Hispanic GroupsUtilizing the Transcultural Nursing Assessment

Guide

Nur 401Coastal Carolina University

By: Rachel Fogarty, Jacqueline, Janelle, Leslie Granger, Ashton Haney, Christine, Mary, and Jennifer

IntroductionCultural congruence is the distance between the cultural competence of healthcare institutions and the perceptual cultural neediness of the client.

• Hispanics are the largest growing group of minorities, numbering 2 million in 2003, and projected to grow to 8 million by 2030. (citation)

• By 2050, minorities are projected to overtake the non-Hispanic Caucasian population, yet Hispanics shoulder a disproportionate amount of ethnic and racial disparities compared to all ethnical groups. (citation)

Ethnic related disparities are related to English fluency. 52% of Hispanic citizens speak English fluently. 74% of Hispanic non-citizens speak little to no English. (citation)

Racial related disparities include:• Delayed care • Lack of cultural and ethnic

knowledge of caregivers • Lack of insurance.

Family and Kinship Systems• Hispanics families have larger household size and greater

prevalence of extended families.• One of most significant changes in family behavior is the

decrease in marriages.• Co-habitation has become widespread offsetting the decrease

in marriages.• Extended family network, family cohesions, and high level of

social support reduce the effect of adverse consequences.

Family and Kinship Systems Cont’d• U.S. Hispanics consistently emphasizes their relatively high

level of familism.• Familism is define as multi-dimensional concept that reflects

both values and behaviors that emphasize needs of family over individual needs.

• Familism declines as Hispanics groups spend more time in the U.S.

Social Life and Networks

• Hard work and the pursuit of a better life are key components to their motivation to migrate (Guidorizzi, 2006).

• The most important social structure is family and kinship, also known as “familism”(Andrews, 2012).

• Many Latinos feel that Hispanic communities are isolated in the United States (Guidorizzi, 2006)

Social Life and Networks Cont’d• La cuarentena is the 40 day period of

mother-child bonding after birth.• Approximately only 1/3rd of Hispanics

are members of community-based organizations (DeSipio, 2004).

• In accordance with the Catholic faith, most Hispanics observe the use of alcohol and tobacco in moderation (Andrews, 2012).

• 80% of Hispanic adults in the U.S. say they use social networking sites like Facebook and twitter (Pew Research Center for the People & the Press, 2012a).

Of all the social media websites, Tumblr boasts the highest amount of

Hispanic visitors (Neilsen, 2014).

Political & Government Systems

• Only 47% of Latino U.S. citizens voted in 2004 (DeSipio, 2005).

• Many Hispanics live in substandard housing and rarely own homes.

• Factors such as fear of deportation may lead to isolation within communities.

Perceptions of laws and justice, housing, opportunities, and community response:

Political & Government Systems Cont’d• Overcrowding of housing

units and poverty result in unsafe living conditions (e.g. holes in walls, pests, and exposed wiring).

• Lack of accessible government and community services to migrants contribute to the disparity of environment (trash pick-up, noise pollution, odors, police and fire response).

Language & Traditions• Spanish is the 4th used language in the

world and recognizes many dialects that vary depending on proximity to the Mexican border.

• “Codeswitching” is known as a mixture of English and Spanish (Giger, 2013).

• Greater than ¼ of the Hispanic population have less than a 9th grade education.

• DHEC creates and provides bilingual education material and resources for non-English speaking clients.

Language & Traditions Cont’d

La Semana Santa “Holy Week”• Religious holiday occurring a

week before Easter. Quince Anos • Right of passage from girlhood

to womanhood. • Girls dress up and dance with

their fathers and brothers.

Dia de los Muertos“Day of the Dead”

• November 2nd is for celebration of deceased family and friends.

• Altars are erected and decorated with flowers, pictures, and food.

Worldviews, Value Orientations, and Cultural Norms

Worldviews, Value Orientations, and Cultural Norms Cont’d

Religious Beliefs and Practices

Influence of Religion in daily life:

• God is an active force in life

• Church & Faith are central to family

• Daily Prayer Symbolism• The cross• Images of Saints• The rosary• Images of the Virgin• Family member mourns in

black

Practices surrounding major life events:

Weddings:

• Marriage-prep classes

• Mass in Catholic Church

• Bible/Church- Spiritual

• Coins/lazo

• Fruitcake soaked in Rum

Grief/ Luto (mourning 9 days):

• Vigils

• Last rites: sacraments

• Baptism before death

• Rosary throughout the day

• Wakes

Religious Beliefs and Practices Cont’dHealth Care Practices: Medical/surgical interventions:

• benefit vs risk

Reproduction:

• Abstinence, temperature/ovulation method

Abortion:

• Morally wrong

• Amniocentesis: Not objectionable

• Permanent sterilization:

Forbidden

• Genetic/Stem cell: Objectionable

Death/dying:

• Ordinary means of Preserving life

Euthanasia: Not permitted

Autopsy/Donation: Permissible

Disposal of body & burial:

• Burial/cremation

(Andrews & Boyle, 2012)

Health Beliefs and Practices

Attitudes regarding health and illness

Home remedies/folk practioners

Biological Variations

Primary Health concerns

Health Beliefs and Practices Cont’dMagico-Religious Paradigm • Health & sickness determined by supernatural forces

Culture-bound Syndromes• Susto, Mal ojo, Emphaco

Curandero (healers)• Knowledgeable in the use of

herbs• Use massage and rituals • Utilize hot/cold therapies

Primary Biological ConcernsObesity

Diabetes Liver, stomach, and cervical

cancers HIV/AIDS Addiction

Healthcare Systems

• In 2012, the percentage of Hispanics lacking insurance was 29.1%.

• Lack of healthcare coverage along with limited English and health literacies are barriers that face the Hispanic population.

• Interpreters and education materials in Spanish are available in many hospital systems.

Healthcare Systems Cont’d

• There are facilities available to the Hispanic population within the community setting.

• Some facilities offer specialized hours of operations to accommodate the Hispanic population

Conclusion

References

Giger, J. N. (2013). Transcultural Nursing Assessment and Intervention (6th ed.).www.ncbi.nih.govwww.explore-hispanic-culture.com

Guidorizzi, M. C. (2006). The Journey of Healing: A Narrative Approach. Journal Of Latino-Latin American Studies (JOLLAS), 2(2), 96-111.

Hispanic families in the United States and Family Structure. www.ncbi.nlm.nih.gov.

Andrews, M. & Boyle, J. (2012). Transcultural concepts in nursing care (6th ed). Philidelphia, PA: Lippincot Williams & Wilkins

Mitrani, V. (2009). Reducing health disparities for Hispanics through the development of culturally tailored interventions. Hispanic Health Care International, 7(1), 2-4.