The Mexican Culture Is Uniquely Essay Example

with Daniela Vela Hernandez, a Licensed Marriage and Family Therapist. She currently works as a regional manager for a private medical group and was able to provide 'her' experiences. Daniela is a second generation Mexican-American whose parents emigrated to the United States to seek better job opportunities. Daniela states both her parents and grandparents specifically search for healthcare providers that speak Spanish. Daniella often sees this behavior in elder Mexican immigrants because of the language barrier. Healthcare workers who may know some Spanish can create a sense of false fluency, furthering the barrier between the provider, and the patient as well as losing a trusted relationship. A consequence of these problems is a marked disparity in the quality of care that Hispanic patients receive (Juckett, 2013). Daniella and her family live in Imperial, California which very close to the Mexican border.

Daniella’s parents and grandparents prefer their medical treatments in Mexico as opposed to receiving care in the United States. Daniela states “healthcare and treatments in Mexico are much more affordable for the same or better care. My family prefers speaking in their native language because they do not understand English.” Her grandmother is uncomfortable using telemedicine when discussing her health issues, especially if it is something personal. Her elderly grandfather has difficulty comprehending speaking through a translation device to discuss his medications when the provider is present in front of him. While more options have become available to aid in translation, Daniella does not find these devices to be particularly patient friendly and feels they can add to the language barrier. She notes “the language barrier could lead Spanish speaking patients to gravitate to Spanish

speaking providers which then narrows patient options for care.” Understanding the role that language plays in generating barriers to quality medical care is critical for healthcare organizations. There has been a steady increase of Spanish speaking Mexican immigrants in the United States (Cultural Insights: Communicating with Hispanics/ Latinos, 2018).

Mexican Americans and Mexicans value many common religious roots however, Mexican Americans are not as heavily Catholic as those who immigrated from Mexico or live in Mexico currently (Donoso, 2014). In regard to religious affiliation, there are differences among Mexicans and Mexican-Americans with 81% of Mexicans identifying as Catholics, and only 61% of Mexican-Americans identifying as Catholic. About 18% of Mexican Americans are identifying as Protestant versus only nine percent of Mexicans identifying as Protestant. Additionally, 17% of Mexican- Americans do not practice a religion, whereas only 7% of Mexicans claim to have no religious affiliation (Donso, 2014). However, in the interview with Daniella, she points out that several other members of her family practice different religions so to never assume a persons' religion by their nationality.

The Posadas pay tribute to Mary and Joseph's long and difficult journey from Nazareth to Bethlehem. They were seeking a location for the Christ Child to be born. Posadas was a tradition brought to Mexico from Spain in the 1500s by Catholic Missionaries (Farfaglia, 2014). The Posada begins with reciting the prayer to Mary, the Mother of Jesus, called the Holy Rosary. During the interview conducted with Daniella Vazquez, she states “I often incorporate rosary into my clients care. I assign praying the rosary as homework for my clients who need to meditate or do deep breathing. This is a good

grounding exercise. It is repetitive, gives tactile stimulation with the beads and takes about 20 minutes which is the ideal time to exercise.” Daniella also notes “the Virgin Mary is the patron saint of Mexico. Many pray to her more than a traditional prayer.”

Death is a cause for celebration in the Mexican culture and is viewed as an important event (Bravo, 2014). Death isn’t just about the heart stopping or a person's breathing ceasing; it is about beginning a new journey (Donso, 2014). A traditional custom in preparation for the afterlife of a deceased family member requires living family members to wrap the deceased in a mat in which they died on prior to cremation. The deceased family members ashes are then put into a hut for nine days until they are ready to pass into the next life and meet God (Bravo, 2014). The eight days in between cremation and the passing into the afterlife, family members gather around the ashes to eat, drink, talk, and pray (Donso, 2014). Ashes are then buried on the ninth day with a celebration of dancing and music (Donso, 2014). This along with many other traditions have been passed down through generations with slight variations. For example, the current custom surrounding death in the Mexican American culture is to make a cross with lime or dirt According to these traditions' death is the beginning of the afterlife (Donso, 2014). A slight variation from the traditional custom, family and friends gather around the cross they draw for nine days to pray, drink, and eat tamales (Donso, 2014). On the ninth day, they perform the ceremony known as the levantacruz,

which means ‘lifting the cross.’ The ceremony completes the rite of gathering God’s steps and ends the persons earthly experience allowing God and the deceased to find each other (Bravo, 2014).

Communication is a key factor in establishing a trusting relationship with Mexican patients and people of Mexican descent. The Hispanic culture has several important values that healthcare workers should be mindful of which include simpatía (kindness), personalismo (friendliness), and respeto (respect) (Juckett, 2013). Simpatía is a general tendency toward avoiding personal conflict (Juckett, 2013). It emphasizes positive behaviors in agreeable situations and discourages negative behaviors in difficult circumstances. Personalismo, means a personal connection. This can be achieved by showing interest in the patient and family (Juckett, 2013). Physical proximity is also perceived as being more personable and healthcare personnel should understand in an attempt to achieve personalismo, one may stand closer when communicating (Cultural Insights: Communicating with Hispanics/ Latinos, 2018). Since Mexicans grant respect to their superiors, they expect their superiors to reciprocate by demonstrating personalismo by showing kindness, warmth, and a friendly demeanor. Respeto is the Spanish term for respect. It implies attentive concern for the patient and respect of personhood and age (Juckett, 2013).

Mexicans offer respect more readily to people in a position of power, or those perceived as experts. Daniella noted during her interview that this form of respect offered to people in a position of power can actually cause a barrier to providing care to patients and refers to it as a “double edged sword.” Stating “they [patients] will either comply with treatment because of cultural norms or if they don’t agree, they won’t tell the provider thus hindering treatment.” What

she suggests is being in tune with body language and asking questions about preferences to get the patient to talk and open up about their concerns with their plan of care. She has found Mexican patients will just nod their heads yes in the office and not work with the provider to develop an alternative treatment plan. She also finds patients who disagree with the plan of care will agree with the plan in the office to adhere to respeto however, when they leave the office they do not adhere to the medical advice. Daniella also suggests asking open ended questions to better understand the patient's thought process and understanding of the disease process and treatments.

A person's elder regardless of their position are granted respect and should be addressed as señor or señora rather than by their first names (Juckett, 2013). Double or hyphenated surnames may seem complicated and make addressing patients properly a challenge. If there is any question about the appropriate way to address a patient it is best to ask the patient how they prefer to be addressed (Juckett, 2013).

Caring for Mexican patients poses a unique set of challenges surrounding cultural values which may differ from traditional Western medicine. Machismo is a characteristic of a man defined as prominently excessive masculinity or toughness needed (Cultural Insights: Communicating with Hispanics/Latinos, 2018). Machismo can range from a personal sense of virility to the more intense form of male chauvinism (Evason, 2018). While many of the unique traits of Mexican- American men are admirable, health care workers should pay special attention to a man of Mexican descent who may need help to cope with emotions

during a difficult situation needed (Cultural Insights: Communicating with Hispanics/Latinos, 2018).

True to these values, men are often reluctant to consult physicians for health problems until he is so ill that a visit to an emergency room is needed (Cultural Insights: Communicating with Hispanics/Latinos, 2018). Holding true to Machismo the man may also attempt to 'tough it out' during illness that may require medical attention. The female’s serve as the maternal powerhouse in their home. In the Mexican culture women are sacred and often protected because the family unit depends on her good health and maternal skills (Evason, 2018). The Hispanic population show great concern for ill family members through excessive care and attention (Evason, 2018). This at times can extend to the point of interfering with rehabilitation and proper medical care (Cultural Insights: Communicating with Hispanics/Latinos, 2018).

Mexican women can view pregnancy as a normal condition and may not attend prenatal visits or receive proper prenatal care (Gress-Smith et al., 2013). Pregnant women commonly look to their elders to provide support and advice during pregnancy. A common belief is that pregnant woman should avoid all contact surrounding anything death-related and is forbidden to attending funerals or burials (Gress-Smith et al., 2013). Hispanic women adhere strongly to familism and value the nuclear and extended family (Gress-Smith et al. 2013). It is common practice for a pregnant woman to prefer that their mother attend to her during labor. Traditionally it is believed tending to a woman during delivery is a woman's job, ideally by her mother and a midwife (Gress-Smith et al., 2013). Cultural tradition is that a husband should not see his wife or child until the

delivery is completed and both the mother and infant have been cleaned and dressed (Gress-Smith et al., 2013).

‘Lying in’ also known as a confinement period or la cuarenta lasts 40-days. It is considered essential to caring for the child and aid in prevention of diseases and complications. During this period the woman’s body is thought to be extremely weak and vulnerable to external forces and she is prohibited from bathing or exercise during this time (Chou, 2017). Many Mexican women choose not to breastfeed until they return home from the hospital following the belief that they have no milk (Chou, 2017). Until a mother's breasts enlarge and are visibly full, she may not feel she has sufficient milk to feed her infant. Some mothers view colostrum as 'bad milk' or 'spoiled' and therefore not good for the baby, not understanding that nursing stimulates milk production and colostrum is full of nutrients (Chou, 2017). Educating mothers during this time is important to successful experience with breastfeeding.

Many aspects of modern western medicine are a last resort for health, wellness and preventative care in the Mexican culture and some treatments are based off of the “hot and cold” theory. Preventative care is not typically sought out in the Mexican culture, believing much of a person's health is based on fate (Sobel & Sawin, 2014). During a period of illness, cultural influences as well as socioeconomic influences dictate that home remedies are to be tried first. They will also take the advice of the elderly for herbal or natural healing methods to aid in healing (Hernandez-Morin, 2018). Then possibly a folk healer also known as a curandero will be

traditionally used (Hernandez-Morin, 2018). Modern western medicine is commonly the last resort for illness which is strongly influenced by a lower socioeconomic status (Sobel & Sawin, 2014). Daniella discussed in her interview the financial hardships her family experienced which determined what they used for their medical care. Often her family would use herbal teas and folk healing passed down from generations since they could not afford to pay for modern medicine. She also noted coming from a low-income family which played a role in where her medical care was going to take place. If she needed to be seen by a doctor, then her parents would take her back to Mexico where both Daniela and her parents felt the care was more heartfelt and warmer as well as financially feasible.

Curanderos is a traditional healer and will distinguish between “hot” and “cold” illnesses as well as determine a treatment. The theory suggests that when there is an imbalance or illness which is labeled either hot or cold then a person can then eat the opposite foods to balance the problem. Proper balance is considered necessary for good health and any imbalance results in an illness (Juckett, 2013).

Folk healing and the use of herbal remedies is common practice for both the population in Mexico and the Mexican American population. Traditional folk medicine and home herbal remedies may delay treatment and possibly reduce positive outcomes (Juckett, 2013). Physicians and healthcare personnel may be perplexed or not understand the importance of traditional folk healing. Patients often utilize brujos or brujas (wizards or witches), yerberas (herbalists), hueseros (bone setters), parteras (midwives), and sobradores (similar to physical therapists) prior to seeking

traditional western medicine practices (Juckett, 2013). Symptoms and disease processes can be perceived differently in the Mexican culture. For example, posttraumatic shock or anxiety may be associated with susto or soul loss rather than posttraumatic stress disorder. A patient may link their abdominal pain to empacho or food being stuck in the intestine (Juckett, 2013). Commonly a child's failure to thrive is attributed to mal de ojo or the evil eye which is a hex conveyed by an envious glance (Juckett, 2013).

Given the frequent use of herbal remedies Nurse to patient communication is vital in terms of avoiding the dangers of herb and drug interactions. Andrea Saiden is an LPN who works in the Infectious Disease Department at Brigham and Women's Hospital in Boston. She was born in Mexico and immigrated to the United States six years ago in search of better job opportunities. Both Andrea and Daniella speak highly of herbal remedies and how they play an important role in their own healthcare and treatment as well as their families. While Andrea and Daniella both work in healthcare and understand herbal treatments should not replace modern medicine, they both often utilize herbal remedies first or in conjunction with modern medicine. Furthering the importance of the nurse to outwardly ask patients if they are using any herbal treatments or remedies.

Andrea states tea being the most common herbal remedy she uses for various illnesses. Daniella reports her mother and grandparents have many options for herbal treatment and states “we have a remedy for every condition in the book, you should see my cabinet!” Most commonly she uses hot teas with different additives to aid in healing.

Daniella pointed out “These remedies are in conjunction with prescriptions. For example, if I take my daughter Raquel to Mexicali for an appointment when she has a cold with phlegm. The MD will prescribe the typical Tylenol and loratadine for congestion, but we will also give her mint tea.” Following the Mexican culture Daniella also uses cinnamon for sore throats and corn silk to rid kidney stones. Mix corn silk in boiling water and allow it too steep for ten minutes this is supposed to help break down the stones to pass them. She also suggests after delivering a baby, a mother commonly soaks in a rosemary bath to help with inflammation. Given the potential for adverse reactions and interactions associated with herbal remedies, it is important to identify the prevalence of herb use in Mexican population.

The language, religion, medicine, and folk healing remedies play an important factor in how a patient will understand and respond to medical advice as well as how they will utilize the information provided to them. Many of the ancient traditions and customs of Mexican ancestors have been preserved and are still commonly practiced today. Personal relationships and incorporating family in care are necessary in order form trust with the patient.