Heritage_Assessment

Understanding culture is an important part of providing holistic patient care. Using the Heritage Assessment Tool can help you to incorporate their beliefs and thought processes regarding healthcare and their everyday life. When you have an understanding of the person’s background, it enables you to better care for these patients as well as their families. Culture can be defined as “the thoughts, communications, actions, beliefs, values, and institutions of racial, ethic, religious or social groups” (Jarvis,2012). Differing cultures will also include people who speak different languages. This may present barriers for communication with our patients. If an individual does not understand the questions being asked of them, or the written information given to them, they might not feel comfortable with the care they are receiving. Interviews The first interview was with Kohn Puplantku, a physician this author works closely with. Kohn’s ethnic background is Ghanaian and German. He has been in Clinton, Iowa for about 7 years now. Kohn is a single, African male who was born in 1974 in Dusseldorf, Germany. His father was studying pediatric medicine at this time. By the age of 5 his parents moved to Ghana, where his parents were both born. Ghana is located in West Africa. His father was born in Tema and his mother was born in Accra. Kohn has 1 brother and no sisters. Kohn and his brother both attended private school while growing up. Kohn and his family rarely saw their extended family, except on a yearly basis. However, he did see his maternal grandmother monthly. The main language spoken in Ghana is English, there are however, 46 different languages used in this country. Kohn also speaks German, French, and Spanish. Kohn and his brother were raised by Protestant faith by their parents. The Protestant faith believes that man was created from good but fell from grace by sin when Adam and Eve ate the fruit from the forbidden garden (Vial, n.d.). They also believe that suffering is due to evil, it is the work of Satan and those who rebel against God (Vial, n.d.). When discussing Kohn’s religious beliefs, he (Puplantku, personal communication, March 17, 2012) may have been raised a Protestant , but is not actively practicing this religion. He does not belong to any religious organizations. He believes in God but prefers to meditate and pray in his own home. In Kohn’s culture, handshakes are a common greeting and should be done with the right hand. Maintaining eye contact during conversation is important. Kohn reports (personal communication, March 17, 2012) Ghananian culture holds the mother with the highest respect. Kohn is very close to his mother and grandmother and speaks little of his father. Kohn’s and his immediate family follow more traditional Western view on health care and medicine. Kohn’s extended family still uses traditional priests that use herbal remedies or certain spiritual ritual and his immediate family follow more traditional Western view on health care and medicine. Kohn’s extended family still uses traditional priests that use herbal remedies or certain spiritual rituals. Kohn stays healthy by keeping active and eating the right foods. He is very conscious of his health and receives regular physical examinations. He believes that well being is as much mental as physical. The second interview was with a man named Fernando Barragan. He is a 26 year old Hispanic male. Fernando, referred to as “Nano” by everyone he knows, has lived in America since he was 17. He resides in Savanna, Il and works at Nuemiller Farms. Nano has worked at the potato farm since he first came to America at age 17. It is the only job he has ever had. Nano was born and raised in Michoacan, Mexico. He lived there until he turned 17 and came to America via the “Coyote”. Nano states (personal communication, March 20th,2012) the “Coyote” is someone who helps illegal immigrants sneek through the border for a large fee. Most of Nano’s family lives in Savanna as well. Through the years, many of his family uprooted their lives to move to this country for work. In Mexico, the wages for hard work are minimal compared to what a person can make in America. Hispanic immigrants are responsible for 56% if the nations growth (Swanson, 2012) In speaking with Nano (personal communication, March 20th, 2012), this author found his family to be very close and traditional. They are all practicing Catholics and attend church regularly on Sundays. This author found that in this family, the women and men tend to stay segregated at social functions and family gatherings. The elderly in the family have a more prestigious status. They are catered to and it is an honor for the family to have them living in their home. Nano’s home consists of his mother, father, 2 sisters, 4 brothers, and his elderly paternal grandmother. He is the oldest child in his family and is looked upon to help out with the children quite often. The women in the family do all of the cooking while the men work outside of the home. They do not socialize much outside of their family. Birthdays, baby showers, and weddings are all major celebrations for this family. Typically a goat is bought and killed for the feast. Nano (personal communication, March 20th, 2012) states that traditionally when a baby is born the husband does not go into the room for this occasion. After the baby is born, the woman lays in bed for up to 6 weeks. All the women in this family breast feed and do not believe in the use of formula for the infants. Some women in the family will breast feed their children until they start school. Most of the food this family consumes is fried prepared in lard instead of vegetable oil. Pinto beans are a staple in the meals as well as corn and flour tortillas. Most of the women in Nano’s family are obese. This is not looked down upon or even commented on by the men and is considered to be “healthy”. The men usually drink beer and like to indulge in tequila on occasion. This family uses more over the counter herbal remedies versus a prescribed medication for ailments. They rely other family members for medical advise rather than make a trip to the local physicians office. They are private and would rather only family know if they have a need rather than the public. The third interview was conducted with Jacob White. His father is an American and his mother is Navajo Indian. Jacob is 21 years old and resides in Colorado, where he has lived since he was born. His mother and father were never married and he has only met him once, when he was 5 years old. Jacob and his mother live on the Navajo Indian Reservation in Colorado. This is the only home Jacob has ever known. Jacob is this author’s nephew that she has never met but thanks to the magic of Facebook, can now see pictures of him and communicate with him. Jacob speaks English and is fluent in his native Navajo language. Jacob is a Christian and so is his mother. Many of his other family members still believe in the “Navajo Gods” and continue with the ceremonial practices. Life on the reservation is similar to life anywhere else in America. They have electricity, internet, x-box, and the homes are no longer “earth homes”. Although, Jacob (personal communication, March 20th, 2012) states that he still wears moccasins because they are comfortable. Although Jacob and his mother believe in Western medicine, some of his other family members still believe in “Medicine men/women” for guidance and healing. Navajo Indians typically put much more faith in the “Medicine Man/Woman” than they do in the Western doctors. To this day the most important person in the tribe is the medicine man or woman (Cantor, 2008). Sweat lodges can still be found on the reservation and are used to help purify the body by sweating out the toxins. Jacob and his mother remain on the reservation because of the strong ties to family. In this culture, the elders are highly respected. Jacob (personal communication, March 20th, 2012) told this author, the older you are, the wiser you are. The elders are looked up to because of their life experiences and wisdom. The common trend that this author has found with her own cultural heritage and that of the three people interviewed is, family is what they all have in common. This author finds that the on factor separating them all is the interpretation of what medicine is and spirituality. That is what makes nursing so complex. This is why nursing should be trans-cultural. Nurses have to be able to adapt to the situations they are placed in. If we do not understand a person’s heritage and beliefs, we can not properly care for and meet all the needs of this individual. References: Swanson, C. (2012). The case for studying cultural competence from the perspective of the hispanic immigrant patient: A state of the science. Online Journal of Cultural Competence in Nursing and Healthcare, 2(1), 1-9. Retrieved from http://www.ojccnh.org Vial, T. (n.d.). Protestant beliefs. Retrieved from http://www.patheos.com/library/protestanism/beliefs.html Jarvis, C. (2012), Physical examination and health assessment. (6th ed.) Canada: Saunders, an imprint of Elsevier Inc. Cantore, J. (2001). Earth, wind, fire, and water. Retrieved from http://www.minoritynurse.com/cultural-competence/earth-wind-fire-and-water Puplantku, K. (2012, March 17th). Interview by H. Jones (Personal communication). Heritage assessment. Barragan, F. (2012, March 20th). Interview by H. Jones (Personal communication). Heritage assessment. White. J. (2012, March 20th). Interview by H. Jones (Personal communication) Heritage assessment.