Heritage Assessment
The Heritage Assessment is a useful tool that can be used to understand the diversity of individuals that are routinely cared for in different regions where local health care facilities are operated. As stated in one dictionary, Heritage is defined as “Valued objects and qualities such as cultural traditions, unspoiled countryside, and historic buildings that have been passed down from previous generations” (Oxford, 2014). Along with heritage, “culture is the sum of total of the learned behavior of a group of people that are generally considered to be the tradition of that people and are transmitted from generation to generation” (Hofstede, 1997). These two when associated with Assessment, which is defined as “the evaluation or estimation of the nature, quality, or ability of someone or something” (Oxford, 2014), forge the ability to create part of a Patient Care Plan. Being in the Health Care profession we must try to identify our patient’s culture or heritage preferences, along with understanding our own to better serve our patient’s.
Though not perfect, as described above, the Heritage Assessment tool is used along with close observation, to assist in learning of ones heritage. Using this tool which “consists of twenty-nine questions aimed at providing an understanding of ones connection with their heritage and level of involvement in cultural and religious practices. The more the individual answers yes to the questions, the more they identify themselves with their heritage” (Spector, 2009). This author found that the use of this tool was friendly to both the interviewer and interviewee. The simplicity, though sensitive in nature, questions asked gave the interviewer only basic information of family history, compiled gave a more complex understanding of the journey that person’s family made to today. The benefit to the health care professional can give weight to the decisions he/she should make when discussing treatment or care they may receive. One’s family and background can also dictate how close in the decision making or involvement their family may or may want to play.
A major component of the Heritage Assessment Tool asks about what “language the person receiving care is preferred” (Spector, 2009). Even though one may speak in English, very well, in times of stress or illness, that same patient may feel more comfortable speaking to someone in their native tongue. This can also be said if their spouse speaks a different language and would be able to have both listen at once. At times though this can be challenging to have the patient spoken to in the requested language, due to the unavailability of interrupters, but, every effort should be made to explain that to the patient and their family members.
Another, very important and serious component is to consider ones religious views. Certain beliefs need to be considered as soon as an illness or injury occurs. This religious consideration can last from that moment to the end of treatment and beyond. Even though we believe that religion, in a lot of cases is considered when the patient has a dire outcome predicted. Those cases a clergyman, priest, rabbi, etc. is usually summoned. But the knowledge of this comes as treatment is started. For example; some religions do not accept the transfusion of blood from another human, this may be expressed and a whole different plan of treatment must then be enacted.
The cultural component of the Heritage Assessment Tool, can have as much meaning as the language and religious beliefs. A cultural association may outweigh the two discussed above. There are many different Native American communities where this author lives and works. In the southwest of the United States, these groups of Native Americans have ancestral lines that have crossed, along with religious, language, and experiences. One patient may have a distinct facial and physical features of one group and speak a different dialect and have a different religious belief. That being said, it is extremely important that the correct information and understanding of the patient is known. Great lengths should be taken to get this accurate.
The culmination of the above components is balanced and represented by the patients spouse and family/friends he/she stays in contact with on a daily basis. If one does not associate with or keep in contact with parents, aunts, uncles, cousins, etc., then the influence may only come from that very small group that the patient surrounds themselves with. A person may be born of one race and have lost most or all ties to that group. If that would occur, that individual then adopts the culture that he/she surrounds themselves with. The religion, accent (speech), mannerisms would be expected to represent one way, now manifest themselves another way.
The three individuals that were interviewed shared some characteristics of the author. This was not surprising due to the area of Arizona where all reside. All showed a belief in a higher being, and all shared a strong relationship with their family and the love for their communities. This author lives in Tucson, AZ where there is a strong Hispanic influence. In new comprised data “According to the 2010 Census data, approximately 25-30 percent self-identified as belonging to a racial or ethnic minority group. Incredible demographic changes are visible around the nation as racial and ethnic minorities are among the fastest growing of all of our communities. It is projected that, by 2050, almost 50 percent of the population will be non-White” (Cross Cultural Health care Program, 2014). That surprising number is nationwide, is not that different than what comes through doors, of where this author works.
The first person this author interviewed, was from the south western part of the Tohono O’odham Nation Indian Reservation. The community is located approximately 10 miles north of the Mexican border. “The primary language spoken is English, in most conversations had throughout the day. The primary language spoken when I go back home and with family (not including spouse who does not speak O’odham) is O’odham” (Family I, October 7, 2014). “I had grown up with a strong catholic upbringing, but don’t follow as closely as intended, even though much of my healing beliefs are associated with prayer” (Family I, October 7, 2014). Family I, appeared to be comfortable in his beliefs and place in life, it was the impression of the author that if alone or with his spouse during a need for treatment that he would be comfortable with quality care and no special needs. Family I, stated that he was taught to “take what the land and god will give you, and your success will depend on what you do with it” (Family I, October 7, 2014).
The second was born and breed in the United States, of Mexican/Spanish descent, growing up in California and then Tucson. She only had one side of her family that had been born in Mexico. Family II stated, “I have a huge family that is cut in half by Tucson and southern California” (Family II, October 6, 2014). During the interview process there was a strong understanding on how religious she is. The Catholic Church had a strong influence on her weekly life and raising of her children and grandchildren. She also described how holistic medicine suited her more than over the counter medication. She even at one point referenced a Curandero (Mexican witch doctor). She had showed me a shelved area with numerous Ziploc bags and various containers and a dozen or so candles. She stated “This is my medicina (medicine)” (Family II, October 6, 2014).
The last interviewed was relocated to Arizona for work. He is dedicated to his family and is compassionate to his wife for leaving her family and making a new life in Tucson. His answer to keeping himself and his family healthy revolved around scheduled doctor and dental visits. Taking prescribed medication, and over the counter as well as Eating right and exercising. He did elude to any “Old Wives Tales”, or really had a positive or negative response to health care in general. He seemed to have faith in the current health care system, though he stated “I know the health care system is not perfect, but my job is to limit the visits my family or I must make” (Family III, October 10, 2014).
In conclusion, the three families interviewed seemed to take responsibility of their own health and that of their families. The common thread was faith in all experiences that were handed down to them or acquired as becoming adults and starting their own families. All three families validated their stance and commitment to health maintenance, health protection and restoration, by taking part in their family’s health care plan, and laying out those three principles without fully knowing when they were maintaining, protecting or restoring their immediate or future health issues. References
Hofstede, G. (1997). Cultures and Organizations: Software of the mind. New York: McGraw Hill. Retrieved from http://www.tamu.edu/faculty/choudhury/culture.html
Oxford. (2014). Heritage. Oxford Dictionary. Retrieved from http://www.oxforddictinaries.com/us/definition/american_english/heritage
Spector, R. E. (2000). Cultural Diversity in health and illness (5th Ed.). Upper Saddle River, NJ: Prentice Hall. Retrieved from http://wps.prenhall.com/chet_spector_cultural_7/94/24265/6211875.cw/index.html