People of Baltic Heritage.People of Brazilian HeritageRead chapter 26 and 27 of the class textbook and review the attached PowerPoint presentions. Read Content chapter 26 & 27 in Davis Plus Online Website. Once done answer the following questions;1. Which countries are known as the Baltic nations?2. Discuss how the Baltic nations view the delivery of evidence-based healthcare and their beliefs related to health and disease.3. Give an overview of the Brazilian heritage, how do they see health and disease and if there is any similarity between them and the Baltic nations.You must cite at least 3 evidence-based references no older than 5 years excluding the class textbook . A minimum of 800 words must be presented excluding the first and reference page.
cultural_nursing_ch26_pp.pptx
cultural_nursing_ch26.pdf
cultural_nursing_ch27_pp.ppt
cultural_nursing_ch27.pdf
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Cultures
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ People of Baltic descent come from Estonia,
Latvia, and Lithuania.
▪ The countries of origin of these ethnic groups are
sometimes referred to as the Baltics or the Baltic
countries because each of them is located in
Europe on the Baltic Sea.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ Historical, cultural, religious, and language
differences prevent the group from being one
cultural entity.
▪ These countries represent three distinct ethnic
groups and are treated as such.
▪ The Estonians are a Finno-Ugric people whose
language is related to Finnish.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ The Union of Soviet Socialist Republics (USSR)
forcibly annexed Estonia in 1949 and maintained
control until 1991 when Estonia regained its
independence.
▪ Latvia, situated between Estonia and Lithuania
on the Baltic Sea, was independent from 1918 to
1940 when it was forcibly annexed by the USSR.
▪ Latvia regained its independence in 1991.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ Russians make up 29 percent of the population
of Latvia; the remainder is made up of
Byelorussians, Ukrainians, and Poles.
▪ Most ethnic Latvians speak a Baltic language
related to Lithuanian.
▪ Lithuania was an independent country from 1918
to 1940 when the USSR forcibly annexed it.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ In 1990, Lithuania re-declared its independence
from Soviet rule.
▪ For Lithuania, 83.5 percent are Lithuanians, 6.3
percent are Russians, 6.7 percent are Poles, and
3.7 percent other.
▪ Lithuanian is a Baltic language related to Latvian.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ The Baltic countries today are democratic,
growing economically, and are successful
compared with many other former Soviet Union
countries where poverty and dictatorship have
been predominant.
▪ In 1940, the three Baltic countries lost their
independent status to Germany and then to the
USSR in 1941.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ During this time, hundreds of thousands of
Latvians, Lithuanians, and Estonians were
deported in cattle cars to Soviet prison camps in
Siberia.
▪ Fearing death or deportation by the communist
regime, Estonians, Latvians, and Lithuanians fled
to the West by any means possible.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ The post-World War II influx of immigrants to the
United States came in 1949.
▪ Because the immigrants fled from the religious,
cultural, and political persecution of the Soviet
regime and could not return to their native
countries after World War II, the U.S. Congress
facilitated their entry by enacting laws
designating them as displaced persons.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ Many of the post-World War II refugees were
professionals.
▪ All three Baltic countries have regular song
festivals and dance festivals in the US and in the
native countries too.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ The Baltic countries are strong in the arts, and
theater, opera, music of all types, and film
continue to flourish.
▪ During the past 10 years, the three Baltic
countries have experienced a “brain-drain” to
some extent because many of their highly
educated have emigrated to the US and Europe.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Overview/Heritage
▪ Education is highly valued by people of Baltic
descent. All three Baltic countries have high
literacy rates.
▪ Education is valued in itself and is seen as a way
of improving life circumstances.
▪ These immigrants made many sacrifices so their
children could become educated. As a result,
many Americans of Baltic descent have advanced
degrees. Many are professionals in medicine and
law.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Communication
▪ People of Baltic descent share thoughts and
feelings readily.
▪ The stereotype of quiet, stoic individuals is
not borne out by observation or research.
▪ For example, humor can be used to relate to
these clients and is appreciated if used in the
right context.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Communication
▪ Clients of Baltic origin may hesitate to share
intimate thoughts and feelings related to
their cultural sense of decorum, but this does
not mean that they do not experience
feelings and emotions.
▪ They may wait to see if the health-care
professional is caring and takes the time to
actually listen to them.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Communication
▪ As a whole, people of Baltic descent are not
flamboyant or highly volatile, but individual
differences are always present.
▪ Some individuals enjoy touch and close contact,
while others do not.
▪ Individuals from these cultures are receptive to a
caring use of touch from family and close friends,
but they may come across as more aloof with
strangers.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Communication
▪ People of Baltic descent give attention to the past,
present, and future.
▪ The past is revered in the sense that significant
historical events for each cultural group continue to
be celebrated and acknowledged.
▪ People of Baltic descent value frugality because they
have had hard times in the past.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Communication
▪ People of Baltic descent view time similarly to the
dominant American culture.
▪ Individuals of Baltic descent have become
acculturated to time awareness and deadlines; they
arrive at appointments on time. Because of their
strong work ethic and high value on work, they take
pride in the efficient and wise use of their time.
▪ Socially, however, they may be less aware of time
and tend to be late.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Communication
▪ Individuals of Baltic descent generally use
their American last name.
▪ First names of women end in “a” and first
names of men end in “as” or “s.” In their
native languages, the last names indicate if
the person is male or female; for females,
the last name indicates if the woman is
married or single.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Communication
▪ In Latvian, the typical last name ends in
“ans,” “ins,” or “e” with the endings
indicating masculine or feminine genders.
▪ Estonian names are similar to Finnish names.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Communication
▪ The father is the head of the household in the
typical family of Baltic heritage.
▪ Both men and women in the family may have
jobs and discuss major decisions.
▪ Health-care and other major decisions are
made jointly by both spouses.
▪ Women in the family are given respect, and
decision-making is done by both men and
women.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Family Roles & Organization
▪ Because education is highly valued, parents
encourage and supervise children in their school
work and progress.
▪ Corporal punishment was used by older
generations but is practiced less by younger
families.
▪ Cultural activities, such as song or dance groups
and ensembles, frequently unite people.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
The language spoken by people from the Baltic
countries is
a. The same for Latvians and Lithuanians but
different for Estonians.
b. The same for Estonians and Latvians but
different for Lithuanians.
c. Different for each country.
d. The same for each country.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: C
The language spoken by people from the Baltic
countries is different for each country.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Family Roles & Organization
▪ The traditional nuclear family is still the
standard in these cultural groups.
▪ Family is highly valued and divorce is still
fairly rare.
▪ Lithuanian Americans are predominantly
Roman Catholic, and their religion supports
strong family values.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Family Roles & Organization
▪ Older people are respected in the Baltic cultures.
▪ If grandparents are unable to live independently,
every effort is made to have them move in with
an adult child, usually a daughter.
▪ Nursing homes are used when needed.
▪ In America, a certain amount of respect is still
given to professionals, but each cultural group
has more of an egalitarian sense of community.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Family Roles & Organization
▪ The literature does not include information
about same-sex couples in these cultures.
▪ Because the dominant religions of the
Baltic countries do not sanction
homosexuality, few individuals and couples
are openly homosexual.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
Newer immigrants from the Baltic countries should
be assessed for
a. Malaria.
b. Thalassemia.
c. Orthopedic disorders.
d. Endocrine disorders.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: D
Newer immigrants from the Baltic countries should
be assessed for endocrine disorders because of
radiation fallout from the Chernobyl accident.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Workforce Issues
▪ Material aspects are seen as secondary to the
more important family values.
▪ Responsibility is taken seriously and is
encouraged.
▪ People of Baltic descent adapt readily to
American values of timeliness in the workplace.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Workforce Issues
▪ People of Baltic descent have no difficulty
maintaining their sense of autonomy and
readily take on work roles, responsibility, and
decision making.
▪ They usually do not like to confront those in
authority directly and find ways to deal with
difficult situations or people through the use of
humor or deference.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Workforce Issues
▪ Recent immigrants who have lived under the
Soviet regime may not be accustomed to
making decisions for themselves or acting
autonomously.
▪ In previous governmental regimes, individuals
and their rights were not considered important.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Biocultural Ecology
▪ People of Baltic descent have white skin.
Estonians are similar to the Finns with brown hair
and eyes, but some are blonde and blue-eyed.
▪ Latvians and Lithuanians have fair complexions
with blonde hair and blue eyes.
▪ Recent immigrants from the Baltics may be at
risk for cancer because of industrial pollution and
radiation exposure from the Chernobyl nuclear
disaster in 1988.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Biocultural Ecology
▪ Some immigrants are survivors of political
torture, having spent years in prison labor
camps in Siberia.
▪ The incidence of alcoholism is high in the
Baltics.
▪ Ashkenazi Jews from the Baltic countries
may respond differently to neuroleptic
agents.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic High-Risk Health Behaviors
▪ Exercise and physical activity are valued, and
people of these cultures make an effort to get a
reasonable amount of exercise.
▪ Individuals who have emigrated to the United
States in the last 15 years tend to continue to
smoke.
▪ Although many people of Baltic descent
maintain jobs and are able to function, their use
of alcohol is high.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Nutrition
▪ Because many individuals who left the Baltics
after World War II experienced food shortages
and times of starvation, food is important to these
people.
▪ Recent immigrants have left the Baltics for
economic reasons and have also experienced
food shortages.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Nutrition
▪ Some foods common among this cultural
group are meats such as pork, chicken, and
beef.
▪ Rye and whole grain breads are popular.
▪ Baked goods such as bacon rolls, yeast baked
goods, and rich tortes and cakes are common.
▪ Fresh fruits and vegetables are enjoyed.
▪ Potato dishes such as potato pancakes, potato
kugel, and potato dumplings are popular.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Nutrition
▪ Beets, mushrooms, and cabbage are used in
soups and sauces.
▪ Dairy products such as sour cream, butter, and
yogurt are included daily in their meals.
▪ Grain porridges are popular, especially among
Latvians who have putras porridges.
▪ The content of porridges varies according to
regions in Latvia.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Nutrition
▪ Foods enjoyed by people of Baltic descent
include smoked and unsmoked sausages, and
smoked fish, eel, and pork.
▪ The spices used are rather mild compared with
those of other cultures, but foods may be high
in salt content.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Pregnancy &
Childbearing Practices
▪ In previous generations in the Baltics, infant
mortality rates were very high. Large families
were encouraged under communism.
▪ Baltic people in the US use a variety of birth
control measures.
▪ Americans of Baltic descent use modern
Western medicine practices obtain early prenatal
medical care, and are receptive to health
teaching for prenatal and postnatal care.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Pregnancy &
Childbearing Practices
▪ Some women and families from these cultural
groups prefer natural childbirth and breastfeeding.
▪ Pregnant women are to remain calm and receive
no shock or frightening news.
▪ Godparents are important in the child’s life and
traditionally give gifts, including candy, to each
other and guests.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Death Rituals
▪ Death is viewed as part of life, and ceremonies of
the wake and funeral are linked with Christian
religious services.
▪ The funeral may take place within 3 to 4 days
following the death, providing time for out-of-town
friends and relatives to gather.
▪ Cremation is permissible.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Death Rituals
▪ The funeral is usually a Christian service,
followed by a meal at which all attendees are
welcomed. Burial is the usual practice.
▪ Grief is expressed by sadness, crying, and
talking about the deceased with fondness and
respect.
▪ Individuals from these cultures express emotions
readily but not in highly dramatic ways.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Death Rituals
▪ Decorum is maintained in public and with
strangers.
▪ The dead are often remembered with frequent
visits to the cemetery.
▪ All Souls Day, November 2, Ve·line·s, is a
significant day for Lithuanian Americans, with
religious ceremonies commemorating the dead.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Spirituality
▪ Estonian Americans and Latvian Americans
are predominantly Lutherans but include some
Catholics, while Lithuanian Americans are
predominantly Roman Catholic.
▪ All these groups celebrate major Christian
religious holidays, particularly Easter and
Christmas.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Spirituality
▪ Individuals of these cultures consider
themselves as having spiritual roots, which
may be closely linked with their high value for
their language, country, and culture.
▪ Under Soviet rule, religion was forbidden;
every effort to eradicate all traces of religious
belief.
▪ Religion was replaced by communist dogma
for 50 years.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Spirituality
▪ A very small percentage of Latvians
maintain an ancient pagan religion.
▪ This religious group is called Dievtui
(those with God) and has a high priest as
the head of the group.
▪ Stories include myths and folk wisdom in
rhyme as an important part of their
content.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Spirituality
▪ Most Americans of Baltic descent consider
prayer an individual expression of their faith.
▪ Many have been sustained through hardships
by their strong religious faith and continue to
have strong religious needs.
▪ Spiritual and religious considerations are
considered private and may not be readily
shared with health-care professionals.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Spirituality
▪ Clergy from the client’s church are usually
welcome.
▪ Clients find considerable comfort in speaking
with the clergy in times of crises and serious
illness.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Health-care Practices
▪ Individuals of Baltic descent adhere to modern
medical regimens and readily use the health-care
system available to them.
▪ Because they consider health and well-being
important, they take an active interest in healthy
lifestyles, nutrition, and exercise.
▪ Fresh air is considered important, and walking,
especially in natural settings such as parks, is
enjoyed by all ages.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Health-care Practices
▪ People of Baltic descent assume responsibility
for their own health.
▪ Because work is highly valued, most are in the
workforce and have insurance coverage.
▪ Medical care and hospitalization are sought
readily. Attempts are made to maintain health
even into old age.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Health-care Practices
▪ Recent immigrants from the Baltics to America
may have different values because they lived
under a communist regime in which the
government “took care” of their medical needs.
▪ These immigrants often need help understanding
the American health-care system and may be
reluctant to use it if they have no medical
insurance coverage.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Baltic Health-ca …
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