Transcultural Health Care A Culturally Competent Approach, .docx

Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Copyright © 2013 F.A. Davis Company
Cuban American Culture
Larry Purnell, PhD, RN, FAAN
*
4th Edition
Cuban American Overview/Heritage The Republic of Cuba is a
multiracial society with people of primarily Spanish and
African origins. Other ethnocultural groups include Chinese,
Haitians, and Eastern Europeans. Spain, the United States, and
the Soviet Union significantly influence Cuba’s history and
culture.
*
4th Edition
Cuban American Overview/Heritage Mistrust of government has

reinforced a strong personalistic tradition and sense of national
identity evolving from family and interpersonal relationships.
*
4th Edition
Cuban American Overview/Heritage Desire for personal
freedom, hope of refuge, political exile, and promise of
economic opportunities prompted migration. Cubans in the
United States take great pride in their heritage and tend to be
conservative, Republican, and anticommunist.
*
4th Edition
Cuban American Overview/Heritage Many possess a strong
ethnic identity, speak Spanish, and adhere to traditional Cuban
values and practices.. The highest concentration of Cubans is in
Florida, although significant numbers live in New Jersey, New
York, Illinois, and California.
*

4th Edition
Cuban American CommunicationMany Cubans live and transact
business in Spanish-speaking enclaves. While the second
generation speaks Spanish, many converse with friends or peers
in “Spanglish,” a mixture of Spanish and English. The highly
educated are more likely to speak English at home.
*
4th Edition
Cuban American CommunicationMany value simpatía and
personalismo in their interactions with others. Simpatía, the
need for smooth interpersonal relationships, is characterized by
courtesy, respect, and the absence of criticism or confrontation.
Personalismo, the importance of intimate interpersonal
relationships, is valued over impersonal bureaucratic
relationships.
*
4th Edition

Cuban American CommunicationChoteo, a lighthearted attitude
with teasing, bantering, and exaggerating is often observed in
their communications with others. Conversations are
characterized by animated facial expressions, direct eye contact,
hand gestures, and gesticulations. Voices tend to be loud, and
the rate of speech is fast.
*
4th Edition
Cuban American CommunicationTouching, handshakes, and
hugs are acceptable among family, friends, and acquaintances
and may be used to express gratitude to the caregiver. Touch is
common between people of the same gender; older men and
women rarely touch in public.
*
4th Edition
Cuban American CommunicationMost tend to emphasize current
issues and problems rather than future ones. Hora cubana
(Cuban time) refers to a flexible period that stretches 1 to 2
hours beyond designated clock time. Most Cubans use two
surnames representing the mother and father’s family names.

Married women may also add the husband’s name.
*
4th Edition
Cuban American Family Roles and OrganizationTraditional
family structure is patriarchal, characterized by a dominant and
assertive male and a passive, dependent female. Traditionally,
Cuban wives stay at home, manage the household, and care for
children, whereas husbands are expected to work, provide
financially, and make major decisions for the family.
*
4th Edition
Cuban American Family Roles and OrganizationHonor is
attained by fulfilling family obligations and treating others with
respeto (respect). Vergüenza, a consciousness of public opinion
and the judgment of the entire community, is considered more
important for women than for men. Machismo dictates that men
display physical strength, bravery, and virility and be the
spokesperson, even though they might not make the decisions.
*

4th Edition
Cuban American Family Roles and OrganizationLa familia (the
family, nuclear and extended, including godparents) is the most
important source of emotional and physical support.
Multigenerational (3 to 4 generations) households are common,
including a high proportion of people 65 years and older who
live with their relatives.
*
4th Edition
Cuban American Family Roles and OrganizationAccording to
U.S. standards, Cuban parents tend to pamper and overprotect
their children. Children are expected to study, respect their
parents, and follow el buen camino (the straight and narrow).
Boys are expected to learn a trade or prepare for work and to
stay away from vices. Girls are expected “to remain honorable
while single,” to prepare for marriage, to avoid the opposite
sex, and not to go out without a chaperone.
*
4th Edition

Cuban American Family Roles and OrganizationWhen a
daughter reaches 15 years, a quinceaneras, or elaborate 15th
birthday party, is typically held to celebrate this rite of passage
for the daughter. Adolescents may undergo an identity crisis
and reject their heritage causing parents to feel their authority is
being challenged.
*
4th Edition
Cuban American Family Roles and OrganizationLittle
information is available on homosexuality. Same-sex behaviors
among men may be regarded as a sign of virility and power
rather than homosexual behavior. The gay lifestyle is
contradictory to the machismo orientation of this culture. Same-
sex couples may be alienated from their families.
*
4th Edition
ClickerCheck
A 22-year-old from Cuba comes to the prenatal clinic for the
first time. She introduces herself as Elena Florencia Gonzalez
Portillo. The receptionist should ask what
Is your husband’s surname?

Is your husband’s last name?
Name do you wish to be called?
What is your legal name?
*
4th Edition
Correct Answer
Correct answer: D
The legal name is what should be used for record-keeping.
*
4th Edition
Cuban American Workforce IssuesCuban ethnic enclaves with a
familiar language and culture have created numerous
employment opportunities for recent Cuban immigrants. A
source of tension is the tendency of Cubans to speak Spanish
with other Cuban or Hispanic coworkers. Speaking the same
language allows them to form a common bond, relieve anxieties
at work, and feel comfortable with one another.
*

4th Edition
Cuban American Workforce IssuesTraditional Cubans recognize
supervisors as authority figures and treat them with respect and
deference. Cubans value a structure characterized by
personalismo, one that is oriented around people rather than
around concepts or ideas. Personal relationships at work are
considered an extension of family relationships. Because of the
emphasis on the job or task in the American workplace, many
Cubans view this workplace as being too individualistic,
businesslike, and detached.
*
4th Edition
Cuban American Biocultural EcologyMost Cubans are white,
and only 5 percent are black with physical features similar to
those of African Americans. Cuban Americans tend to have
lower incidences of diabetes mellitus, obesity, and hypertension
than other Hispanic groups or whites. Because of their diet,
which is high in sugar, many exhibit a high prevalence of tooth
loss, filled teeth, gingival inflammations, and periodontitis.
*

4th Edition
Cuban American Biocultural EcologyCommonly occurring
health conditions of Cubans are hypertension, coronary artery
disease, obesity, diabetes mellitus, and lung cancer.Specific
information related to drug metabolism is limited; however, in
general, many require lower doses of antidepressants and
experience greater side effects than non-Hispanic white
populations.
*
4th Edition
Cuban American High-risk Health BehaviorsCuban Americans
tend to exhibit a higher incidence of smoking than other
Hispanic or European groups. Alcohol use is greater among
males than females and among younger versus older groups.
Violent deaths account for high mortality rates among
adolescents and young adults. Suicide rates also exceed those of
the white non-Hispanic population.
*
4th Edition
ClickerCheckThe nurse is using an interpreter to interview the

parents of a 6-year-old Cuban, Leonardo, who has stomach pain.
The nurse should direct questions to A. The father.B. The
mother.C. The interpreter.D. Both parents.
*
4th Edition
Correct Answer
Correct answer: D
The nurse should address the questions to both parents to
demonstrate respect to both of them.
*
4th Edition
Cuban American NutritionFood allows families to reaffirm
kinship ties, promotes a sense of community, and perpetuates
customs and heritage.Staple foods include root crops like yams,
yuca, malanga, and boniato; plantains; and grains. Many dishes
are prepared with olive oil, garlic, tomato sauce, vinegar, wine,
lime juice (sofrito), and spices.
*

4th Edition
Cuban American NutritionMeat is usually marinated in lemon,
lime, sour orange, or grapefruit juice before cooking. A
leisurely noon meal (almuerzo) and a late evening dinner
(comida), sometimes as late as 10 or 11 PM, are often
customary. Being overweight is seen as positive, healthy, and
sexually attractive. Food allows families to reaffirm kinship
ties, promotes a sense of community, and perpetuates customs
and heritage.
*
4th Edition
Cuban American Pregnancy and Childbearing PracticesCuban
women’s fertility rate is lower than that of other Hispanic
American women. Cuba’s current reproductive rate is among the
lowest in the developing world. Even before the revolution,
Cuba had the lowest birthrate in Latin America. The low
fertility rate has been attributed to many women in the
workforce.
*
4th Edition

Cuban American Pregnancy and Childbearing PracticesPreterm
births and neonatal and post-neonatal deaths are lower among
Cuban American women than among other Hispanic American
groups.Prenatal care is higher than among other Hispanic and
white non-Hispanics.Mothers tend to use advice about child
health given by their spouses, mothers, mothers-in-law, and
clerks and pharmacists.
*
4th Edition
Cuban American Pregnancy and Childbearing
PracticesChildbirth is a time for celebration with family
members and friends congregating in the hospital. Traditionally,
men have not attended the births of their children, but younger,
more acculturated, fathers are frequently present.
*
4th Edition
Cuban American Pregnancy and Childbearing PracticesDuring
the postpartum period, ambulation, exposure to cold, and bare
feet place the mother at risk for infection. Family members and
relatives often care for the mother and baby for about 4 weeks
postpartum. Most women consider breast-feeding better than

bottle feeding; approximately half choose to breast-feed.
*
4th Edition
Cuban American Pregnancy and Childbearing PracticesCutting
the infant’s hair or nails in the first 3 months is believed to
cause blindness and deafness.
*
4th Edition
Cuban American Death RitualsIn death, as in life, the support of
the extended family network is paramount. Bereavement is
expressed openly as loud crying with other physical
manifestations of grief. Death is often seen as a part of life and
some, especially men, may approach death stoically.
*
4th Edition

Cuban American Death RitualsThe dying person is typically
attended by a large gathering of relatives and friends. In
Catholic families, individual and group prayers are held for the
dying to provide a peaceful passage to the hereafter. Religious
artifacts such as rosary beads, crucifixes, or estampitas (little
statues of saints) are placed in the dying person’s room.
*
4th Edition
Cuban American Death RitualsFor adherents of Santería, death
rites may include animal sacrifice, chants, and ceremonial
gestures.Candles are lighted after death to illuminate the path of
the spirit to the afterlife.A velorio (wake) lasts 2 to 3 days and
is usually held at a funeral parlor or in the home where friends
and relatives gather to support the bereaved family.
*
4th Edition
Cuban American Death RitualsBurial in a cemetery is common
practice, although some may choose cremation.The deceased are
customarily remembered and honored on their birthdays or
death anniversaries by lighting candles, offering prayers or
masses, bringing flowers to the grave, or gathering with family
members at the grave site.

*
4th Edition
Cuban American SpiritualityApproximately 85 percent of Cuban
Americans are Roman Catholic; the remaining 15 percent are
Protestants, Jews, and believers in African Cuban Santería.
Roman Catholicism is personalistic and characterized by
devotion and intimate, confiding relationships with the Virgin
Mary, Jesus, and the saints.
*
4th Edition
Cuban American SpiritualitySignificant religious holidays
include Noche Buena (Christmas Eve), Christmas, Los Tres
Reyes Magos (Three Kings Day), and the festivals of the La
Caridad del Cobre and Santa Barbara.Santería is a 300-year-old
African Cuban religious system that combines Roman Catholic
elements with ancient Yoruba tribal beliefs.
*

4th Edition
Cuban American SpiritualityFollowers of Santería believe in the
magical and medicinal properties of flowers, herbs, weeds,
twigs, and leaves. Sweet herbs such as manzanilla, verbena, and
mejorana are used for attracting good luck, love, money, and
prosperity. Bitter herbs such as apasote, zarzaparilla, and yerba
bruja are used to banish evil and negative energies. Santería is
viewed as a link to the past and is used to cope with physical
and emotional problems.
*
4th Edition
Cuban American SpiritualityPhysical complaints may be
diagnosed and treated by a physician, whereas the santero may
assist in balancing and neutralizing the various aspects of the
illness. Deeply held religious beliefs provide guidance and
strength during the long and difficult process of migration and
adaptation and continue to play an important role in their day-
to-day lives.
*
4th Edition

Cuban American SpiritualityBelief in a higher power is evident
in practices used to maintain health and well-being or cure
illness, such as using magical herbs, special prayers or chants,
ritual cleansing, and sacrificial offerings. Many tend to be
fatalistic, believing that they lack control over circumstances
influencing their lives.
*
4th Edition
Cuban American Health-care PracticesAfrican Cubans may seek
biomedical care for organic diseases but consult a santero for
spiritual or emotional crises. Conditions such as decensos
(fainting spells) or barrenillos (obsessions) may be treated
solely by a santero or simultaneously with a physician.Many
tend to seek help only in response to crisis situations.
*
4th Edition
Cuban American Health-care PracticesMany Cuban Americans
rely on the family as the primary source of health advice. Older
women provide traditional home remedies such as herbal teas or
mixtures to relieve mild or moderate symptoms or cure common
ailments.Older Cuban Americans were socialized into a strong
health ideology and successful primary care system while still

in Cuba.
*
4th Edition
Cuban American Health-care PracticesUse of preventive
services in the US is generally determined more by access to
care than by acculturation.Many Cuban Americans use
traditional medicinal plants in the form of teas, potions, salves,
or poultices. In Cuban communities, stores called botanicas sell
herbs, ointments, oils, powders, incenses, and religious
figurines to relieve maladies, bring luck, drive away evil spirits,
or break curses. Santería necklaces and animals used for ritual
sacrifice are often available at botanicas.
*
4th Edition
Cuban American Health-care PracticesBlood transfusions and
organ donations are usually acceptable.
*

4th Edition
Cuban American Health-care
PractitionersBoth traditional and biomedical care are
acceptable. Folk remedies may be used at home, but if the
condition persists, folk practitioners such as santeros and
biomedical practitioners may be used either simultaneously or
successively. Santeros may prescribe treatment or perform
rituals to enable ill people to recover by invoking supernatural
deities to intervene to help make them well.
*
Population Presentation:
one cultural group and one socio-cultural group from the list
provided below and set up a PowerPoint presentation (APA
style) Minimum of 16 slides.
Preparation for the presentation will include synthesizing the
information from assigned readings, the scientific literature,
Internet resources, and other sources. Students will provide a
minimum of 6 references.
The presentation will address the following:
· A brief history of the cultural/socio-cultural group
· Values
· Worldview
· Language and communication patterns
· Art and other expressive forms
· Norms and rules
· Lifestyle characteristics
· Relationship patterns
· Common rituals

· Degree of assimilation or marginalization from mainstream
society
· Health behaviors and practices.
The presentation must include a comparative and contrast
analysis of common characteristics and distinguishing traits
between the cultural group and the socio-cultural group. As well
as a brief explanation of differential approaches needed by
health care professionals.
Grades will also be based on overall quality of the professional
presentation including references.
Cultural Groups:
Socio-cultural group
Hispanic & Latino Americans
Cuban Heritage

Transcultural Health Care A Culturally Competent Approach, .docx

Recommended

Recommended

More Related Content

Similar to Transcultural Health Care A Culturally Competent Approach, .docx

Similar to Transcultural Health Care A Culturally Competent Approach, .docx (19)

More from turveycharlyn

More from turveycharlyn (20)

Recently uploaded

Recently uploaded (20)

Transcultural Health Care A Culturally Competent Approach, .docx