Culture and Health Nursing: Two Psychiatric Case Studies
This paper presents two nursing case studies exploring the intersection of culture, mental health, and evidence-based treatment. The first case examines Jeannette, a patient with posttraumatic stress disorder whose family is also utilizing a Haitian voodoo priestess for traditional healing. The discussion addresses cultural sensitivity, the risks of herbal remedies combined with conventional medications, and the neurobiological basis of PTSD, recommending cognitive behavioral therapy alongside pharmacological intervention. The second case focuses on Julie, a bipolar patient who attempted suicide following childbirth and is non-adherent to treatment. The analysis covers the risks of bipolar disorder in the postpartum period, the importance of individualized medication management, talk therapy, and family involvement in care.
- Introduction: Culture-Sensitive Nursing Practice: Framing candid patient disclosure and cultural competence
- Case Study: Jeannette and PTSD: PTSD, traditional healing, and disclosure challenges
- Traditional Healing and Evidence-Based Care: Risks of herbal remedies and neurobiological PTSD treatment
- Case Study: Julie and Bipolar Disorder: Bipolar disorder, mood cycles, and combined therapy
- Postpartum Crisis and Treatment Adherence: Suicide risk, postpartum depression, and non-adherence
- Conclusion: Cultural sensitivity and evidence-based integration
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What makes this paper effective
- Each case study grounds its clinical recommendations in specific cited evidence, such as the neurobiological definition of PTSD from Abdallah et al. (2019) and the staging framework for bipolar disorder from Salagre et al. (2018).
- The paper models genuine cultural sensitivity by acknowledging the legitimacy of spiritual comfort while clearly distinguishing it from practices that carry clinical risk, avoiding dismissiveness without compromising patient safety.
- Both cases end with concrete, multi-modal treatment recommendations (combined pharmacology and talk therapy, family involvement), demonstrating applied clinical reasoning rather than abstract theory.
Key academic technique demonstrated
The paper effectively uses the case study format to move from diagnosis and cultural context to evidence-based intervention. By introducing a clinical complication in each case — herbal remedy interactions in Jeannette's case and postpartum non-adherence in Julie's — the writer demonstrates the ability to identify barriers to care and propose targeted solutions supported by peer-reviewed literature.
Structure breakdown
The paper is organized into two discrete case analyses of roughly equal length. Each case opens with the patient's presenting situation, addresses the cultural or behavioral complication, grounds the complication in clinical literature, and closes with a recommended treatment approach. References follow APA format and are drawn from PubMed-indexed journals and the NIH.
Introduction: Culture-Sensitive Nursing Practice
Treating patients appropriately demands that providers foster an environment in which patients can be candid about their health conditions. This principle is especially important when cultural beliefs shape how patients and families understand and respond to illness — including mental health conditions that may carry stigma or be interpreted through a spiritual lens.
Case Study: Jeannette and PTSD
It should be viewed as a positive first step that Jeannette and her mother disclosed the fact that they have been using a Haitian voodoo priestess (mambo) coming to the house to treat Jeannette. Unfortunately, many of the herbs used in such traditional practices are not only ineffective but can be potentially dangerous, particularly if mixed with conventional medical treatments such as antidepressants (Kelak, Cheah, & Safii, 2018). Mental health issues such as posttraumatic stress disorder can be confusing and frightening for a family, and using traditional medicine may be comforting to people like Jeannette's mother. It may also be less traumatic to think of her daughter as cursed rather than as suffering from a mental illness.
Traditional Healing and Evidence-Based Care
Clinicians must be culturally sensitive. Seeking spiritual comfort is a natural and accepted part of treatment. On the other hand, some spiritual practices — such as the aforementioned use of herbs — can be counterproductive and delay needed conventional medical treatment.
Additionally, posttraumatic stress disorder is a neurobiological issue as well as a mental health issue. Its symptoms can be extremely severe and involve unlearning ingrained fear-based responses. "PTSD was found to be associated with deficits in fear extinction, increased generalization of fear, and a negative bias of viewing threat from neutral stimuli and feeling danger in a safe environment" (Abdallah et al., 2019, par. 3). Unlearning the patterns of behavior that cause the individual to re-experience the trauma she has undergone requires treatment beyond the care Jeannette is currently receiving. Evidence-based medical guidance suggests that a combination of talk-based therapy — such as cognitive behavioral therapy (CBT), which is well-supported for PTSD patients — along with targeted pharmacology to treat anxiety and depression, is recommended.
Case Study: Julie and Bipolar Disorder
Ideally, bipolar patients should be treated with a combined approach of medication to reduce the severity of their mood cycles and talk-based therapies to address the complications their illness has caused in their lives. Bipolar disorder is characterized by alternating periods of depression and mania. The severity is dependent upon the type of bipolarity, with some patients experiencing extreme shifts between mania and depression, while others experience milder depression alternated with periods of hypomania. The most common forms of treatment are mood stabilizers or, in some instances, atypical antipsychotics ("Bipolar Disorder," 2020). While bipolar disorder is considered a mental health condition requiring some form of chemical intervention, this does not mean patients cannot benefit from talk therapy. In fact, it is usually recommended that the two approaches be used in conjunction, particularly when a patient like Julie is navigating the transition into new motherhood.
Conclusion
Both cases illustrate the importance of integrating cultural awareness with evidence-based clinical practice to create treatment plans that patients and families can accept and sustain. Whether the barrier to care is a family's reliance on traditional healing or a patient's non-adherence to medication, the clinician's role is to engage respectfully and collaboratively, ensuring that effective, personalized treatment remains the goal.
References
Abdallah, C. G., Averill, L. A., Akiki, T. J., Raza, M., Averill, C. L., Gomaa, H., Adikey, A., & Krystal, J. H. (2019). The neurobiology and pharmacotherapy of posttraumatic stress disorder. Annual Review of Pharmacology and Toxicology, 59, 171–189. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326888/
Bipolar disorder. (2020). NIH. Retrieved from https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml
Kelak, J. A., Cheah, W. L., & Safii, R. (2018). Patient's decision to disclose the use of traditional and complementary medicine to medical doctor: A descriptive phenomenology study. Evidence-Based Complementary and Alternative Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5832099/
Salagre, E., Dodd, S., Aedo, A., Rosa, A., Amoretti, S., Pinzon, J., Reinares, M., Berk, M., Kapczinski, F. P., Vieta, E., & Grande, I. (2018). Toward precision psychiatry in bipolar disorder: Staging 2.0. Frontiers in Psychiatry, 9, 641. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282906/
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