This presentation provides an overview of cultural considerations for healthcare providers treating Cuban patients. It discusses the Cuban family structure, common health risks like hypertension and diabetes, and cultural interpretations of illness. The presentation advises healthcare providers to respect gender and parental roles, include extended family, and assess traditional remedies. It also provides strategies for culturally-competent care, like using interpreters and showing respect. A case study example illustrates how to effectively interview Cuban patients to identify and address barriers to treatment compliance.

1. Culturally Competent
Teaching Presentation
Cuban Heritage
By: Jennifer Panzarella RN, BSN

2. Goals
Cultural considerations will discussed, and the learner
will be able to:
1. Identify Cuban characteristics based on an overview of
the heritage.
1. Identify the role of the family structure, function and
processes as related to the Cuban culture.
3. Identify common health risks and health care practices
for this population.
3. Identify communication techniques for the health care
provider in order to improve adherence to treatment
goals.

3. Introduction to the
Cuban Heritage
“Latino” or “Hispanic” are terms used
interchangeable
Most Cubans are white and 5% are black
16% of US population
30% by 2050

4. Overview of the
Cuba
90 miles south of Key West
Influenced by Soviet Union
Government mistrust
Migration for freedoms
Primarily Spanish speaking

5. Family Roles
“La familia”
The female (mother) will typically determines the
need for medical care and the male (head of
household) will make the decision to seek medical
care .
Nuclear and extended families
Includes godparents
Multigenerational (3-4 generations)
Parents are often over-protective
Parents often seek health advice from non-medical
personnel first

6. Advice for health care providers…
Gender roles should be respected
Parental decision should be respected
Egalitarian decision-making prevails in the U.S.
Verbal consent from family and next of kin
Extended family for discharge needs

7. Spirituality
85% Roman Catholic
15% Protestants, Jews and African Cuban
Santeria believers
Important role in daily lives
Belief in a higher power
Rituals and chants

8. Death Rituals
Openly expressed
Large family gatherings
Candles (use battery operated in health care
facilities)
Ceremonial Gestures
Clergy

9. Advice for health care providers…
Clergy to perform death rites
Gathering space
Do not remove statues or small offerings

10. Health Risks
Alcohol (higher in younger males)
Smoking is prevalent
Violent deaths
Hypertension
Heart disease is leading cause of death
Higher rates of obesity and diabetes

11. Health Behaviors
Health is viewed as the “absence of pain”
Lack preventative care
Seek health care when there is a crisis
Rely on family for health advice
Special considerations
Pregnancy and childbearing practices

12. Cultural Interpretations
Cold Conditions
Cancer
Headache
Menstrual Cramps
Pneumonia
Upper respiratory
Infections
Indigestion
Colic
Hot conditions
Anger
Anxiety
Diabetes
Diaper rash
GERD
HTN
Pregnancy
Sore Throat
Infection

13. Nutrition
Purpose of meal preparation
Staples are root crops, plantains, and grains
Prepare foods with olive oil, garlic, tomato sauce, vinegar,
wine, and spices
Marinate meats in citrus juices
Lack fiber
Lack leafy greens
Coffee is strong and bitter
Lactose intolerance is common
Meal times
Being overweight is a positive attribute

14. Cuban Food
Pyramid

15. www.Choosemyplate.gov
The newest update on the pyramid is a plate that
illustrates the 5 food groups with a focus on
consumption of portions.

16. Advice for health care
providers…
Assess food preparations and flavorings
Determine customs
Caloric intake
Meal times
Counseled on acceptable weights
Incorporate preferred foods
Alcohol consumption

17. Common Health Care
Practices
Older women provide home remedies using teas, fruits, and
vegetables. They also create remedies using a combination of
items:
Stomach aches – anise tea
Cough – Lemon and honey tea
Elevated BP – grapefruit and garlic
Sore throat – salt water
Heartburn – baking soda, lemon and water

18. Pain
Expressed with verbal complaints
Moaning
Crying

19. Advice for health care
providers…
Need to assess level of acculturation
Preventative care
Include family
Determine medicinal products
Determine resources
Determine folk healers and treatments

20. Barriers Contributing to
Non-Compliance
Language
Lack of insurance
Cultural beliefs
Immigration
Mistrust
Literacy
Poverty

21. Approach to Care
Simpatia (kindness)
Personalismo (friendliness)
Respecto (respect)

22. The Health Care
Environment
Allow extra time
Patient gown
Bilingual signage
Interpreter
Handouts
Culturally sensitive

23. Case Study
Robert is 48 with Type II DM, hypertension, and has a BMI of
35. He was given two prescriptions for medications at the last
visit. They also discussed dietary changes and an exercise
program at his last visit. He has been noncompliant even
though he agreed to medications and verbalized that he
understood the instructions from his last appointment. At this
visit there is a telephone interpreter available.

24. The Interview

25. LEARN
LISTEN and understand the patients perspectives.
EXPLAIN and clarify the perceived problems
ACKNOWLEDGE and discuss
RECOMMEND treatment
NEGOTIATE and come to agreement

26. Interview questions
What do you call your problem?
What do you think caused the problem?
Why do you think it started?
How severe do you perceive your illness to be?
What are your fears?
What are the results that you hope to obtain?
What do you believe your treatment should be?

27. Therapeutic Communication
Techniques
Open-ended questions
General lead questions
Restate
Clarify
Reflect
Validation

28. Findings

29. Evaluation
“Teach back or “Show me”
 Assess literacy
 Assess language
 Handouts
 Repeat instructions
 Increase understanding

30. References
Cultural Competency Series: Framework for Cross-cultural Health Care.
(2007). National Center for cultural Competence. Retrieved from:
http://clinicians.org/images/upload/cultural_competence.pdf
Junckett, G. (2013 January 1). Caring for Latino Patients. American Family
Physician. Volume 87 (1): 48-54. Retrieved from:
http://www.aafp.org/afp/2013/0101/p48.html
Peterson-Iyer, K. (n.d.). Culturally Competent Care for Latino Patients.
Markkula Center of Applied Ethics. Retrieved from:
Purnell, L. (2014). Guide to Culturally Competent Health Care. (3rd Edition).
F.A. Davis Company. Philadelphia, PA.
https://www.scu.edu/ethics/focus-
areas/bioethics/resources/culturally-competent-care/culturally-
competent-care-for-latino-patients/