Heritage.pdf

Discussion: Heritage
Discussion: Heritage ON Discussion: HeritagePeople of Indian Heritage, People of Turkish
Heritage, and People of Vietnamese Heritage.Read content chapter 25, 37 and 38 in Davis
Plus Online Website and review the attached PowerPoint presentation. Once done present a
900-word essay without counting the first and last page discussing the cultural health care
beliefs of the study heritages and how they influence the delivery of evidence-based health
care. Discussion: HeritageYou must cite at least 2 evidence-based references without
counting the class textbook. APA Style, Fonts: Arial 12.Transcultural Health Care: A
Culturally Competent Approach, 4th Edition American Indians Alaskan Natives (AI/ANs)
Larry Purnell, PhD, RN, FAAN Copyright © 2013 F.A. Davis Company Transcultural Health
Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ? Amount of Indian
blood necessary to be considered a tribal member varies among the tribes—¼ to be a
Navajo, which is the largest tribe in United States and live in the Southwest ? 556 different
tribes in the United States and Canada .Discussion: Heritage? Each tribe unique but share
similar views regarding cosmology, medicine, and family organization Copyright © 2013
F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th
Edition Overview Heritage ? Forced migration by United States government ? Life on MOST
reservations is hard with high poverty and high unemployment although a few have
significant money due to oil, land leases, gambling casinos, etc. ? Children were taken from
them and placed in “White Man’s Schools” Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition AI/AN Cultural
Values ? ? ? ? ? ? ? Group, clan, or tribal emphasis Present oriented Time is always with us
Age Cooperation Harmony with nature Giving/sharing Copyright © 2013 F.A. Davis
Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition AI/AN
Cultural Values ? ? ? ? ? ? ? Pragmatic Mythology Patience Mystical Shame Permissiveness
Extended family and clan Copyright © 2013 F.A. Davis Company Transcultural Health Care:
A Culturally Competent Approach, 4th Edition AI/AN Cultural Values ? ? ? ? ? ? ? Non-
aggressiveness Modesty Silence Respect other’s religion Religion is a way of life Land,
water, forest belong to all Beneficial, reasonable use of resources Copyright © 2013 F.A.
Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage Continued ? Low educational levels for most tribes, preferring children
to remain at home and learn Indian ways ? For the traditional, health care is an undesirable
profession because one should not work with the dead or ill ? Navajo sometimes have a
special cleansing ceremony to allow them to work in a hospital Copyright © 2013 F.A. Davis

Communication ? Language and dialect vary by tribe, but most speak English and in the
southwest many speak Spanish instead of English ? Minor variations in pronunciation can
change the meaning of the word .Discussion: Heritage? Talking loudly or interrupting
someone is considered rude Copyright © 2013 F.A. Davis Company Transcultural Health
Care: A Culturally Competent Approach, 4th Edition AI/AN Communication ? Navajos
generally do not share thoughts and feelings easily outside family and friends, making it
difficult to obtain trust in the healthcare setting ? Comfortable with long periods of silence ?
Touch is unacceptable unless you know the person very well Copyright © 2013 F.A. Davis
Communication ? No set pattern for willingness to share tribal ceremonies ? Pueblo groups
usually do not share any tribal ceremonies ? Light passing of the hands for a handshake ?
Considered rude to point with the finger; instead shift your lips in the desired direction
Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent
Approach, 4th Edition AI/AN Communication ? Direct eye contact is rude and
confrontational—deadpan facial expression ? Proximity for conversations usually greater
than 24 inches ? Time sequence is present, past, and future Copyright © 2013 F.A. Davis
Communication ? The future is out of one’s control. Discussion: Heritage? Very few are
future oriented and for the Navajo there is no future verb tense ? Time is not something that
can be controlled, nor should time control the person; events start when the people arrive
Approach, 4th Edition Family Roles and Organization ? Navajo, like most Native Indian
tribes, is matrilineal in decision-making and land rights ? Relationship between brother and
sister is more important than that between husband and wife ? Children’s names are not
revealed at birth Copyright © 2013 F.A. Davis Company Transcultural Health Care: A
Culturally Competent Approach, 4th Edition Family Roles and Organization ? Older people
are addressed as grandmother, grandfather, mother, father, or a nickname. ? Algonquin are
egalitarian society ? Dene and Athabascan are patriarchal ? Navajo, Iroquois, Pueblos, and
Haida are matriarchial societies Copyright © 2013 F.A. Davis Company Transcultural Health
Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization
.Discussion: Heritage? AI/AN naming traditions vary greatly from tribe to tribe and are
frequently determined by nature, animals, or character. ? In the past, AI/AN women
practiced breastfeeding exclusively. ? Since the early to mid-1980s, the use of formula has
become popular. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A
Culturally Competent Approach, 4th Edition Family Roles and Organization ? A primary
social premise is that no person has the right to speak for another. ? Parents are permissive
in childrearing practices and may allow a child decide whether if not go to school or take
medicine. ? Ceremony plays a vital, essential role in AI/ANs everyday life. Copyright © 2013
Edition Family Roles and Organization ? When a couple marries in the Pueblo tribes, the
man goes to live in the woman’s house. ? In Navajo tradition, families have separate
dwellings but are grouped by familial relationships. ? The Navajo family unit consists of the

nuclear family and relatives such as sisters, aunts, and their female descendants. Copyright
© 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach,
4th Edition Family Roles and Organization ? In all American Indian and Alaska Natives
extended family members play an important role in the infants’ life. ? Older adults are
looked on with clear deference ? Elders play an important role in keeping rituals and in
instructing children and grandchildren. Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and
Organization ? Social status is determined by age and life experiences. ? Among the Pueblos
governors are chosen from a particular clan; unless one is born in the clan they cannot run
for tribal governor. Discussion: HeritageGenerally, individuals are discouraged from having
more possessions than their peers, and those who display more material wealth are
ignored. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally
Competent Approach, 4th Edition Family Roles and Organization ? Standing out is not
encouraged among the different tribal groups. Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Workforce Issues
? Many AI/ANs remain traditional in their practice of religious activities. Family matters are
more important than work, resulting in high rates of absenteeism. ? In addition, tribal
ceremonies are seen as necessary and they often must take time from work or school.
Approach, 4th Edition Workforce Issues ? Tribal members in the community function
informally as cultural brokers and assist by helping non– American Indian staff to
understand important cultural issues. ? Conflict is addressed indirectly through third
parties in some tribes Copyright © 2013 F.A. Davis Company Transcultural Health Care: A
Culturally Competent Approach, 4th Edition Workforce Issues ? Group activities are an
important norm in AI/AN cultures. ? One individual should not be singled out to answer a
question because the student’s mistakes are generally not forgotten by the group. Copyright
© 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach,
4th Edition Workforce Issues ? Issues of superior-subordinate roles exist and are related to
age. ? IHS is the only organization allowed to discriminate in hiring practices; it is required
to hire an AI/AN when possible. Copyright © 2013 F.A. Davis Company Transcultural Health
Care: A Culturally Competent Approach, 4th Edition ClickerCheck AI/AN tribes and clans
are a. Patriarchal. b. Matriarchal. c. Egalitarian. d. Discussion: HeritageDepends on the tribe
and clan. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally
Competent Approach, 4th Edition Correct Answer Correct answer: D Some tribes and clans
are patriarchal, some are matriarchal, and some are more egalitarian. Variations exist
within the tribe and clan as well. Copyright © 2013 F.A. Davis Company Transcultural
Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ? Skin color
among AI/ANs varies from light to very dark brown, depending on the tribe. ? Each of the
American Indian tribes vary in terms of facial features and height. ? Never assume that an
AI/AN patient is from a particular tribe, if wrong, he or she will be offended. Copyright ©
2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th
Edition Biocultural Ecology ? Historically, most diseases affecting AI/ANs were infectious
such as tuberculosis, smallpox, and influenza. ? Diseases of the heart, malignant neoplasm,

unintentional injuries, diabetes mellitus, and cerebrovascular disease are the top five
leading causes of AI/AN deaths Copyright © 2013 F.A. Davis Company Transcultural Health
Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ? Type 1 diabetes
mellitus is almost nonexistent in AI/ANs but type 2 diabetes mellitus is the third most
prevalent chronic disease affecting all AI/AN tribes. ? The incidence of diabetes varies
among tribes has steadily increased and is approaching 30 percent. Copyright © 2013 F.A.
Biocultural Ecology ? Albinism occurs in the Navajo and Pueblo tribes. ? Navajos who lived
in Rainbow Grand Canyon are genetically prone to blindness that develops in individuals
during their late teens and early 20s. Copyright © 2013 F.A. Davis Company Transcultural
Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ? The Zunis
have an incidence of cystic fibrosis seven and one-half times that found for Caucasians. ?
Methamphetamine (meth) abuse and suicide are two top concerns in Indian country. ?
Suicide rates among American Indians and Alaska Natives (AI/ANs) are 1.7 times higher
than the national average. Copyright © 2013 F.A. Davis Company Transcultural Health Care:
A Culturally Competent Approach, 4th Edition Biocultural Ecology ? Alcohol use is more
prevalent than any other form of chemical misuse. ? Many accidents are attributed to
driving while under the influence of alcohol. ? Spousal abuse is common and frequently
related to alcohol use. The wife is the usual recipient of the abuse, but occasionally, the
husband is abused. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A
Culturally Competent Approach, 4th Edition Nutrition ? Food has major significance beyond
nourishment in AI/AN populations. ? Food is offered to family and friends or may be burned
to feed higher powers and those who have died. ? Life events, dances, healing, and religious
ceremonies evolve around food. Copyright © 2013 F.A. Davis Company Transcultural Health
Care: A Culturally Competent Approach, 4th Edition Nutrition ? Corn is an important staple
in the diet of American Indians. Discussion: Heritage? Rituals such as the green corn dance
of the Cherokees and harvest-time rituals for the Zuni surround the use of corn. ? Corn
pollen is used in the Blessingway and many other ceremonies by the Navajo. Copyright ©
Edition Nutrition ? Each tribe has its own version of fry bread. ? Access to fresh fruits and
vegetables is minimal during wintertime. ? AI/AN diets may be deficient in vitamin D
because many members suffer from lactose intolerance or do not drink milk. Copyright ©
Edition Childbearing Family ? Traditional AI/ANs do not practice birth control and often do
not limit family size. ? In Apache and Navajo tribes, twins are not looked on favorably and
are frequently believed to be the work of a witch. Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Childbearing
Family ? Some want their blood and urine specimens returned to them upon discharge. ?
Many use herbs during labor and delivery. ? A ceremony may be performed by the medicine
man during labor and delivery. Copyright © 2013 F.A. Davis Company Transcultural Health
Care: A Culturally Competent Approach, 4th Edition Childbearing Family ? Be flexible with
positioning for delivery. ? Some may want the umbilical cord, meconium, and afterbirth. ?
Some may use peyote during labor and delivery. Copyright © 2013 F.A. Davis Company

Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck The
most common form of substance abuse among AI/ANs is a. Alcohol. b. Peyote. c. Marijuana.
d. Methamphetamine. Discussion: HeritageCopyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer
The most common substance abuse among AI/AN tribes is alcohol which is 1.7 times higher
than other groups who have been studied. Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals ?
Most AI/AN tribes believe that the souls of the dead pass into a spirit world and became
part of the spiritual forces that influenced every aspect of their lives. ? Today some tribes
maintain their traditional practices but use a mortuary or use the IHS morgue to prepare
their dead. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally
Competent Approach, 4th Edition Death Rituals ? The Pueblo tribes prepare their own dead
and only certain family members are allowed to prepare the body. ? Hopis bury their dead
before the next setting of the sun and bury them in upright sitting positions with food and
goods in the grave with the person. ? After the Zuni burial, the members must take off three
days from work for a cleansing ceremony. Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals ?
The body must go into the afterlife as whole as possible. ? In some tribes, amputated limbs
are given to the family for a separate burial and later the limb is buried with the body.
Approach, 4th Edition Death Rituals ? In some tribes, family members are reluctant to deal
with the body because those who work with the dead must have a ceremony to protect
them from the deceased’s spirit. ? In the Navajo, if the person dies at home, the body must
be taken out of the north side of the hogan and a ceremony conducted to cleanse the Hogan
or it must be abandoned. Copyright © 2013 F.A. Davis Company Transcultural Health Care:
A Culturally Competent Approach, 4th Edition Death Rituals ? Older adults are reluctant to
discuss advance directives once they discover what it means. Discussion: Heritage? Effective
discussions require that the issue be discussed in the third person, as if the illness or
disorder is happening to someone else. Copyright © 2013 F.A. Davis Company Transcultural
Health Care: A Culturally Competent Approach, 4th Edition Death Rituals ? If a provider
makes a statement such as “if you don’t get medical care, you will die,” this implies that the
provider wishes the client dead. ? If the patient does die or is extremely ill, the provider
might be considered a witch. Copyright © 2013 F.A. Davis Company Transcultural Health
Care: A Culturally Competent Approach, 4th Edition Death Rituals ? The Navajo are not
generally open in their expression of grief; they often will not touch or pick up the body or
prepare the body for burial. ? Grief among the Pueblo and Plains Tribes are expressed
openly and involves much crying among extended family members Copyright © 2013 F.A.
Spirituality ? AI/AN religion predominates in many tribes. ? When illnesses are severe,
consultations with appropriate religious organizations are sought. ? Sometimes, hospital
admissions are accompanied by traditional ceremonies and consultation with a pastor.
Approach, 4th Edition Spirituality ? AI/AN tribal traditional members start the day with

prayer, meditation, and corn pollen. ? Prayers ask for harmony with nature and for health
and invite blessings to help the person exist in harmony with the earth and sky. Copyright ©
Edition Spirituality ? The meaning of life for AI/ANs is derived from being in harmony with
nature. ? The individual’s source of strength comes from the inner self and depends on
being in harmony with one’s surroundings. Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality ?
Spirituality cannot be separated from the healing process in ceremonies. ? Illnesses,
especially mental illnesses, result from not being in harmony with nature, from the spirits of
evil persons such as a witch, or through violation of taboos. ? Healing ceremonies restore an
individual’s balance mentally, physically, and spiritually.Copyright © 2013 F.A. Davis
Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-
care Practices ? Traditional AI/AN beliefs influence biomedical healthcare decisions. ?
asking patients questions to make a diagnosis fosters mistrust. ? This approach is in conflict
with the practice of traditional medicine men, who tell people their problem without their
having to say anything. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A
Culturally Competent Approach, 4th Edition Health-care Practices ? IHS has attempted to
shift its focus from acute care to health promotion, disease prevention, and chronic health
conditions. ? Wellness-promotion activities include a return to past traditions such as
running for health, avoiding alcohol, and using purification ceremonies. Copyright © 2013
Edition Health-care Practices ? Medicine men, diagnosticians, crystal gazers, and shamans
tell them how to restore harmony. ? Many families do not have adequate transportation and
must wait for others to transport them to their appointments. Copyright © 2013 F.A. Davis
Company Transcultural Health Care: A C …Purchase answer to see full attachment.

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