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Heritage Assessment Tool

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Heritage Assessment Tool
Stacey Howard
Grand Canyon University
4/20/2014

Heritage Assessment Tool The Heritage Assessment Tool is useful in determining how connected an individual is to their specific culture which enables the culturally competent practitioner to identify health traditions, evaluate needs, and create appropriate plans for health maintenance, protection and/or restoration of the patient. Heritage and culture are interchangeable words that represent the concept of learned or inherited thought processes, ideas, and traditions that have been passed down from parentage, nationality and/or ethnicity. It is important for the practitioner to understand the beliefs of their patient to better facilitate treatment compliance and enhance rapport with the patient and family. As noted by Edelman, Kudzman & Mandle (2014), culture has an impact on a person’s health, healing, perceptions of wellness versus disease and attitude towards health practitioners. Many times important revelations regarding the patient’s health practices, traditions, and perceptions are gleaned not from the patient answering direct assessment question but from their relaxed conversation, ramblings, and casual remarks. The patient will not feel comfortable to converse with a practitioner they don’t trust or have a rapport. It is through cultural sensitivity, competence and appropriate assessment that practitioners are able to develop the trust and rapport needed to assist them in developing a workable plan of care that involves patient participation. Through the use of 29 questions, the Heritage Assessment Tool assisted in the evaluation of the common health traditions and needs of three individuals from different backgrounds. The tool proved extremely valuable in identifying certain health traditions based on culture such as; drinking hot tea prior to each meal regardless of the climate, eating an abundance of in- season fruits and vegetables to cure common colds and constipation, and taking daily vitamins as soon as a child is able to eat solid food to ensure health. The individuals interviewed were from three separate cultures; the first individual is of West Indian decent with both parents from Jamaica, the second is from West Africa and still resides in his home country of Ghana, the third was born and raised in the Midwestern United States with grandparents who migrated from Alabama to Ohio. The tool revealed that the individual from Ghana is the most closely tied to his heritage and has strong family bonds that would need to be included in any health care promotion plan. The tools questions regarding origins of parentage, proximity and frequency of interaction with extended family members were especially helpful in evaluating the needs of the whole person and family unit. The first individual interviewed with the family from Jamaica, West Indies identified definitive ideas regarding health maintenance, protection and restoration. This individual believes that health is maintained by eating nutritious foods and getting plenty of exercise. Eating any foods prepared outside of the home places the person at risk for illness. The belief is that restoration of health is also obtained by drinking homemade tonics, soups and juices. This individual’s health promotion plan would need to be centered on nutrition and exercise that could be obtained in the home. The second individual interviewed from Ghana had ideas regarding health maintenance, protection and restoration that are steeped in spirituality. He was one of seventy- six brothers, his father lived to be one hundred and six years old and fathered his last child at the age of one hundred and one. He believes that health is maintained by eating foods that have not been fertilized, using herbs from the Ghanian jungle to season food and sincere prayer at all times. This Ghanian family believes that all disease such as dementia and stroke that leave an individual helpless are the result of a curse that can only be lifted by prayer. Although the Jamaican and Ghanian families share the common thread of nutrition as a primary means of health maintenance, the Ghanian individual’s health restoration beliefs are centered in prayer and spirituality, not nutrition. The third and last individual interviewed was a woman who can’t imagine health maintenance, protection, and restoration aside from the recommended immunizations, prevention and maintenance that she grew up with here in the United States. This individual was the only one of the three interviewed who spoke of daily vitamins, regular visits to the family doctor and dentist. In comparison to the other two families this individual’s health care traditions based on cultural heritage are more difficult to identify. Although this person embraces eating African American foods, listening to the music and strong family bonds their health care beliefs are more American than African so a plan for their healthcare maintenance, protection and restoration would not be difficult to devise and compliance would be anticipated. In comparing the differences in health traditions between the three individuals it is clear that heritage and culture assessment should be a pre-requisite to the creation of a health care plan for our patients. While discussing vitamin supplements as a part of the third families health maintenance or protection plan would be feasible, it would prove futile for the first and second individuals interviewed. Conversely, natural juicing recipes may not be something the American family would adhere to. All individuals spoke of the importance of infection prevention through cleanliness, however the Ghanian family emphasized prayer in regards to protection and restoration of health. Of all the individuals interviewed the Jamaican family focused the most on the importance of exercise and abstaining from fast food, these are important elements to consider in preparing a health promotion plan as well. Without the use of a cultural diversity tool such as the Heritage Assessment Tool it would be difficult to obtain the information needed to appropriately diagnose, plan, implement and evaluate health promotion plans based on health traditions. The tool not only gives the practitioner specific answers to questions of ethnicity and country of origin but also serves as a great conversation starter which helps build rapport and leads to more information. With nursing being looked to as the future primary care providers it would behoove serious minded nurses to learn how to effectively use a tool such as this when planning for the patient’s health care needs.

Reference
Edelman, Carole, Carol Lynn Mandle, and Elizabeth Kudzman. Health promotion throughout the life span. Eigth ed. St. Louis, Mo.: Mosby, 2014. Print.

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