Health beliefs, practice, and priorities for health care of Arab Muslims in the United States.

The Arab Muslim population is one of the dramatically increasing minorities in the United States. In addition to other factors, religion and cultural background influence individuals' beliefs, behaviors, and attitudes toward health and illness. The author describes health beliefs and practices of the Arab Muslim population in the United States. That population is at an increased risk for several diseases and faces many barriers to accessing the American health care system. Some barriers, such as modesty, gender preference in healthcare providers, and illness causation misconceptions, arise out of their cultural beliefs and practices. Other barriers are related to the complexity of the health care system and the lack of culturally competent services within it. Nurses need to be aware of these religious and cultural factors to provide culturally competent health promotion services for this population. Nurses also need to integrate Islamic teachings into their interventions to provide appropriate care and to motivate healthy behaviors.     

Ensuring cultural sensitivity for Muslim patients in the Australian ICU: Considerations for care

Australia is a diverse and multicultural nation, made up of a population with a predominant Christian faith. Islam, the second largest religion in the world, has demonstrated significant growth in Australia in the last decade. Coming from various countries of origin and cultural backgrounds, Muslim beliefs can range from what is considered ‘traditional’ to very ‘liberal’.It is neither possible nor practical for every intensive care clinician to have an intimate understanding of Islam and Muslim practices, and cultural variations amongst Muslims will mean that not all beliefs/practices will be applicable to all Muslims. However, being open and flexible in the way that care is provided and respectful of the needs of Muslim patients and their families is essential to providing culturally sensitive care.This discussion paper aims to describe the Islamic faith in terms of Islamic teachings, beliefs and common practices, considering how this impacts upon the perception of illness, the family unit and how it functions, decision-making and care preferences, particularly at the end of life in the intensive care unit.     

Understanding culture care practices of caregivers of children with cancer in Taiwan

This ethnonursing method (Leininger, 1985) was used to explore the emic perspectives (insider's perspectives) of cultural care practices of caregivers who have children with cancer in Taiwan. Forty key and general informants, including 34 family caregivers and 6 nurses, were interviewed in a medical center located in the central region of Taiwan. The results and conclusions included the emergence of significant themes such as caregivers' use of all cultural knowledge (folk and Western) that was available to them and that became available to promote the best and most appropriate methods of health care for the child. The second theme was the influence of cultural context on caregivers' decision-making for the child's overall health and care. The third theme was the caregivers' promotion and expectation of a care practice of unconditional giving for the purpose of recovery from the illness and well-being for the child with cancer. The results of this study could promote culturally competent care for Taiwanese caregivers and children with cancer. Nurses would be able to understand and integrate generic and professional care and promote culturally congruent professional care to Taiwanese caregivers who have children with cancer.     

The immigrant Haitian mother: transcultural nursing perspective on preventive health care for children

Thirty immigrant Haitian mothers in Southeast Florida were interviewed regarding their beliefs and practices about preventive health care (illness prevention and health maintenance measures) for infants and preschool children (up to age 5). All mothers used preventive health care measures from both the Western biomedical and traditional Haitian ethnomedical (folk) systems. Ninety-seven percent used magico-religious measures; 47% administered home remedies; 47% gave children over-the-counter drugs; and 35% utilized a variety of measures to ensure cold air did not enter neonates and cause illness or pain. The Haitian mothers considered the preventive health care measures effective because the children remained healthy and will likely use them again. They sought consultation from a variety of individuals who formed their health management groups and child caretaker networks. Infants and toddlers were considered at higher risk than newborns for illness due to "evil harm" inflicted by other people and/or voodoo spirits. Implications for transcultural nursing practice include developing community outreach programs, implementing nursing interventions that combine biomedical and ethnomedical preventive health care measures, and functioning as part of the health management group. The authors wish to thank Maude Vincent, R.N., for her assistance in data gathering and analysis.     

Transcultural care values and nursing practices of Philippine-American nurses.

The purpose of this ethnonursing research was to discover, explicate, and analyze the nursing care values and caregiving practices of Philippine nurses working in an American hospital context. The study, which was part of a larger study, was conceptualized within Leininger's theory of culture care. Consistent with the tenets of the theory, a brief overview of Philippine world view, social structure, culture, and ethnohistory was provided. Qualitative analysis of observation-participation and interview data revealed a major care theme of obligation to care. This care theme was supported by three care patterns which were: 1) expressed seriousness and dedication to work, 2) attentiveness to physical care as comfort, and 3) respect and patience as caring modalities. The study also showed that Philippine-American nurses attempted to achieve cultural care congruence by preserving some generic care values and practices, by accommodating to some of the host professional culture's values and practices, and by restructuring or repatterning less serviceable values. Implications for transcultural nursing education, practice, and research were discussed.     

The Phenomena of Care in Sicilian-Canadian Culture: An Ethnonursing Case Study

This study examined the caring beliefs and behaviors of first- and second-generation Sicilians who immigrated to Canada and now reside in an Ontario metropolitan area. Madeleine Leininger's ethnonursing model of “Cultural Care Diversity and Universality” (2978,1985,1988)provided the framework; qualitative information was gained from the perceptions and cognitions of two Sicilian-Canadian families. Emphasis was placed on cultural and social structure dimensions that depicted caring, health beliefs, and related practices. The research questions guiding this inquiy were: a) What care values, care beliefs, and behavior patterns are deemed to promotelpreserve well- being in this culture? b) Who provides care in this culture and under what circumstances? Implications for nursing that emerged included: provision of continuity of care, the importance of the involvement of the family, and the development of innovative means to enhance self-care practices to prevent illness and to reduce aversion to the professional healthcare system.     

Meanings and expressions of care and caring for elders in urban Namibian families: a transcultural nursing study

Since Namibia's Independence in 1990, the population of elders--persons 65 years old and older--in urban communities is growing steadily. As such, requests for home health care, health counselling, respite care and residential care for aging members of society are overwhelming nurses and the health care system. This study expands transcultural nursing knowledge by increasing understanding of generic (home-based) patterns of elder care that are practised and lived by urban Namibian families. Guided by Madeleine Leininger's theory of culture care diversity and universality and the ethnonursing research method, emic (insider) meanings and expressions of care and caring for elders in selected urban households have been transposed into five substantive themes. The themes, which depict what carring for elders means to urban families, include: 1 nurturing the health of the family, 2 trusting in the benevolence of life as lived, 3 honouring one's elders, 4 sustaining security and purpose for life amid uncertainty, and 5 living with rapidly changing cultural and social structures. These findings add a voice from the developing world to the evolving body of transcultural nursing knowledge. Synthesis of findings with professional care practices facilitates the creation of community-focussed models for provisioning culturally congruent nursing care to elders and their families in urban Namibia.     

Mexican American, nurse practitioner, and lay control group beliefs about cause and treatment of chest pain

This study compared the health beliefs of Mexican Americans concerning the specific symptom of chest pain to beliefs of a group of predominant culture nurse practitioners and a lay predominant culture control group. Two hypotheses were examined; The health beliefs of groups differ significantly with culture and the health beliefs of groups differ significantly with professional education. A 43-item structured questionnaire was developed, based on literature review and unstructured interviews with Mexican American respondents. the questionnaire was administered to three nonprobability samples of 30 subjects each: Mexican Americans, nurse practitioners, and lay controls. Significant differences were found between Mexican Americans and the predominant culture groups of nurse practitioners and lay controls on folk beliefs regarding chest pain. On some items significant differences between nurse practitioners and the lay groups of Mexican Americans and predominant culture controls were based on professional education.     

Unequal cancer survivorship care: addressing cultural and sociodemographic disparities in the clinic

The number of individuals diagnosed with cancer is growing worldwide. Cancer patients from underserved populations have widely documented disparities through the continuum of cancer care. As the number of cancer survivors (i.e., individuals who have completed cancer treatment) from underserved populations also continue to grow, these individuals may continue to experience barriers to survivorship care, resulting in persistent long-term negative impacts on health and quality of life. In addition, there is limited participation of survivors from underserved populations in clinical trials and other research studies. To address disparities and change practices in survivorship care, a better understanding of the roles of both socioeconomic status (SES) and of culture in cancer care disparities and the relevance of these to providing high-quality care is needed. SES and culture often overlap but are not identical; understanding the impact of each is especially relevant to survivorship care. To enhance health equity among cancer survivors, clinicians need to practice culturally competent care, address cultural beliefs and practices that may influence survivors’ beliefs and activities, gain awareness of historical patterns of medical care in the survivor’s community, and consider how barriers to cross-cultural communications may hinder communication in clinical settings. While the design and implementation of survivorship care programs emphasizing effectiveness and equity is complex and potentially time consuming, it is critical for providing optimal care for all survivors, including those from the most vulnerable populations.     

Assessing the patient from a cultural perspective

If effective and efficient care is to be provided, the licensed practical/vocational nurse must be aware of differing cultural health practices and beliefs among people. Nurses should identify sources of discrepancy between the client's health beliefs and practices and health providers' perceptions of health. However, nurses must also recognize that while there are differences between cultural groups, many differences also exist between people of the same culture. Thus, an individualized assessment must be conducted if culturally appropriate care is to be planned and delivered.     

Preventive skin care beliefs of people with spinal cord injury

Although health beliefs have been correlated with self-care adherence in other chronic conditions, little is known about skin care beliefs after spinal cord injury (SCI). The purpose of this qualitative study was to identify the skin care beliefs of individuals with SCI. The conceptual framework was the Health Belief Model (HBM), which proposes that adherence to a health regimen is motivated by beliefs about susceptibility, severity, barriers, benefits, and self-efficacy. Purposive sampling was used to recruit 22 people with SCI. Content analysis of data collected using semistructured questions was used to identify domains of skin care beliefs, including HBM components. Themes that emerged about skin care beliefs included taking vigilant care, taking charge, maintaining health, and passing up care. Although most participants believed they were susceptible to pressure ulcers and preventive care was important, paradoxical statements about beliefs and preventive behaviors were common. These incongruent responses may reflect ambivalence about competing priorities or the efficacy of preventive practices. Further research is needed to understand this phenomenon. Increased understanding of skin care beliefs will assist in developing tailored teaching programs for people with SCI.     

The Health Beliefs and Practices of an Old Order Amish Family

In caring for people from different cultures, it is important that nurses acknowledge the health beliefs and practices of clients. The purpose of this case study was to describe the health beliefs and practices of one Old Order Amish family. The study was conducted by interviewing a Lancaster County, Pennsylvania, Old Order Amish family. The data focused on five areas of inquiry: (a) care of elderly family members, (b) health practices, (c) home births, (d) death, and (e) health insurance. This study revealed that the Old Order Amish have health beliefs and practices that are unique to their culture.     

Ethno-medical beliefs and practices of Mexican-Americans

Family nurse practitioners working with Mexican-Americans are acutely aware that some of their clients are skeptical of typical Western medical techniques. Examination of their health-care seeking behavior shows that they will seek professional medical care when their self-treatment and folk-healing practices have not been successful. FNPs working in a primary care setting need to have a working knowledge and understanding of these beliefs which are deeply rooted in tradition. Only then can the FNP and other health care practitioners render care that is culturally sensitive and acceptable to the client. This article examines some of the more common afflictions in the Mexican-American culture (and their causative factors) in an effort to broaden health care providers' perspective of cultural differences in health and illness.     

Culture & spirituality as an integrated concept in pediatric care

The purpose of this article is to propose an integrated approach to culture and spirituality in pediatric care. In the spirit of sensitive and respectful communication with patients, pediatric nurses have become increasingly concerned with the child's and family's culture, spirituality, and religion. As a result, various approaches and models have been created to help nurses initiate discussions surrounding these topics. These models have given rise to categorizations of culture, spirituality, and religion. It is important for pediatric nurses to understand that while delineations can be made, there are also many intersecting factors that make separation of these issues difficult and perhaps unnecessary for the purpose of culturally sensitive communication. Pediatric nurses should, perhaps, focus instead on understanding the individual child's or family's traditions, values, and beliefs and how these dimensions impact the health of the child. This article suggests three areas that can be used as an organizing framework for pediatric nurses to broach culturally sensitive issues within the context of pediatric primary healthcare: (1) Family beliefs/values, (2) Family daily practices, and (3) Community involvement.     

Cardiovascular disease in the Amish: an exploratory study of knowledge, beliefs, and health care practices

The Old Order Amish population is growing, yet little is known about their cardiovascular health care practices. This ethnographic study explored their cardiovascular knowledge, beliefs, and health care practices. This study showed that the Amish have distinct beliefs and practices which affect their cardiovascular health, and that culturally appropriate education is needed.     

Cultural approach in nursing care of North African Muslims needing palliative care

Working in a multi-cultural medical establishment, concerning both patients and nursing staff, calls for deliberations regarding the intercultural as well as palliative approach in nursing care. These deliberations are: 1) intra-personal, in questioning the nursing staff on his/her values, beliefs, convictions, personal culture and identity, as well as opinions regarding health, illness and death. 2) Interpersonal, in recognizing the other person through his/her culture, values, individuality, while taking into account his/her opinions on health, illness and death. The goal of this project is to initiate this intercultural approach by first studying the culture from the perspective of North African Muslims currently hospitalized. It will develop in three steps: The first step to consider consists in training health-care professionals. The second step will lead to the preparation of pedagogical support concerning "nursing care and North African culture". The third step should significantly demonstrate the intercultural approach in clinical nursing procedures. In the future, the project's aim should progress towards a health-care collaboration in which each patient feels implicated regardless of his/her condition, culture, beliefs, education or lifestyle.     

The influence of culture on immigrant women's mental health care experiences from the perspectives of health care providers

It is well documented that serious mental health problems such as depression, schizophrenia, and post migration stress disorders exist among immigrant women. Informed by Kleinman's explanatory model, this qualitative exploratory study was conducted with seven health care providers who provided mental health services to immigrant women. Analysis of the data revealed that (a) immigrant women face many difficulties when accessing mental health care services due to cultural differences, social stigma, and unfamiliarity with Western biomedicine, (b) spiritual beliefs and practices that influence immigrant women's mental health care practices, and (c) the health care provider-client relationship, which exerts great influence on how immigrant women seek mental health care. The study also revealed that cultural background exerts both positive and negative influences on how immigrant women seek mental health care. We suggest that although cultural knowledge and practices influence immigrant women's coping choices and strategies, awareness of social and economic differences among diverse groups of immigrant women is necessary to improve the accessibility of mental health care for immigrant women.     

Primary health care practitioners' tools for mental health care

The purpose of this study was to describe and analyse the content of mental health care from the practitioner's point of view. The specific aim of this paper was to outline the types of mental health care tools and the ways in which they are used by primary health care practitioners. The data were derived from interviews with doctors and nurses (n = 29) working in primary health care in six different health care centres of the Pirkanmaa region in Finland. The data were analysed by using qualitative content analysis. The tools of mental health care used in primary health care were categorized as communicative, ideological, technical and collaborative tools. The interactive tools are either informative, supportive or contextual. The ideological tools consist of patient initiative, acceptance and permissiveness, honesty and genuineness, sense of security and client orientation. The technical tools are actions related to the monitoring of the patient's physical health and medical treatment. The collaborative tools are consultation and family orientation. The primary health care practitioner him/herself is an important tool in mental health care. On the one hand, the practitioner can be categorized as a meta-tool who has control over the other tools. On the other hand, the practitioner him/herself is a tool in the sense that s/he uses his/her personality in the professional context. The professional skills and attitudes of the practitioner have a significant influence on the type of caring the client receives. Compared with previous studies, the present informants from primary health care seemed to use notably versatile tools in mental health work. This observation is important for the implementation and development of mental health practices and education.