Members of the Hispanic American community have
their origins in Cuba, Central and South America, Mexico, Puerto
Rico, and other Spanish speaking countries.
The majority of Hispanics are
Catholic, with an increasing presence of Pentecostals. Health
is a gift from God and should not be taken for granted. The
prevention of illness is an accepted practice that is accomplished
with prayer, the wearing of religious medals, or amulets, and keeping
relics in the home. Visiting shrines, offering medals and
candles, offering prayers and the lighting of candles is a frequently
observed practice. Many homes have shrines with statues and
pictures of Saints. The candles are lit here and prayers are recited.
Elders have a prestigious status in the Hispanic
family because of their experience. Family members look to elders for
advice. An individual who becomes sick will turn first to family
members, especially elders, for support, comfort and advice. They may
recommend safe, simple home remedies.
In the traditional household, the man is the head
of the family and makes all major decisions. There is a strong
sense of Paternalism what most Westerners call "Male
Dominance", but the females role is equivalent and she is the
Maternal powerhouse in her home. The truth is women are sacred and
revered, often protected, not because she can't handle herself or has
no voice, but because the solidarity of the family unit depends on
her well being.
Hispanics are far more emotionally
expressive. They expect to be pampered when ill, it is one way
the family shows love and concern. This is a present oriented
society, and as such they may neglect preventive health care, and may
also show up late, or not at all, for appointments.
Most Hispanics are Catholics, and birth control
methods other than rhythm are unacceptable.
Most Latin Americans see thinness as a problem
and plumpness as the ideal. Advice that a patient lose weight
might not be followed because it would create a negative body image.
Hispanics are not accustomed to the profession of
social workers, and rely on their families, other relatives and close
friends for support and help. Curanderismo is defined as a medical
system. It is a coherent view with historical roots that
combine Aztec, Spanish, spiritualistic, homeopathic , and scientific
elements. The curandero is a holistic healer; the people
who seek help from him do so for social, physical, and psychological
purposes. Since the curandero has a religious
orientation, much of the treatment includes elements of both the
Catholic and Pentecostal rituals and artifacts: offerings of money,
penance, confessions, lighting candles, wooden or metal offerings in
the shape of the afflicted anatomic part and laying on of hands.
Personal matters should be handled only within
the family. Modestly is valued in Hispanic culture, and not
just for women. The area between the waist and knees is
considered particularly private.
Typically, Hispanics look down on people who are
mentally ill. Patients with mental health concerns do not like
to share this information with their relatives or friends and are shy
of seeking professional help.
To attend a woman during delivery is a woman's
job, ideally the job of her mother and midwife. Cultural
tradition dictates that a husband not see his wife or child until the
delivery is over and both have been cleaned and dressed.
In general, Hispanic women prefer that their mothers attend
them in labor.
Latin American women practice the custom of
postpartum lying -in period. This period is designed to give a
woman the period of rest between childbirth and returning to
work. In these cultures women traditionally did not return to
office work, but to physical labor in the fields.
A Hispanic woman had to sign an informed consent form for a
hysterectomy. The patient spoke no English and the hospital staff
relied on her bilingual son to serve as the interpreter. When the son
explained the procedure to the mother, he appeared to be translating
accurately and indicating the proper body parts. His mother signed
the consent form willingly. The next day, however, when she learned
that her uterus had been removed and she could no longer bear
children, she became very angry and threatened to sue the hospital.
Because it is inappropriate for Hispanic male to
discuss her private parts with his mother the embarrassed son had
explained that a tumor would be removed from her abdomen and pointed
to the general area. The woman became quite angry and upset because a
Hispanic woman's status is derived in large part from the number of
children she produces.
Even speaking the same language is not always
sufficient. Cultural rules often dictate who can discuss what with
whom. In general, it is best to use a same sex interpreter when
translating matters of a sexual or private nature.
A 36 year old Mexican man with second degree burns on his hands and
arms. The skin grafts had healed, and there was now a danger that the
area would stiffen and the tissue shorten. The only way to maintain
maximum mobility was through regular stretching and exercise. The
nurses explained to the wife that feeding himself was an essential
therapeutic exercise. She seemed to understand the nurses'
explanation yet continued to cut her husband's food and put it in his mouth.
When one of the nurses, observed this, she took
the fork out of the wife's hand and told the patient to feed himself
because he needed to exercise his arms and hands. The wife appeared
skeptical but did not argue. When the nurse returned later, she saw
the wife once again cutting her husband's food and putting it in his
mouth. The nurses were irritated by the wife's assistance with tasks
the patient could do himself. Fortunately a Cuban nurse on staff
explained to the nurses that Hispanic men expect to be waited on.
Having the patient's wife available to care for him most of the time
also eased their burden.
Failure to care for oneself is common in cultures
that emphasize the family over the individual (almost all cultures
other than Anglo-American). In many cases, Americans' ethnocentrism
blinds them to the fact that life in a typical Hispanic household may
be different than in the normal Anglo home. Hispanic cultures
emphasize family interdependence over independence. For them self
care is not an important concept, where someone is usually at home to
care for the patient.
In this situation, it is of greater importance
that when a family member is ill, love and concern are demonstrated
through care and attention. The nurses might have instructed the wife
to help her husband in ways not to hinder his rehabilitation. For
example, show her how to massage lotion on his hands.
A home health nurse, received an angry call from a Mexican American
woman after visiting her house the day before. Her infant had been
crying and feverish the next morning and the woman recalled the nurse
had remarked the child was adorable. The nurse's compliment and the
fact that she had not touched the child, led her to concluded that
the nurse had given him the evil eye.
In Mexican culture, babies are considered weak
and very susceptible to the power of an envious glance. A simple
compliment without touching the child, can bring on the evil eye.
Touching the person while complimenting him or her, neutralizes the
power of the evil eye.
Not all Mexicans adhere to this belief, so it is
important to pay close attention to non-verbal clues from the mother.
Fernandez V.M.: Personal
interviews and experiences with patients in Venezuela, Colombia,
Mexico and Cuba. 1995-1999
Galanti G.A.: Caring for Patients
from Different Cultures. University of Pennsylvania Press,
Spector R.E.: Cultural Diversity
in Health and Illness. Appleton-Century-Crofts, New York, 1979