Case Study - Chapter 13: Community Health Nursing in a Diverse Society

Danielle Gardenhire

NR442

April 15, 2021

Case Overview:

Michael, an occupational health nurse in Clay County, Vermont, is faced with the challenge of addressing the health needs of a growing Hispanic population that has recently moved into the community. The county, which has traditionally been dominated by a white Anglo-Saxon Protestant culture, is now seeing a significant demographic shift. Michael has observed that the Hispanic employees working at the plant where he is employed are facing health issues that, if left unaddressed, could have negative repercussions on the community. To tackle these challenges, Michael has organized a community forum involving various local stakeholders.

Question 1:

Mr. Barnes, a department of human services social worker, states, “I don’t understand why a lot of these clients come in with so many different family members along. Why can’t they just leave the kids, aunts, and uncles at home, so we can get done what needs to be done?” This statement reflects:

A. Ethnocentrism B. Cultural negotiation C. Cultural stereotyping D. Culturological assessment

Answer: A. Ethnocentrism - This statement reflects ethnocentrism, where Mr. Barnes is judging the Hispanic clients' behavior based on the norms and values of his own culture, rather than trying to understand the cultural practices and values of the Hispanic community.

Explanation: Ethnocentrism occurs when an individual evaluates or judges another culture based on the standards of their own culture. Mr. Barnes’s statement indicates a lack of understanding and appreciation for the cultural importance of family in the Hispanic community, where family members often accompany individuals to important appointments and meetings for support. Rather than recognizing this as a cultural norm, Mr. Barnes is displaying ethnocentrism by viewing it as an inconvenience or something that should be changed to fit the dominant culture’s norms.

Question 2:

A nurse from the local hospital reports a large number of Hispanic patients who refuse intake of certain foods and fluids because they are “hot” or “cold.” This nurse states, “It doesn’t make sense to me. I can heat the food up as requested, and it is still not eaten!” This nurse has not recognized that these Hispanic patients are acting according to what perspective about the cause of illness?

Answer: The nurse has not recognized that the Hispanic patients are acting according to the “hot-cold theory of disease.”

Explanation: The hot-cold theory of disease is a cultural belief system common in many Hispanic communities, where certain illnesses are believed to be caused by an imbalance of hot and cold elements within the body. Foods and fluids are classified as either “hot” or “cold,” and the balance of these is thought to be crucial to maintaining health. For example, a “hot” condition might be treated with “cold” foods, and vice versa. This belief system influences dietary practices during illness, and failure to recognize and accommodate these practices can lead to non-compliance with prescribed diets or treatments.

Question 3:

During the course of the community forum, Michael points out that the elimination of disparities in health is a current focus of Healthy People 2020. He advocates an ongoing process to look at the health status of the community as a whole, with an emphasis on disparities in the new immigrant population. Which of these follow-up activities would be appropriate to his role as a community health nurse? Select all that apply.

Answer: A. Conducting a needs assessment to identify specific health disparities affecting the Hispanic population. B. Partnering with local organizations to develop culturally appropriate health education materials. C. Organizing training sessions for healthcare providers on cultural competence and sensitivity. D. Advocating for policies that improve access to healthcare services for immigrants. E. Establishing ongoing communication with the Hispanic community to ensure their health needs are met.

Explanation: All the follow-up activities mentioned above are appropriate to Michael’s role as a community health nurse. Each activity is aimed at addressing the specific health needs and disparities within the Hispanic community by promoting cultural competence, improving healthcare access, and ensuring that health services are tailored to the cultural practices and beliefs of the population. Conducting a needs assessment (A) allows for the identification of health disparities. Partnering with local organizations (B) helps in the development of culturally relevant materials. Organizing training sessions (C) ensures that healthcare providers are equipped to offer culturally sensitive care. Advocating for policies (D) can lead to systemic changes that benefit the immigrant population. Establishing ongoing communication (E) ensures that the community’s evolving health needs are continuously addressed.