The document provides an overview of transcultural nursing with a focus on Hispanic/Latino groups, exploring their diverse cultural attributes, beliefs, and practices regarding health and illness. It highlights the importance of family dynamics, religious influences, traditional medicine, and the need for culturally sensitive nursing care tailored to the specific customs of various Hispanic subgroups. Additionally, it emphasizes the role of healthcare providers in fostering respectful relationships and understanding patients' cultural backgrounds to ensure better health outcomes.

1. Transcultural Nursing:
Hispanic/ Latino Groups
Aleli Bray Silverio, RN
Mariel J Ebcas, RN
Roy Gebusion, RN

2. I. INTRODUCTION

3. INTRODUCTION

4. INTRODUCTION
• The term Hispanic refers to a diverse population of Latin
America. This includes those of Cuban, Mexican, Puerto
Rican, South or Central American, or other Spanish origin
regardless of race (Juckett, 2013)
• Hispanics share a strong heritage that includes family
and religion, each subgroup of the Hispanic population
has distinct cultural beliefs and customs.
• The following presentation will explore cultural
attributes and how to apply culturally sensitive nursing
care to the Hispanic patient.

5. INTRODUCTION
Hispanic Groups
• Argentine
• Bolivian
• Chilean
• Colombian
• Costa Rican
• Cuban
• Dominican
• Ecuadorian
• Guatemalan
• Honduran
• Mexican
• Nicaraguan
• Panamanian
• Paraguayan
• Peruvian
• Puerto Ricans
• Salvadoran
• Spanish
• Uruguayan
• Venezuelan

6. • History
 Latino history is American history. Latinos trace
their origins to Latin America and other Spanish
colonies, both in the Caribbean and in the
contemporary United States. These groups include,
but are not limited to, Indigenous, Mestizos, Afro-
Latinos, and other mixed-race people. Currently
representing the largest ethnic minority in the
country, Latinos have participated in the creation
and growth of this nation well before it was named
the United States. Complex stories of colonization,
immigration, and slavery make Latino history an
infinite source for inquiry and knowledge.

7. • History
 HISPANIC – actually refers to “Hispania”, a large
geographical area of ancient Roman era that consist
of the Iberian peninsula. Person that originated
from Mexico, Puerto Rico, Cuba, Dominican Republic,
Central or South America, and of Spanish or
Portuguese culture or origin.
 LATIN(AMERICA) – was first coined by the French as
Amirique Latine, during the French Intervention in
Mexico. It is a combination of the European word
“latino”And the New World; “America”. It was to
symbolically sever Mexico’s Spanish roots, while at
the same time, reinforcing a notion of belonging
between the two nations.
 LATIN RACE - composed of all descending from a
nation who spoke “Romance tongue”
• Romance Language – a dialect of inhabitants of the
Iberian Peninsula of Spain, Portugal, Andorra and
Gilbraltar.

8. • Food
 Food plays an important role in the
Hispanic culture.
 In some Hispanic cultures, a good meal
will be balanced in food and herbs by
“hot” and “cold” types. Those who eat
foods whose temperatures are wrong for
them can get sick.
 A good appetite is associated with good
health.
 Children are not forced to eat foods
that they resist because their
preferences are respected.
 A mother or grandmother will withhold a
food she thinks causes illness from her
children’s diet.

9. • Food
TRADITIONAL HISPANIC FOODS
• Tacos
Tacos are extremely versatile and can be
incorporated into any menu. Chances are you
already know that tacos are tortillas folded
around filling, so you can see how much
potential this dish has to be customized! For
instance, a seafood restaurant could serve mini
tilapia tacos with a lemon garlic sauce as an
appetizer, or a steakhouse could offer steak
tacos as a special for the month.
• Stuffed Peppers
Stuffed peppers in various forms are popular all
around the world, including Hispanic countries.
The peppers used can be hot and spicy, like
jalapeno poppers, or mild like the Mexican chile
relleno. They are usually filled with meats,
cheeses, beans, rice, and salsa.

10. • Food
• Grilled Corn
Grilled corn on the cob is a popular Mexican
street food. The corn is shucked and grilled so
the kernels just begin to char. It’s then served
slathered in a sauce made of mayonnaise, chili
powder, and other flavors. The combination of
sweet and smoky flavors makes it a perfect side
dish to charbroiled chicken or steak!
• Paella
This rice-based dish is one of the most popular
meals in Spain. It combines white rice,
vegetables, beans, meat, and herbs and spices
like rosemary and saffron. You can also prepare
paella in a wide variety of styles, like
seafood, vegetarian, mixed, or whatever other
kind of paella makes the most sense for your
restaurant.

11. • Food
Common Hispanic Food
Preparations:
• Rice & Bean prepared with
lard.
• Tortilla, arepa or bread with
every meal.
• Chicken soup (caldo de pollo /
gallina) is frequently is given
to persons who are ill

12. • Religious Practices
 Most Hispanics are Roman Catholics
 Spiritual and religious influences
play a major role in health,
illness, and daily life.
 Churches are central to the life of
the family and community, hence can
be important resources in planning
and delivering services.

13. • Religious Practices
Influence of Religion in daily life
• God is an active force in life
• Church and faith are central to family
• Daily prayer
Symbolism
• The cross
• Images of saints
• The rosary
• Images of the Virgin Mary
• Family mourns in black

14. • Religious Practices
Practices surrounding life events:
• Weddings
- Marriage prep classes
- Mass in Catholic Church
- Bible/Church – spiritual
- Coins/Lazo
- Fruitcake soak in rum
Grief/Luto(mourning 9 days)
- Vigils
- Last rites: sacraments
- Baptism before death
- Rosary through out the day
- Wakes

15. • Religious Practices
Reproduction:
- abstinence,temperature/ovulation method
Abortion:
- Morally wrong
- Permanent sterilization – forbidden
- Genetic/Stem cell - Objcetionable
Death/Dying:
- Ordinary means of persevering life
- Euthanasia not permitted

16. • Religious Practices
Important Rites:
– Baptism of infants:
Especially on life threatening
situations.
– The Anointing of the Sick:
required in life threatening
situations.

17. • Role of Religion in Healing
Faith and church remain
powerful sources of hope and
strength in the Hispanic
community, especially in times
of sickness.
Along with Catholicism the use
of magicoreligious is common.

18. • Role of Religion in Healing
– Candles with pictures of saints
 Each saint has a specialized as well as general
religious function:
• Cancer: St. Peregrine
• Dying: St. Joseph
• Bodily ills: Our Lady of Lourdes
• Infertility: St. Anne
• Chronic Illness: St. Juliana Falconieri
• AIDS Patients and Caregivers: St. Aloysius
Gonzaga
• Arthritis / Rheumatism: St. James the Greater

19.  Health Beliefs, Behaviors and Practices
 The meaning of health varies among Hispanics.
Some maintain that health results from good
luck or is a reward for good behavior (Spector,
1996).
 Illnesses are thought to have either natural or
supernatural causes.
Fatalism – Fatalistic views are shared by many
Hispanic patients who view illness as God’s will
or divine punishment brought about by previous or
current sinful behavior.

20.  Health Beliefs, Behaviors and Practices
 Older generations still believe mental
retardation or developmental disability is
a punishment for the sins of the parents
 Usually mothers accept the child as a
blessing or gift from God, feeling that
they have been found worthy of such a
child.
 More serious mental illness—schizophrenia,
delusions, and hallucinations—may be
conceived as “part of life” or “God’s
will.”

21.  Health Beliefs, Behaviors and Practices
 Influences include emotional, spiritual, and social
state, as well as physical factors such as humoral
imbalance expressed as too much "hot" or "cold"
 In general, cold diseases/conditions are characterized
by vasoconstriction and low metabolic rate.
 "Cold“ diseases/conditions include menstrual cramps,
frio de la matriz, coryza (rhinitis), pneumonia,
empacho, and colic.
 "Hot" diseases/conditions are characterized by
vasodilation and high metabolic rate. Pregnancy,
hypertension, diabetes, acid indigestion, susto, are
examples of hot conditions
 "Cold" conditions are treated with "hot" medications
and "hot" with "cold" medications, thus bringing the
individual back into balance.

22. • Health Beliefs, Behaviors and Practices

23.  Family Dynamics
 For Hispanics/Latinos, the valuing of family
considerations over individual or community
needs, is strong, almost universal value, a
concept known as familismo.
 Hispanics/Latinos seek encouragement,
direction, and advice from a large number of
family members.
 The nuclear family is the most basic and common
social unit, but many extended families also
present.
 The Hispanic/Latino family structure tends to
be patriarchal and follow a rigid hierarchical
structure
 Family members provide social, emotional, and
even financial support to each other.

24.  Family Dynamics
 The father or oldest male (direct
relative) holds the greatest power in
most families and may make health
decisions for others in the family.
 Hispanics typically subscribe to
values of “machismo” and “marianismo,”
which culturally define the desirable
male and female qualities.
 Men are expected to provide for and be
in charge of their families.
 Women are expected to manifest respect
and even submission to their husbands.

25.  Outlook on Health
Hispanics view health holistically
and focus on alternative therapies
for treatment.
Getting diseases is a bigger
concern than dying. For the
Hispanic community, issues of
morbidity rather than mortality
are of greatest concern.
Many patients seeking medical care
will have already sought help from
family resources.
Tend to have a collectivistic view
and focus on the group more than
the individual.

26.  Indigenous Health Beliefs
Folk illnesses are health problems associated
with members of a particular group and for which
the culture provides etiology, diagnosis,
prevention, and regimen of healing; and which
also have psychological and/or religious
overtones.
• Common hierarchy of seeking relief from lay
healers:
– Home Remedies
– Relatives / Neighbors (especially females)
– Yerbatero (Herbalist)
– Sobador (massage therapist)
– Partera (midwife who may also treat children)
– Curandero Total (lay healer that intervenes in
multiple dimensions – physical / spiritual)
– Doctor Naturalista – prescribe natural remedies
without spiritual component.

27.  Outlook on Caring
 Most Hispanics, including those from
traditional backgrounds, use cosmopolitan
sources of health care (e.g., primary care
physicians) as primary sources of health
care.
 Regardless of the source of care, the
patient (and family) are likely to include
faith in God as a vital component of
understanding of the problem and the cure.
 Patients of all cultural backgrounds
warrant kindness, a personal connection,
and respect, the consequences of omitting
these traditional values may be more
problematic with Latinos.

28.  Outlook on Caring
Latino culture has several normative values
that must be recognized in clinical
settings. These includes:
 Simpatía(kindness) emphasizes politeness
and conflict avoidance.
 Personalismo(friendliness) a personal
connection, can be achieved by asking
about the patient and his or her family.
Because people stand closer to each other
in most Latino cultures, physical
proximity is also perceived as being more
personable.
 Respeto(respect) implies attentive concern
for the patient and respect of his or her
personhood and age, especially if the
patient is older.

29.  Nursing Intervention to Fulfill
Cultural Expectation
 Family involvement in health care is
common and health care providers are
strongly advised to encourage such
involvement and to include the family as a
resource and focus of care in health
planning.
 Older patients should be addressed as
señor or señora rather than by their first
names. Using don or doña with the given or
full name indicates even greater respect
for older patients.
 Rapport begins through exchange of
pleasantries or chit chat before beginning
the business of medical history-taking and
physical examination.

30.  Nursing Intervention to Fulfill
Cultural Expectation
 The nurse-patient relationship is built
through communication and the effective
use of language, both verbal and
nonverbal.
 Hispanics expect health care personnel to
be warm in personal and express a strong
need to be treated with dignity.
 Healthcare providers are expected to
exhibit confidence, and many
Hispanics/Latinos expect a more
paternalistic attitude from healthcare
providers.
 Verify understanding through encouraging
questions, using comprehensions checks and
by using teach-back methods.

31.  Traditional Medicine Approach
 Traditionally, Hispanics have utilized healers.
Healers were an important part of the Hispanic
culture.
 Home remedies were the first line of treatment.
These remedies were teas, made from various
fruits, herbs, and spices. If the use of home
remedies and the assistance of a senora/abuela
had no effect on the illness then the
individual had the option to consult either a
yerbero (herbalist), sobador (message
therapist), or partera (midwife) depending on
the type of infliction.
 Hispanics generally use multiple methods to
treat themselves which involve prayer, folk
medicine, prescription medications left over
from friends as well as new medications
prescribed by physicians.

32.  Traditional Medicine Approach

33. ASSESSMENT & REFLECTION
• Cultural issues play a major role in patient compliance.
• It is essential that healthcare providers are
knowledgeable of and respect the healthcare values and
beliefs that the culture holds.
• Nurses that demonstrate cultural competency will
ultimately be able to provide better quality care to
patients of the Hispanic origin.
• Nurses can incorporate “cultural awareness” into their
practice by acknowledging and respecting patients’
worldviews, particularly their perception of illness.

34. ASSESSMENT & REFLECTION
• Understanding diverse communication patterns and
remaining non-judgmental during provision of care can
help nurses to provide culturally appropriate care.
• Identified access to culturally responsive care as a key
strategy to increase health service utilization among
Hispanics/Latinos, particularly when services included
culturally competent practices such as race/ethnicity
matching, as well as language, regional culture, and
belief system congruence.
• Every culture has beliefs about health, disease,
treatment, and health care providers.

35. ASSESSMENT & REFLECTION
• People within any cultural group are not homogeneous,
even though they may hold many beliefs, practices, and
institutions in common.
• Messages and materials must respect the variations
within cultural groups
• Understanding how social, structural, psychological,and
cultural factors affect physical health and being
sensitive to these factors can make an important
difference health outcomes

36. ASSESSMENT & REFLECTION
• Beliefs affect:
• – how and from whom a person will seek
care,
• – how self-care is managed,
• – how health choices are made, and often,
• – how a patient responds to a specific
therapy