Thesis Defense Draft I


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The purpose of the project was to increase understanding of meanings and expressions of care and caring for self and others as identified by Somali adolescents who are attending an urban American school.

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  • Islam by itself is a culture and belief system that shapes their thinking, attitudes, social customs and gender roles. Somali share this common belief in one God, Allah and dedicated their actions to study of the teachings of his prophets. Mohammed is the central prophet of Allah. Islam has its own calendar and numbering begins from the year. This is different from what is obtainable in the western society even though the Julian calendar.
  • Thesis Defense Draft I

    1. 1. Meanings and Expressions of Care and Caring For Self and Others by Somali Adolescents attending an urban American School: A Mini-Ethno Nursing Study <ul><li>Rose Nambozo </li></ul><ul><li>Thesis Defense </li></ul><ul><li>December 10, 2010 </li></ul>
    2. 2. Purpose <ul><li>To increase understanding of the meanings and expressions of care and caring for self and others as identified by Somali adolescents, age 15-17, who are attending an urban American school. </li></ul>
    3. 3. Objectives <ul><li>To identify patterns of health and health seeking behaviors among Somali adolescents </li></ul><ul><li>To respect the importance of the lived experiences as expressed by the Somali adolescents who are attending an urban American school </li></ul><ul><li>To respond competently to cultural differences and similarities among the Somali adolescents </li></ul><ul><li>To provide insights as to how the educational system can support culturally congruent models of wellness and health promotion among a diverse student body </li></ul>
    4. 4. Why was this Study Done? <ul><li>Am a mother of an adolescent </li></ul><ul><li>Somali adolescents have a higher than average rate for failing in school when compared to Caucasian students </li></ul><ul><li>Immigrant and refugee students are at a disadvantage educationally & more vulnerable to of health and wellness concerns directly related to cultural tension and cultural clashes </li></ul><ul><li>Cross-cultural concerns expressed by teachers and school nurses related to social, health and educational needs of a diverse student population </li></ul><ul><li>( Masney & Ghahremani-Ghajar, 1999; Blake et al., 2001; American Academy of Pediatrics, 1997; Carlsten & Jackesen, 2003) </li></ul>
    5. 5. Diverse Population in Minnesota <ul><li>MN is home to the country’s largest population of Somalis </li></ul><ul><li>Most live in metro area </li></ul><ul><li>Somali children attend urban schools </li></ul><ul><li>Somalis have moved to Rochester, Owatonna, and other Minnesota communities </li></ul><ul><li>Attitudes and behaviors of Somali youth influenced & shaped by cultural worldview </li></ul>
    6. 7. Augsburg-Fairview Academy for Health Careers
    7. 9. Horn of Africa <ul><li>Somalia is in East Africa along the Indian Ocean. It borders Djibouti to the north, Ethiopia to the west, and Kenya to the south. </li></ul><ul><li>The country is a desert </li></ul><ul><li>The population estimate is unknown </li></ul><ul><li>Civil war is on-going </li></ul><ul><li>There has been no officially language in Somalia, though some Somali people speak Arabic, Oromo, and English. </li></ul><ul><li>Islam is a dominant religion of Somalia </li></ul>
    8. 10. Statement Problem <ul><li>The American Academy of Pediatrics ( 1997) noted that immigrant and refugee children could have difficulties in adapting to school due to stress induced by resettlement challenges. This leads to learning disabilities affecting their performance in school. </li></ul>
    9. 11. Dr. Leininger’s Theory of Culture Care Diversity and Universality <ul><li>Provided the theoretical framework for this study </li></ul><ul><li>- Leininger (2006) </li></ul>
    10. 12. Dr.Leininger’s Words <ul><li>Go to the people live among them; </li></ul><ul><li>Learn from them; </li></ul><ul><li>Love them, start with what they know, </li></ul><ul><li>Build on what they have; but of the best leaders when their task is done, the people will remark: “We have done it ourselves.” </li></ul><ul><li>People will forget what you say, they will forget what you do, but they will never forget how you make them feel. </li></ul>
    11. 13. Goal of Theory <ul><li>Culturally Congruent Care that contributes to the health and well being of people </li></ul><ul><li>Culture Care preservation and /or maintenance </li></ul><ul><li>Culture Care Accommodation and /or Negotiation </li></ul><ul><li>Culture Care Repatterning and/or Restructuring. </li></ul>
    12. 14. Domain of inquiry <ul><li>The meanings and expressions of care and caring for self and others as identified by the Somali adolescents age 15-19 who are attending an urban American school” </li></ul>
    13. 15. Key Inquiry Focus <ul><li>Caring strengths expressed and sustained by culture, society, and environment </li></ul><ul><li>Nursing care practices support Somali adolescents in caring for themselves </li></ul>
    14. 16. Research Questions <ul><li>What does health mean to Somali adolescents in an American culture? </li></ul><ul><li>What activities do Somali adolescents believe keep them healthy? </li></ul><ul><li>What role does Somali culture play in shaping adolescent health and illness behaviors? </li></ul><ul><li>What is the most difficult challenge integrating into American culture? </li></ul><ul><li>What are the transcultural health challenges in meeting the wellness care needs of Somali students in an urban school setting? </li></ul>
    15. 17. Study Design & Key Participants <ul><li>Somali adolescents as Key Participants/Informants </li></ul><ul><li>Somali adults as general informants </li></ul><ul><li>School personnel who know the culture as general informants </li></ul>
    16. 18. Theory Assumptive Premises <ul><li>Key participants can talk about their caring experiences </li></ul><ul><li>Beneficial nursing care occurs when meanings and expressions of Somali adolescents are known and applied in culturally appropriate ways. </li></ul><ul><li>Culture care concepts, meanings, and patterns vary transculturally with commonalities and differences </li></ul><ul><li>Culturally congruent care occurs when patterns are known and used in meaningful ways </li></ul>
    17. 19. Literature Review: Cultural Social Structure Dimensions/Factors <ul><li>Cultural values and life styles </li></ul><ul><li>Kinship and social factors </li></ul><ul><li>Technological factors </li></ul><ul><li>Economic factors </li></ul><ul><li>Educational factors </li></ul><ul><li>Political factors </li></ul><ul><li>Religious and philosophical factors </li></ul><ul><li>Worldview and health </li></ul>
    18. 21. Life Ways Gender roles are highly respected within this culture group .
    19. 22. Cultural Values
    20. 23. Nutrition and Food Somali diet prohibits pork according to Islamic tradition. Lunch is the heaviest and most important meal of the day whereby family members eat together. Depending on the socio-economic status of the family.                                                              Ingredient
    21. 24. Kinship and Social factors
    22. 25. An extended family structure often provides a cooperative path to economic stability and advancement for the Somali.
    23. 26. Children in the Family
    24. 27. Child Rearing Practices
    25. 28. Technological Factors
    26. 29. <ul><ul><li>Educational factors </li></ul></ul>
    27. 31. Economic factors Most Somalis women are farmers; men cattle keepers
    28. 32. Economic Factors
    29. 33. Religious / Philosophical
    30. 34. Mosque- Islam
    31. 35. Islam Respect <ul><li> </li></ul>                                                         
    32. 36. Traditional healing Practices
    33. 37. Circumcision <ul><li>Both male &Female Children are circumcised </li></ul>
    34. 38. Political Factors                                 Disembar, 2007, 17:55 GMT; 20:55 SGA  
    35. 39. Findings <ul><li>Isolation </li></ul><ul><li>Loneliness/Stress </li></ul><ul><li>Language/Communication Barriers </li></ul><ul><li>Economic dependence </li></ul><ul><li>Time </li></ul><ul><li>Settling in and coping </li></ul>
    36. 40. Isolation <ul><li>Cultural change </li></ul><ul><li>Affected by war </li></ul><ul><li>Moving to another country </li></ul>
    37. 41. Culture shock <ul><li>Not everyone experiences culture shock. </li></ul><ul><li>Some people overcome culture shock rather quickly, others may take longer to make a positive adjustment to their new surroundings </li></ul>
    38. 42. Language Barrier/Communication
    39. 43. Settling and Coping
    40. 47. Immigrants don’t only learn traditional “American” customs: they co-mingle with other immigrant groups
    41. 48. Like other immigrants not yet fluent in English Somali adolescents are working hard to improve their language skills.
    42. 49. ELL Somali female students in a classroom
    43. 51. Somali adolescents in English language classes
    44. 52. Adjusting to a new way of life, Somali adolescents begin to participate in and exercise their civic privileges, from voting and volunteerism to running for elected office
    45. 54. Time-Changes
    46. 55. Significance <ul><li>Study will lead to increase understanding by educators and community nurses, of the meanings of health and illness, and the caring behaviors that Somali adolescents practice to stay healthy in a school setting. </li></ul><ul><li>Findings will relate to how the education system can support culturally congruent models of wellness and health promotion for Somali adolescents. </li></ul>
    47. 56. Significance <ul><li>Will add to the body of transcultural nursing knowledge about the worldview of Somali adolescents in an American education system and their health and illness behaviors. </li></ul>
    48. 57. Culture Care Accommodation <ul><li>Develop educational tools on finding comprise with cultural differences that affect family and community. </li></ul><ul><li>Recognize Somali Adolescents as instrumental and vital for health of family </li></ul><ul><li>Promote practice built on shared responsibility for health, promote relationship as primary to health </li></ul><ul><li>Incorporate caring for Somali adolescents as influential on health and well-being. </li></ul><ul><li>Develop care models with philosophies supporting Somali culture i.e. care of generosity. </li></ul><ul><li>Health staff and teachers to be aware of the potential for situations where cultural practices intersects with health to influence learning and what accommodations can be made to incorporate both cultural practice and western medicine to ensure adherence. </li></ul>
    49. 58. Culture Care Repatterning <ul><li>Organize forums and invite dialogue on caring modalities in support of health </li></ul><ul><li>Build trust and establish rapport with Somali adolescents who are gatekeepers for health and cultural issues in their schools. </li></ul><ul><li>Recognizing health and illness as integral to cultural oriented beliefs and practices </li></ul><ul><li>Maintain the strength of cultural values for adolescents in School settings. </li></ul>
    50. 59. Summary <ul><li>Research is needed in health field, with emphasis in school health, to study the influence of culture on behaviors as it intersects with health and education of Somali students in a western culture </li></ul><ul><li>More Somali involvement in school health programs </li></ul><ul><li>Government involvement in such study will be beneficial due to the size of funding and resource that will be needed for such a study </li></ul><ul><li>The concept of education needs to be defined in the Somali perspective and applicable goals set to reduce or eliminate confusion created in educators assisting Somali students with a main stream culture background </li></ul>