Introduction
Complete cultural assessment is essential in healthcare as it helps assess patients, individuals or family members on various cultural competencies that can help improve health. It is essential to provide culturally sensitive and competent healthcare to patients to improve patient outcomes and meet the multicultural community’s health needs (Purnell, 2021). Purnell supports the need to support culturally sensitive healthcare by insisting on cultural assessment competencies. He developed a model to prepare a cultural competence assessment with 12 domains to ensure all essential cultural information is captured during a cultural assessment. According to the Purnell model, the 12 domains for assessment include; Overview, Communication, Family roles and organization, Workforce issues, Biocultural ecology, High-risk behaviors, Nutrition, Pregnancy, Death rituals, Spirituality, Healthcare practices and Healthcare practitioners (Purnell, 2021). The paper will focus on an interview with a Mexican American patient, D.S. living in the U.S using the above 12 domains; it will also highlight the health implication of culturally competent healthcare.
Overview/Heritage
D.S. is a patient who is a Mexican American; he is 20 years old and living in the United States. He was born in the United States and has lived in the same city his entire life. The patient is Hispanic; his parents are also of Mexican descent. He is a college student studying to become a teacher. The patient earns a living from selling clothes though he is undertaking an education course. He is not politically active though he wishes to join politics once he attains the age of 35 years.
Communication
The patient is bilingual, speaking both English and Spanish. He is more comfortable speaking English and prefers to communicate in that language when possible. Mr. D.S. notes that he also has some knowledge of traditional Mexican slang, which they use when speaking with other Mexican Americans. He Speaks in a low tone and volume; He maintains eye contact when communicating and uses facial expressions to indicate some information. The patient says he starts by greeting before talking to anyone. He is always ready to engage in lengthy communication and does not feel shy when communicating with strangers. He notes he starts with an introduction when communicating on various critical issues.
Family Roles and Organization
D.S. is the oldest of three children and is the only one to have attended college. He notes that their parents have emphasized the importance of education and encouraged all their children to pursue higher education. D.S.’s parents are traditional because the father is the head of the household and is expected to provide for the family. The mother is expected to take care of the home and the children. The girls engage in home chores and taking lighter chores, while the boys protect the homestead and engage in more energy-consuming tasks (Gramann et al., 2019). The family is a nuclear family with high social status; it practices lifestyles such as regular physical exercises.
Workforce Issues
The patient indicates that their parents have always worked hard to provide for the family and that their experiences in the workforce have been positive. He also notes that there is a strong emphasis on respect for authority in the Mexican American community, which is reflected in the workplace. He reports acculturations issues in the workplace; he also notes that sometimes the principle of autonomy does not perfectly work at the workplace as the manager sometimes limits people from making their own decisions. The patient also indicates that they sometimes experience language barriers at the workplace when they encounter new clients.
Biocultural Ecology
D.S. says that their family is closely connected to their Mexican heritage and culture and that they often celebrate traditional Mexican holidays and attend festivals to celebrate Mexican culture. The patient also says that their cultural community has biological variations where some people have different physical characteristics, such as skin color and other traits, despite belonging to one community and culture. The patient also indicates that different individuals in their culture and community have different heredity and genetics and live in different ecological identities (Gramann et al., 2019). He reports that some people may have various drug resistance while others may not have problems with drug metabolism of the same drugs indicating variation in drug metabolism.
High-Risk Behaviors
D.S. notes that their family is not involved in high-risk behaviors like drug or alcohol abuse. He says that their parents have always stressed the importance of good decision-making and have emphasized the importance of staying away from risky behaviors. He confirms that no member of their family is involved in drugs or any health-risk behaviors, he denies any of their families using recreational drugs or engaging in high-risk physical activities, and therefore there is safety in their family.
Nutrition
D.S. notes that their family has a traditional Mexican diet, which includes a lot of beans, tortillas, and other traditional Mexican dishes. The patient indicates that their family also consumes a lot of fresh fruits and vegetables but tends to consume more processed foods than fresh produce. He says there are some special foods with different meanings, and they are used on special occasions and events (Gramann et al., 2019). Some foods are used to make rituals for healing and other purposes. The patients also state that nutrition is emphasized in their culture to ensure a healthy life free of diseases and complications that can arise from deficiencies.
Pregnancy
The patient says their family is very traditional regarding pregnancy and childbirth. He notes that their family believes that childbirth should be a natural process and that family and friends should surround the mother during labor and delivery. He notes that they believe pregnancy is sacred and should be honored and cared for until delivery. They also practice traditional birth culture, which they believe is shaped by the beliefs of a hot-cold balance within the body. The women don’t eat some foods during pregnancy. They practice the medical birthing process but accept the traditional one (Gramann et al., 2019). They take the postpartum period seriously and care for the mother and their infants with nutrition and family support. They also believe it is essential or postpartum mothers to avoid cold showers and drinking hot soups, and they should abstain from sex; it is also essential to bind the abdomen with a postpartum faja.
Death Rituals
The patient notes that their family observes the traditional Mexican funeral rituals when someone passes away. Their family typically holds a vigil in the deceased’s home for 24- 48 hours. During this time, they eat and drink together, perform special prayers, and friends and guests bring some gist to the bereaved. The family will then accompany the body to a cemetery for burial. According to the D.S, communion and last rites are offered to people when death is near, and a Rosario is performed nine days after the death of a family member; this practice involves flowers, prayers, candles and sharing of memories of the diseased (Gramann et al., 2019). The deceased are buried with their clothing and some important possessions before death.
Spirituality
The patient notes that their family is Catholic and attends church regularly. He also notes that their family practices many spiritual rituals, such as praying the rosary and attending mass. They use prayers for various occasions, including parties, during meals, at the hour of sleep, and for casting out spells and bad omens in the family and the community. They believe in and worship God through Jesus Christ. They also use prayers to exorcist demons and clean their family members. The patient says they believe in life after death, and their meaning of life is anchored in the belief that humans are living on Earth to fulfill the desire of GOD, after which they die and go to live forever in heaven. They believe sin separates man from God and can lead a person to hell when they die.
Healthcare Practices
The patient notes that their family typically seeks traditional medical care when needed, and their family is also open to alternative healthcare practices, such as acupuncture and herbal remedies. They believe in healing the sick using prayers and religious rituals; they practice western medicine practices such as surgery and have accepted transplantation practices in a limited measure. They also practice self-medication, rehabilitation, and physical activities to improve their health.
Healthcare Practitioners
The patient notes that their family typically seeks medical care from physicians they know and trust. He also says they are open to seeking medical care from other healthcare practitioners, such as naturopaths and chiropractors. In their culture, women are preferably handled by female healthcare practitioners, but in forced circumstances, men are also allowed to treat female patients and vice versa.
Implications for Health Practices
From the cultural assessment, it is clear that cultural competency is essential for healthcare providers as it helps them provide quality health to patients.
Based on the cultural assessment of the patient, it is evident that certain cultural considerations need to be taken into account when providing health care to patients from different cultures. First, providers should be aware of the importance of communication and ensure they can communicate effectively with patients. This improves the health process and allows the nurses to provide the required healthcare to patients. It is also essential to consider the importance of a patient’s traditional rituals and practices when caring for such patients. Spirituality and religion also affect the healthcare delivery process; healthcare providers need to screen for spirituals needs in patients and address such needs when caring for them. To provide quality healthcare, it is also essential to consider the patient’s nutrition, health practices and other cultural characteristics when caring for them.
Conclusion
Cultural competency in healthcare is essential for providing high-quality care to all patients. Healthcare professionals must understand their patients’ cultures and health beliefs to provide the best care possible (Sharifi et al., 2019). Cultural competency helps to reduce health disparities, improve communication, and promote respect and understanding. It also helps to ensure that healthcare professionals provide culturally-sensitive care tailored to the patient’s needs. Cultural competency can help healthcare providers understand our society’s cultural and health disparities and how to address them. The healthcare providers should therefore follow the Purnell model when assessing patients’ cultural needs when caring for them.
References
Gramann, H, J., Floyd, F, M., Saenz, R. (2019). Outdoor recreation an Mexican American ethnicity: A benefits perspective. Culture, Conflicts and communication in the Wildland- urban Interface, 69-84.
Purnell, D, L. (2021). The Purnell model ad theory for cultural competence. Textbook for cultural health care: A population approach, 19-59.
Sharifi, N., Hajbanhery, A & Najafi, M. (2019). Cultural competence in nursing: A concept
analysis. International Journal of Nursing Studies 99. https://doi.org/10.1016/j.ijnurstu.2019.103386
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