THEORETICAL FOUNDATION FOR NURSING PRACTICE 8
TheoreticalFoundation for Nursing Practice
Thepurpose of this paper is to provide a framework for understanding thesensitivity in cultural communication in the provision of health careto the Mexican-American population. Mothers and children of thisparticular cultural group have distinctive cultural features thathave a bearing on the way they respond to clinical procedures. Thispopulation has generally accepted values such as Familism, respetoand simpatia (respect and congeniality). This society believes thatthe elderly population should be taken care of by the younger familymembers. The group is is familiar with Spanish language but rarelyunderstands English, a factor that makes it difficult for the medicalofficers to coummunicate with them effectively. The programs to reachthem with medical services are integrated into their culture. Forexample, they are taught how to make use of the traditional foods forbetter health. Also, community educators, Promotaras are used to passimportant health messages to them.
Thepurpose of this paper is to provide a framework for understanding thesensitivity in cultural communication in the provision of health careto the Mexican-American population. The paper presents the mechanismsfor the application of innovative health practices that takes care ofthis group, especially women, and children. Members of thispopulation have complicated ways of integrating cultural values intheir daily health response. There are three major patterns witnessedin this group in regard to response to health Care. First, theircultural beliefs and expectations, are freely shared by the familyand the wider society, and work as complimentary to community members(Lannet,2014).Second, cultural beliefs can be a source of stress and conflictarising from the pressure from the surrounding. Third, culturalvalues may not be treated with importance compared to other concernswhen providing health care, such as when there are access problems inthe health care system (Padila & Villalobos, 2007). These threepatterns are unoque to this cultural group and are the reasons forits choice for study in this paper. Nurses Should portray high levelof cultural competence in their work. Cultural competence means thatthe nurse will apply the cultural knowledge about the patient’sbeliefs and integrate them with the scientific knowledge so as toavoid stereotyping and misapplication of knowledge (Srivastava,2007).
TheMexican American culture had been qualified by a set of generallyaccepted values such as Familism, respeto and simpatia (respect andcongeniality). Religiosity and spirituality, curanderismo (folkhealing) and language are also emphasized. There is a need toresearch about more dynamic conceptualization and interpretation ofthe cultural aspects that can guide the health care provision forthis group beyond what is provided by the above cultural terms. Theviews in this paper are in three dimensions. These include sharedexpectations in the family and society, managing tension betweencompeting pressures and cultural values, and overriding concern whenproviding health care (Padila & Villalobos, 2007).
Familismis regarded as a very crucial value among the Mexican-Americanpopulation. Familism refers to a strongly felt sense of family careand obligation. Familism emerges from family relationships, and itsrealization is based on common expectations of the members of thefamily. In terms of social support, the concept of familism is deeplyheld by the Mexican-American population. A complex dynamism exists interms of family`s social support for the elderly members against theextent of the responsibility of the family members in Caregiving.Familism is an element of health expectations of the elderlyMexican-American people. Studies indicate that these expectationshave implications on their response to health and the subsequentoutcomes. Ethnographic studies indicate that older Latina women donot view health as the absence of illness. On the contrary, they viewhealth decline as anticipated and natural (Padila & Villalobos,2007).
Thus,the elderly Latina people may suffer poor health and illnesses whileexpecting and relying on the care given by the family members. On theother hand, the non-Latino white counterparts view theirdeterioration in health as a burden to the family and are likely todetach themselves from the family. Among the elderly Latino, positiveresponse to aging and health care problems is dependent on the leveland quality of social support accorded by their children and closefamily members. The immigrants respond to health care based on thecultural practices from their place of origin. In addition, theLatino, who have disabilities and are alienated lack social supportfrom the family, and fail benefit from paid in-home care services.
Insome cases, the family expectations of Caregiving may create tensionwithin the family because of unfulfilled competing pressures such aspoverty, support or stigma. There is minimal reliance on outsideparties such as colleagues, neighbors, and social serviceprofessionals. The entire burden is borne by the family members. Inthe case where the family is experiencing problems and their supportis weak, some needs are left unfulfilled. Women who do not receiveadequate support may experience physical illnesses or emotionalimbalance. Family support has been shown to improve birth outcomes.However, for pregnant Latino women from poor families fail to receiveenough care to protect them from health problems. In other cases,adherence to cultural demands, makes some Mexican-American to concealinformation that is vital to healthcare. For instance, women whosechildren are diagnosed with hyperactivity experience stigmatizationbecause the children do not meet the cultural standards of goodbehavior. Thus, such women keep their child`s condition as a secret(Padila & Villalobos, 2007).
OverridingConcerns in access to Health
Insome cases, cultural aspects may not be regarded when seeking healthcare for the elderly. Other factors are common to both Latino andnon-Latino. Such factors include the sensitivity of the physician toalternative medicine, age, social class and health insurance coverdiscrimination (Lannet,2014).However, there are some factors that are specific to Latino,including immigration and language. Mexican-Americans emphasize onrespect that is, respect, patience, understanding and care aspersonal processes in healthcare. Language is a concern to a bigpercentage of Mexican-Americans as some speak Spanish as opposed toEnglish. Mexican-Americans are culturally religious and thus payattention to spirituality in matters of healthcare (Padila &Villalobos, 2007). Some lack information on where to seek healthcaresupport services, and others do not realize when they have healthproblems. Others may lack transport to get them to the healthcarecenters.
Variousapproaches can be implemented to reach many Mexican-Americans withhealth care. First, their culture should be reconceptualized asstrength. Proper assessment is necessary in identify the differencein clinical response among the people of different racial and ethnicgroups (Srivastava,2007).Cultural aspects can be used for curanderismo, familism, simpatia canbe applied to expand health care programs. For instance, good healthis attributed to better maternal health. Using curanderismo, motherscan be taught the importance of taking healthy traditional foodscoupled with exercise and the use of traditional medicine coupledwith the modern medicine. The lay community educators, promotaras,can be used to strengthen family-oriented healthcare. Promotaras aremembers of the Mexican-American community who can speak Spanish.Promotaras can be used to conduct training and campaign on healthcare for the youth, the elderly and the mothers. In reference to thesubstituted judgment (DeNisco & Baker, 2013. p.550), familism isaccepted by the court, but the home caregiver is held accountable inadherence to ethical principles of commitment,fidelity and freedom,among others.
Second,approaches to reducing barriers from access to health care should beimplemented. More health care objectives can be achieved through thepromotion of community-level outreach methods. This method involvesthe use of designing information in a way that it will be passed tothe communities in a clear way. For instance, Spanish-Englishspeakers can be used to pass the information through informalchannels such as friends, family members, and can visit churches andcommunity centers. Both legal and illegal immigrants should beallowed to access health care, contrary to the Proposition 187 of1994 that limited undocumented Americans from accessing healthcare(Padila & Villalobos, 2007). Application of religious beliefs canbe allowed to some groups as the overriding principle in the face ofconflict (DeNisco & Barker, 2013).
Identificationof Mexican-American cultural traits is important in understandingtheir patterns of health care access. However, more needs to be donebeyond the cultural orientation. Better programs should be adopted toboost their access to healthcare. Integration of their culturalvalues into the healthcare programs can work progressively and reachthe majority. Language barrier can be broken by the use ofSpanish-English speakers. The traditional foods can be encouraged forhealth promotion. Based on the concept of familism, family caregiversshould be educated on how to take of the elderly and identify whenthey need better attention to avail them to health centers.
DeNisco,S., & Barker, A. M. (2013). AdvancedPractice Nursing: Evolving Roles for the Transformation of theProfession.Burlington, Mass: Jones & Bartlett Learning. pp. 548-563.
Lannet,A. (2014). Cultural Competence in the Nursing Practice.Nursetogether.com.Available at:<http://www.nursetogether.com/cultural-competence-in-the-nursing-practice>.
Padila,C. Y., & Villalobos, G. (2007). Cultural Responses to Healthamong American Mexican Women and their Families. Family& Community Health,30 (1): S24-S33.
Srivastava,R. (2007). Thehealthcare professional`s guide to clinical cultural competence.Toronto: Mosby Elsevier.