Heritage of the Appalachian and Arab People

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Heritage of the Appalachian and Arab People Assignment

Read chapter 8 and 9 of the class textbook and review the attached Power Point presentation. Once done, answer the following questions;

  1. Give an overview of the Appalachian and Arab heritage related to their healthcare beliefs and mention if there is any similarity in both cultures. Give an example.
  2. How the Appalachian and Arab heritage view the process of death and explain if there is any similarity in any of them?
  3. Explain is there is any similarity in the healthcare beliefs of the Appalachian and Arab heritage with the evidence based nursing care that is provide.

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard title “Week 4 discussion questions”. A minimum of two evidence based references no older than 5 years old besides the class textbook are required. 500 words are required.

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The word document is a example that I need .

Health Heritage and Practices of the Appalachian and Arab People

The health heritage of the Appalachian and Arab people as well as their cultural beliefs have an influence on the delivery of health care especially, as concerns community care. Definitively, the Appalachian people are those found in the Appalachia which is the cultural area along the Appalachian Mountains in the eastern part of the United States (Purnell, 2014). The area runs from western New York State to Mississippi and Alabama including regions such as New York, Ohio, Kentucky and Pennsylvania among others within the defined area (Ibid, 2014). They are basically Germans, Scots-Irish, French, Welsh and English people who settled these regions between the 17th and 19th centuries. A key characteristic of the Appalachian people is that typically, they are white, blue collar workers and often rural folk. Heritage of the Appalachian and Arab People Assignment

Outstanding cultural traits that have influenced communal health care, are their distrust for outsiders which manifests as trust issues. They also have distinct dialects and styles of communication and additionally, the social hierarchy is based on kinship and loyalty is particularly valued within the community (Ibid2, 2014). In terms of communal health, there are difficulties arising from their distrust especially as regards counselling interventions. Therapists who fail to recognize these distinctiveness of culture as compared to the mainstream population, often fail in delivery of such care and thus they must be aware of the differences and utilize acceptable theories and techniques for intervention.

On the other hand, Arabs are identified as people from any of the 22 Arab countries stretching from North Africa to the Arabian Gulf including Libya, Morocco, Syria, Egypt, Iraq, and Yemen among others (Hajaj, 2015). However, contrary to common belief, Turkey and Iran are not Arab countries. Essentially, Arabs are diverse in terms of religion, political standing as well as ethnicity but they have a commonality of understanding the classical Arabic language as formally spoken and printed (Ibid, 2015). In the United States of America, Arabs have substantial numbers in Los Angeles, Detroit, New York and Washington D.C. cities.

In terms of their acculturation, Arabs view discrimination as the greatest barrier with many believing that they are more of a nation in exile than they are immigrants or citizen of America. For this reason, they have often divided loyalties between their home countries and the United States with a common dilemma being the decision as whether to accept or reject assimilation into Western culture and way of life.

In the Arabic culture, mental health is held as most stigmatizing and in particular women fare worse than their male counterparts in that regard (Ibid2, 2015). In general, this group has negative notions and views regarding mental health especially concerning psychiatric and psychological interventions.

A key health practices of the Appalachian people is managing illness by individuals with no medical training and the problem is that effective interventions are hindered. For instance, 70 – 90% of the population are averse to making positive health behavior change such as quitting smoking (Purnell, 2014). For the Arabs, there are misconceptions regarding the causes of illnesses due to the religious and cultural beliefs that view fate as their master rather than being masters of their own fates as Westerners typically do (Hajaj, 2015). As a result, many fail to visit healthcare facilities and when they do there is preference for gender healthcare givers and providers especially among the women. Conclusively, these are both detrimental health practices arising from the cultural aspects of both the Appalachian and Arabic peoples. Heritage of the Appalachian and Arab People Assignment

References

Hajaj, H. (2015).Working with Arab American Clients: A culturally relevant, sensitive, and competent approach. Retrieved fromhttp://www.smchealth.org/sites/main/files/file-attachments/arabamericanpresentationjan2015.pdf

Purnell, L. (2014). Guide to Culturally Competent Health Care. F.A. Davis.

Appalachians
Larry Purnell, PhD, RN, FAAN

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview

Heritage from England, Wales, Scotland, Ireland, France, and Germany
Came to the United States for religious freedom and better economic opportunities
Purposely isolated themselves in the mountains to live and practice their religions as they chose
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview Continued

Appalachia includes 410 counties in 13 states and extends from southern New York to northern Mississippi.
Continuous migration from the country to the city and vice versa
High proportion of aging in Appalachia
Farming, mining, textiles, service industries, etc.
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview Continued

High poverty and unemployment rates
Originally most educated group in America, now some of the least educated due to isolation
Area still lacks infrastructure
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications

Carry over from Elizabethan English
Spellin for spelling
Warsh for wash
Badder for bad
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Ethic of Neutrality

Avoid aggression and assertiveness
Do not interfere with others’ lives
Avoid dominance over others
Avoid arguments and seek agreement
Accept without judging—use few adjectives and adverbs, resulting in less precise description of emotions and thoughts
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications

Sensitive about direct questions and personal issues
Sensitive to hints of criticism. A suggestion may be seen as criticism.
Cordiality precedes information sharing so “sit a spell” and chat before doing business, which is necessary for developing trust
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communication Continued

A few may avoid direct eye contact because it can be perceived as aggression, hostility, or impoliteness
More being than doing oriented, more relaxed culture and being in tune with body rhythms
Be formal with name format until told to do otherwise. Heritage of the Appalachian and Arab People Assignment
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communication Continued

Healthcare provider must be flexible and adaptable
Come early or late for an appointment and still expect to be seen
Family lineage is important
Formality with respect—Miz Florence or Mr. John
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family

Varied decision-making patterns but the more traditional Appalachian family is still primarily patriarchal
Women make decisions about health care and usually carry out the herbal treatments and folk remedies
Women marry at a young age and have larger families than the other white ethnic groups
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Continued

Children are accepted regardless of what they do
Hands-on physical punishment is common
Motherhood increases the status of the woman in the eyes of the community
Take great pride in being independent and doing things for oneself
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Continued

Family rather than the individual is the treatment unit
Having a job is more important than having a prestigious position
Consistent with the ethic of neutrality, alternative lifestyles are accepted, they are just not talked about
Extended family is the norm
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Biocultural Ecology

High incidence of respiratory conditions due to occupations
Increase of parasitic infections due to lack of modern utilities in some areas
High incidence of cancer, otitis media, anemia, obesity, cardiovascular disease, suicide, accidents, SIDS, and mental illness
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

High-Risk Behaviors

Tobacco is a main farming crop in some areas of Appalachia
Smoke at a young age
Alcohol use at a young age—binge drinking
Believe in the mind, body, spirit connection
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Ten Steps in Seeking Health Care

Use self-care practices learned from mother or grandmother
Call mother or grandmother if available
Then trusted female family member, neighbor, or a nurse
Then go to OTCs they saw on TV
Then use a neighbor’s prescription medicine
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Ten Steps in Seeking Health Care Continued

Pharmacist or nurse for advice
Physician or Advanced Practice Nurse
Then to a specialist
Then to the closest tertiary medical center
DO NOT BE JUDGMENTAL, if you want to keep them in the system
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

Food may be synonymous with wealth
Wide variety of meats, do not trim the fat—low-fat wild game is also eaten
Organ meats are common
Bones and bone marrow used for making sauces
Preserve with salt
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

Lots of frying (using lard or bacon grease) and pickling
Anytime is the time to celebrate with food, especially in the rural areas
Many teens have particularly poor health
Status symbol to have instant coffee and snack foods for some
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

Early introduction of solid foods
May feed babies teaspoons of grease to make them healthy and strong
Diet is frequently deficient in Vitamin A, iron, and calcium
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Childbearing Family

Must eat well to have a healthy baby
Do not reach over your head when pregnant to prevent the cord from wrapping around the neck of the fetus
Being frightened by a snake or eating strawberries or citrus can cause the baby to be marked
Use bands around the belly and asafetida bags
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Death Rituals

Must stay with the dying person
Family should not be left alone
Funerals with personal objects at the viewing and buried in their best clothes
May take the deceased for viewing at home
After the funeral there is more food and singing and for some a “wake” to celebrate life
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Death Rituals Continued

Flowers are more important than donations to charity
Particularly good at working through the grieving process
Funeral directors are commonly used for bereavement
Cremation is acceptable and ashes may be saved or dispersed on the “land”
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality

Baptist, Pentecostal, Episcopalian, Jehovah’s Witness, Methodist, Presbyterian
Each church adapts to the community
Most are highly religious even though they do not attend church
Common to attend Sunday and other days
Preacher has a calling to “preach”
Ministers are trained
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality Continued

Meaning in life comes from the family and “living right with God,” which varies by the specific religious sect
Nature is in control—fatalism
Religion and faith is important in a hostile environment
I will be there if the “creek does not rise” or if “God is willing”—fatalism
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices

Good health is due to God’s Will
Self-reliance fosters self-care practices
Family important for health care
May be very ill before a decision is made to see a professional resulting in a more compromised health condition
Direct approaches are frowned upon
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices Continued

Herbal medicines, poultices, and teas are common
See Table 8–1 in the textbook; these practices are still alive and well
Folk medicines used in conjunction with biomedical treatments
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Barriers

Fatalism
Self-reliance
Lack of infrastructure
Health profession shortages
Culture of “being”
Poverty and unemployment
Care not acceptable from outsiders
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Responses to Health and Illness

Take care of our own and accept the person as whole individual
Not mentally ill, the person has “bad nerves” or are “odd turned”
Having a disability with aging is natural and inevitable—if you live long enough
Must establish rapport and trust
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Responses to Health and Illness Continued

Pain is something that is to be endured
Some may be stoical
Pain legitimizes not working or fulfilling one’s responsibilities
Withdraw into self when ill
Culture of being works against rehabilitation
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practitioners

Lay and trained nurses and midwives still provide much of the care in some parts of Appalachia
Breckenridge Frontier Nursing Service
Prefer people known to the family and community —the insider versus outsider concept
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practitioners Continued

Culture of “being” says the healthcare provider should not give the perception of being rushed
Physicians may not be trusted due to outsided-ness, not to being foreign
Must ask the clients what they think is wrong
Heritage of the Appalachian and Arab People Assignment