Transcultural Health Care- Hindu Culture
Transcultural Health Care- Hindu Culture
Transcultural Health Care- Hindu Culture
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
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Hindu Overview/Heritage
More than a billion people inhabit India.
Eighty percent of the population are Hindus, followers of Hinduism.
Other significant religious groups include Sikhs, Moslems, and Christians.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Hindu Overview/Heritage
Different religious sectors share many common cultural beliefs and practices.
Immigrants to the United States come predominantly from urban areas, including all major Indian states.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Overview/Heritage
Most recent immigrants are highly educated.
More than 1,600,000 Asian Indians are living in the United States.
Most come to the United States to attain a higher standard of living, better working conditions, and job opportunities.
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Hindu Communication
Asian Indian languages fall into two main groups: Indo-Aryan in the north and Dravidian in the south.
Hindi, with 1,652 dialectical variations, is the national language along with English.
Women often speak in a soft voice, making it harder to understand what they say.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
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Hindu Communication
Men may become intense and loud when they converse with other family members.
Women avoid direct eye contact with men.
Direct eye contact with older people and authority figures may be considered a sign of disrespect.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
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Hindu Communication
Touching and embracing are not acceptable for displaying affection.
Even between spouses, a public display of affection such as hugging or kissing is frowned upon, being considered strictly a private matter.
Temporality is past-, present-, and future–oriented.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
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Hindu Communication
Punctuality in keeping scheduled appointments may not be considered important.
Older family members are usually not addressed by name but as elder brother, sister, aunt, or uncle.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
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Hindu Communication
A woman never addresses a man by name because the woman is not considered an equal or superior.
Strangers are greeted with folded hands and a head bow that respects their personal territory
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
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Hindu Family Roles & Organization
No institution in India is more important than the family.
The hierarchical structure of authority is the patriarchal joint family based on the principle of superiority of men over women.
The male head of the family is legitimized and considered sacred by caste and religion, which delineate relationships.
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Hindu Family Roles & Organization
Central relationships are based on continuation and expansion of the male lineage through inheritance and ancestor worship, related to the father-son and brother-brother relationships.
A matrilineal system exists in a few areas in the southwestern and northeastern regions of the country; however, power rests with the men in the woman’s family.
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Hindu Family Roles & Organization
A submissive and acquiescent role is expected of women in the first few years of married life with little or no participation in decision-making.
Strict norms govern contact and communication with the men of the family, including a woman’s husband.
Parents strongly encourage and emphasize scholastic achievement in fields that promise good employment and a high social status.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Family Roles & Organization
Although many parents expect and accept the Westernization of their children, the question of marriage is still a concern for parents who have opinions about how their children should be married, whether “arranged” or partly arranged.
Hindu parents or Indians from all religious traditions want their children to marry other Indians.
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Hindu Family Roles & Organization
Arranged marriages at a young age are considered most desirable for women.
The practice of an arranged marriage continues in the United States in order to minimize the stress associated with differences in castes, lifestyles, and expectations between the male and female hierarchy.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Family Roles & Organization
The two major types of transfer of material wealth accompanying marriage are bride price and a dowry.
Bride price is payment in cash and other materials to the bride’s father in exchange for authority over the woman, which passes from her kin group to the bridegroom’s kin group.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Family Roles & Organization
In the joint family structure, Hindu women are considered “outsiders” and are socialized and incorporated in such a way that “jointness” and residence are not broken up.
A close relationship between the husband and wife is disapproved because it induces favoring the nuclear family and dissolving the joint family.
A marriage is regarded as indissoluble.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Family Roles & Organization
Older family members are held in reverence and cared for by their children when self-care becomes a concern.
Single-parent, blended, and communal families are not well accepted by Hindus.
Homosexuality may cause a social stigma.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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ClickerCheck
A male nurse is giving dietary discharge instructions to Mrs. Mukhopadhya. She she does not maintain eye contact with the nurse. This means she is
Embarrassed.
Does not understand.
Demonstrating respect.
Does not care.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Correct Answer
Correct answer: C
Out of respect, traditional Hindus do not maintain eye contact with authority figures, nor do females maintain eye content with men.
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Hindu Workforce Issues
At work, Hindus adopt American practices and cultural habits.
Hierarchies of age, gender, and caste prescribe transactions among Hindus.
At work, relationships are a reproduction of the authority-dependence characteristic of family and social relationships.
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Hindu Workforce Issues
In seeking to establish a personal and benevolent relationship, Hindus may be seen as too eager to please, ingratiating, or docile, all antithetical to the task of assertion and independence.
Women avoid direct eye contact with men.
Direct eye contact with older people and authority figures is a sign of disrespect.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Biocultural Ecology
Indian diversity of physical types and can be divided into three general groups according to the color of their skin:
White in the north and northwest,
Yellow in areas bordering Tibet and Assam, and
Black in the south.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Biocultural Ecology
Indids (whites) have a light-brown skin color, wavy black hair, dark or light brown eyes, are tall or of medium height, and are either dolichocephalic (long-headed) or brachycephalic (short-headed).
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Biocultural Ecology
Melanids, often referred to as the Dravidians and are the population of southern India, have dark skin ranging from light brown to black, elongated heads, broad noses, thick lips, and black, wavy hair.
They are usually shorter than 5 feet 6 inches tall.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Biocultural Ecology
Common health conditions of Asian Indians include malaria, filiariasis, tubersulosis, pneumonia, cardiovascular diseases, rheumatic heart disease, sickle cell anemia, dental disease, lactose intolerance, cancer of the cheek, nose, and mouth, breast and stomach cancer, ichthyosis vulgaris, beriberi, thiamine deficiency, goiter, osteomalacia, dropsy, and flurosis.
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Hindu Biocultural Ecology
Many individuals require lower doses of lithium, antidepressants, and neuroleptics, and they may experience side effects even with the lower doses.
They are also more sensitive to the adverse effects of alcohol consumption, resulting in marked facial flushing, palpitations, and tachycardia.
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Hindu High-risk health Behaviors
Alcoholism and cigarette smoking among Hindu Americans, especially among men, cause significant health problems.
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Hindu Nutrition
Dietary habits are complex and regionally varied. Most believe that food was created by the Supreme Being for the benefit of man.
The influence of religion is pervasive in food selection, customs, and preparation methods.
Classification of regional food habits can be two-fold based on the types of cereals and fresh foods consumed.
In the first category are rice and bread eaters; in the second category are vegetarians and non-vegetarians.
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Hindu Nutrition
Vegetarianism is firmly rooted in culture.
The term non-vegetarian is used to describe anyone who eats meat, eggs, poultry, fish, and sometimes cheese.
Many Brahmins in North India consider eating meat to be religiously sanctioned.
In some parts of India, eating fish is acceptable to Brahmins, whereas in other parts eating meat is sacrilegious.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Nutrition
Dietary staples include rice, wheat, jowar, bajra, jute, oilseeds, peanuts, millet, maize, peas, sugarcane, coconut, and mustard.
Cereals supply 70 to 90 percent of the total caloric requirements.
A variety of pulses or lentils, cooked vegetables, meat, fish, eggs, and dairy products are also consumed.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Nutrition
Heavily spiced (curry) dishes with vegetables, meat, fish, or eggs are favored, and hot pickles and condiments are common.
Spice choices include garlic, ginger, turmeric, tamarind, cumin, coriander, and mustard seed.
Vegetable choices include onions, tomatoes, potatoes, green leaves, okra, green beans, and root vegetables.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Nutrition
In North India, wheat is the staple food. Other cereals are jowar, bajra, and ragi, consumed in porridges, gruels, and rotis (baked pancakes).
People from Punjab do not favor fish, and people from the south generally dislike the idea of meat of any kind.
In Saurashtra in the south, fish, fowl, flesh, and eggs are taboo practically everywhere.
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Hindu Nutrition
Women generally serve the food but may eat separately from men.
Women are not allowed to cook during their menstrual periods or have contact with other members of the family.
Foremost among the perceptions of Hindus is the belief that certain foods are “hot” and others are “cold,” and therefore, they should only be eaten during certain seasons and not in combination.
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Hindu Nutrition
Geographic differences in the hot and cold perceptions are dramatic.
Many foods considered hot in the north are considered cold in the south. Such perceptions and distinctions are based on how specific foods are thought to affect body functions.
Failure to observe rules related to the hot and cold theory of diseases results in illness.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Pregnancy and Childbearing Practices
Birth control methods include intrauterine devices, condoms, and rhythm and withdrawal methods.
Grandmothers, mothers, and mothers-in-law are considered to have expert knowledge in the use of home remedies during pregnancy and the postpartum period.
Many older women frequently travel to the United States to assist new mothers in antenatal and postnatal care that is consistent with traditional customs.
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Hindu Pregnancy and Childbearing Practices
The birth of a son is a blessing because the son carries the family name and takes care of the parents in their old age.
The birth of a daughter is cause for worry and concern because of the traditions associated with dowry, a ritual that can impoverish the lives of those who are less affluent.
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Hindu Pregnancy and Childbearing Practices
No taboo against the father being in the delivery room exists, but men are usually not present during birthing.
Because self-control is valued, women suppress their feelings and emotions during labor and delivery.
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Hindu Pregnancy & Childbearing Practices
Certain “hot” foods like eggs, jaggery, coconut, groundnut, maize, mango, papaya, fruit, and meat are avoided during pregnancy because of a fear of abortion caused by heating the body or inducing uterine hemorrhage.
Pregnancy is a time of increased body heat; hence, “cold” foods, such as milk, yogurt, and fruits, are considered good. Buttermilk and green leafy vegetables are avoided because of the belief that these foods cause joint pain, body aches, and flatulence.
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Hindu Pregnancy & Childbearing Practices
Burning sensations during urination, scanty urine, or a white vaginal discharge are considered serious signs of significant overheating.
Overeating and consumption of high-protein foods, including milk, are avoided because such foods result in an exaggerated growth of the baby that may lead to a difficult delivery.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Pregnancy & Childbearing Practices
Morning sickness is caused by an increase in body heat.
Anemia caused by iron deficiency is one of the nutritional disorders affecting women of childbearing age. This condition may be aggravated because of the practice of reducing the consumption of leafy vegetables to avoid producing a dark-skinned baby.
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Hindu Childbearing Practices
After the birth, both the mother and the baby undergo purification rites leading to the 11th day.
The baby is officially named on the 11th day during the “cradle ceremony,” and several rituals are performed to protect the baby from evil spirits and to ensure longevity.
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Hindu Childbearing Practices
The postpartum mother is considered to be impure and is confined to a warm room and often keeps the windows closed to protect her against cold drafts. Exposure to air conditioners and fans, even in warm weather, may be considered dangerous.
The pollution lasts for 10 days. This period of necessitated and mandatory confinement assists in bonding between the mother and the newborn. It provides the mother with adequate rest and time to tend to the baby’s needs.
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Childbearing Practices
A sponge bath for the newborn is recommended until the umbilical cord falls off.
Soft massage to the extremities is recommended before bathing the infant.
Washing the infant’s hair daily is believed to improve the quality of the hair.
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Childbearing Practices
During the postpartum period, hot foods, such as brinjals, drumsticks, dried fish, dhal, and greens, are good for lactation.
Cold foods, such as buttermilk and curds, gourds, squashes, tomatoes, and potatoes, are restricted because they produce gas. Cold foods are thought to produce diarrhea and indigestion in the infant.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Childbearing Practices
Abstentions are primarily practiced for the baby’s health; harmful influences might be transmitted through the mother’s breast milk. Some believe that colostrum is unsuited for infants. Most women think that the milk does not “descend to the breast” until their ritual bath on the third day and, as a result, newborns are fed sugar water or milk expressed from a lactating woman.
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Childbearing Practices
Breast milk is commonly supplemented with cow’s milk and diluted with sugar water. A child’s stomach is considered weak as a result of diarrhea; therefore, the child is given diluted milk.
Sources of protein, such as eggs, curds, and meat are avoided because they might adversely affect the baby.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Childbearing Practices
The mother’s diet the first few days is restricted to liquids, rice, gruel, and bread.
Boiled rice, eggplant, curry, and tamarind juice are added to the diet between 6 months and a year after the birth of the baby.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Death Rituals
A tenet of Hinduism is that the soul survives the death; death is a rebirth.
The death rite is called antyesti, or last rites.
The priest pours water into the mouth of the deceased and blesses the body by tying a thread around the neck or wrist.
The eldest son completes prayers for ancestral souls, but all male descendants perform the rites; each offers balls of rice on behalf of the deceased ancestor.
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Hindu Death Rituals
The body is usually cremated rather than interred.
The ashes are immersed or sprinkled in the holy rivers. Such immersions are of great benefit to the souls of the dead.
Hindus may save their family’s ashes to later scatter them in holy rivers when they return to their homeland.
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Hindu Death Rituals
Women may respond to the death of a loved one with loud wailing, moaning, and beating their chests in front of the corpse, attesting their inability to bear the thought of being left behind to handle situations by themselves.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Spirituality
Hinduism, the largest religion and oldest tradition practiced in India, represents a set of beliefs and a definite social organization.
Hinduism denotes belief in the authority of Vedas and other sacred writings of the ancient sages, immortality of the soul and a future life, existence of a Supreme God, the theory of karma and rebirth, theory of the four stages of life, and the theory of four Purusarthas, or ends of human endeavor.
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Hindu Spirituality
Orthodox Hindus view society as divinely ordained on the basis of the four castes: (a) Brahmin, the highest caste, priests and scholars, emerged from the head of God; (b) Kshtriya, warriors, from the arms; (c) Vaisya, merchants, from the waist; and (d) Sudra, menials, from the feet of God.
Hindu legal codes are based on the caste system.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Spirituality
Women often fast one day a week or for a lunar month to fulfill a vow made to a deity in supplication for a particular blessing.
Wives frequently fast to secure the continued health of their husbands and families.
Shrines may be set up in the living room, dining room, or in a back room or in a closet.
The shrine typically contains representations or symbols of one or more deities.
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ClickerCheck
The wife of Mr. Ganganna ask the nurse to arrange antyesti for her critically ill husband. The nurse recognizes that antyesti is
a. Last rights.
b. A Hindu religious leader.
c. A traditional Hindu healer.
d. A strength enhancing special drink.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Correct Answer
Correct answer: A
Antyesti is last rights among Hindus.
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Hindu Health-care Practices
Physical examinations are especially traumatic to women who may not have experienced or heard about Pap tests and mammography exams.
Most individuals believe that illnesses attack an individual through the mind, body, and soul.
Some believe that too much sexual activity and worry are associated with tuberculosis.
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Hindu Health-care Practices
Suffering of any kind produces hope, which is essential to life.
To maintain harmony between self and the supernatural world, the belief that one can do little to restore health by oneself provides a basis for ceremonies and rituals.
Worshiping goddesses, pilgrimages to holy places, and pouring water at the roots of sacred trees have medicinal effects in healing the sick person and in appeasing the planets to help prevent illnesses and misfortunes.
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Hindu Health-care Practices
In Ayurveda, the traditional system of medicine in India, the primary emphasis is on the prevention of illnesses. Individuals have to be aware of their own health needs.
One of the principles of Ayurveda includes the art of living and proper health care, advocating that one’s health is a personal responsibility.
The key to health is an orderly daily life in which personal hygiene, diet, work, and sleep and rest patterns are regulated.
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Hindu Health-care Practices
A common health problem is self-medication.
Those migrating to America are accustomed to self-medicating and may bring medications with them or obtain medications through relatives and friends.
The traditional healers use Ayurvedic, Siddha, and Unani medical systems all of which are based on the Tridosha theory.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Health-care Practices
The Ayurvedic system uses herbs and roots; the Siddha system, practiced mainly in the southern part of India, uses medicines; and the Unani system, similar to the Siddha, is practiced by Muslims.
According to the Tridosha theory, the body is made up of modifications of the five elements: air, space, fire, water, and earth.
Transcultural Health Care- Hindu Culture
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
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Hindu Health-care Practices
Because of their religious beliefs of karma, Hindus may attempt to be stoic and may not exhibit symptoms of pain.
Pain is attributed to God’s will, the wrath of God, or a punishment from God and is to be borne with courage.
Family may not want to disclose the gravity of an illness to the patient or discuss impending disability or death for fear of the patient’s vulnerability and loss of hope, resulting in death.
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Hindu Health-care Practitioners
The sick role is assumed without any feeling of guilt or ineptness in doing one’s tasks.
The individual is cared for and relieved of responsibilities for that time.
Psychological distress may be demonstrated through somatization, which is common, especially in women.
Transcultural Health Care- Hindu Culture
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Transcultural Health Care- Hindu Culture
Hindu Health-care Practices
Because of the stigma attached to seeking professional psychiatric help, many do not access the health-care system for mental health problems.
Mental illness is considered to be God’s will.
No Hindu policy exists that prevents receiving blood or blood products.
Donating and receiving organs are acceptable.
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Transcultural Health Care- Hindu Culture
Hindu Health-care Practitioners
Although Hindus in general have a favorable attitude toward American physicians and the quality of medical care received in the United States, relatives and friends are usually consulted before health-care professionals.
Physicians are considered omnipotent because God grants cures through physicians.
Clients tend to be subservient and may not openly question physicians’ behavior or treatment.
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Transcultural Health Care- Hindu Culture
Hindu Health-care Practitioners
Physician is also viewed like an older person in the family; a protective, authoritative, and responsible relationship; and a parent-child relationship.
Mental health traditional healers such as Vaids, practice an empirical system of indigenous medicine; mantarwadis cure through astrology and charms; and patris act as mediums for spirits and demons
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