Patient
Lillian was an 84 year old diagnosed with sickle cell anemia and uncomfortable with the American culture. She went to America from Philippines at a young age of 24 as a bride of war. She married a Caucasian American and became a neutralized citizen and according to her, she was a Filipino. Having lived in America for many years, she assumes some American traditions and continues to practice Filipino traditions. Philippines fall under the Asian culture, which includes many races with a variety of illness and health beliefs. She has a problem with the Asian culture because some of the Asian generalized beliefs differ with Filipino culture. This culture was undergoing evaluation for illness and health beliefs as an Asian group of people. She saw inclusion of Filipino culture rarely.
Family
The Filipino culture had strong beliefs in family, which cared for their children. Children were required to respect and obey their parents. Filipino parents always set rules for their children, which the children had to obey and follow them strictly. Although children were required to obey the rules, they would disobey the rules during adolescent and argue with the parents because of rules mixed with adolescent autonomy (Darling, 2005). Such are the frustrations that affect the family because of culture and Lillian was a victim of such. There are things concerning her health that she could have done better and helpful than following the Asian culture. Health maintenance was a family’s responsibility and not an individual.
Problems
Health in Filipino culture had its base as balance and harmony principle. Balance resulted to health while imbalance resulted to illness (Becker, 2003). Main problems include nutrition and metabolism, activity and exercise, elimination as well as sleep and rest. People from Filipino had beliefs about cold, hot, and believed that warming the body promoted health while rapid changes from hot to cold brought diseases and illness (Becker, 2003). The Filipino culture considered cancer as the cause of overheating the body therefore rapid cooling causes illness and other related diseases (McBride, 2001). In a study conducted by Becker, Filipino people felt the responsibility to the family rather than individual responsibility. It was therefore notable that Filipinos would seek medical attention when needed and follow treatment plans medically. This was the problem and required her practice some culture she did not want.
Patient’s culture
As a culture within a setting, Asian people practicing the Asian culture do many things to restore, maintain and protect health. The practices of moxibustion, herbal and acupuncture remedies were incorporated with the Asian culture. In order for her to get well, she had to undergo the remedies and many more (Spector, 2004). Prayers were also inclusive as well as massage and rituals. The cultures made her have beliefs that after massage and prayers, she could heal and relieve pain.
Her national culture, which is Filipino, maintained that in order to develop a good health, one has to eat a balanced diet and refusing to eat some, food presented to her from another home appeared to be abusive and shameful to the host. In this context, the host observes the Asian culture. Filipinos also did exercises like walking and swimming to maintain health. Medical culture noted bodily awareness as an important aspect in health maintenance. Her awareness of the body helped maintain the body balance thus better recovery from the cancer ailment.
Functional health pattern
Nutrition and metabolism focused on the pattern of food and water consumption relating to metabolic need. Most of her problems related to fluid balance, host defense and tissue integrity. She also had problems with gastrointestinal system. Elimination data collection concentrated on excretory patterns like bowel, skin and bladder. Lillian had problems with incontinence constipation, urinary retention and diarrhea stained with blood. Activity and exercise focused on activities requiring energy in the daily adventure including walking. Sleep and rest focused on how Lillian slept and her relaxation practices. She preferred resting on bed and she slept for more hours than she did keep awake.
Nursing interventions and rationale
In nursing diagnosis, deficient knowledge about sickle cell anemia, self-care, treatment and genetic factors related to the resources of the disease. As an intervention, I observed the patient’s ability and readiness to learn about the disease. The rationale was for assessment and knowing the intervention extent, which I can say, worked well. I assessed barriers to learning where the patient brought to learning situation a personality of her own as a rationale. I determined client’s previous knowledge about her illness and her willingness to learn new things. As a rationale, there was assimilation of new information into the previous assumptions due to her culture and lastly involved the patient in writing specific outcomes for the lessons. The rationale was client involvement to improve compliance with health regimen and make learning and teaching a partnership.
Evaluation
My goals were met but only short term ones, because after I left the patient she continued with the previous culture practices to avoid rejection and shame to the family. My interventions worked but only for a short time again because of cultural practices regarding health.
Resources
Bhungalia, S. & Kemp, C. (2002). Asian Indian health beliefs and practices related to the end of life.Journal of Hospice and Palliative Nursing, 4, 54-58.
Doorenbos, A. Z. & Nies, M. A. (2003). The use of advanced directives in a population of Asian Indian Hindus. Journal of Transcultural Nursing, 14, 17-24.
Leuning, C. J., Swiggum, P. D., Wiegert, H. M. B., & McCullough-Zander, K. (2002). Proposed standards for transcultural nursing. Journal of Transcultural Nursing, 13, 40-46.
Maier-Lorentz, M. M. (2008). Transcultural nursing: Its importance in nursing practice. Journal of Cultural Diversity, 15, 37-43.
Purnell, L. D. & Paulanka, B. J. (2003). Transcultural health care: A culturally competent approach. Philadelphia: F. A. Davis Company.
