Implications of Religion and Spirituality on
the Health Practices of Mexican Americans
Lujan, J. & Campbell, H.
B. The role of religion on
the health practices of
Mexican Americans.
(2006). Journal of Religion
and Health, 45 (2),183195.
Dr. Josefina Lujan, Ph.D., R.N.
Regional Dean
Texas Tech University Health Sciences
Center El Paso
Anita Thigpen Perry School of Nursing
Discuss the origin and role of religion in relation to the health
practices of Mexican Americans.
Describe the Hispanic cultural metaparadigms of the conquest,
collectivism, famliarismo and personalismo in relation to
religion and spirituality of Mexican Americans.
Examine the potential benefits of addressing these clients’
religious needs to offer suggestions on how healthcare
providers can provide culturally competent care.
Why is this topic important?
• Mission of TTUHSC
• CLAS standards
• Growing numbers of Mexican Americans
• 80 to 90% of Mexican Americans are
self-reported Catholics
• Greater religiousness with proximity to
border
• Transcends generations
• External Locus of Control
U. S. – Mexico Border
Majority Minority Priviledge
Eurocentrism
Cultural Competence
• Having the skills, knowledge, and
understanding about another culture that
allow the healthcare provider to assess and
intervene in a culturally appropriate manner.
• Knowledge about a diverse culture means
knowing what questions to ask.
CLAS Standards
Office of Minority Health:
Culturally and Linguistically appropriate standards for
Health Care
Dimensions of Culture (Purnell & Paulanka)
12 Domains of Culture
(Purnell & Paulanka, 2003)
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Inhabited localities, topography
Communication
Family roles and organization
Workforce issues
Biocultural ecology
High-risk behaviors
Nutrition
Pregnancy and childbearing practices
Death rituals
Spirituality
Health care practices
Healthcare practitioners
You and IWe meet as strangers, each carrying a mystery within us.
I cannot say who you are. I may never know you completely.
But I trust that you are a person in your own right,
possessed of a beauty and value that are the Earth’s richest
treasures.
So I make this promise to you:
I will impose no identities upon you, but will invite you to
become yourself without shame or fear.
I will hold open a space for you in the world and allow your
right to fill it with an authentic vocation and purpose. For as
long as your search takes, you have my loyalty. Unknown
“
Implications of cultural diversity for
healthcare providers
What are the steps for embracing cultural
diversity?
Integration
Adaptation
Perception
Minimization
Defense
Denial
Metaparadigms of
Hispanic Culture
•Conquest
•Collectivism
•Familiarismo
•Personalismo
Conquest
Collectivism:
• Intellectual: humility,
• Courage, empathy,
• integrity, perseverance,
• sense of justice,
• Faith in reasoning
Familiarismo
Personalismo
What do you see?
Guidelines for the implementation of cultural competence:
Kleinman’s explanatory model: 8 Questions“
1. What do you call the problem?
2. What do you think has caused the problem?
3. Why do you think it started when it did?
4. What do you think the sickness does? How does it work?
5. How severe is the sickness? Will it have a short or a long
course?
6. What kind of treatment do you think the patient should
receive? What are the most important results you hope
she receives from this treatment?
7. What are the chief problems the sickness has caused?
8. What do you fear most about the sickness?
Hispanic Values and Health Practices
Related to Pediatric Care
•Hot and cold theory of disease
•Empacho
•Susto
•Mal de ojo
•Caida de mollera
•Religion or religiousness is the belief in, practice
of, or participation in the rituals and activities of
an organized religion (Kaye & Raghavan, 2002).
•Spirituality is the belief in a higher being or force
without mandatory mediation through organized
activities (Kaye & Raghavan, 2002)
When is religion most important?
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Childbirth
Chronic illness
Mental health illness
End of life (Berry, 1999)
Specific Health Practices of Mexican Americans in
Relation to Religion
•Prayer
•Religious artifacts (rosary beads, escapularios, milagros
candles)
•Pilgrimages
•Mandas
•Novenas (Prayer)
•Last Rites
Milagros
Rosary and Scapular
Mandas or pilgrimages
Benefits of assessing client’s religious
status
1. Allows for modification of delivery of
care.
2. Establishes rapport with client.
3. Allows provider to support client’s
religiousness needs through
appropriate referral to clergy or
pastoral care in a timely manner.
Helpful Assessment Questions
• Please tell me a little bit about how religion or spirituality affect your
health.
• Do you identify with any organized religion?
• Do you have a belief system that provides comfort and strength?
• How do your religious or spiritual beliefs influence how you care for
yourself?
• Who are your support people?
• What provides you with strength and hope?
• What gives your life meaning and purpose?
• How has your life changed since you became ill?
• How might we (your health care providers) best address any needs in this
area?
Assessing religious needs across the
lifespan
•What concerns do you have about your child’s illness?
•How can we help you support your religious practices?
(referrals)
•What do you think brought or caused your child’s illness?
Instruments for the assessment of religiousness or
spirituality
•Index of Core Spiritual Experiences (INSPIRIT)
•JAREL Spiritual well-Being Scale
•Belief in Divine Intervention Scale
”Thinking
is hard work, that is
why so few people do it.”
Henry Ford
• Ennis (1985) described critical thinking
attitudes as dispositions.
• Paul (1990) called them traits of
the mind.
• Attitudes motivate and justify the use of
cognitive skills.
Draw circles of inclusion instead of divisive lines
University of Pennsylvania Nursing
School - 1962
El Arte de no Enfermarse
Dr. Dráuzio Varella
“Real intelligence is a creative
use of knowledge, not merely an
accumulation of facts.”
The border presents the opportunity to discover &
understand how and why some of us fight, others
accept defeat and still others, who could have done
much, choose the path of silent resignation”
(D. Morales, 1997)
No venimos a ver si podemos, sino porque
podemos venimos. (B. Nevarez; mi mama)
We are not here to see if we can,
it is because we can that we are here.
Gracias