Introduction
Due to the processes of economic development of the United States, the import of foreign labor into the country is growing. Foreign workers fill different niches in the country’s economy. According to summary statistics, more than 130 nationalities live in the USA today (Shaw et al., 2018). In addition to the indigenous ethnic group, the Hispanic ethnic group occupies a significant place in the structure of the country’s population. It is well known that the cultural characteristics of patients largely determine many medical parameters (Rho et al., 2018). These include strategies for forming a healthy lifestyle, attitude to illness, following the day regimen, and many others. In this regard, it is reasonable to take into account various types of intercultural communication in the practical activities of a nurse. This paper contains the elementary basics of intercultural communication skills with Hispanic patients related to various cultural aspects of this minority.
Differences
Health Beliefs & Practices
The Hispanic community has preserved the old, time-tested health beliefs and practices: for example, wine treatment is widespread. In the treatment of different diseases Hispanics often use a certain wine or several types of wines, mixing them in certain proportions. They believe that red wine has antibacterial properties and its use increases the body’s resistance to infection (Shaw et al., 2018). Therefore, in folk medicine, recipes based on wines which are mixed with medicinal plants and bee products are often used.
Hispanics believe in the medicinal properties of garlic. They are often used in folk medicine in the form of ahoblanko, which can be translated as white garlic (Moreira et al., 2018). This is crushed garlic with dry bread with the addition of olive oil. It is believed that this dish has a lot of benefits: Hispanics consume it as a source of vitamins, fiber, minerals. They consider garlic useful for the immune system, and they often eat it instead of taking antiviral drugs.
For Hispanics, it is traditional to use all kinds of natural remedies that strengthen the body. Among them, thistle has an important place: migrants from Latin America have a practice of using a decoction of milk thistle seeds to strengthen the liver and purify bile (Shaw et al., 2018). They buy various milk thistle preparations in pharmacies: crushed seeds, decoctions and oil. It is believed that after 40 years, once a year it is worth cleaning the liver with this proven remedy (Gordon et al., 2022).
Moreover, many Hispanics assume that dates enhance male sexual potency and facilitate childbirth, contribute to improving brain activity, and increase the immune defense of the body (Rho et al., 2018). There is a practice of boiling them in milk to take for as a cough remedy. Thus, the institute of traditional medicine is quite strong among Hispanics and various health practices are widespread.
Family Patterns
The features of the traditional Hispanic family are still persistently preserved in society. The usual family pattern is not only a husband, wife and children, but also parents, and a lot of more or less close relatives. Large Hispanic families are found mainly in villages, in the city there are usually one or two, less often three children in the family (Gordon et al., 2022). They grow up late, and this is largely due to the increased care that their parents show them. Parents and children maintain close relationships all their lives, regardless of age. Relatives in the Hispanic family are strongly connected by common family traditions. They often communicate, participate in each other’s lives, and are close to each other. Therefore, most likely, when providing medical services, the nurse will have to contact a large number of relatives of the Hispanic patient.
Communication Style
Nonverbal communication among migrants from Latin America is given great importance. Therefore, the nurse should be prepared that patients can sometimes put their hand on the shoulder or elbow of the interlocutor. When greeting, men most often shake hands, and among women, a light pat on the right shoulder is common. It is worth considering that Hispanics are used to communicating at arm’s length, which may be unusual for Americans. A Hispanic person is usually addressed by title or academic degree (doctor, architect, engineer, lawyer, or professor) and surname (Rho et al., 2018). Only family members, children and close friends are addressed by name. If a person does not have titles or academic degrees, then the nurse needs to address them as “senor”, “senorita” or “senora” (Bailey et al., 2019).
Space & Time Orientation
Hispanics are not punctual because for migrants from Latin America, time is a relative concept. A late arrival does not symbolize a small interest in Hispanics, as in American culture. However, if a Hispanic patient is late, they think should be waited for, because, in their opinion, they are always late only for objective reasons that prevented them from arriving on time. Therefore, the time of admission of Hispanic patients should be prescribed taking into account the fact that they may be delayed up to an hour (Bailey et al., 2019). Moreover, a medical examination and a survey often takes quite a long time, since Hispanic patients are used to think about the details of the question for a long time (Shaw et al., 2018). The nurse should be friendly and patient with Hispanic patients, and tactfully remind them that patient time is limited.
The Hispanics culture differs from the American not only in the perception of time, but also in the perception of space. Due to the short distance between the interlocutors, representatives of another culture may experience awkwardness, alienation or irritation when in conflict with Hispanic traditions of communication. Hispanic minority has a different concept of personal space – it is not unusual to touch the interlocutor during a conversation (Bailey et al., 2019). In the Hispanic communicative space, orientation and the angle of communication are important. Orientation is expressed in the location of partners in relation to each other. Thus, migrants from Latin America often communicate at a small angle to each other, and Americans have a larger angle of communication (Shaw et al., 2018). Thus, a nurse should definitely take into account the perception of time and space when working with Hispanic patients, since these concepts differ significantly from American ones.
Nutritional Patterns
Hispanics adhere to the Mediterranean diet, the dishes of which are nutritious. It is rich in useful vitamins and microelements due to the high content of all kinds of vegetables, fruits and seasonings in it (Gordon et al., 2022). A constant product of many traditional Hispanic dishes is chili pepper, and most of the food is spicy: spicy ingredients are included in the vast majority of recipes (Rho et al., 2018). They are added to soups, considered an indispensable ingredient of second courses, and even hot drinks and desserts are served with them. The main ingredients of Hispanic cuisine are beans, avocados, tomatoes, and jalapeno peppers (Bailey et al., 2019). Corn is present in many dishes: in corn flour products (tortillas), as a daily snack in boiled and fried versions, in desserts and or drinks. However, most of the dishes of Hispanic cuisine are prepared in a large amount of oil, and contain fats and cholesterol.
Pain Responses
Self-assessment of the intensity of pain and the form of response depends on socio-cultural characteristics. Race, ethnicity, and gender affect the experience and self-report of pain. Hispanics in similar clinical situations describe more pronounced pain sensations than white ones (Shaw et al., 2018). Compared to the Americans, they showed a rather weak result during the tests (Moreira et al., 2018). At the same time, they were affected by various devices, injections which caused migraines and other ways. For the purity of the experiment in the medical center, representatives of different races were influenced by many varieties of pain (Rho et al., 2018). Thus, the conducted research can be called objective and sufficiently reasoned in order to assert that Hispanics has more pronounced pain responses.
Childbirth & Perinatal Care
Hispanic women often give birth at home: in many Latin American countries there is a law that allows them to do it legally. It is customary to turn to dowls who use herbs, rebozo (traditional Indian blanket) and the wisdom of their ancestors (Shaw et al., 2018). In addition, some Hispanic peoples have a belief that if a girl sees women giving birth from childhood, she is not afraid of childbirth, becoming a woman (Moreira et al., 2018). Therefore, sometimes daughters are present with their mothers at childbirth. After giving birth, the first meal of a Hispanic mother should be traditional cocoa with cinnamon (Gordon et al., 2022). Among the Hispanic rituals of childbirth, the closure of childbirth is mandatory (Moreira et al., 2018). It resembles swaddling, and is carried out to close the energy centers that were opened during childbirth (Gordon et al., 2022). If this is not done, it is believed that the woman can quickly get tired with open energy centers and may fall into postpartum depression.
Newborns and young Hispanic children are carefully protected from prying eyes. The care of the healthy life of the child begins with the postpartum recovery of the mother. Young children are pampered, treated indulgently to their whims and habits. Often one can meet 3-year-old with a chocolate bar and a bottle of sweet soda (Moreira et al., 2018). Therefore, 35% of Hispanic children are obese, and often they are diagnosed with diabetes (Shaw et al., 2018). Traditionally, Hispanic mothers do not work, but take care of children and the house, and a lot of attention and care is paid to the younger generation. Even poor parents can give their last money to arrange a children’s party for the baby and their friends. Therefore, parents are often ready for expensive treatment and medical examination of their children.
Death & Dying
Hispanics, unlike Western people, have a more positive attitude towards death. They believe that death is the beginning of a new existence, and it is not accepted to grieve for too long. Hispanics even celebrate the Day of the Dead on the first and second of November, as they believe that deceased relatives and friends return to the world of the living once a year (Moreira et al., 2018). In the culture of Mexico, the goddess of Holy Death plays an important role. She is treated as a deity from whom one can ask for protection, wealth, love and even the elimination of enemies. The goddess is worshipped by criminals who revere her for the fact that Santa Muerte gives what they ask for, without demanding to lead a righteous life (Gordon et al., 2022). She is especially revered by those who work at night: policemen and taxi drivers, because according to beliefs, the gods of Death are the sovereign mistress of this time of day.
Hispanics are descendants of the Aztecs and Mayans who perceived death as a step forward, a transition to the next level, after which a person can return to the human world again and influence the course of history. Such a positive perception of the afterlife has merged with Christian traditions (Rho et al., 2018). Hispanics do not believe that a person, having died, returns to life. However, they still have the idea that a person is better in the afterlife than in the world of the living. Therefore, Hispanics has a calmer and more neutral attitude towards dying, which should be taken into account by the nurse, for example, notifying relatives about patient’s terminal illnesses. In everyday communication, jokes about the dead are common among Hispanics.
Spirituality, Religion, & Faith
Some Hispanic peoples still have ancient spiritual practices. Fire and the plant of power – peyote – are usually used in their rituals (Bailey et al., 2019). With the help of the cleansing powers of fire, special songs and peyote cactus, shamans heal people and help them look into the depths of their subconscious. However, the use of peyote entails the risk of unpredictable negative health consequences. In most Hispanic spiritual practices, fire is a key figure and it is through interaction with it that purification takes place. According to beliefs, a person gives away the heaviness accumulated in the heart, through fire comes relief and joy of liberation from fears and mental pain (Rho et al., 2018). Even when shorter daytime ceremonies are held, shamans always make a ritual bonfire. The shape of the arrangement of firewood and ashes inside the fire has great symbolic significance (Gordon et al., 2022).
The main part of the Hispanic population professes Catholicism; its specificity lies in its syncretism. The mixing of traditional cults and beliefs with the official religion has given rise to new phenomena. The cult of the Virgin Mary of Guadalupe has spread widely among Mexicans, and among migrants from Venezuela – the national patroness of the Mestizo Maria Lyons (Rho et al., 2018). The African cults of Candomble and Santeria have mixed with the Catholic religion for the natives of the Caribbean (Rho et al., 2018). Their peculiarity is the worship of African deities with Catholic rites. Christian saints and African deities are side by side on the altars. Migrants from Bolivia, Peru and some other countries, in addition to Christian religious traditions, have a widespread cult of the dead and animal sacrifice (Moreira et al., 2018). In general, religion is tightly intertwined with the daily life of the Hispanic population and plays an important role.
The majority of Hispanics regards the Catholic religion as an integral part of the national culture, and perceives the traditions and rituals preserved to this day as a symbol of the connection of generations. However, many Hispanic communities are faced with the fact that the number of believers, in particular Christians, is steadily decreasing (Rho et al., 2018). Most of all among atheists and non-believers are young people. Catholic faith still has a significant impact on the older generation of Hispanics. Catholicism prevails among the older generation, which may affect some medical aspects. For example, religion justifies the negative attitude of Hispanic to abortion and the use of contraceptives, and extremely negative – to homosexuality.
Catholicism has remained the main religion of the Hispanics, and many traditions and events are inextricably linked with religion. Throughout the year, the Hispanic community celebrates religious holidays. Baptisms and weddings are the most important events that are closely connected with the church. Many other holidays are religious in nature: almost every day is the day of a some of the saints. The peculiarities of certain religious holidays are accompanied by an abundance of wine and food. All major Catholic holidays at Hispanics are accompanied by folk dances, masses, solemn processions and traditional food exhibitions (Gordon et al., 2022). Often religious holidays include elements of pre-Columbian beliefs, Mayan and Aztec cultures, as well as Christian beliefs incorporated by Hispanics during the colonial era (Gordon et al., 2022). The most revered religious holiday for Hispanics is Christmas. The main symbol of it is belen, literally meaning a manger, which is a mock–up of the birth of the Christ child (Gordon et al., 2022).
Prayer & Meditation
Hispanics pray together and alone, in community and in solitude; the most important communal prayer is the Liturgy. Every Sunday, religious Hispanics gather in the temple, remembering the saving sacrifice of the cross of Jesus Christ and His Resurrection from the dead (Moreira et al., 2018). Images of the Savior and saints help them to focus on prayer. The use of recorded prayers introduces Hispanics to the rich Catholic tradition. In the church, psalms are often read, with which Jesus and his disciples glorified God. At the Sunday Liturgy, which is called the Holy Mass, they sing hymns of praise in unity with the whole Church, listen to the Holy Scriptures and bring petitions about the needs of the community (Rho et al., 2018). The entire Hispanic community gathers to pray together for its members at important moments of their Catholic life. Prayer is performed at baptism, chrismation, marriage, and funeral.
The most popular form of meditation in the Hispanic community is transcendental meditation. This is a special form of silent meditation, which does not involve contemplation and concentration. The best effect is achieved by regular practice twice a day for twenty minutes (Rho et al., 2018). The birthplace of transcendental meditation, like most similar practices, is India. It was founded by the neo-Hindu preacher Maharishi Mahesh Yogi, who for several decades has trained instructors of this technique around the world (Shaw et al., 2018). Maharishi became active outside his native India in 1958 (Shaw et al., 2018). The popularity of transcendental meditation in Europe, and especially the USA, was great, and leading scientists immediately took up research on its usefulness. Later, Hispanics was adapted to their mentality and habits, and it is often performed during their traditional siesta.
Conclusion
Since Hispanic patients have cultural differences, it is important to consider different communication components when working with them. This is due to the fact that the patient’s belonging to a Hispanic ethnic group, culture, religious denomination leaves its mark. It largely determines their attitude to alcohol intake, tobacco smoking, nutrition, argument in persuasion, methods of suggestion, and the implementation of some doctor’s recommendations. Moreover, the particular perception of the concepts of time and space by representatives of the Hispanic community affects the methods of examination and the nature of interaction during treatment. Belonging of Hispanic patients to a particular religious denomination affects the attitude towards the doctor and some methods of treatment. The patient’s ethnicity has to be taken into account when using arguments in persuasion and when constructing suggestion formulas. Successful treatment is possible only within the framework of these stable relationships and patient characteristics.
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