Issues in Healthcare Diverse Cultures

Analysis Paper-Diverse Cultures

Diverse Cultures

Healthcare providers and those who work with Native Americans must understand specific cultural beliefs when treating individuals from this population for alcoholism (Austin et al., 1993). The American Indian perspective on health and illness highlights the importance of understanding the culture. This perspective is based on the idea of self-determination, which includes the freedom to make decisions regarding one\'s health and well-being. This perspective has specific issues that affect Native American communities, such as lack of trust in healthcare providers, lack of resources for treatment and rehabilitation, lack of available support for families and significant others, and involvement with tribal governments – all these factors are in direct opposition to the principles espoused by the person in environment perspective. Therefore, this paper presents a Critical analysis of advanced clinical practice theory and evaluates the person in environment perspective related to advanced clinical practice from \"SPOTLIGHT ON SPECIAL POPULATIONS, American Indians and Alcohol\" by Fred Beauvais.

The person-in-environment (PIE) model is described as a \"holistic model\" that encompasses the individual, family, physical and social environment. Several domains in the PIE model of care can incorporate American Indian perspectives. For example, psychosocial development and substance abuse are domains in which the PIE model views individuals as \"accountable for their behavior, capable of self-regulation, and having control over their health status\" (Austin et al., 1993). The PIE model incorporates these aspects into its conceptualization of \"health\" because it is believed to be more following the natural order of things.

The person-in-environment perspective espouses a \"holistic approach\" to care, no longer focusing exclusively on the patient\'s physical condition. This perspective is defined as the \"combination of knowledge, skills, and behaviors that are used to promote health and prevent disease in an individual\" (Abbott, 1996). The PIE perspective strives to consider the environment in which a person lives. While this may be a physical world, it also includes the social, economic, and spiritual aspects that affect one\'s experiences. In addition, there are also concepts within the PIE model of care, such as \"agency\" – an individual\'s beliefs about their desire to improve their overall well-being (Abbott, 1996). In other words, they believe that positive changes can be made regarding their health or behavior. This has been a powerful tool in overcoming the addiction because it allows those suffering from alcohol addiction more control over their behaviors.

In contrast to the PIE model of care, the American Indian perspective on health and illness is vastly different. In general terms, this perspective on health is that the body is sacred and can never be disrespected. The primary focus is on the spiritual side of healing, which also encompasses one\'s relationships with others, community, family, and land (Beauvais, 1998). The Individual & Family Services Plan – Tribal Component, which the Cherokee Nation created, provides specific examples in which cultural differences between Native Americans and those involved in the healthcare system are addressed. For example, the healthcare provider must assess the potential for cultural insensitivity, including a review of the provider\'s own personal attitude and behavior. This assessment identifies any areas in which cultural differences are perceived and enables a resolution plan. Cultural insensitivity may be as simple as not understanding appropriate or respectful ways to speak with specific individuals or groups (Beauvais, 1998). Additionally, if a healthcare provider is non-Indian and inappropriately uses ceremonies or sacred objects, this may also be considered cultural insensitivity.

The American Indian perspective on health and illness incorporates spiritual components that might appear to be incorporated into the PIE model (Austin et al., 1993). Spirituality is generally described as one\'s belief and relationship with the divine. The American Indian perspective can also incorporate the belief in higher powers. Still, the focus is less on a relationship with God or specific traditional ideas and more on a connection with nature. When looking at Native Americans and alcoholism, it becomes apparent that spirituality is integral to healing. However, obtaining an understanding of the spirituality of Native Americans is not easy because many of the beliefs are deeply rooted in culture, and some aspects are not publicly shared. It was found that spirituality can be viewed as a coping mechanism for Native American people (Austin et al., 1993). Those who struggle with alcohol abuse found that their alcoholism is often considered a way to cope with something negative or traumatic—for example, the loss of a loved one or abuse.

In addition to cultural differences between the healthcare system and Native Americans, specific cultural beliefs must be considered when working with individuals from this population. Some of the particular artistic ideas are (Beauvais, 1998):

\"The role of tribal government and laws, as well as the principles of democracy and self-determination, should not be diminished because of differences in cultural attitude or practice.\"

\"Self-determination includes an individual\'s right to determine their own life and lifestyle, which usually means decisions in the area of healing, education, and work. Individual autonomy is significant when pursuing activities recognized by individual tribes as sacred.\"

\"Individuals have the inherent right to their culture regardless of whether they consciously choose it. They have the right to choose when and how they interact with others outside their culture.\" \"This includes the right to learn about other cultures and choose whether to integrate or build a bridge with them.\"

Among these beliefs, there is recognition that Native Americans need to maintain an ethnic identity as well as an individual identity. For example, the Native American perspective stresses that personal spirituality should not be judged by \"members of society outside the tribe.\" One of the challenges faced by many healthcare providers and those who work with Native Americans is that individuals may want support for a process or practice that may be culturally offensive. For example, \"extreme beliefs and values are often taken as the only way to be Indian when in fact, there is a multitude of ways\" (Beauvais, 1998). Another challenge is that many individuals may feel pressured to conform to certain aspects of culture that they disagree with. Those who face this challenge may be less likely to obtain help for their alcoholism.

The following is a list of beliefs about spirituality according to research that can be explicitly applied to Native Americans suffering from alcoholism: For Native Americans suffering from alcoholism to receive adequate treatment, healthcare providers must understand specific cultural aspects surrounding health and illness (Austin et al., 1993). It is also essential that individuals from this population also understand the role spirituality plays in their condition. Understanding the stressors or events that may have triggered a particular individual\'s alcoholism can enable them to work towards resolving these issues and potentially preventing relapse.