Heritage Sways Healthcare Perception
Cynthia K. Martin
Grand Canyon University: NRS 429V Family Centered Health Promotion
November 09, 2013 Cultural beliefs are the foundation of an individual, families, and communities that

persuasively influences the standards by which they reason and behave in every aspect of their

life. Therefore, as healthcare providers, it is imperative that we consider a patient’s cultural

heritage when assessing them from a holistic approach and planning for a desirable healthcare

outcome. Madeliene Leininger brought to the forefront the concept of transcultural nursing

which was founded on “the belief that optimal health for all is an essential cultural value”

(Edelman & Mandle, 2010) and further declared that “our rapidly growing multicultural

world makes it imperative that nurses understand different cultures to work and function

effectively with people having different values, beliefs, and ideas about nursing, health, caring,

wellness, illness, death and disabilities” (Edelman & Mandle, 2010).

The Heritage Assessment Tool

The Heritage Assessment Tool is useful for gaining understanding of the patient in regard

to how intricately they are ingrained in their culture and sets the stage for determining how they

perceive health maintenance, health protection, and health restoration through open ended

questions. This tool not only affords a course by which communication of beliefs, values,

tradition, and personal preferences can be obtained for the usefulness of planning the patient’s

care, but consequently prepares a reciprocal pathway for building a trusting relationship between

the patient and family, and the nurse. Inadvertently, the Heritage Assessment Tool allows for

an increase in the nurse’s knowledge of diversity of cultures which can only be a positive

development of their professional career and, in turn, corroborate the care of other patients of the

same culture in the future. This paper will analyze the findings of three different cultural

assessments, American from the south, Hispanic and Asian (East Indian from Goa with

Portuguese influences), when using the Heritage Assessment Tool (Spector, 2000) and open-

ended questions focused on perceptions of health maintenance, health protection, and health

restoration.

Health Maintenance Perception of Three Different Cultures

The Hispanic family interviewed incorporated cultural influences from Honduras

and El Salvador. When questioning their perceived ability to maintain the health of their

family, they verbalized the need to eat organic fresh foods, bought from local markets or farms.

In Honduras, the dad remembers most of their meat being bought from local farms and the fruit

and vegetables from markets called "mercados" where farmers sold fresh produce in season, and

currently they continue to maintain a similar diet when at all possible. They also talked about the

necessity to maintain regular exercise habits and that here in America it must be planned. “In

Honduras, most people were poor and couldn’t afford cars, so they walked or rode their bikes

everywhere which increases health” (J. Valladares, personal communication, November 6,

2013). The mother was raised in America but conferred with her husband in health maintenance

perception, was raised by these standards, and continues them for her family as they maintain an

ethnic diet.

The Asian mother that I interviewed was East indian from Goa, a Portuguese

colony. At age 29, she married an American and moved to the United States with her mother and

her husband. She talked about the need for regular exercise which she gets by walking two hours

daily with her mom and a diet that is healthy in fresh foods cooked in healthy ways as a means to

maintain health. Her mom, who lives with them, cooks ethnic food, but Sweat is “trying to learn

American cooking, but in healthy ways” (P. Sweat, personal communication, November, 6,

2013).

The American culture my family was raised in was from southern influence and

farmers. We love all the deep fried food options which I occasionally indulge in, but we were

also raised with a value placed on health maintenance through a diet of fresh garden options and

daily exercise. We have chosen to continue the healthy aspect of our culture, through gardening,

purchasing from local farmers markets and organic in local grocery stores, and eating very little

processed food, sugar, or fried foods. Regular exercise through outside activities like hiking,

biking or walks to the park is also followed. We primarily eat at home and at the table together,

essential to our tradition.

Health Protection Perception of Three Different Cultures

The Hispanic family verbalized the a belief in the ability to protect their health by

taking care of themselves. They reiterated that eating healthy by staying away from processed

foods and regular exercise were inherent for protecting the health of their family. They also

discussed the need for going to the doctor for well-checks, regular screening, and staying

current on vaccination. In Honduras it was not a practice to go to regular doctor visits, but they

were vaccinated in school by nurses. Home remedies are also used like chamomile teas made

from fresh herbs to make the stomach strong and teas made with hierba buena, translated to

“good herb”, are used for overall health. According to Valladares, these teas are used daily to

“protect health overall” (personal communication, November 6, 2013).

Similarly, the Asian family from East India spoke about the measures taken by the

family for health protection. Regular well-checks for their child, as well as, dental and health

screenings and vaccinations schedules are maintained. As it is common in East Indian culture,

they use homeopathic herbs for making teas to protect the health of their family. An example of

this is use of fenugreek which is “soaked in water over night and then the brew that it makes is

added to hot water to make a tea that is used for increasing her breast milk supply (she is

currently breastfeeding), weight loss, strong stomach, and helps you be healthy overall” as

voiced by Sweat, (personal communication, November 6, 2013). They also sprout it and make it

into breads. She further stated that “knowledge is given by God, so we will use the doctors and

the herbs as a benefit” for health protection (P. Sweat, personal communication, November 6,

2013).

Health protection in our American family, resembling the first two families, is done

through regular health checks, dental checks and health screenings, as well as staying with

the recommended vaccination schedule. Similarly, we pursue a healthy diet as stated above,

and, likewise, incorporate herbs and essential oils, i.e., fresh oregano in smoothies and while

cooking for healthy immune system and cilantro used the same way for it is known to attach to

toxins and flush them out of the body, to name a few. We also blend green smoothies with all

kinds of seasonal vegetables and fruits for at least one meal daily, mainly for breakfast.

Health Restoration Perception of Three Different Cultures

Now, when discussing restoration of health, the Hispanic family talked about

starting with herbal remedies first. Valladares shared about how he calls his mom and

grandma when he can’t remember what is the exact mix is for a remedy, i.e., “two drops of

oregano oil mixed in boiling water, then a tent is formed over it and the steam is inhaled for

treatment of sinus infections” (personal communication, November 6, 2013). “Much of this was

learned from homeopathic doctors in Honduras who were poor and couldn’t get their MD

through education, yet were their neighbors and practiced in their homes for those who couldn’t

afford to go to the doctor”, as attested by Valladares (personal communication, November 6,

2013). If these remedies don’t work, then we go to the doctor for care.

The practice for health restoration of the Asian family followed a comparable

pathway to the Hispanic family, but her mom lives with her and automatically gets the

right herb out for the ailment; it’s a way of life. She continually learns from her mother, but

knows many of the homeopathic remedies because she was 29 years old when she immigrated to

the United States. More profound was the trust she put in God as Sweat articulated, “ I pray for

them first, then take them to the doctor. I pray that God directs us to the right doctor and uses

their hands to bring healing. I pray also for wisdom for that doctor. God is the Great Physician; I

trust Him” (personal communication, November 6, 2013).

In conformity with the other two families, we as the Americans use herbal remedies

first, but rely on my friend who is knowledgable in homeopathic treatments. Conventional

medicine is, likewise, the next physical step to health restoration. Foremost, though, parallel to

the statement made by the Sweat, we above all trust God as the Great Physician, and trust His

direction as we seek homeopathic or conventional treatment. We confer that He is the author of

all wisdom and knowledge, recognizing that it all originates from Him and our lives are truly in

His hands as declared in Psalm 139:16b. In the event of third stage breast cancer, conventional

treatment was rigorously followed, incorporated with prayer. He was the One who truly brought

healing and all the physicians involved were amazed that it disappeared. I proclaimed, “God is

truly amazing!”

Heritage Summary

Using the Heritage Assessment Tool was valuable to the understanding of each family as

a foundation to inquiry of their health perceptions in regard to maintenance, protection, and

restoration. It brings to light how deep patients and their families are seated in cultural norms or

how much they have acculturated into this society’s norms, therefore, effecting health

perceptions. Some things found can be surprising, therefore, the need to individualize our care of

patients becomes more apparent. The requisite point that we should follow as health care

professional is to avoid an ethnocentric perspective, “which views other ways as inferior”, as

stated by Edelman, (2010), and instead, interfuse the holistic and the conventional health care for

optimization of ethnic Americans.

References

Edelman, C. L., Mandle, C. (2010). Health Promotion Throughout the Life Span (7th ed, p. 32-33). St Louis: Mosby, Inc. Retrieved from http://pageburstls.elservier.com/ books/9789323056625/id/B97803230566200024_p0380
Spector, R. E.(2000). CulturalCare: Guide to heritage assessment and health traditions (5th ed.). Pearson Education/PH College. Retrieved from wps.prenhall.com/wps/media/ objects/663/679611/box_6_1.pdf

-----------------------

2