  1. Read and follow the directions on pages 160 and 161.
  2. Conduct an interview with an older family member.
  3. Summarize your findings regarding familial and social changes, and your ethnocultural and religiousheritage. (Include one example)
  4. Your paper should be:
    • One (1) page
    • Typed according to APA style for margins, formating and spacing standards
      • See NUR3045 – Library (located on left-side on menu) for tutorial Using APA Style
    • Typed into a Microsoft Word document, save the file, and then upload the file. Family traditions

CULTURALCARE

There is something that transcends all of this I am I . . . You are you Yet. I and you Do connect Somehow, sometime.

To understand the “cultural” needs Samenesses and differences of people Needs an open being See—Hear—Feel With no judgment or interpretation Reach out Maybe with that physical touch Or eyes, or aura You exhibit your openness and willingness to Listen and learn And, you tell and share In so doing—you share humanness It is acknowledged and shared Something happens— Mutual understanding Family traditions

—Rachel E. Spector

Cultural Diversity in Health and Illness

E I G H T H E D I T I O N

Rachel E. Spector, PhD, RN, CTN-A, FAAN Needham, MA 02494

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ISBN-13: 978-0-13-284006-4 ISBN-10: 0-13-284006-5 Family traditions

Editor-in-Chief: Julie Levin Alexander Executive Acquisitions Editor: Kim Norbuta Senior Marketing Manager: Phoenix Harvey Managing Editor, Production: Central

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Production Manager: Tom Benfatti Creative Director: Jayne Conte Cover Designer: Bruce Kenselaar Composition: PreMediaGlobal Printer/Binder: RR Donnelley & Sons Cover Printer: RR Donnelley & Sons Family traditions

Notice: Care has been taken to confirm the accuracy of information presented in this book. The author, editors, and the publisher, however, cannot accept any responsibility for errors or omissions or for consequences from application of the information in this book and make no warranty, express or implied, with respect to its contents.

The authors and publisher have exerted every effort to ensure that drug selections and dosages set forth in this text are in accord with current recommendations and practice at time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package inserts of all drugs for any change in indications of dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Family traditions

Copyright © 2013 by Pearson Education, Inc., Upper Saddle River, New Jersey 07458. All rights reserved. Printed in the United States of America. This publication is protected by Copyright and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. For information regarding permission(s), write to: Rights and Permissions Department. Family traditions

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Pearson Education Ltd., London Pearson Education North Asia Ltd., Hong Kong Pearson Education Singapore, Pte. Ltd. Pearson Educación de Mexico, S.A. de C.V. Pearson Education Canada, Inc., Toronto Pearson Education Malaysia, Pte. Ltd. Pearson Education—Japan Pearson Education, Upper Saddle River, Pearson Education Australia PTY, Limited New Jersey Family traditions

Library of Congress Cataloging-in-Publication Data Spector, Rachel E. Cultural diversity in health and illness/Rachel E. Spector.—8th ed. p. cm. Includes bibliographical references and index. ISBN-13: 978-0-13-284006-4 ISBN-10: 0-13-284006-5 1. Transcultural medical care—United States. 2. Health attitudes—United States. 3. Transcultural nursing—United States. I. Title. RA418.5.T73S64 2013 610—dc23 2012012708

10 9 8 7 6 5 4 3 2 1

I would like to dedicate this text to Family traditions

My husband, Manny; Sam, Hilary, Julia, and Emma; Becky, Perry, Naomi, Rose, and Miriam; the memory of my parents, Joseph J. and Freda F. Needleman, and my in-laws, Sam and Margaret Spector; and the memory of my beloved mentor, Irving Kenneth Zola.

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Contents

PREFACE xi

ABOUT THE AUTHOR xvii

ACKNOWLEDGMENTS xviii

UNIT I CULTURAL FOUNDATIONS 1

Chapter 1 Building Cultural and Linguistic Competence 3 National Standards for Culturally and Linguistically

Appropriate Services in Health Care 8 Cultural Competence 11 Linguistic Competence 11 Institutional Mandates Family traditions12 CULTURAL CARE 13

Chapter 2 Cultural Heritage and History 19 Heritage Consistency 20 Acculturation Themes 29 Ethnocultural Life Trajectories 32 Commingling Variables 34 Cultural Conflict 36 Cultural Phenomena Affecting Health 37

Chapter 3 Diversity 43 Census 2010 45 Immigration 48 Poverty 54

Chapter 4 Health and Illness 62 Health 63 Illness 74 Family traditions

UNIT II HEALTH DOMAINS 85

Chapter 5 HEALTH Traditions 89 HEALTH and ILLNESS 91 HEALTH Traditions Model 92 HEALTH Protection 95 Health/HEALTH Care Choices 102

vii

viii ■ Contents

Folk Medicine 104 Health/HEALTH Care Philosophies 108

Chapter 6 HEALING Traditions 120 HEALING 121 Ancient Forms of HEALING 123 Religion and HEALING 124 HEALING and Today’s Beliefs 136 Ancient Rituals Related to the Life Cycle 138 Family traditions

Chapter 7 Familial HEALTH Traditions 158 Familial Health/HEALTH Traditions 160 Consciousness Raising 171

Chapter 8 Health and Illness in Modern Health Care 178 The Health Care Provider’s Culture 179 Health Care Costs 182 Trends in Development of the Health Care System 187 Common Problems in Health Care Delivery 191 Pathways to Health Services 195 Barriers to Health Care 197 Medicine as an Institution of Social Control 199

UNIT III HEALTH AND ILLNESS PANORAMAS 207

Chapter 9 HEALTH and ILLNESS in the American Indian and Alaska Native Population 210 Background 211 Traditional Definitions of HEALTH and ILLNESS 213 Traditional Methods of HEALING 215 Current Health Care Problems 222 The Indian Health Service 228 Family traditions

Chapter 10 HEALTH and ILLNESS in the Asian Populations 238 Background 239 Traditional Definitions of HEALTH and ILLNESS 241 Traditional Methods of HEALTH Maintenance

and Protection 246 Traditional Methods of HEALTH Restoration 247 Current Health Problems 257

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Chapter 11 HEALTH and ILLNESS in the Black Population 265 Background 266 Traditional Definitions of HEALTH and ILLNESS 270 Traditional Methods of HEALTH Maintenance

and Protection 271

Contents ■ ix Family traditions

Traditional Methods of HEALTH Restoration 272 Current Health Problems 279

Chapter 12 HEALTH and ILLNESS in the Hispanic Populations 291 Background 292 Mexicans 294 Puerto Ricans 308

Chapter 13 HEALTH and ILLNESS in the White Populations 323 Background 324 German Americans 326 Italian Americans 330 Polish Americans 334 Health Status of the White Population 339

Chapter 14 CULTURALCOMPETENCE 345 CULTURALCOMPETENCY 351

Appendix A Selected Key Terms Related to Cultural Diversity in Health and Illness 354

Appendix B Calendar: Cultural and Religious Holidays That Change Dates 364

Appendix C Suggested Course Outline 367 Family traditions

Appendix D Suggested Course Activity—Urban Hiking 373

Appendix E Heritage Assessment Tool 376

Appendix F Quick Guide for CULTURALCARE 379

Appendix G Data Resources 381

BIBLIOGRAPHY 383

INDEX 403

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xi

Preface

Every book, every volume you see here, has a soul. The soul of the person who wrote it and of those who read it and lived and dreamed with it.

—Carlos Ruiz Zafon, The Shadow of the Wind, 2001 Family traditions

In 1977—more than 35 years ago—I prepared the first edition of Cultural Diversity in Health and Illness. Now, as I begin the eighth edition of this book— the sixth revision—I realize that this is an opportunity to reflect on an endeavor that has filled a good deal of my life for the past 30 years. I believe this book has a soul and it, in turn, has become an integral part of my soul. I have lived—through practice, teaching, and research—this material since 1974 and have developed many ways of presenting this content. In addition, I have tracked for 40 years:

1. the United States Census; 2. immigration—numbers and policies; 3. poverty—figures and policies; 4. health care—costs and policies; 5. morbidity and mortality rates; 6. nursing and other health care manpower issues; and 7. the emergence and growth of the concepts of health disparities and

cultural and linguistic competence. Family traditions

My metaphors are HEALTH, defined as “the balance of the person, both within one’s being—physical, mental, and spiritual—and in the outside world— natural, communal, and metaphysical”; ILLNESS, “the imbalance of the person, both within one’s being—physical, mental, and spiritual—and in the outside world—natural, communal, and metaphysical”; and HEALING, “the restoration of balance, both within one’s being—physical, mental, and spiritual—and in the outside world—natural, communal, and metaphysical.” I have learned over these years that within many traditional heritages (defined as “old,” not con- temporary or modern) people tend to define HEALTH, ILLNESS, and HEALING in this manner. Imagine a kaleidoscope—the tube can represent HEALTH. The ob- jects reflected within the kaleidoscope reflect the traditional tools used to care for a given person’s HEALTH. If you love kaleidoscopes, you know what I am describing and that the patterns that emerge are infinite. Family traditions

xii ■ Preface

In addition, I have had the unique opportunity to travel to countless places in the United States and abroad. I make it a practice to visit the tra- ditional markets, pharmacies, and shrines and dialogue with the people who work in or patronize the settings, and I have gathered invaluable knowledge and unique items and images. My tourist dollars are invested in amulets and remedies and my collection is large. Digital photography has changed my eyes; I may be a “digital immigrant,” rather than a “digital native,” but the camera has proven to be my most treasured companion. I have been able to use the im- ages of sacred objects and sacred places to create HEALTH Traditions Imagery. The opening images for each chapter and countless images within the chapters are the results of these explorations. Given that there are times when we do not completely understand a concept or an image, several images are slightly blurred or dark to represent this wonderment Family traditions .

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