Introduction
Today, in the 21st century, health care service providers across the United States and in other countries are increasingly interacting with patients from an ever widening variety of cultural, racial and ethnic backgrounds, suggesting the need for cultural awareness and sensitivity in nursing practice. Lack of cultural awareness and sensitivity may lead nursing professionals to stereotype groups of people according to their race or ethnicity, hence adversely affecting patient outcomes and jeopardizing patient safety (Blais & Hayes, 2012). This paper briefly describes the stereotypical health care beliefs and practices that dominate Italian and American Indian cultures, and also provides examples of how the cultural orientations of the two ethnic groups relate to the discussed health care stereotypes.
Stereotypical Health Care Beliefs & Practices Associated with Italian Culture
Many elderly Italian immigrants in the United States and other countries around the world hold stereotypical beliefs that they will be treated poorly and given medicine to keep them quiet upon admission into aged care facilities. Additionally, many elderly Italians do not seek the services of the care facilities as they see them as an insult to the family unit which is mandated to take care of the elderly in the Italian culture (Rozendal, 1987). The elderly in the Italian culture fit into this stereotype as they often express fear that joining care facilities for the aged drives the family into disrepute as it is a direct admittance that their children are not taking care of them. However, an increasing number of elderly Italians no longer fit into this stereotype because they are visiting the care facilities after realizing that seeking health care assistance does not amount to loss of independence and control.
Spirituality is an important component in achieving positive patient outcomes. In this respect, another stereotype targeting the Italian culture is that all Italians are Catholic and hence nursing professionals may relate to members of this community from this perspective (De Filippo, 2012). As an example, many Italian nurses and doctors continue to provide services in Church-based healthcare organizations and agencies in America, reinforcing the belief that all Italians are Catholic. However, to refute the claim, it has now been proved that a sizeable proportion of Italians are indeed atheists (De Filippo, 2012).
Another commonly held belief is that all Italians eat pasta, hence a nurse with inadequate cultural competency training may often generalize that Italian patients in a hospital setting will always ask for pasta and nothing else (De Filippo, 2012). To provide an example, this stereotype has been reinforced by the fact that pasta is an important component of Italian diet as witnessed in most immigrant Italian families. However, the stereotype can be discounted on the basis that a sizeable number of Italians do not eat pasta for health-related reasons (Rozendal, 1987).
It is often generalized that all Italians are always late for appointments and are impatient for explanations, hence the need for health care professionals to allocate sufficient time and maintain composure when dealing with this group of the population (De Filippo, 2012; Rozendal, 1987). Indeed, as an example, many elderly Italians are often late for appointments in healthcare settings and demonstrate an impatient behavioral predisposition that may adversely impact health care outcomes as well as patient safety. However, not all Italians are always late for appointments and a good number of them even arrive earlier than expected, hence discounting the commonly held belief.
Lastly, there is a commonly held belief that all Italians gesticulate; that is, they always regress to the language of the body when required to express themselves or their feelings (De Filippo, 2012; Rozendal, 1987). As an example, a sizeable number of Italian women have reinforced the habit of using hands and facial expressions to demonstrate how they feel. But while body language and non-verbal cues are important indicators for nurses in a culturally diverse world and may actually enhance patient treatment outcomes (Blais & Hayes, 2012), not all immigrant Italians in the United States are into the habit of gesticulating to make their problems known to the health care professionals.
Stereotypical Health Care Beliefs & Practices Associated with American Indian Culture
One commonly held belief associated with the American Indian culture is that members are spiritual and live in harmony with nature (Culture Card, 2009); therefore they often do not require nursing or health care services. An example that reinforces this belief is grounded on the fact that it has taken health professionals many years to finally bring American Indians into the mainstream health care services (Dixon & Iron, 2006). However, common practice demonstrates that American Indians are real people with no mystic spirituality, hence are in need of health care services.
Another commonly held stereotype that may adversely affect health outcomes for American Indians is that they can only access health services from the Bureau of Indian Affairs (BIA) and the Indian Health Service (HIS) due to the fact that this group of the population only opens up to its members (Culture Card, 2009). As an example, this stereotype is often reinforced by the elderly American Indians who still preserve traditions of the ethnic group and often feel uncomfortable relating to outsiders especially on personal issues such as health (Dixon & Iron, 2006). However, this stereotype has been discounted by the fact that more American Indians are seeking for health care services from conventional facilities without due consideration to race or ethnic background of care providers.
Moving on, it is often generalized that American Indians have the highest level of alcoholism and other self-destructive behaviors in the United States (Dixon & Iron, 2006). As an example to reinforce this stereotype, research has found that many American Indian villages do experience frequent cases of alcohol abuse as is the case in other ethnic groupings (Culture Card, 2009). However, what may be of interest for nursing professionals in regards to this stereotype is the fact that American Indians also have the highest rate of complete abstinence from alcohol, and that “social” drinking is often frowned upon in this group of the population.
Lastly, many nursing professionals and healthcare practitioners buy the generalization that American Indians are real “Indians”, and hence end up providing misaligned health care services with obvious adverse ramifications for patient treatment outcomes. As an example to reinforce this belief, nurses in healthcare settings often desist from serving beef to American Indian patients as cows are considered a sacred symbol in India (Dixon & Iron, 2006). However, what these professionals fail to realize is that American Indians are not real “Indians” and they do not refer themselves as Indians; on they contrary, American Indian families are multicultural and adapt to their surrounding culture (Culture Card, 2009).
Conclusion
From the above description, it is clear that nurses need to be culturally well informed and sensitive to ethic diversity not only to gain acceptance and trust in culturally diverse populations, but also to effectively deal with underlying stereotypes that may adversely affect care delivery, patient outcomes and patient safety.
References
Blais, K.K., & Hayes, J.S. (2011). Professional nursing practice: Concepts and perspectives (6th ed.). Upper Saddle River, NJ: Prentice Hall.
Culture Card. (2009). A guide to build cultural awareness: American Indian and Alaska Native. Web.
De Filippo, A. (2012). Some clinches about Italians. Web.
Dixon, M., & Iron, P.E. (2006). Strategies for cultural competency in Indian health care. Washington, DC: American Public Health Association.
Rozendal, N. (1987). Understanding Italian American cultural norms. Journal of Psychosocial Nursing & Mental Health Services, 25(2), 29-33.