Understanding different cultural beliefs and practices is a vital consideration when working in a cross cultural set up (Kirmayer, 2012). The nursing profession requires the health care providers to have a wide understanding of different cultural aspects in order to provide excellent patient care. Using the LEARN communication model, I was able interrogatean African-American and understand vital aspects that could significantly help in managing cross-cultural patient care. Once you understand patients cultural background, you can be be able to identify areas of concern that can be used by health care providers to overcome cultural and communication barrier to ensure successful patient education (Giger&Davidhizar, 2002).Effective communication entails providing health care related information to people in a manner that increases their knowledge related to health (Suhonen et al, 2012). Communication is mainly influenced by cultural values, attitudes, and beliefs.
I interviewed Jane, African American woman, in her mid-30s, married to African American man. She migrated from her native country Kenya. Since she was born in Kenya, she mainly identifies with the African cultures and precisely the Kenyan culture. There were challenges that she encountered when she migrated to the United States of America which includes different climatic conditions and cultural barriers. Jane along with her family migrated to United States after she was through with her high school studies. During the interview, language barrier was not a challenge because Jane was fluent in English. The interview focused on vital aspects that would help establish cultural practices and believes from the client’s perspective. Vitals aspects considered in the in interview included cultural affiliations, values orientation, health-related beliefs and practices, client’s heath status, and traditional therapies.
Jane grew up in a family strict family set up that valued African culture. She was caned for almost every mistake she did when she was in the elementary school. The parent child-relationship was more of a “formal” relationship. Children were to respect their parents and conduct themselves with a lot of decorum in the presence of their parents and elders. There was no close bond between the parents and the children as a result of this tensed relationship. Therefore, it was difficult for the children to consult their parents whenever they were faced with some challenges. To some extent, it was difficult to disclose some challenges to the parents. In such relationship, children suffer in silence even when they have psychological problems that can be solved by their parents.
Jane is quit conversant with the African culture. Unlike the western culture that allows a free-style kind of dressing, the African culture is somehow conservative. In her African society, women are expected to wear long dresses and cloths that appropriately cover their body. Clothing plays a vital role in African culture. In order relate well with members from her community, it is important to consider appropriate dressing.
Jane was brought up in a society that supported female genital mutilation (FGM). This is considered a significant ritual that ushers girls to adulthood. It is a ritual that qualifies girls to become reliable wives and mothers in future. In fact, those who neglect the ritual are considered social out casts. However, with continued campaigns and laws against FGM, the culture is losing relevance, though some die-hardspromote the act in secret. This culture was considered insignificant because it lacks scientific significance and at the same time it might result to death of the victims.
There are believes that some diseases are caused by spirits that can only be expelled through spiritual divination or prayers. Sometimes sacrifices are offered to appease the spirits and ancestors who are thought to cause illnesses and diseases when they are annoyed. Other disease such as Aids and cancer are thought to result from curses. There is a lot of stigmatisation to victims of these diseases because they are considered a cursed lot.
Client’s View toward Health and Illness
Jane considered illnesses as product of people’s lifestyle or disease causing micro-organisms. She argued that lifestyle diseases such as obesity can be controlled by checking our life style. She also believed that others diseases such as ulcers result from stressful situations in life. However, she also believes in spiritual intervention for hear. Being a protestant, she claims to have witnessed miraculous supernatural intervention for people with diseases such as cancer and HIV aids. She believes that there are some diseases that need spiritual intervention, especially diseases that are consider having no remedy or curing. Some illnesses can result from demonic powers that can interfere with the normal functioning of the physical body. Therefore, in her opinion, it is important to consult spiritual leaders and seek for prayers in such situations. She opined that some illnesses might result from spiritual curses, as a punishment from the supernatural world. In that case, it is important to seek forgiveness and repentance for the wrong deed that might have caused the punishment.
Client’s Health Status
Jane has been fighting Nephrolithiasis or what is referred to kidney stone for five years. She understands that the disease is caused by “stone” that block the urinary track within the kidney. She also believes that the disease is hereditary because her mother and her grandmother were suffering from the same illness.The disease has made her visit hospital often for evaluations and treatment. As a result of this complication, she takes more water during the day. She also believes that water melon, lemon juice and olive oil are appropriate combinations that can significantly reduce the disease effect. She believes that lemon juice and olive oil which are traditionally used as a home remedy to remove gall bladder stones can also be applied in the same manner to remove stones from the kidney.
Though she has approached several spiritual for prayer with success, she still believes that through prayers she can be healed. However, she often visits health centre for advice, evaluations and treatment. She believes that the spiritual aspect combine with medical treatment will bring healing in her condition.
Jane asserted that she is bothered with symptoms of allergic disease and sinutis. From her social background, patients employ both traditional and corresponding therapies before seeking the care of medical professionals. Traditional medicine is widely used by individuals with both advance and moderate illness cases. Traditional medicine is also commonly used among persons with moderate and advance HIV disease. However, because of high stigma associated with HIV, majority of the patients seek these traditional therapies in secret.
Jane appreciated that traditional beliefs and norms plays a significant role in community health care. For example, most deliveries are done at home by traditional midwives who understand basic procedures of undertaking the delivery process. However, they do it in a manner that is not acceptable in the nursing profession. There are rituals that are done to the baby to protect her from bad omen. Also, the placenta is buried in fertile soils in order to ensure the mother’s fertility is preserved. These rituals are done by older women who pure libation to appease the ancestors and spirits.
There are other traditional therapies that are done to the new-borns and toddlers. Some traditional healing practice administered to the young ones includes pricking the gums with sharp object for bleeding to take place in order to protect them from possible complication during teeth growing. The procedure is normally carried out by a respected older woman or a traditional healer. The instruments used to administer these therapies are not sterilized and no anaesthesia is used. The painful process is usually done to prevent prolonged fever and gastroenteritis which is thought to result from teething. Many parents believe that during teething period babies develop running nose, high fever and loose stools. However, experts do not agree with this belief. Many parents resort to traditional medication and therapies once their child’s symptoms persist even after evaluation and getting medication from a local health facility. The primary consequence of this practise is dental abnormalities.
Carrying out cultural interview is the best approach to understand cultural differences (Papastavrou et al, 2012). The questions asked in the interview were designed to bring out vital cultural aspects that could help in cross-cultural patient care. The interview which took approximately 40 minutes brought out key differences as well as vital similarities between our cultures. First and foremost, it helped deliver vital information on how communication can be facilitated between different cultures.
The interview was successful because it helped gather the vital information on African culture. My client was quite cooperative and willing to offer her view on various cultural aspects. I learned new thing that I had not learned in book about African culture. In the current world, it is becoming difficult to maintain indigenous cultures. Though it is becoming difficult and challenging to maintain indigenous culture as a result of globalisation and increased interaction of people from different cultural backgrounds, individuals still preserves distinct cultural values that determine how relate with healthcare services (Giger & Davidhizar, 2002). Effective health care services are based on mutual communication and understanding between patients, nurse and physicians (Ceravoloet al, 2012). Relating appropriately with patients is among the most esteemed skills of clinical care.
In conclusion, intercultural exploration supported by this kind of an interview comprises an actual encounter with realities from different cultural backgrounds. Ideally, It presents a significant opportunity to recognize vital aspects, similarities and differences among different cultures. By identifying and highlighting these differences and similarities, individual seeking to interact have a base of doing it effectively by creating the right impression. The right impression promotes effective communication between medical practitioners and the patients,which would help realize the goals of healthcare fraternity.The essence of conducting this interview lies in the opinion that patients’ beliefs determine the origin of disease, the needed treatment and the expected recovery. Patients’ beliefs serves as guide map that in turn reveals vital aspects that help health care providers have better understanding of the patient’s condition.The interview was quite resourceful and significant in understanding different cultural aspects.
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