Nursing an Hispanic Patient

Course Outline

1. History of Hispanic American Immigration

Early History

  • In the Southeast
  • In the Southwest
  • Mexican Independence and Free Trade

Conflict With the United States

  • Problems For Landowners

Immigration in the Early 1900’s

  • Immigration Restrictions
  • Growing Discrimination

Effects of World War II

Immigration In the Mid-1900’s

  • Puerto Rican Migration
  • Cuban Migration
  • Problems With Cuban Migration
  • Living Conditions for Cuban Americans

Immigration in the Late 1900’s

  • Hispanic Americans Today
2. Understanding the Hispanic Culture

Cultural Backgrounds of Hispanic Americans

  • Cultural Bonds
  • National and Ethnic Origins
  • Where Hispanics Live
  • Settlers in the West Indies
  • Spanish and African Influences in Puerto Rico and Cuba
  • Aztec Influence in Mexico
  • Spanish and Indian Cultures in Mexico
  • Holidays

The Day of the Dead–Mexico Honors Those Gone But

  • Not Forgotten

Hispanic Values

  • Family Values
  • Etiquette
  • Rituals and Religions
  • Celebrations and Holidays
  • Eating Habits
  • Teaching and Learning Implications
  • References
3. What It Means to Be Latino

On Terminology: Hispanic or Latino?

‘Hispanic’ vs ‘Latino’

4. Getting to Know The Hispanic/Latino Culture
  • La Familia  
  • Respeto  
  • Personalismo  
  • Confianza  
  • Names  
  • Family Structures  
  • Communication and Social Interaction  
  • Time Orientation  
  • Concept of Health  
  • References  

Mexican-American

  • Food Habits and Their Relationship to Dietary Guidelines 
  • Eating Practices, Food Preferences and Food Preparation Techniques 
  • Teaching Implications 
  • References 

Puerto Rican  

  • Food Habits and Their Relationship to Dietary Guidelines 
  • Eating Practices, Food Preferences 
    and Food Preparation Techniques 
  • Teaching Implications 
  • References  

La Cocina—Southwestern Cuisine

5. Hispanic Health Status
  • Key Facts

Mortality and Morbidity

  • Smoking
  • Diet
  • Cholesterol
  • Weight and Exercise
  • Alcohol and Substance Abuse
  • Violence and Unintentional Injuries
  • Environment

Key Areas of Concern

  • AIDS and HIV
  • Cancer
  • Coronary Heart Disease, Stroke, and Hypertension
  • Diabetes
  • Environmental Health
  • Mental Health
  • Tuberculosis

Health Beliefs and Practices

  • Concept of Health
  • Potential Culture-Related Health Concerns Among Hispanic
    Populations
  • Health Promotion, Prevention, and Treatment
  • Folk Beliefs of Some Hispanics About Health and Illness
    That Can Affect Care and Treatment
  • Major Folk Illnesses Among Hispanic Populations
  • Major Systems of Folk Healing Among Hispanic Populations
  • Sources for Further Reading

Health Culture Sketch

  • Introduction
  • Geographic Distribution in U.S.
  • General Characteristics
  • Health Care Decision-Making
6. Cultural Diversity: Eating in America

Mexican-American

  • Food Habits and Their Relationship to Dietary Guidelines
  • Eating Practices, Food Preferences and Food Preparation
    Techniques
  • Teaching Implications
  • References

Puerto Rican

  • Food Habits and Their Relationship to Dietary Guidelines
  • Eating Practices, Food Preferences and Food Preparation Techniques
  • Teaching Implications
  • References

La Cocina—Southwestern Cuisine 88

7. Acculturation Erodes the Diet Quality of U.S. Hispanics
  • Status of Hispanics Varies by Origins
  • Table 1. U.S. Hispanic Populations Vary Widely in Age,
    Earnings, Level of Schooling, and Household Size
  • Disease and Mortality Puzzle Policymakers
  • Hispanics Surpass Non-Hispanics in Diet Quality
  • . . . Especially Spanish-Speaking Hispanics
  • Table 2. Hispanic Spanish Speakers Score Highest on Healthy
  • Eating Index
  • Table 3. Hispanic Attitudes and Knowledge About Nutrition Diverge
  • References

Nutrition Counseling Tips For Hispanic-American Clients

8. Folk Medicine in Hispanics
  • Concept of Disease
  • Origins of Hispanic Folk Medicine
  • Utilization of Lay Healers Among Hispanics
  • Hypertension
  • Diabetes Mellitus
  • Folk Medicine-Treatments-Upper Respiratory Infection
  • Folk Medicine-Treatments-Osteoarthritis/Rheumatism

Treatment of Folk Illnesses

  • Conclusion
  • Folk Remedies Everyone Should Know
  • Illustrations: Plants and Herbs Commonly Used as Folk Remedies
  • Curandera Preparing for a Barrida
9. The Influence of Ethnicity on the Use of Herbal Remedies

Introduction

  • Discussion
  • Conclusion
  • Table 1. Herbal Users by Perceived Health Problems
  • Table 2. Botanical Nomenclature for Commonly Used Herbal Remedies
  • Table 3. Herb Users’ Sources of Information on Herbal Remediesa
  • Table 4. Frequency of Use of the Top 10 Herbs Used by Herbal Users
  • Table 5. Most Frequently Used Herbal Remedies forTop Five Perceived Health Problems
  • References
10. Hispanics/Latinos: Health Disparities Overview
  • Terminology

Demographics

  • Size and Origin of Population
  • Location
  • Age
  • Family Size
  • Underlying Causes of Health Disparities: Income and Education
  • Education
  • Socioeconomic Status and Health Status
  • Income and Economic Status
  • Employment

Health Status

  • Leading Causes of Mortality
  • Specific Health Concerns
  • Traditional Health Beliefs and Practices
  • Traditional Illnesses

Risk Factors and Challenges

  • Racism
  • Environmental and Occupational Hazards
  • Health Insurance Coverage and Access to Quality Care
  • Language and Communication
  • Obesity
  • Smoking
  • Alcohol Use
  • Physical Activity
  • Practical Tips For Treating Hispanic Patients
  • Strengths and Protective Factors
  • Diet

Adherence Factors

  • Decision-making 
  • Communication 

Complementary and Alternative Medicine

  • References and Resources

Quality & Culture Quiz

Quality & Culture Quiz Answers

11. Cancer Health Disparities

Cancer Rates

  • Overall Incidence and Mortality Rates
  • African -Americans
  • Hispanics/Latinos
  • Asian Pacific Islanders
  • American Indian/Alaska Natives

What Are Cancer Health Disparities?

  • Financial Issues
  • Minorities Are More Likely Not to Have a Regular Doctor
  • Minorities Face Greater Difficulty in Communicating
  • Transportation Can Limit Access
  • Accurate Information is Not Universally Available
  • Percentage of Adults Who Have Problems Communicating With Their Doctor
  • Percentage of U.S. Women Who Had Screening Tests
  • Available Information Does Not Reach All Populations
  • Potential Biases Can Affect Cancer Health
  • Not Everyone Receives the Screening Equally
  • Higher Percentage of Whites Receive Medicare Services in Managed Care Plans
  • Older African Americans Receive Lower Rate of Surgery And Have Lower Resulting Survival Rate
12. Disparities in Cardiovascular Disease (CVD)

Eliminate Disparities in Cardiovascular Disease (CVD)

  • What is the burden of cardiovascular disease in the United States?  
  • Where are the disparities?  
  • What is the goal?  
  • What is the strategy?  
  • What can healthcare providers do to help reduce the burden of CVD?  
  • What can individuals do to decrease their risk of developing CVD?  
  • For More Information About Cardiovascular Disease: 
13. Unequal Treatment: What Healthcare Providers Need to Know

Do Racial and Ethnic Minorities Receive a Lower Quality of

  • Healthcare?

What Are the Sources of Healthcare Disparities?

  • Clinical Uncertainty
  • The Implicit Nature of Stereotypes
  • Healthcare Provider Prejudice or Bias
  • Medical Decisions Under Time Pressure with Limited Information
  • Patient Response: Mistrust and Refusal

What Can Healthcare Providers Do to Help Eliminate

  • Disparities in Care?
  • Guide to Information Sources
  • REFERENCES
  • Did You Know…
14. Diabetes in Hispanic Americans

Major Studies of Diabetes in Hispanic Americans

How Many Hispanic Americans Have Diabetes?

  • Table 1. Hispanic American Populations in the United States and
    Percentage With Diabetes

What Factors Increase the Chance of Developing Type 2 Diabetes?

  • Genetic Risk Factors
  • Figure 1. Prevalence of Diagnosed and Undiagnosed Diabetes in Mexican Americans, U.S., 1988-94
  • Figure 2. Genetic Origins of the Major Hispanic Subgroups in the United States
  • Medical and Lifestyle Risk Factors
  • Prediabetes (Impaired Glucose Tolerance and Impaired Fasting Glucose)
  • Gestational Diabetes
  • Hyperinsulinemia and Insulin Resistance
  • Obesity
  • Figure 3. Prevalence of Overweight Individuals Among Whites,
    Blacks, and Mexican Americans in the Population, 1988-91
  • Physical Activity

How Does Diabetes Affect Hispanic Young People? 

How Does Diabetes Affect Hispanic Women During Pregnancy?

How Do Diabetes Complications Affect Hispanic Americans?

  • Eye Disease
  • Kidney Disease
  • Nerve Disease
  • Peripheral Vascular Disease
  • Heart Disease
  • Diabetes and Diet

How Is NIDDK Addressing the Problem of Diabetes in Hispanic Americans?

  • Diabetes Prevention Program 
  • National Diabetes Education Program 

Points to Remember  

  • References
15. Minority Women’s Health Concerns

What Health Problems Affect a Lot of Hispanic Americans/Latina Women?

  • Obesity and Overweight
  • Heart Disease
  • Stroke
  • Cancers
  • Maternal and Infant Health
  • Smoking and Pregnancy: A Critical Risk Factor for Pregnant Females
  • HIV/AIDS
  • Cultural Attitudes
  • Gender Roles
  • Attitudes About Sex
  • Other Sexually Transmitted Diseases
  • Diabetes Mellitus
  • Tuberculosis
  • Psychiatric Disorders

Violence Against Women

  • Hispanic American/Latina Women
  • Leading Causes of Death for Women in the United States, 2000

Getting Health Care

  • What types of care coverage exist? How do I find
    out about them?
  • For More Information
16. Factors Affecting The Health of Women of Color

Adolescent Females of Color

  • Access to Services
  • Health
  • Health Risk Behaviors
  • Sexual Intercourse
  • Substance Abuse
  • Unsafe Moter Vehicle Operation
  • Healthful Behaviors

Elderly Women of Color

  • Demographics
  • Native Americans
  • Hispanics
  • Black Americans
  • Asians and Pacific Islanders
  • Access to Health Care
  • Health Assessment
17. Maternal Health of Hispanic Women
  • Folic Acid Knowledge and Use Among Hispanic Women
  • Preventing Alcohol-Exposed Pregnancies Among Hispanic Women

Maternal Health Risks of Immigrant Women From Latin America

Maternal & Reproductive Health Beliefs

Understanding the Health Culture of Recent Immigrants to the United States: A Cross-Cultural Maternal Health Information Catalog

  • Examples of Cultural Beliefs Held by Certain Immigrant Groups
  • Examples of Epidemiological Data Affecting the Health of Childbearing Women
  • Examples of Proposed Links Between Epidemiological Data and Cultural Beliefs/Practices; and Associated Health Risks to Pregnant Women and Infants
  • Lessons for Health Care Professionals From Knowledge of Cultural Beliefs or Immigrant Experiences
  • REFERENCES
18. Violence and Minority Women

Screening for Abuse in Spanish-Speaking Women

  • Women Abuse Screening Tool
19. Hispanic American Elders

Introduction

The Older Hispanic Population: Past, Present, and Future

  • Residence
  • Educational Level
  • Living Arrangements
  • Poverty
  • Health
  • Self-Rated Health Status
  • Access to Medical Care
  • Diversity of Hispanic Elders
  • Health and Chronic Illnesses
  • Hispanic Americans and Family Caregiving
  • Older Hispanic Americans and Poverty
  • Education

Elderly Abuse in Hispanic Families

20. Alcohol and Minorities

Ethnic Differences in Drinking Patterns

Ethnicity and Alcohol Problems

  • Medical Consequences
  • Social Consequences

Contributors to Ethnic Differences

  • Social Factors
  • Biological Factors

Prevention

  • School-Based Prevention
  • Family-Based Prevention
  • Alcohol Availability

Treatment

NIAAA Analysis Reveals Increased Risk for Liver Cirrhosis Death Among Hispanic Americans

  • References
21. Hispanics and Tobacco

Health Effects

Cigarette Smoking Prevalence

  • Prevalence of Other Forms of Tobacco Use
  • Tobacco Industry Influence
  • References
22. Mental Health

Latinos/Hispanic Americans

  • Need For Mental Health Care
  • High-Need Populations
  • Availability of Mental Health Services
  • Access to Mental Health Services
  • Use of Mental Health Services
  • Appropriateness and Outcomes of Mental Health Services
  • Culturally Specific Mental Health Resources

Learning Objectives

After completing the course you’ll be able to:

History of Hispanic American Immigration
  1. Recount the history of Hispanic immigration in the United States.
Understanding the Hispanic Culture
  1. Describe the core values and norms of the Hispanic culture.
What It Means to Be Latino
  1. Describe what it means to be a Latino.
  2. Explain what the terms Latino and Hispanic imply.
Getting to Know The Hispanic/Latino Culture
  1. Explain the concepts of la familia, respeto, personalismo, and confianza in the context of Hispanic culture.
Hispanic Health Status
  1. Describe mortality and morbidity in Hispanic population.
  2. List top ten leading causes of death for Hispanics of all age groups.
  3. Describe the impact of various lifestyle and health behavioral factors on
    Hispanics’ health status.
  4. Describe the concept of health and preventive medicine in the context of
    Hispanic culture.
  5. Explain typical Hispanic health beliefs and practices.
  6. Explain major folk illnesses among Hispanic populations, defining
    curanderismo.
Cultural Diversity: Eating in America
  1. Describe the eating practices, food preferences and cultural implications of Mexican-American and Puerto Rican diet.
Acculturation Erodes the Diet Quality of U. S. Hispanics
  1. Discuss how acculturation erodes the diet quality of U.S. Hispanics.
  2. Discuss Hispanic attitudes and knowledge about nutrition among various population groups.
Folks Medicine in Hispanics
  1. Describe the origins and applications of Hispanic folk medicine.
  2. Identify common Hispanic folk illnesses and their remedies.
  3. Incorporate the knowledge of Hispanic folk medicine beliefs into the development of effective patient management and counseling plans.
The Influence of Ethnicity on the Use of Herbal Remedies
  1. Distinguish between non-Hispanic whites and Hispanics in their use of herbal remedies.
Hispanics/Latinos: Health Disparities Overview
  1. Describe the socioeconomic and health status of Hispanics and compare
    it with that of other population groups.
  2. Follow recommendations to confirm patient teaching and treatment with
    the traditional health beliefs and practices.
  3. Implement recommendations to improve communication with Hispanic
    patients.
Cancer Health Disparities
  1. Cite statistics that show cancer health disparities among various racial
    and ethnic groups.
  2. Discuss various sources of disparities in cancer treatment for minority
    population groups.
Unequal Treatment: What Healthcare Providers Need to Know
  1. Discuss how bias, prejudice, and stereotyping can contribute to unequal
    treatment of patients on the basis of race and ethnicity.
Diabetes in Hispanic Americans
  1. Discuss the epidemiology of diabetes in Hispanic Americans.
  2. Identify the factors that increase the chance of developing type 2
    diabetes.
Minority Women’s Health Concerns27. Discuss the health problems affecting minority women.
  1. Describe the health impact of sexually transmitted diseases on minority
    women.
  2. Discuss the prevalence of psychiatric disorders among various women
    groups.
Factors Affecting The Health of Women of Color
  1. Discuss factors affecting the health of women of color and their access
    to services.
  2. Discuss health risk behaviors that place adolescent females of color at
    increased risk of morbidity or death.
  3. Describe the demographics of elderly women of color.
  4. Discuss the access to health care available to elderly women of color and
    its impact on morbidity and mortality.
Maternal Health of Hispanic Women
  1. Discuss the key findings of the report dealing with pregnancy-related mortality in Hispanic women in the United States.
  2. Describe maternal health beliefs and practices that are common to Hispanic culture.
  3. Cite examples of epidemiological data affecting the health of childbearing women from various immigrant groups.
  4. Make a link between epidemiological data and cultural beliefs and health risks to pregnant women and infants.
  5. Apply the knowledge of cultural beliefs and immigrant experience to providing effective health care.
Violence and Minority Women
  1. Define terms such as intimate partner violence, sexual assault, dating violence, elder abuse.
Hispanic American Elders
  1. Describe the special problems faced by Hispanic elders.
  2. Describe the prevalence of elderly abuse in Hispanic families.
Alcohol and Minorities
  1. Identify social and biological factors that contribute to ethnic differences
    in drinking.
  2. Describe ethnic differnces in drinking patterns.
Hispanics and Tobacco
  1. Discuss the use of tobacco in the Hispanic population.
Mental Health
  1. Discuss the need for mental helth care in Hispanic Americans.

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.


Customer Comments

“I liked the layout of the test questions & the titles in the book with explainations.”

– J.J., RN, CA