Miami Dade College Transcultural Health Care Essay Please read the instructions below and do this research following all these steps Review the attached P

Miami Dade College Transcultural Health Care Essay Please read the instructions below and do this research following all these steps

Review the attached PowerPoint presentation. Read content chapter 10 and 31 of the class textbook.Once done, please present an essay discussing the health care beliefs of both heritages and if there is any similarity in both heritages health care. Please mention how the health care beliefs affect the delivery of evidence-based health care.

The essay must be presented in an APA format, word document, Arial 12 font attached to the forum in the discussion tab titled “week 5 assignment”. The assignment must include at least 3 evidence-based references (excluding the class textbook). Reference should not be older than five years.

A minimum of 700 words (excluding the first and references page) is required.

Style: APA
References: 3
Double space

Please let me know if you have any questions.

Thank you Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Guatemalan Culture
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ People of Guatemalan heritage comprise a
growing number of Hispanic/Latino
populations in the United States.
▪ Guatemalans may share a common Spanish
language with other Hispanic ethnic groups.
▪ In Guatemala, 56 percent of the population
lives below the poverty level.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ Guatemala is inhabited by Mestizo (mixed
Amerindian-Spanish – in local Spanish called
Ladino) and European 59.4 percent, K’iche 9.1
percent, Kaqchikel 8.4 percent, Mam 7.9
percent, Q’eqchi 6.3 percent, other Mayan 8.6
percent, indigenous non-Mayan 0.2 percent,
other 0.1 percent.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ The major languages in Guatemala include the
official language, Spanish, which is spoken by 60
percent of the population, and Amerindian
languages, which are spoken by the remaining
40 percent.
▪ There are 23 officially recognized Amerindian
languages.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Some Mayan men do not have a formal
education but are able to speak Spanish
because of frequent interactions with Spanish
speakers.
▪ Guatemalan people tend to value the past
and live in the present, being more
concerned with today than the future
because the future is uncertain for many.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Time is related to the natural environment,
such as sunrise, sunset, rainy season, etc.
▪ Punctuality is difficult for many because of
limited transportation and unexpected family
needs.
▪ Guatemalans who have a Hispanic heritage
use the Spanish format for names.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ At birth, a child is given a first name (Ovidio) followed by
the surname of his father (Garcia), and then the surname
of his mother (Salvador), resulting in Ovidio Garcia
Salvador.
▪ Men’s names remain the same through their lifetime.
▪ However, when a woman named Jovita Garcia Salvador
marries Francisco Vasquez Gutierrez, she then becomes
Jovita Garcia de Vasquez or simply Jovita Garcia
Vasquez.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ To convey respect, address the Guatemalan in a formal
manner unless otherwise requested by the patient.
▪ Male children and adults are referred to as Mr. (Señor).
Females are referred to as Ms. (Señorita) or Mrs.
(Señora).
▪ Guatemalans are customarily greeted with a handshake.
In rural areas, people shake hands softly.
▪ To give a firm handshake indicates aggressive behavior.
▪ In the cities, the handshake tends to be more firm.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Guatemalans avoid direct eye contact with
others, including health-care providers, which is
a way of demonstrating respect and should not
be misinterpreted as avoidance, low selfesteem, or disinterest.
▪ Guatemalans speak softly in public.
▪ Speaking loud is considered rude.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Many Guatemala families follow traditional roles
for husbands, wives, and children, although this
is changing for some.
▪ Traditionally, the man has been the head of
household and is the primary “breadwinner” and
provider for the family.
▪ Ultimate decision-making power resides with the
man of the house.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Women’s roles have traditionally involved raising
the children and caring for the home.
▪ Guatemalans place a high value on the family
and extended family.
▪ Most families are nuclear.
▪ Extended family is important and may include
grandparents, aunts, uncles, and cousins.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ A young woman’s 15th birthday (quinceñera) is
celebrated as her passage to womanhood.
▪ Coming of age for a young man is age 18 years.
▪ Children are a gift from God and are highly
valued in Guatemalan society.
▪ Sons are more valued than daughters.
▪ Children are taught to be obedient and
demonstrate respect for older people.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Among Mayan communities, family members and
other adults take an active part in raising a child.
▪ They believe it takes a village to raise a child to
become a productive member of the community
and to continue their culture.
▪ Values include being humble, content, and
respectful of others, working hard, avoiding
arguments, and placing the needs of the family
before one’s own individual needs.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ When family members are unable to take care of
themselves, the expectation is that their family
will take care of them.
▪ Guatemalan families who migrate to the United
States do so with the hope of a better life for
themselves and their children.
▪ More opportunities are available in the United
States.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Catholic, protestant, and evangelical
Guatemalans do not believe in homosexuality or
sexual activity among the unmarried, or infidelity.
▪ Indigenous women dress conservatively with a
woven long skirt (corte), blouse (huipil), a scarf
(tzute), and shawl (rebozo) that promote
modesty.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ A single woman is believed to be a prostitute if
she is out in public alone.
▪ Despite a prevailing macho attitude with a deeprooted homophobia, some inroads have been
made for gays, lesbian, and transgendered
populations in Guatemala with Lesbiradas, an
organization for lesbians and bisexual women.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Larger cities in the United States offer
organizations such as Ellas, a support group for
Latina lesbians; El Hotline of Hola Gay, an
organization with information and referrals in
Spanish; and Dignity, a gay Catholic support
organization.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Workforce Issues
▪ During the civil war in Guatemala, residents were
permitted to migrate to the United States and
apply for political asylum.
▪ If granted, this allowed Guatemalans to stay
permanently in the United States, but they were
not permitted to ever return to Guatemala.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Workforce Issues
▪ Guatemalans may miss work due to an illness
of a loved one, a need for transportation to an
appointment, or lack of childcare.
▪ When a Guatemalan learns that a loved one in
Guatemala is ill or has passed away, they feel
compelled to return to Guatemala for an
extended period of time, risking loss of their job
if a leave of absence is not possible.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Workforce Issues
▪ Because punctuality is not valued in Guatemala,
the Guatemalan employee in the United States
may arrive for work late.
▪ They may not wear a timepiece, be able to tell
time, or understand the importance of
punctuality in the United States.
▪ Guatemalans tend to respect persons in
positions of authority.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Workforce Issues
▪ Those of lower socioeconomic status and/or
with formal education and English language
skills usually acquire positions with
responsibility but little authority.
▪ They prefer to get along well with others and
not criticize or voice complaints when treated
poorly.
▪ The Guatemalan is likely to remain in a position
equal to his peers rather than seek a promotion.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ Most Guatemalans are a mixture of Spanish and
Mayan Indian heritage.
▪ There is a small population of Black
Guatemalans with ancestry from the Caribbean
and Africa.
▪ This accounts for variations in skin color, facial
features, hair, body structure, and other
biological variations.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ Guatemalans who are predominately Spanish
may have blonde or brown hair, fair
complexion, and blue eyes and be of average
or taller height with a medium to large build.
▪ Guatemalans with predominately Mayan Indian
ancestry tend to have black hair, brown skin,
and dark eye color and are of short height with
a petite build.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ The leading causes of mortality in Guatemala
are pneumonia, diarrhea, communicable
diseases, diseases of the circulatory system,
perinatal conditions, and tumors.
▪ Other major health problems for Guatemalans
include musculoskeletal pain, abdominal pain,
upper respiratory problems, headaches, rashes
and itching, and eye disorders.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
High-Risk Health Behaviors
▪ Alcohol is the most misused substance.
▪ Guatemalan families readily participate in
immunization programs for their children yet do
not participate themselves.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ Food to Guatemalans signifies physical, spiritual,
and cultural wellness.
▪ Foods vary among Guatemalans based on
cultural traditions and accessibility.
▪ Corn is highly valued in the Mayan culture. Corn
is the chief crop and the basis for many food
products and meals. Foods bring strength, good
health, and a spiritual connection to the past.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ The Mayan diet primarily consists of maize, black
beans, rice, chicken, squash, tomatoes, carrots, chilies,
beets, cauliflower, lettuce, cabbage, chard, leek, onion
and garlic.
▪ These foods are used to maketortillas, atole, (liquid
corn drink), pinol (chicken flavored corn gruel), pepi’an
(chicken stew with squash seeds, hot chilies, tomatoes,
and tomatillos [small green tomato]), and caldos (soups
made of chicken stock and vegetables.)
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ Guatemalan food is not served spicy. A spicy
hot sauce may be served alongside a meal for
individuals who prefer to add it.
▪ The diet of many Guatemalans is low in protein,
iron, and vitamin C.
▪ Lactose intolerance is especially prevalent
among indigenous populations.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ Some Guatemalan families encourage their
children to drink coffee with sugar when they
refuse the poor tasting drinking water.
▪ This practice leads to gastritis, dehydration,
and dental caries.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Guatemalans value life beginning from
conception; a baby is a gift from God.
▪ Most do not believe in contraception or abortion
for religious reasons.
▪ A Guatemalan woman may bear 10 or more
children in her lifetime. In Guatemala, of these,
many die before the age of 5 years.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Mayan midwives (comadronas) deliver 80 percent of all
children born in Guatemala in the home. It is unknown
how widespread this practice is in the United States.
▪ If the baby dies during delivery, the family accept it as
God’s will.
▪ On the day a Guatemalan woman becomes pregnant,
she and her husband share the news with respected
elders of the village. Godparents are also selected at this
time.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ In the 7th month of pregnancy, the woman introduces
her fetus to the environment.
▪ She goes through her daily activities showing and
telling her fetus about the life she leads. The mother
tells the fetus to be honest and never abuse nature.
▪ If someone eats in front of the pregnant woman without
offering her food, she will have a miscarriage.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Children are permitted at the delivery.
▪ The woman’s husband, village leaders, and
parents of the couple may be present.
▪ A single woman must not observe the birth of
the baby.
▪ Mayan women do not believe in lying down to
give birth or delivering in a hospital.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ A midwife and witch (brujo) may both attend the
birth.
▪ The midwife helps with delivery.
▪ The brujo prays for long life, good health, and
protection from the evil eye (mal ojo).
▪ A breech delivery or one in which the baby’s cord
is around the neck are considered good luck.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Following delivery, the placenta has to be
burned, not buried, because it is disrespectful to
the earth to do so.
▪ The placenta can be burned on a log and then
the ashes used for a steam bath, temascal.
▪ To celebrate the birth of a baby, the villagers
slaughter a sheep.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ The mother and baby are kept separated from
others for 8 days.
▪ When the baby is born, the hands and feet are
bound for 8 days. This signifies that they are
meant for hard work, not for stealing.
▪ Guatemalan women may continue
breastfeeding until the child reaches the age of
5 years.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ During the first 8 postpartum days, friends and
extended family bring food, clothing, small
animals, or wood as gifts for the newborn’s
family.
▪ They also offer their services, like carrying water
or chopping wood.
▪ The family of the newborn does nothing for these
8 days; their needs are taken care of by others.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing
Practices
▪ A bag with garlic, lime, salt, and tobacco is hung
around the baby’s neck and a red thread is used
to tie the umbilical cord to protect the baby,
provide strength, and denote respect for the
ancestors.
▪ If the baby is a female, the midwife pierces her
ears at birth.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
Juanita Juarez, is pregnant with her second child. The nurse
recommended that she increase her milk consumption,
which she has not done. He has been compliant with
other dietary recommendations. The most likely reason
for not increasing her milk consumption is that she
a. Does not like milk.
b. Cannot afford milk.
c. Has lactose intolerance.
d. Has fructose intolerance.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: C
Many Guatemalans have lactose intolerance and
cannot drink milk or milk products because it
caused bloating and indigestion.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Death Rituals
▪ Many Guatemalans grow up experiencing far more death
than most North Americans.
▪ They see babies and children die of malnutrition and disease,
parents and grandparents die from violence, and loved ones
die because the health care they needed was too far away or
was too expensive.
▪ The family may decide the cost for treatment of one family
member is too much and decide against it because of the
financial strain on the entire family.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Death Rituals
▪ When death occurs in Guatemala, it is
customary to place the deceased in a simple
wooden coffin/casket and conduct a funeral.
▪ Graves are decorated with flowers on All Saint’s
Day in memory of the deceased.
▪ Some Guatemalans relate their illness to
“punishment” or impending death to “God’s will”.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Death Rituals
▪ When a Guatemalan dies in the United States,
the family may request repatriation because it is
important for the final resting place to be the
home country.
▪ Guatemalans believe in burial; they do not
practice cremation.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Death Rituals
▪ Yellow is the color of mourning.
▪ Yellow flowers are placed at the grave.
▪ Food is placed at the head for the spirit of the
departed.
▪ Church bells are rung to gain favor with the gods.
▪ Ladinos mourn the dead by wearing black.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Spirituality
▪ Approximately 65-80 percent of Guatemalans
are Roman Catholic.
▪ Others continued to practice their Mayan
religion.
▪ Still other Guatemalans combined beliefs and
practices of the two.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Spirituality
▪ Two practices influenced by the Spanish are
guachibal and cofradia.
▪ Guachibal involves the practice of keeping an
image of a Christian saint in the home and
celebrating on the particular saint’s day.
▪ Cofradia refers to a “religious brotherhood” that
serves to maintain the “cult” of a particular
saint.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Spirituality
▪ Family provides Guatemalans with meaning in
their lives.
▪ Spirituality helps to explain life and the
circumstances faced by Guatemalans.
▪ When illness occurs, many Guatemalans turn to
their faith for strength, wisdom, and hope.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Health-care Practices
▪ The preferred mode of treatment among Ladinos
is medication administered by hypodermic
injection. For example, if an infant has a cold,
Ladinos believe an injection is necessary to treat
it effectively.
▪ If someone has the flu, they like an intravenous
infusion. Intramuscular medications are preferred
to those taken orally.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Health-care Practices
▪ Health-care seeking among Guatemalans
generally occurs by first seeking advice from a
mother, grandmother, or other respected elder.
▪ If this approach is unsuccessful, then the family
usually seeks health care from folk healers.
▪ Modern medical care may be the last resort.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Health-care Practices
▪ Many are fearful of hospitals.
▪ In Guatemala, when hospital care is necessary,
patients are often seriously ill, resulting in
death, which perpetuates the belief that
“hospitals are places where patients go to die.”
▪ Guatemalans often delay seeki…
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