WK14 Cultural Nursing Paper Read chapter 23, 33 and 34 of the class textbook and review the attached PowerPoint presentations. Read content chapter 33 and

WK14 Cultural Nursing Paper Read chapter 23, 33 and 34 of the class textbook and review the attached PowerPoint presentations. Read content chapter 33 and 34 in Davis Plus Online Website. Once done answer the following questions;1. Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care.2. Identify sociocultural variables within the Irish, Italian and Puerto Rican heritage and mention some examples.References must be no older than 5 years. A minimum of 700 words is required. Please follow the instructions on how to present the first page and the name of the assignment when you post should be Week 14 discussion questions. Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Italian American Culture
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
Italian American immigrant groups include
▪ First-generation, traditional older Italians primarily living in
enclaves
▪ Second-generation, less traditional Italians living in
suburban and urban neighborhoods with ethnic enclaves
▪ Third-generation, more educated Italians primarily living in
the suburbs
▪ A relatively small group of newer immigrants with strong
ties to their homeland
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ This presentation describes the beliefs and
practices of Italian Americans from the mainland
of Italy, although some of these characteristics
may be shared by Italian Americans with a
heritage from Sicily and Sardinia.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview
▪ Italy is famous for the marvels of ancient Rome,
such as the Coliseum, Parthenon, museums.
Also famous for St. Peter’s Square, the Leaning
Tower of Pisa, the canals and Piazza in Venice,
the ruins of Pompeii, artists, and the Portofino
lace makers, wineries, and marble.
▪ New York City has the largest Italian population
of any city in the country.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ In addition to New York, other states with high
Italian populations are New Jersey,
Massachusetts, Pennsylvania, and California.
▪ Major cities in addition to NYC hosting large
Italian Americans populations include Chicago,
New Orleans, Philadelphia, Boston, Newark, New
Jersey, and San Francisco.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ Italian enclaves, or “Little Italy’s” as they are
called, can be found in New York City, Boston,
Cleveland, and other major cities in the US.
▪ The current Italian American population of almost
16 million ranks fifth in the United States,
preceded by German, Irish, English, and African
Americans.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ The official language of Italy is Italian, a
Romance language derived from Latin.
▪ All socioeconomic groups in the 19 regions of
Italy speak different dialects.
▪ The dialects of northern Italy contain
numerous German words. Spanish, French,
and German languages influence Neapolitan
Italy.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Piedmontese is strongly affected by the French
and Spanish languages, whereas the dialects of
Sicily have been strongly influenced by French,
Spanish, Greek, Albanian, and Arabic languages.
▪ Sardinia has its own language, Sardinian.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ First-generation Italians who immigrated to America
bring the dialects of their region with them.
▪ Today, in some second-generation and thirdgeneration Italian homes, these dialects are still
spoken.
▪ Many second-generation Italian Americans do not
speak Italian well or at all.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Either their parents encouraged them to learn
English, or more often, the children refused to speak
the mother tongue.
▪ Often the next generation becomes curious about its
background and tries to recover parts of its heritage.
▪ A number of third-generation Italian Americans are
studying Italian in an effort to reconnect with their
Italian heritage.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Grammatically correct Italian is musical and
romantic because vowels predominate over
consonants, expressing the many subtleties
of thought and feeling in a delicate manner.
▪ In many Italian households, discussions can
become quite passionate with vocal volume
raised and many people speaking at once.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ The willingness to share thoughts and feelings among
family members is a major distinguishing characteristic
of the Italian American family.
▪ Positive and negative emotions and sentiments are
permissible, encouraged, and color their daily lives.
▪ Many times a fluctuating emotional climate exists
within the family with expressions of affection
erupting briefly into what may appear to an outsider
as anger or hostility.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Conflict is usually confined to periodic outbursts
and does not usually cause resentment or open
and permanent ruptures.
▪ In fact, emotional neutrality to Italians denotes
noninvolvement or the absence of affection.
▪ Italians are sentimental and not afraid to express
their feelings.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Traditional Italian Americans value close family
ties, express warmth freely, and have heart and
feeling for each other.
▪ The emotional bond among Italian Americans
is reaffirmed by frequent kissing.
▪ The “typical” kiss is eastern European style,
with a kiss on each cheek.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ They frequently touch and embrace family
and friends. Touching between men and
women, between men, and between women
is frequently seen during verbal
communication.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ It is said that the Italians from southern Italy
are capable of carrying out a conversation
without saying a single word.
▪ Gestures convey a range of feelings from
poetic eloquence to intense anger.
▪ Italians are past, present, and future
oriented.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Past orientation is evidenced by the pride they take
in their rich Roman heritage.
▪ Within the context of fatalism, they do not allow
their imagination to stray too far, occupy themselves
with concrete problems and situations, and accept
things.
▪ They are future oriented as evidenced by the
importance given to planning ahead and saving
financially for the future.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Time orientation varies by immigrant group.
▪ First-generation and newer immigrants view time as
an approximation rather than categorically
imperative.
▪ Second-generation and third-generation Italian
Americans adhere to clock time at least in the work
situation and for appointments. For this group,
deadlines and commitments are considered
important and adhered to firmly.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Before the Napoleonic era, last names were not
commonly used in southern Italy.
▪ After the Napoleonic era ended in 1814, the French
often assigned to a family, or sometimes an entire
village, the name of that village.
▪ The contadini peasant custom was to name first
children for their grandparents and later children for
their godparents.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ To avoid confusion, they instituted a practice of
assigning nicknames according to some physical
characteristic or their occupation.
▪ For example, Giovanni Pelo is translated as
“Johnny one hair”. This nickname was given
because his body was covered with dark hair.
▪ This practice of assigning nicknames continues
with many Italian American families.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ In the past, an Italian father’s decision may have been
accepted as law even among his married children.
▪ To criticize one’s father is considered a sacrilege.
▪ In many traditional Italian American families today, the
father continues to dominate family decisions as long as
he remains in good health and is the chief breadwinner.
▪ He is known as the Padrone or capo di famiglia, the
“head of the family.”
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ In old age and illness, the eldest son supersedes
the father, but even then, the father retains much
of his prestige.
▪ The “typical” traditional Italian father frequently
demonstrates public and private affection for his
children, but such demonstrations are less
frequent in public for his wife.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Many husbands turn over their paychecks to their
wives to run the home, and thus Italian women
tend to have more power in economic decisions.
▪ Women also dominate decision making on
childbearing issues and family social events.
▪ A trend toward more egalitarian relationships is
evolving.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Italian American children are taught to have good
manners and respect for their elders.
▪ Both male and female children are encouraged
to be independent and expected to contribute to
the family’s support as soon as they are old
enough to work.
▪ This work ethic continues in second-generation
and third-generation families.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ L’ordine della famiglia, “family order,” a system of social
attitudes, values, and customs, has proven to be
impenetrable to the exploitation of strangers and is the
main tie that holds the Italian American household
together.
▪ The rules governing family membership are simple and
explicit: Fear God and respect the saints. The father is
the father, and he is experienced. Always honor and obey
your parents.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Italian American families maintain close
relationships.
▪ Love and warmth, security, and the expression of
emotions are the most common characteristics of
the Italian American family.
▪ Daughters have close ties with both parents,
particularly as they approach old age.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Although many second-generation and thirdgeneration Italian Americans no longer live in an
immediate Italian enclave, they return home
frequently to maintain family, community, and
ethnic ties.
▪ While parents are alive, their home is most often
the focus of kinship gatherings.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Italian Americans are almost twice as likely as
other ethnic groups to see a parent daily or at
least several times a week.
▪ If personal contact is not possible, frequent
telephone contacts are made, sometimes several
times a day.
▪ Continuity in parental roles is an important factor
in maintaining the high status of older people.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ The loss of the work role does not noticeably
affect their central role in the family. Instead, the
absence of the work role permits greater family
involvement.
▪ Italian Americans have an actively functioning
kinship and extended family system that is the
primary focus of solidarity for the nuclear family.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Social status for most Italian Americans families
comes from family lineage.
▪ Titles are more important than names.
▪ Despite values clearly defined around family
obligations, Italian Americans generally do not
reject another family member because of an
infraction or alternative lifestyle.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Workforce Issues
▪ Italians believe strongly in the work ethic, are
punctual, and rarely miss work commitments
owing to a cold, headache, or minor illnesses.
▪ If completing their work requires staying later,
they do so.
▪ Although the family is of utmost importance to
Italians, work takes priority over family unless
serious family situations arise.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Workforce Issues
▪ Among Italian Americans, work is viewed as a
matter of pride, demonstrating that one has
become a man or woman and is a full functioning
member of the family.
▪ So strong is this ethic that it governs behavior
apart from monetary gain derived from
employment.
▪ To Italian Americans, it is morally wrong not to be
productively occupied. Poveri si, ma perche
lognisi? (Poor yes, but why lazy?)
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Workforce Issues
▪ Even though Italian Americans have the utmost
respect for their employer, they are emotional
and passionate people, and when a confrontation
arises, Italians are likely to get involved.
▪ Italians born and educated in the United States
usually have little difficulty communicating with
others in the workforce.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ Italians as a group have varied physical
characteristics.
▪ Those from a predominantly northern
background have lighter skin, lighter hair, and
blue eyes, whereas those from the south of
Rome, particularly from Sicily, have dark, often
curly hair, dark eyes, and olive-colored skin.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ People of Italian ancestry have some notable
genetic diseases, such as familial Mediterranean
fever, Mediterranean-type glucose-6-phosphate
dehydrogenase deficiency (G-6-PD), thalassemia, and recurrent polyserositis.
▪ Italian Americans have a high incidence of
hypertension and coronary artery disease related
to smoking and perhaps their type A behavior.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ Italian Americans have significantly higher risks
of nasopharyngeal, stomach, liver, and
gallbladder tumors.
▪ Females exhibit a low risk for cancer of the oral
cavity, esophagus, colon, rectum, and pancreas.
▪ Males exhibit a low risk for cancer of the larynx,
lung, melanoma, breast, prostate, bladder, and
non-Hodgkin’s lymphoma.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
High-risk Behavior
▪ Although there is much education in the general
population regarding the risks of smoking, many
Italian Americans immigrants continue to
smoke.
▪ Alcohol misuse also presents a risk in this
group.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ To the Italian Americans, food is symbolic of life
and the principal medium of life, particularly
family life.
▪ Respect for food as the medium of life is upheld
even among the poor.
▪ The ceremony of eating is honored by Italian
Americans who convey to their children that the
waste or abuse of food is a sin.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ In an emotional sense, food is a connection
between an Italian child and the parents,
representing the product of the father’s labor
and prepared with care by the mother.
▪ In a symbolic sense, meals are a communion
of the family, and food is sacred because it is
the tangible medium of that communion.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ An Italian mother may demonstrate her
affection by feeding her family and anyone else
she likes.
▪ To the average Italian mom, love is a four letter
word.
▪ The Italian diet, rich in vegetables, pasta, fruit,
fish, and cheese, varies according to the region
of Italy from which the individual originated.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ Northern Italian foods are rich in cream and
cheese, resulting in a potential high intake of fat.
▪ Southern Italian foods are prepared in red
sauces, spices, and added salt.
▪ The staples of the Italian Americans diet are
spaghetti, lasagna, ravioli, pasta with pesto, and
manicotti.
▪ Vegetables, fresh fruit, and beans are common.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ Popular Italian foods include lentils, sausage,
eggplant parmigiana, salami, olive oil, espresso
and cappuccino coffee, wine, ice cream (gelato),
pastries such as cannoli and bisciotti, and
cheeses such as provolone, ricotta, romano, and
parmigiana.
▪ Other common dishes include escarole, Caesar
salad, calzone, and pizza.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ Dinner is a gathering of the family. Italian wine is taken at
almost every meal, and a mixture of water and wine is
given to children.
▪ Breakfast has never been an important meal for southern
Italians.
▪ Eating a fresh raw egg every morning, keeps the person
strong.
▪ Fresh dandelions are used to make a salad or are boiled
to make soup to give the person strength.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ One of the most common practices for health
promotion is eating a clove of garlic every night
before going to bed to prevent upper respiratory
infections.
▪ Garlic may also be worn around the neck when
there is an epidemic of influenza or other upper
respiratory ailments to prevent the wearer from
getting the infection.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
Genetic conditions common Italians and Italian
Americans is
a. Hemophilia
b. Polydactylism
c. Bi-polar disorders
d. Thalassemia
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: D
Thalassemia is a common genetic disorder among
Italians and Italian Americans. The other
conditions are not.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Many third-generation Italian Americans use birth
control from the beginning of the marriage, and
sex is commonly discussed in the family.
▪ There continues to be a weakened external
restriction on premarital sex, but internal
inhibitions remain strong.
▪ In the past, adultery was often seen as
unacceptable but sometimes excusable.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Italy has some of the lowest birth rates in the
world, which is surprising for a predominantly
Catholic country.
▪ Traditional ideas among Italian Americans
regarding pregnancy have undergone slight but
significant variations in the United States.
▪ The belief that a mother does not conceive while
nursing continues to be held by many Italian
women.
Transcultural Health Care: A Culturally Competent Approach, …
Purchase answer to see full
attachment