Health_Assessment

HERITAGE HEALTH ASSESSMENT Heritage Health Assessment Grand Canyon University Family Centered Health Promotion NRS 429v February 17, 2012 Heritage Health Assessment As health care improves in the United States and across the world, people are living longer. In 1970, it was estimated there were 307 million people in the world over the age of 60. There were 500 million in 2000 an in 2020 it is estimated there will be one billion (Bee, 2000). Worldwide, the number of people in this age bracket is growing faster than any other age group (World Health Organization [WHO], 2002). Not only are the numbers of older adults ever increasing, but the composition of this sector of the population is also changing. Immigration is one aspect affecting the makeup of the elderly in the United States. In addition, immigration to the United States continues to increase each year. The Administration on aging (2005) reports that minority groups are predictable to increase from 5.7 million in 200(16.4% of the elderly population), to 8.1 million in 2010(20.1% of the elderly), and then to 12.9 million in 2030 (23.6% of the elderly). As the first-generation immigrants begin to age, their need for health services will begin to increase. For this reason, it becomes essential to gain understanding of how these groups interact and utilize health services in the United States. The wide category of immigrants comprises about 32 different national and ethnic groups (Austin & Prendergast, 1994). The distribution of Asians in the United States is: Chinese (23.8%); Filipino (18.3%); Asian Indian (16.25); Vietnamese (10.9%); Korean (10.5%); Japanese (7.8%); Cambodian (1.8%); Hmong (1.7%); Lao (1.6%); Pakistani (1.5%); Thai (1.1%); and other (4.7%) (U.S. Bureau of the Census, 2000). Since the majority of these immigrants are foreign born, strong cultural values, beliefs, and traditional health practices are still apparent in their behaviors. These are reflected in their unfamiliarity with our concepts and terminology of illness and diseases, as well as modern diagnostic techniques or treatments. Lack of understanding of the U.S. healthcare system prevents them from utilizing available services or following prescribed treatments. Many Asian Americans may also be hesitant about seeking medical help from American doctors or practitioners, and as a result, may hold back or not disclose information about their cultural practices. The lack of culturally knowledgeable services becomes a major obstacle for provision of services to Asians patients, and a challenge to healthcare providers. Therefore, the use of a heritage or cultural assessment will be of great use in the assessment and evaluation for the needs of the whole person. This heritage or cultural assessment tool will be specific for the use in clinical nursing practice, it will assist nurses, and health care practitioners in understanding the social positioning of the diverse ethnic-cultural groups in support of, whom they will deliver high quality care. Heritage assessment tools will be a used as a great vehicle so that nurses will be able to deliver effective trans-cultural nursing care. We do not all react the same way to the same illness. Instead, the assumptions of our particular culture influences the way we interpret our symptoms, as well as the kind of treatment we seek or receive. The same complaint might be interpreted in one group as the result of witchcraft, in another as a case of “tired blood” and in a third as a viral infection, with quite different consequences for the treatment and possible cure. Even the question of whether we actually have a disease depends on our culture. When people have decided that they are ill, their health seeking behavior is influenced by cultural assumptions. Members of some religious sects refuse medical treatment on the ground that Satan is the author of disease, and only God can cure it. Other people turn to faith healers, astrologers, and quacks of various kinds whose remedies are scorned by health care providers. Thousands of American cancer patients have sought out treatment with Laetrile, an apricot-pit extract, despite the fact that a health care provider regards it as useless, even dangerous. Some ethnic Americans use their own unlicensed medical systems. Chinese-Americans, for example, subscribe to the ancient belief that health requires a balance of the “cold” and “hot” forces of yin and yang, which can be achieved by the use of specific herbs and foods. Winn, Kim. (February 14, 2012). Personal Interview. American-Indians have a traditional system, one that is based on a view of the scared relationship between humanity and nature, and relies on three techniques, the use of herbs and other drugs, religious or spiritual rituals, and physical manipulations such as surgery, sweat baths, or poultices. The intent is to restore harmonious balance among all things in the universe, living and inanimate. Bhattara, Om. (February 10, 2012). Mexican-Americans recognize certain illnesses that occur only within their own groups. These include mal ojo, susto, and mal puesto, which translate as “evil eye,” “shock,” and “sorcery.” Fuentes, Magil. (February 12, 2012). Personal Interview. White American healthcare providers are considered unable to understand or treat these ailments; so patients go to curanderos or curanderas, healers who rely on Mexican folk medicine. The three main techniques of treatment are foodstuffs and herbs, massages and manipulations of the body, and magical and religious symbols. Most White- Americans accept the medical profession’s authority over disease and after some delay, or unsuccessful attempt at self-medication, and then they will consult with a healthcare provider. Knowing your patients heritage is imperative, when culturally appropriate care is not delivered, a negative path of events ranging from simple miscommunication to life threatening incidents. With the use of a heritage assessment in place, it will prevent poor and inadequate communication between the health care professional and the patient and the impact on the health economics of health care provisions. Inadequate encounters may result in failure to conform to treatment, as a result wasting valuable resources; therefore, the identification of cultural needs is crucial for interactions during diagnosis, treatments, and management of health care events. These interactions are crucial for building and sustaining a positive patient nurse relationship. It is incumbent on nurses ethically, morally, and by way of our professional codes of practice to be aware of and sensitive to heritage, cultural and diversity in our patients and patient populations.