Heritage Assessment
Grand Canyon University: NRS429
June 13, 2014

Heritage Assessment

The increasing population of immigrants in the United States has contributed to health disparities in the health care system. Cultural competence can remove health disparities by eliminating personal biases, and treating every person with respect. Simply recognizing and accepting different cultures is not enough, one must be able to consistently recognize and understand the differences in order to be culturally competent. Knowledge and culturally competent practices are a must for nurses to deliver quality care in our rapidly changing multicultural world (Edelman, 2014 p. 25).
The heritage assessment tool is a set of questions that can be used to determine a patient’s ethnic, cultural, and religious heritage. The tool is helpful in assessing how deeply a person is tied to their traditions, and can help nurses become culturally competent. The greater the number of positive responses reflects how closely one is tied to their particular heritage. Once the history is learned and the degree which one identifies with the tradition is discovered, the focus is placed on discovering the role that the tradition plays in the situation (Culture Guide, 2014).

Family Interviews I interviewed three families from different cultures to see how closely they were bound to their heritage. The families originally were from China, Vietnam, and England. The families all moved to the United States when the adults were middle age and the children were young adults. While the children seemed to adapt and accept medical values from the United States, the parents stayed true to the cultures and traditions from their own country.
Health Maintenance Health maintenance refers to what the individual must do to maintain health. There may be special food, clothing, or exercises that one must do or not do in order to stay healthy. There may be games, songs, dances, prayers, religious customs or meditation to be performed on a regular basis. This is helpful information to know when assessing a patient. A special diet may need to be ordered, and specific clothes may need to be worn in addition to a patient gown. Pastoral care may need to be ordered and at a specific time (Cultural Guide, 2014). I have had Persian patients that I allowed to leave their burka in place for surgery, and Asian patients that preferred warm water over cold. Before surgery I ask if the patient would like pastoral care, what denomination and time frame. The patients are always appreciative of the respect for their culture. In the Chinese culture, Taoism is the philosophical and theoretical foundation of Chinese medicine. According to Tao doctrine, two forces, Yin and Yang, hold innate energy called Chi, and sexual energy, called Jing, in balance. Yin is cold, dark, and feminine while Yang is warm, positive, light, and masculine. An imbalance can be cause by an improper diet or by experiencing strong emotions. A variety of herbs are used for healing purposes and keeping the body balanced. Acupuncture is also used as alternative medicine. How closely the individual identifies with their heritage seems to determine the use or non-use of these practices (Edelman, 2014, p. 36). In the family interview I found that the parents and grandparents were using alternative medicine, but the adult children were not. In the Vietnamese culture, illness can come from spiritual causes. Imbalances of Am and Dong are similar to Yin and Yang, and health maintenance refers to keeping a balance. Soup and tea are part of a daily diet. Doctors are held in high respect and are expected to diagnose and treat illness in one visit. Drawing blood for laboratory tests is feared because belief is that the blood cannot be replace. Surgery is feared for this reason and is a last resort (Health Beliefs, 2011). In the European culture, primary reliance in on Western medicine (modern health care). There are some homeopathic practices observed such as taking cod liver oil daily. Socializing with friends and family with afternoon tea is good for the health and spirit. Dressing warm as to not catch cold is important (Cultural guide, 2014).
Health Protection Health protection is what one must do to protect health. There may be special foods that must be eaten or avoided after certain events, or symbolic clothes to be worn. There may be people that must be avoided or seen, or rituals to be performed. There may be religious customs or superstitions to be considered (Cultural guide, 2014). I have had patients request to have certain people at the bedside for a prayer or ritual before surgery. The patients are always thankful for allowing and respecting their values. In the Chinese culture drinking ginger tea is a means of protecting health and keeping the Yin and Yang in balance. For example, hot energy can be cooled by a cool herbal tea, or cold energy can be warmed by warm herbal tea. The culture also tends to protect their elders from bad news. For example, a son may divert the conversation from initiating a do not resuscitate order to when his father can go home (Chinese health, 2007). In the Vietnamese culture, individuals often combine traditional methods with Western medicine. They will combine massage, steam baths and tiger oil with prescription medications, although, as soon as their symptoms dissipate, they are inclined to stop taking the prescription medication. They feel if the symptoms are gone the illness is as well (Health beliefs, 2011). With this known, it is important to council patients on the importance of finishing prescription medications. In the European culture it is important to get a lot of fresh air to protect health. Dressing warm is important as well. It is believed that drinking brown ale after cleaning a room where someone was ill provides protection from the disease (Cultural guide, 2014).
Health Restoration Health restoration refers to what one does to become healthy after illness. There may be special procedures or remedies to be performed. There may be individuals who are special healers, or there may be rituals or prayers to be considered. In the Chinese culture, the traditional method for curing the common cold is cupping. Glass, plastic, or bamboo cups are heated and placed on the skin of the individuals back. It creates a vacuum which is a type of acupressure. It is also used to treat back, neck, and shoulder pain (Traditional beliefs, 2011). This is important information to know if marks on a patients back are noticed. It could be the result of cupping. In the Vietnamese culture, acupuncture is used to treat a variety of illness and conditions such as muscular pain, headaches, asthma, digestive issues, anxiety, and depression. Tiny needles are inserted into specific points of the body. Acupuncture stimulates healing and energy to the body and mind. It can also be used as preventative health care. Acupuncture has also become popular in Western medication (Traditional beliefs, 2011). In the European culture when one has a fever, mint or chamomile tea is ingested. For cough and congestion, formaldehyde crystals are placed in a plastic bag and placed on the chest. For mumps, hot mustard poultice is applied to the skin. For a nose bleed, a cold key is placed on the persons back, and for general illness, bread cubes in warm sweet milk is served (Cultural guide, 2014).
Common Health Traditions Based on Cultural Heritage My family migrated from Europe and Canada, although I was born and raised in the United States. We enjoy eating Swedish food and praying before our meals. We practice and believe in Western medicine and go routinely to the doctor for preventative checkups. We stay healthy by eating a balanced diet, taking vitamins, and exercising. Understanding one’s own culture and biases will help provide and open mind when considering cultures and beliefs of others (Cultural guide, 2014). In examining Chinese and Vietnamese cultures, I realized the similarities between them. They both believe in the hot and cold balances within the body, and both practice acupressure and cupping. I also see that Americans have used some of their practices. Many Americans use herbs and acupressure or acupuncture for health maintenance and healing. When I was pregnant I used wrist bands that applied pressure to a point on my wrist which reduced my nausea. Also, when I was feeling depressed I took St John’s wort, and I believe it helped. In examining European practices, I realized how similar their beliefs are to Western medicine probably due to immigration from Europe to the United States. My family is from Holland, so some of the same cultural ideas are shared, such as eating bread cubed in warm sweet milk. My mom always make it for me when I was sick and she called it milk toast.
How Families Subscribe to Tradition Families subscribe to tradition by incorporating their beliefs and traditions into their everyday lives. It includes religion, diet, clothing, customs, prayers, meditation, superstitions, and folk remedies. Some families are closely tied to their customs and some adapt and bring in cultures of others to provide the melting pot that we live in today in the United States.
Summary
Assessing cultural values and traditions is important in providing sensitive and effective care. Using tools such as the heritage assessment tool can provide an understanding of how closely tied one is to their heritage. Understanding one’s own cultural beliefs and biases help provide and open mind when considering others. Asking questions in an unbiased manner will earn respect and make patients and family members happy.

References
Cultural Care Guide. (2014, January 1). . Retrieved June 13, 2014, from http://wps.prenhall.com/chet_spector_cultural_7/94/24265/6211875.cw/index.html

Edelman, C., Kudzma, E., & Mandel, C. (2014). Emerging population and Health. Health

promotion throughout the lifespan.
Health Beliefs and Healing Practices. (2011, January 1). . Retrieved June 13, 2014, from http://www.vietfamilyhealth.org/culture/beliefs.html
How Traditional Chinese Health Beliefs and Chinese Culture Influence Health and Illness. (2007, December 31). . Retrieved June 13, 2014, from http://ezinearticles.com/?How- Traditional-Chinese-Health-Beliefs-and-Chinese-Culture-Influence-Health-and-Illness?&id=903741
Traditional Asian Health Beliefs and Healing Practices. (2011, January 1). . Retrieved June 13, 2014, from http://www.dimensionsofculture.com/2010/10/traditional-asian-health-beliefs-healing-practices/