User:Christy Brackman/sandbox

Cuban, Haitian, and Dominican cultures as they are related to nursing congruent healthcare Many ideas about transcultural healthcare are shared in a variety of ways. Topics come together in that intertwine and may become confusing at times; such is the case of nursing considerations for those living in Cuba, Haiti, and the Dominican Republic. This group values their old ways while slowly embracing new achievements in medicine for vaccines, healthier living conditions, and health promotion for the countries as a whole.


 * Cuba


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Cuba, for example, has a familial unit that is very tight. In this culture the family is the primary source of advice for many things including health which is typically the older female. Home remedies including herbal teas or mixtures are used to cure common ailments and illnesses. Those that become ill will rely heavily on their family for assistance and will be showered with attention. Crisis situations are what will bring them to mainstream medicine. As an alternate form of medicine, they also rely on a santero or a botanica. Since Castro, Cuba has developed a hierarchy or regionalized organized healthcare that allows for primary and secondary healthcare services. Remote communities and regions are assigned physicians and nurses to support, diagnose, and cure disease. In this current state, the use of traditional remedies are still used but the country's inhabitants have evolved into utilizing a more beneficial health system.

When treating these patients, it is important to recognize their strong folk and traditional practices. Because Cubans consult family first, they may be self-medicating and possibly making their conditions worse. With universal coverage, healthcare is accessible and more readily accepted. These individuals need to be encouraged to listen to prescribers and nurses regarding their health conditions. It is important to consider the patriarchal influence when encouraging patients to accept new regimens such as taking medications as prescribed. With the use of herbals and mixtures, a complete health assessment is essential which includes current intake of these homeopathic solutions. Directly asking questions is seen as rude and therefore, the healthcare staff must elicit answers from conversation and indirect questioning. Open-ended questions are not suggested. At this time in the patient-provider relationship, the patient is looking to the provider for assurance and support with a fair amount of faith. In this important state of the patient, they are more open to ideas, suggestions which leads to more compliance. Medication adherence is difficult as they have to adapt to times, routines, and understand side effects.


 * Haiti


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Again, the family has a strong bond in their culture. Different from Cuba, the conseil de famille or family council is relied upon for support and decision making as they believe the action of one will have an affect on the family as a whole. In this culture, good health is seen in eating a balanced diet, prayer, and good personal hygiene as they seek a balance between cho (hot) and fret (cold). Food is relished as a treasure and to promote health despite the socioeconomic status of the majority of Haitians. Those who believe in a form of religion voodoo and other folk medicine use healers. Western medicine or folk medicine is used depending upon the type of religion the individual follows. Harmony is important.

To determine the type of treatment for an illness or "disturbance", they identify it as natural or unnatural. Unnatural illnesses are seen spiritual in nature and folk medicine is used as a first line of treatment. The lack of resources for primary care still creates a barrier to healthcare. Conventional medicine is questioned in this culture and will only be sought after all other possibilities are exhausted. For this culture, medication adherence is extremely questionable. Because of the doubt aimed at mainstream medicine, taking medicine prescribed by them is equally untrustworthy. The provider or nurse needs to understand these concepts and acknowledge the hesitation. An honest and open relationship must be developed over time to adequately treat and help patients. As there is no mainstream or government healthcare, it weighs heavily on the healthcare professionals to accomplish positive health management.


 * Dominican Republic


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Due to the relationship land-wise with Haiti, the Dominican Republic shares many of the same views and ideas that their sister country does. The family is the primary unit which makes the majority of the decisions regarding all aspects of life and care. Outside medicine is questionable and accessibility to resources is limited. Folk medicines are widely utilized as in Haiti including the use of herbs, rituals, and region specific practices.

Providing congruent and sensitive medical care is elemental for positive outcomes. Maintaining the patient relationship with the family in mind is a key point. The first step is to maintain and prevent deterioration of the patient's health. By acknowledging and accepting their cultural practices, the provider or nurse has an increased chance of adapting a plan of care that will be within the patient's ability to actively accept and adopt. A clear understanding of the cultures opens the doorway to positive approaches toward forming relationships for better outcomes. Over the last years, the influence of modern medicine has made large progress toward more personal and appropriate care. Nurses have migrated to assist those in remote and impoverished areas to help with vaccines, disease management, and adapting healthier lifestyles with the resources at hand. The acceptance of the rich culture and traditional methods of healing is incorporated into the development of the health goals. Re-patterning is important because it is the base of future health. When the healthcare provider lives in the immediate region they can model responsible self-management regarding diet, personal hygiene, and medication adherence. By teaching the better habits, practices including medication, lifestyle, and success can be measured. Many worldly endeavors regarding the implementation of healthcare in these countries has made vast improvements over the last decades. Although Haiti and the Dominican Republic are not as up to date advanced as Cuba, world medicine continues to provide the support with supplies, staff, resources to address the healthcare needs that plague them. This being said, the medical field continues to follow these countries still needs assistance to bring about change for the people.