Culturally Competent Teaching PresentationCuban HeritageBy: Jennifer Panzarella RN, BSN

Goals Cultural considerations will discussed, and the learner

will be able to:

1. Identify Cuban characteristics based on an overview of

the heritage.

1. Identify the role of the family structure, function and

processes as related to the Cuban culture.

3. Identify common health risks and health care practices

for this population.

3. Identify communication techniques for the health care

provider in order to improve adherence to treatment

goals.

Introduction to the

Cuban Heritage

“Latino” or “Hispanic” are terms used

interchangeable

Most Cubans are white and 5% are black

16% of US population

30% by 2050

Overview of the

Cuba

90 miles south of Key West

Influenced by Soviet Union

Government mistrust

Migration for freedoms

Primarily Spanish speaking

Family Roles

“La familia”

The female (mother) will typically determines the need for medical care and the male (head of household) will make the decision to seek medical care .

Nuclear and extended families

Includes godparents

Multigenerational (3-4 generations)

Parents are often over-protective

Parents often seek health advice from non-medical personnel first

Advice for health care providers…

Gender roles should be respected

Parental decision should be respected

Egalitarian decision-making prevails in the U.S.

Verbal consent from family and next of kin

Extended family for discharge needs

Spirituality

85% Roman Catholic

15% Protestants, Jews and African Cuban

Santeria believers

Important role in daily lives

Belief in a higher power

Rituals and chants

Death Rituals

Openly expressed

Large family gatherings

Candles (use battery operated in health care

facilities)

Ceremonial Gestures

Clergy

Advice for health care providers…

Clergy to perform death rites

Gathering space

Do not remove statues or small offerings

Health Risks

Alcohol (higher in younger males)

Smoking is prevalent

Violent deaths

Hypertension

Heart disease is leading cause of death

Higher rates of obesity and diabetes

Health Behaviors

Health is viewed as the “absence of pain”

Lack preventative care

Seek health care when there is a crisis

Rely on family for health advice

Special considerations

Pregnancy and childbearing practices

Cultural Interpretations

Cold Conditions

Cancer

Headache

Menstrual Cramps

Pneumonia

Upper respiratory

Infections

Indigestion

Colic

Hot conditions

Anger

Anxiety

Diabetes

Diaper rash

GERD

HTN

Pregnancy

Sore Throat

Infection

NutritionPurpose of meal preparation

Staples are root crops, plantains, and grains

Prepare foods with olive oil, garlic, tomato sauce, vinegar,

wine, and spices

Marinate meats in citrus juices

Lack fiber

Lack leafy greens

Coffee is strong and bitter

Lactose intolerance is common

Meal times

Being overweight is a positive attribute

Cuban Food

Pyramid

www.Choosemyplate.gov

The newest update on the pyramid is a plate that

illustrates the 5 food groups with a focus on

consumption of portions.

Advice for health care

providers…Assess food preparations and flavorings

Determine customs

Caloric intake

Meal times

Counseled on acceptable weights

Incorporate preferred foods

Alcohol consumption

Common Health Care

Practices

Older women provide home remedies using teas, fruits, and

vegetables. They also create remedies using a combination of

items:

Stomach aches – anise tea

Cough – Lemon and honey tea

Elevated BP – grapefruit and garlic

Sore throat – salt water

Heartburn – baking soda, lemon and water

Pain

Expressed with verbal complaints

Moaning

Crying

Advice for health care

providers…

Need to assess level of acculturation

Preventative care

Include family

Determine medicinal products

Determine resources

Determine folk healers and treatments

Barriers Contributing to

Non-ComplianceLanguage

Lack of insurance

Cultural beliefs

Immigration

Mistrust

Literacy

Poverty

Approach to Care

Simpatia (kindness)

Personalismo (friendliness)

Respecto (respect)

The Health Care

Environment

Allow extra time

Patient gown

Bilingual signage

Interpreter

Handouts

Culturally sensitive

Case Study

Robert is 48 with Type II DM, hypertension, and has a BMI of

35. He was given two prescriptions for medications at the last

visit. They also discussed dietary changes and an exercise

program at his last visit. He has been noncompliant even

though he agreed to medications and verbalized that he

understood the instructions from his last appointment. At this

visit there is a telephone interpreter available.

The Interview

LEARN

LISTEN and understand the patients perspectives.

EXPLAIN and clarify the perceived problems

ACKNOWLEDGE and discuss

RECOMMEND treatment

NEGOTIATE and come to agreement

Interview questions

What do you call your problem?

What do you think caused the problem?

Why do you think it started?

How severe do you perceive your illness to be?

What are your fears?

What are the results that you hope to obtain?

What do you believe your treatment should be?

Therapeutic Communication

Techniques

Open-ended questions

General lead questions

Restate

Clarify

Reflect

Validation

Findings

Evaluation

“Teach back or “Show me”

Assess literacy

Assess language

Handouts

Repeat instructions

Increase understanding

References

Cultural Competency Series: Framework for Cross-cultural Health Care.

(2007). National Center for cultural Competence. Retrieved from:

http://clinicians.org/images/upload/cultural_competence.pdf

Junckett, G. (2013 January 1). Caring for Latino Patients. American Family

Physician. Volume 87 (1): 48-54. Retrieved from:

http://www.aafp.org/afp/2013/0101/p48.html

Peterson-Iyer, K. (n.d.). Culturally Competent Care for Latino Patients.

Markkula Center of Applied Ethics. Retrieved from:

Purnell, L. (2014). Guide to Culturally Competent Health Care. (3rd Edition).

F.A. Davis Company. Philadelphia, PA.

https://www.scu.edu/ethics/focus-

areas/bioethics/resources/culturally-competent-care/culturally-

competent-care-for-latino-patients/