Delivery of health care from the Haitian and Iranian population.

Delivery of health care from the Haitian and Iranian population.

Delivery of health care from the Haitian and Iranian population.

 review the attached Power Point presentations.  Chapter 32 contents can be found in Davis Plus Online Website.  Once done answer the following questions;

1.  Discuss the cultural beliefs related to delivery of health care from the Haitian and Iranian population.

2.  Discuss any differences and/or similarities in the delivery of health care in both culture. Delivery of health care from the Haitian and Iranian population.

3.  How religious beliefs influence the delivery of health care in both.  Give at least one example.

As stated in the syllabus and instructed here, please present the assignment in a word document Arial 12 font   A minimum of 3 evidence based references .  Please follow  APA  format. A minimum of 500 words excluding the first and references page are required.

If you have any questions and/or concern please contact me via email.

Due date:   October 19, 2017

  • attachment

    Ch32.ppt
  • attachment

    Ch15.ppt

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

Copyright © 2013 F.A. Davis Company

Iranian

Larry Purnell, PhD, RN, FAAN

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition Delivery of health care from the Haitian and Iranian population.

Overview/Heritage

  • Over 400,000 in the United States with about ½ living in California
  • Currently about 76 million in Iran with 75% under the age of 30
  • Much diversity in Iran (Persia) among its inhabitants and also much diversity among Iranians in the United States. Delivery of health care from the Haitian and Iranian population.

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

Overview/Heritage Continued

  • The reform institutions of current Iran are colored by religious traditions and ideology of Islam.
  • Current industrialization of Iran has been from the outside, not from the inside and is due to the oil production industry.
  • Political instability continues with clashes between conservatives and liberals.

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

Overview/Heritage Continued

  • First wave of immigration between 1950 and 1970 were mostly students and professionals from the social elite and many stayed in the United States.
  • Second wave between 1970 and 1978 were varied in their background, but most were still affluent and urban and came for education and to be with family.

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

Overview/Heritage Continued

  • Not a major influence in the United States because they did not live in ethnic enclaves and assimilated into the United States culture easily
  • The third wave of immigration began in 1979 at the time of the Islamic revolution and included voluntary and involuntary political exiles and others who come for economic and personal security. Delivery of health care from the Haitian and Iranian population.

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

Overview/Heritage Continued

  • The hostage crisis between 1979 and 1981 increased ethnic tension of Iranians in the United States
  • Many are unable to find work in the United States that is compatible with their education in Iran
  • Most highly educated immigrant group in the United States. Delivery of health care from the Haitian and Iranian population.

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

Communications

  • Farsi (Persian) is the national language of Iran but half speak another language with the educated group speaking three or more languages, including English
  • Invasions by numerous other nations have caused a mistrust and suspicion of foreigners resulting in not sharing one’s feeling with strangers

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

Communications Continued

  • Tell stories rather than being blunt and to the point in conversations leading to politeness and sometimes disguised as modesty
  • Hierarchical relationships dictate politeness and social communication resulting in a public self and a personal self

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

Communications Continued

  • Family affairs remain within the family
  • Self-control is valued and therefore do not show anger or emotions
  • Men can show affection for men and women for women in public, but not men and women
  • Stand close in conversations, regardless of social status between conversants

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

Communications Continued

  • Maintain intense eye contact between intimates, but avoid eye contact with superiors and elders
  • Expressive gesturing
  • Balance in temporality
  • Clock time is meaningless, even with appointments unless well acculturated

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

Communications Continued

  • Formality in addressing each other unless close friends
  • More traditional men do not mention their wives’ names in public
  • Man should wait for woman to extend her hand for a greeting

*Delivery of health care from the Haitian and Iranian population.

 

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

Name Format

  • Order of the name is the same as the Western method with the given name followed by the surname.
  • Traditional women do not take their husband’s last name although some in the United States and elsewhere may upon immigration.

 

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

Family Roles

  • Society is patriarchal and hierarchical
  • Oldest son takes over if father is not present or unable to carry out decision-making
  • Male children are more desirable than female children—true in other cultures as well

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

Family Roles Continued

  • Men deal with finance and matters outside the home.
  • Women care for the home and children.
  • Before 1960s social reform, women were legally expected to be obedient and submissive to their husbands.

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

Family Roles Continued

  • Marry early and have children. New law says women cannot marry until age 14—was 12 and marriages may still be arranged, but less so in the United States
  • Respect elders and never speak rudely to them
  • Children rarely left with babysitters

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

Family Roles Continued

  • Traditional do not allow dating; women are expected to remain virgins until married, but not men
  • Strong intergenerational ties and family life together or nearby
  • May dress conservatively outside the home but less so while at home

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

Family Roles Continued

  • Divorce uncommon in Iran and carries a stigma—if divorce, it is the woman’s fault, never the man’s—varies in the United States
  • Pregnancy before marriage can have devastating outcomes and is not talked about, it does not happen—it is just taken care of
  • Gay and lesbianism highly stigmatized and is a capital crime punishable by death in Iran

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

Biocultural Ecology

  • Wide variations in skin color, hair color, and eye color and depends on heritage from previous domination by other countries and cultures
  • Common illnesses in Iran include malaria, hypertension, meningitis, hookworms, and parasitosis

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

Biocultural Ecology Continued

  • Great numbers with genetic disorders brought on by close sanguinity marriages resulting in blindness, epilepsy, anemias, hemophilias
  • Glucose-6-phosphate dehydrogenase deficiency —fava bean allergies can cause hemolytic crisis

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

Nutrition

  • Food is a symbol of hospitality; serve the best food for guests who are expected to eat several servings.
  • Polite to refuse snacks and beverages when first offered—accept it on the third offering
  • Rarely eat fast food; fresh food is greatly preferred, and many hours are spent preparing meals

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

Nutrition Continued

  • Strict Muslims avoid pork and alcohol and meat must be prepared with ritual slaughter called halal.
  • Food should be eaten with the right hand (clean hand) and food should be passed with the right hand or both hands.
  • Traditional prefer family to bring food from home if hospitalized.

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Delivery of health care from the Haitian and Iranian population.

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

Nutrition Continued

  • Balance food between garm (hot) and sard (cold) —if balance does not occur, one may become “chilled” or “overheated.”
  • Women are more susceptible to these conditions than are men.
  • Newer immigrants may have protein and vitamin deficiencies.

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

Childbearing Family

  • Menstruating women are not allowed to touch holy objects, have intercourse, exercise, or shower.
  • Iran is changing from openly discouraging birth control to now cautiously and secretly encouraging birth control because of the population explosion.

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

Childbearing Family Continued

  • Cravings must be satisfied because the fetus needs the craved food
  • Avoid fried foods or foods that cause gas
  • Eat lots of fruits and vegetables
  • Balance garm and sard foods
  • Pregnant woman should not work after the sixth month

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

Childbearing Family Continued

  • The father should not be present at birth in the traditional family
  • 30- to 40-day postpartum period where other women are to care for the new mother
  • Ritual bath after this period so religious obligations can continue
  • Eat different foods if a boy baby versus girl baby
  • Eat an herbal extract (taranjebin) to have a boy

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

Death Rituals

  • Okay to begin life support, but usually not okay to end life support
  • Multiple family members come to bedside of the dying person and recite/read prayers
  • Bed should be turned to face Mecca
  • More traditional want to return to Iran to die

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

Death Rituals Continued

  • Even though death is seen as a beginning, not an end, mourning and grief are displayed openly and even dramatically to encourage letting go
  • After death, relatives and friends gather on days 3, 7, and 40 to pray and grieve with family and friends

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Delivery of health care from the Haitian and Iranian population.

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

Death Rituals Continued

  • All wear black for mourning and women should not wear makeup
  • On the anniversary of the death, family and friends again gather to express grief and pay respect to their loved one

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

Death Rituals Continued

  • Ritual body washing by another Muslim after death and dressed in a white shroud; body orifices stuffed with cotton and ritual prayers said during the cleansing
  • If non-Muslim, touch the body only with gloves
  • No embalming in Iran nor is cremation practiced

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

Spirituality

  • Specific Muslim practices include praying 5 times each day and need privacy and ritual washing before prayer
  • During Ramadan, fasting from sunup to sundown unless pregnant or ill
  • Family relationships and friendships are primary sources of strength

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

Spirituality Continued

  • Sadness is valued and a sad person is considered to be deep, thoughtful, and sensitive
  • God’s Will and power over one’s fate fosters passivity and dependence

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

ClickerCheck

A 76 year old Iranian, Muslim male is in the process of dying after a long debilitating illness. The nurse would

Have his Imam visit.

Make sure no one touches him with bare hands.

Turn him to face Mecca.

Place him in a supine position.

 

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

Correct Answer

Correct answer: C

At the time of death, the dying person should be positioned to face Mecca. This can be accomplished by moving the bed or at a minimum of turning the patient’s face towards Mecca.

Delivery of health care from the Haitian and Iranian population.

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

Healthcare Practices

  • Combination of humoral medicine, Islam, and biomedical practices
  • Humoral medicine—illness is caused from an imbalance in wet and dry and hot and cold forces
  • Sacred men are able to heal
  • Evil eye is alive and well

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

Healthcare Practices Continued

  • Good health is a daily way of life
  • Seek care immediately and shop around for the right treatment
  • Use traditional herbs and over-the-counter medicine to relieve symptoms and seek care provider to determine the cure
  • Able to purchase a wide variety of drugs over-the-counter in Iran and bring them to the United States

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

Healthcare Practices Continued

  • Narahati—general term to express unpleasant emotional or physical illnesses and somatization is common and accepted and can be treated religiously or medically, depending on what the cause might be
  • Ghalbam gerefteh—distress of the heart—is an expression of emotional turmoil or homesickness

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

Healthcare Practices Continued

  • Various remedies for the evil eye and dependent on the age and family of the person afflicted
  • Language can be a barrier to care for some
  • Descriptions of conditions may be different from the US description
  • Many do not have health insurance

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

Healthcare Practices Continued

  • Concept of insurance may not be known to some
  • Usually very expressive with pain and discomfort
  • Mental illness is highly stigmatized and may hinder other family members from marriage
  • Prefer drugs, the stronger the better, and prefer IV over IM, and IM over pills
  • The more invasive, the better

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

Healthcare Practitioners

  • Organ donations and transplantations may be seen as a business transaction
  • Folk or religious practitioner used for narahatis
  • Most respected biomedical practitioner is a middle-aged male with a title and white hair
  • Firm believers in high technology

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Delivery of health care from the Haitian and Iranian population.

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

Healthcare Practitioners Continued

  • Nurses are usually afforded little respect—partially because of training
  • Physicians are on top—all other healthcare providers take a lesser position
  • If self-care is encouraged, it may be seen as non-caring

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

ClickerCheck

Mrs. Said is brought to the nurse practitioner by her daughter because she has naharati. The nurse recognizes this condition as

Equivalent to congestive heart failure.

Generalized distress.

Generalized weakness of aging.

Abdominal pain.

 

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

Correct Answer

Correct answer: B

Naharati is generalized distress that can be brought on by stress, anxiety, homesickness, or other things that can cause emotional turmoil.

 

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