Implications of Religion and Spirituality on the Health Practices

of Mexican Americans Lujan, J. & Campbell, H. B. The role of religion on the health practices of Mexican Americans. (2006). Journal of Religion and Health, 45 (2),183-195.

Dr. Josefina Lujan, Ph.D., R.N.Regional Dean

Texas Tech University Health Sciences Center El Paso

Anita Thigpen Perry School of Nursing

Discuss the origin and role of religion in relation to the health practices of Mexican Americans.

Describe the Hispanic cultural metaparadigms of the conquest, collectivism, famliarismo and personalismo in relation to religion and spirituality of Mexican Americans.

Examine the potential benefits of addressing these clients’ religious needs to offer suggestions on how healthcare providers can provide culturally competent care.

Why is this topic important?• Mission of TTUHSC

• CLAS standards• Growing numbers of Mexican

Americans• 80 to 90% of Mexican Americans are

self-reported Catholics• Greater religiousness with proximity to

border• Transcends generations• External Locus of Control

U. S. – Mexico BorderU. S. – Mexico Border

Majority Minority Priviledge

Eurocentrism

Cultural Competence

• Having the skills, knowledge, and understanding about another culture that allow the healthcare provider to assess and intervene in a culturally appropriate manner.

• Knowledge about a diverse culture means knowing what questions to ask.

Office of Minority Health:

Culturally and Linguistically appropriate standards for Health Care

CLAS Standards

Dimensions of Culture (Purnell & Paulanka)

12 Domains of Culture(Purnell & Paulanka, 2003)

• Inhabited localities, topography• Communication• Family roles and organization• Workforce issues• Biocultural ecology• High-risk behaviors• Nutrition• Pregnancy and childbearing practices• Death rituals• Spirituality• Health care practices• Healthcare practitioners

You and I-

We meet as strangers, each carrying a mystery within us.

I cannot say who you are. I may never know you completely.

But I trust that you are a person in your own right, possessed of a beauty and value that are the Earth’s richest treasures.

So I make this promise to you:

I will impose no identities upon you, but will invite you to become yourself without shame or fear.

I will hold open a space for you in the world and allow your right to fill it with an authentic vocation and purpose. For as long as your search takes, you have my loyalty. Unknown

“

Implications of cultural diversity for healthcare providers

Integration

Adaptation

Perception

Minimization

Defense

Denial

What are the steps for embracing cultural diversity?

•Conquest•Collectivism•Familiarismo •Personalismo

Metaparadigms of Hispanic Culture

Conquest

Collectivism: • Intellectual: humility,• Courage, empathy,• integrity, perseverance,• sense of justice,• Faith in reasoning

Familiarismo

Personalismo

What do you see?

Guidelines for the implementation of cultural competence: Kleinman’s Explanatory Model: 8 Questions“

1. What do you call the problem?

2. What do you think has caused the problem?

3. Why do you think it started when it did?

4. What do you think the sickness does? How does it work?

5. How severe is the sickness? Will it have a short or a long course?

6. What kind of treatment do you think the patient should receive? What are the most important results you hope she receives from this treatment?

7. What are the chief problems the sickness has caused?

8. What do you fear most about the sickness?

Hispanic Values and Health Practices Related to Pediatric Care

•Hot and cold theory of disease•Empacho•Susto•Mal de ojo•Caida de mollera

•Religion or religiousness is the belief in, practice of, or participation in the rituals and activities of an organized religion (Kaye & Raghavan, 2002). •Spirituality is the belief in a higher being or force without mandatory mediation through organized activities (Kaye & Raghavan, 2002)

When is religion most important?

• Childbirth• Chronic illness• Mental health illness• End of life (Berry, 1999)

Specific Health Practices of Mexican Americans in Relation to Religion

•Prayer•Religious artifacts (rosary beads, escapularios, milagros candles) •Pilgrimages•Mandas•Novenas (Prayer)•Last Rites

Milagros

Rosary and Scapular

Mandas or pilgrimages

1. Allows for modification of delivery of care.

2. Establishes rapport with client.3. Allows provider to support client’s

religiousness needs through appropriate referral to clergy or pastoral care in a timely manner.

Benefits of assessing client’s religious status

Helpful Assessment Questions

• Please tell me a little bit about how religion or spirituality affect your health.

• Do you identify with any organized religion?• Do you have a belief system that provides comfort and strength?• How do your religious or spiritual beliefs influence how you care for

yourself?• Who are your support people?• What provides you with strength and hope?• What gives your life meaning and purpose?• How has your life changed since you became ill?• How might we (your health care providers) best address any needs in this

area?

Assessing religious needs across the lifespan

•What concerns do you have about your child’s illness?•How can we help you support your religious practices? (referrals)•What do you think brought or caused your child’s illness?

Instruments for the assessment of religiousness or spirituality

•Index of Core Spiritual Experiences (INSPIRIT)•JAREL Spiritual well-Being Scale•Belief in Divine Intervention Scale

”Thinking is hard work, that is why so few people do it.”Henry Ford

• Ennis (1985) described critical thinking attitudes as dispositions.

• Paul (1990) called them traits of the mind.• Attitudes motivate and justify the use of

cognitive skills.

El Arte de no EnfermarseDr. Dráuzio Varella

University of Pennsylvania Nursing School - 1962

Draw circles of inclusion instead of divisive lines

“Real intelligence is a creative use of knowledge, not merely an

accumulation of facts.”

The border presents the opportunity to discover & understand how and why some of us fight, others accept defeat and still others, who could have done much, choose the path of silent resignation”

(D. Morales, 1997)

No venimos a ver si podemos, sino porque podemos venimos. (B. Nevarez; mi mama)

We are not here to see if we can, it is because we can that we are here.

Gracias