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06.01 Care for Hispanic Patient Populations

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Overview

  1. Latino vs. Hispanic
    1. Preference
    2. Latino
      1. Latin American descent
    3. Hispanic regions
      1. Cuban
      2. Mexican
      3. Puerto Rican
      4. South American
      5. Central American
  2. Culture
    1. Family
      1. Gender roles are specific
        1. Men
          1. Decision makers
          2. Protectors
        2. Women
          1. Glue of family
      2. Involvement in care
        1. Encouraged as resource
    2. Religion
      1. Plays major role in health
        1. Saints for illness/healing
        2. Rites
          1. Baptism
          2. Anointing of sick
        3. Illness is punishment
    3. Respect
      1. Avoid
        1. Direct eye contact
        2. Being overly familiar/friendly
          1. Particularly with elderly
        3. Gesturing
      2. Watch
        1. Nonverbal cues
          1. Silence is natural
            1. Questions are limited
            2. Can be non-understanding
            3. Can be cultural
            4. Can result in non-compliance
        2. Your actions
          1. Build rapport
            1. Warmth
            2. Dignity
          2. Communication
            1. Translator when needed
              1. Avoid using family member
    4. Treatment practices
      1. Home/natural remedies
      2. Family
      3. Curandero
        1. Folk healer
      4. Prayer
      5. All result in late care
        1. Must be based on beliefs

Reference Links

Video Transcript

Today we’re going to be talking about Hispanic culture.

Let’s talk first about the difference between Latino and Hispanic. Being called Hispanic versus Latino is really a matter of identity and preference, but geographically speaking, Latinos are of Latin American descent. Hispanics are defined by language, in this case Spanish speaking. This encompasses Mexican, Cuban, Puerto Rican, South and Central Americans and if you’re looking at these two maps, they mostly overlap.  

Family is an important part of Hispanic culture. In that family, gender roles are very specific. Men are designated as the decision-makers and protectors of the family. Women are relied on as the “glue” that keeps the family functional. Even though the male head of the household is the ultimate decision-maker, family in Hispanic culture is encouraged to be involved in care not only when it comes to the decision-making process but also to act as a resource.

If you know someone from any Hispanic culture, you know that religion is of very high value. Most Hispanics and Latinos are Catholic, which assigns specific Saints for specific illnesses and healing.  Rites of passage for different stages of life are also important to the culture, like Baptism and anointing the sick, which is done to provide spiritual strength near death. Another belief is that illness is a form of punishment for some bad deed or sin a person has committed in their life.

Understanding how to respond to a Hispanic patient and the different cues that can be exhibited in your exchange during care is important so that you don’t inadvertently create additional barriers. Here are some do’s and don’ts. You want to avoid making direct eye contact. This is seen as a sign of disrespect. If you absolutely have to make eye contact, don’t make it for too long, as it can create tension and possibly, your patient to shut down. Some of us are super friendly and engaging, but you have to be careful with different cultures because that friendliness can be mistaken for something different. In this case, it’s disrespectful. So, try not to walk in the room acting like you’ve already met this person for the first few meetings. This is very important with the elderly, who are to be respected at all times, so formalities are a necessity. I talk a lot with my hands but when dealing with a person from a different culture I have to understand that my hand talk may not go over very well, no matter how much I disclaimer it. Watch your gesturing. What you do want is to understand that silence can be very natural despite being uncomfortable. Look for nonverbal cues during that silence. There may not be a lot of questions from your patient. Maybe it’s cultural, maybe they don’t understand, but either way, if you’re not paying attention to those non-verbal cues, you’re increasing the chance for noncompliance. Lastly, when you come in the room, start building a rapport. If you need a translator, use a professional so the medical message gets through. This definitely gives your patient a sense of dignity and sincerity and it builds on that respect to create trust and a good working relationship.

There are a few exceptions to this next one, but most of the time when we see a Hispanic patient in the hospital, we are providing late care because they have tried other treatments that are either more natural or stick to their cultural belief system first. These are in no particular order because there are multiple factors affecting them. Home and natural remedies are most likely what we all tend to try before we see a doctor. But things like the Curanderos and prayer are more culture related practices. Curanderos use different remedies like herbs for instance, to heal illness. Most prayers go to the Saint assigned to that illness and are typically done in church with candle lighting. Remember, regardless of how early or late, the care we provide in any setting has to accommodate the cultural values and beliefs of that patient, which is essentially the core of person-centered care.

We love you guys! Go out and be your best self today! And as always, Happy Nursing!

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