Academic journal article Journal of Cultural Diversity

From Recipes to Recetas: Health Beliefs and Health Care Encounters in the Rural Dominican Republic

Academic journal article Journal of Cultural Diversity

From Recipes to Recetas: Health Beliefs and Health Care Encounters in the Rural Dominican Republic

Article excerpt

Abstract: With the growing influx of immigrants from the Dominican Republic entering the U.S. yearly, it is important for nurses to become familiar with their traditional health beliefs and health care experiences. The purpose of this study was: (a) to identify health beliefs of rural Dominicans and (b) to describe health care encounters between rural Dominicans and a visiting team of U.S. nurses. The data on health beliefs were collected in six focus groups and were analyzed using content analysis techniques. Health encounter data were collected from 693 Dominicans as they presented to mobile clinics for care. Findings from the focus group interviews suggested that health beliefs fall into two major categories: physical and spiritual/mystical. The most frequently occurring health problems, summaries of medications dispensed, treatments provided, referrals made, and health teaching information are presented.

Key Words: Dominican Republic; Health Beliefs; Health Care; Cultural Diversity

The rapidly changing demographics in the U.S. present health care professionals with the challenge of providing culturally sensitive and appropriate health care to diverse populations. The Spanish speaking population is the fastest growing group with predicted increases from 8% to 11.3% resulting in a total of 31 million Spanish speaking immigrants by the year 2000. Spanish is the most common language; many of the recent immigrants come from places as diverse as Mexico, Puerto Rico, the Dominican Republic, Guatemala, Honduras, El Salvador, and South America. Statistics show a steady increase of Caribbean immigrants to the U.S. predicting increases from 104,804 Caribbean immigrants in 1994 to 116,801 in 1996 (U.S. Immigration and Naturalization Service, 1997). In 1996, immigrants from the Dominican Republic alone totaled 39,604, or 4.3% of the total number of immigrants entering the U.S.

Given this recent influx of Dominicans, it is imperative that nurses and other providers become familiar with the traditional health beliefs and health care experiences in the homeland of these people. This study focused on understanding health beliefs and health care needs of Dominicans. The purpose of the study was twofold: (a) to identify health beliefs of rural Dominicans and (b) to describe health care encounters between rural Dominicans and a visiting team of U.S. nurses using mobile clinics to meet episodic health care needs of this underserved population.

BACKGROUND

A culture consists of whatever it is one has to know or believe in order to operate in a manner acceptable to its members (Kelley, 1997). Culture dictates beliefs about self care and care of others, including health care beliefs and practices. Outsiders who do not share the Dominican culture must suspend ethnocentric beliefs about what is correct and important to discover what is essential to the Dominican way of life. When health care providers begin to understand what health beliefs and practices fit into the Dominican world view, then success in reaching out to offer appropriate and acceptable health care becomes possible.

In the literature, there are multiple ways of classifying cultural health beliefs. Tripp-Reimer (1984) proposed a emic-etic distinction in which culturally specific (i.e., emic) definitions of wellness and illness are compared and contrasted with biomedical (i.e., etic) definitions of health. The need to assess the congruence between the client's, the nurse's, and the dominant health care system's values, beliefs, and customs has been emphasized (Tripp-Reimer, Brink, and Saunders, 1984). Another classification of cultural health beliefs is Jackson's (1993) three categories: biomedical (e.g., Western medicine), personalistic (e.g., sorcery, supernatural), and natural stic (e.g., balance, equilibrium, harmony, equilibrium). It is also necessary to consider folk beliefs and behaviors that fall outside the realm of the biomedical paradigm but may influence illness experiences (Pachter, 1994). …

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