Research Proposal on "African-American Population"

>

Not surprisingly, there is now a growing number of blacks coming into the United States as African immigrants and as of 2000, more than 880,000 Africans have arrived from countries like Nigeria, Somalia and the Sudan. Therefore, with these facts in mind, the health care needs of a growing number of black Americans, both naturally born in the U.S. And as naturalized citizens, are now influenced by a wide variety of traditional beliefs and practices brought from Africa related to ancient rituals, folklore, healing practices and spiritual personal health, all of which have only increased the difficulty in providing medically-proven techniques set against a number of cultural barriers based on superstition and the alleged spiritual power of long-dead ancestors (Spector, 2008, 261).

BACKGROUND INFORMATION:

Despite the fact that most African-Americans are now fully integrated into American culture via Westernized ideals, principles and behaviors, there still remains a large group that communicates with each other and within a family environment through deep-seated cultural identities-based mostly upon language and speech patterns left over from pre-slavery times. Of course, almost all African-Americans speak English, with the exception of individuals recently arrived from Africa who still speak their native languages and dialects which in a health care/nursing environment can cause problems related to communication between the patient and the caregiver. Veronica Duncan notes that this problem is especially prevalent with black males who possess "a culturally-induced vulnerability" which causes them to be very wary of opening themselves to outsiders (2005, 134). In one of her studies on this phenomenon, Duncan

discovered that African-American men are not comfortable with disclosing their inner feelings and desires to strangers; in fact, some of them find this to be downright unacceptable which can led to verbal and physical aggression (2005, 154). Duncan also discovered that some black males and a small number of females are often not open to compromise (2005, 157). Thus, it is clear that these culturally-influenced traits may make it difficult to provide adequate health care to some African-Americans, especially when they refuse to reveal exactly what is troubling them as it relates to an illness or disease.

Influence of Beliefs:

As to the influence of health-related beliefs and practices, African-Americans do not seem to be much different from other ethnic groups that originated outside of America and became part of it in the late 17th and early 18th centuries. As Spector relates, African beliefs concerning life and the nature of being a human person are based solely on ancient tribal customs and superstitions. For example, when a person is healthy, this means that the person is in harmony with the natural world; in contrast, illness is a state of disharmony. Thus, health is not just physical in nature but is a conglomerate of the mind, the body and the spirit (2008, 264).

Since illness is seen as a disharmonious state, Africans (and many modern-day African-Americans) attribute it to the presence of demons and malevolent spirits which must be removed if health is to be attained and maintained. In order to accomplish this, Africans traditionally employ voodoo or some other type of superstition-based remedy under the guidance of a healer, almost always a woman, who possesses wide-ranging knowledge on the use of herbs and other naturally-occurring plants to treat various afflictions of the body and the mind (Spector, 2008,

264). Of course, these and other beliefs and practices may cause a number of problems for caregivers, physicians and nurses, due to some African-Americans remaining steadfast and loyal to the ancient practices of their African heritage.

Barrier Factors:

Some of the barrier factors that are closely linked to these and other superstitious beliefs and practices from a nursing standpoint include unintentional insults related to not understanding the cultural background of a particular patient; a feeling that as a patient, he/she is nothing more than material or a source of experimentation, even when seeking medical assistance and care in a hospital setting or a private clinic; utilizing home-based medicinal remedies handed down through the generations which in effect may cause more harm than good; and lastly, some African-American patients may view their caregivers/nurses as inadequate for providing their health care needs, meaning that they see traditional healers as more knowledgeable and capable, due to being from the same cultural/African background (Spector, 2008, 275-276).

Ethical Dilemma:

As to a prominent ethical dilemma related to the delivery of adequate health care for African-Americans, there is a growing population of blacks in today's America who practice Islam, one of the three major world religions and based on what is known as the Five Pillars of Islam and the teachings of the prophet Muhammad. Within the strict Muslim lifestyle, a practicing Muslim is forbidden to eat or consume anything containing pork; thus, if a black

American Muslim requires insulin as a result of having diabetes, the caregiver/nurse must be made aware of this situation and have the foresight to administer insulin that is not pork-based nor made from the pancreas of a pig which Muslims consider as unclean (Spector, 2008, 272).

ANALYSIS OF THE CULTURE:

THE GIGER-DAVIDHIZER TRANSCULTURAL ASSESSMENT MODEL:

Often referred to as the "Great Melting Pot," the United States is currently composed of a combination of various cultures and ethnicities, many of which possess their own distinctive beliefs and practices handed down through the generations. As a result, today's American health care systems must understand and appreciate these beliefs and practices when it comes to providing health care to these often divergent cultures. One important consequence related to failing to understand these beliefs and practices is that certain ethnic/cultural groups, especially African-Americans, may not receive proper health care. Thus, in order to address this seemingly growing problem, we will examine what is known as the Giger-Davidhizer Transcultural Assessment Model which utilizes six specific criteria that allows nurses and physicians to provide proper transcultural assessment and care. As will become apparent, the importance of this model for professional nurses is that it allows them to understand the differences related to health issues in divergent cultures and how to apply specific knowledge and information for optimized health care.

The first criteria of the Giger-Davidhizar assessment model is communication which covers both verbal and physical body language. For example, if a nurse is unable to effectively communicate with a patient, particularly if the patient is of a different ethnic group, then it would be almost impossible to understand exactly what the patient requires related to an illness or its symptoms. One way of overcoming this problem, outside of learning to speak the native tongue of such a patient, is to understand how different cultures communicate with each other without using language. In this respect, it could be something as simple as physical touching or a type of gesture that tells the patient that the nurse or physician understands his/her ailment and the possible pain associated with it, or it could be eye contact. However, a nurse must be extremely careful when applying any type of touching or gesture, due to the fact that people from certain cultures outside of the U.S. may be offended. Thus, every practicing nurse must clearly understand these and other types of communicative expressions in order to effectively assist patients from different cultural backgrounds (Transcultural Nursing, 2004, pg. #?)

The second criteria is space as it relates to personal physical space. For instance, within some cultures, the physical space between two people is very important, meaning that people from certain cultures find it uncomfortable to be placed in a position of close physical contact with another person.… READ MORE