Culture care beliefs and practices of an Ethiopian immigrant community: An ethnonursing study

Beth Chiatti

Immigrant populations are subject to health disparities based on language differences, cultural preferences and traditions, and a lack of knowledge about how to navigate the complex U.S. health care system. A barrier to obtaining quality health care is also affected by the inability of those working in the health care system to view cultural differences as important. Nurses have an ethical responsibility to tend to the culture care needs of all patients. Ethiopians represent the third largest African immigrant population in the U.S. and generally reside in large cultural groups within major cities. The purposes of this ethnonursing study were to identify and describe the culture care beliefs and practices of Ethiopian immigrants living in the mid-Atlantic region of the U.S. and to advance the science of transcultural nursing. Leininger's Theory of Culture Care Diversity and Universality was utilized as the framework for this study and research was guided by various qualitative enablers. The aims of this study sought to further nursing research and science, nursing education, and nursing practice by examining how culture, worldview, illness interpretation, technology, socioeconomic status, religion, politics, values, education, age, gender, years in adopted country, and family structure, formed the basis of the patient's health care perspective. Data were collected through field notes, participant observation, journaling, and face-to-face interviews using Wehbe-Alamah's Open Inquiry Guide. Five key and 10 general informants participated in this study; ages ranged from 23 to 63 years and length of time living in the U.S. ranged from 6 months to 33 years. Ethnic identities included Amharic, Oromo, Tigray, Wolaita, and Gurage; religious affiliations were Christian Orthodox, Protestant, and Muslim. Participants entered the U.S. for a variety of reasons; five as refugees seeking political asylum, five as Diversity Visa Lottery winners, and five accompanying their spouse. Participants immigrated to the U.S. to escape from poverty, and for better employment opportunities, accessibility of quality education, and availability of life-saving health care and treatment. Culture care beliefs and practices revolved around cultural identity, family and friends, community, and religious practices. Based on the data, the researcher identified 14 care patterns and five themes. These patterns and themes indicated that the informants were acculturated to the western lifestyle in which they resided, while still maintaining culturally-based health care beliefs and treatment options. Nursing care actions and decisions were formulated based on the findings of the study and modes of transcultural nursing care. Through analysis of the data, it became clear which aspects of culture care practices should be maintained, such as valuing the patient's cultural identity, which should be accommodated, such as availability of interpreter services and expectations of nursing care centered on evidence-based practices, and which should be restructured, such as reinforcing an internal locus of control by promoting preventive care and health screenings. Participants preferred nurses to inquire about their culture, the language that they spoke, their food and dietary preferences, family dynamics, and what they considered important to maintain their cultural practices. They believed that giving them a choice whether to take a medication or not indicated non-caring on the part of the health care provider and they expressed the belief that medication administered via injection is more effective than any other route. Implications for nursing research and science, nursing practice, and nursing education included that nurses would spend time with the patient, fully explain procedures, practices, expectations, and the plan of care, show an interest, be attentive to their needs, be a partner in their care, and take time to know the patient and their culture. Positive findings of this study were that health care, technology, economics, and education available in the U.S. were seen as beneficial by Ethiopian immigrants.

Culture care beliefs and practices of an Ethiopian immigrant community: An ethnonursing study

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Culture care beliefs and practices of an Ethiopian immigrant community: An ethnonursing study

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