Nursing an Hispanic Patient

Course Outline

1. History of Hispanic American Immigration

  • Early History
    • In the Southeast
    • In the Southwest
    • Mexican Independence and Free Trade
  • Conflict With the United States
    • Problems For Landowners
  • Immigration in the Early 1900s
    • Immigration Restrictions
    • Growing Discrimination
  • Effects of World War II
  • Immigration In the Mid-1900s
    • Puerto Rican Migration
    • Cuban Migration
    • Problems With Cuban Migration
    • Living Conditions for Cuban Americans
  • Immigration in the Late 1900s
    • Hispanic Americans Today

2. Understanding the Hispanic Culture

  • Cultural Backgrounds of Hispanic Americans
    • Cultural Bonds
    • National and Ethnic Origins
    • Where Hispanics Live
    • Settlers in the West Indies
    • Spanish and African Influences in Puerto Rico and Cuba
    • Aztec Influence in Mexico
    • Spanish and Indian Cultures in Mexico
    • Holidays
  • The Day of the Dead–Mexico Honors Those Gone But
    • Not Forgotten
  • Hispanic Values
    • Family Values
    • Etiquette
    • Rituals and Religions
    • Celebrations and Holidays
    • Eating Habits
    • Teaching and Learning Implications
    • References

3. What It Means to Be Latino

  • On Terminology: Hispanic or Latino?
  • ‘Hispanic’ vs ‘Latino’

4. Getting to Know The Hispanic/Latino Culture

    • La Familia
    • Respeto
    • Personalismo
    • Confianza
    • Names
    • Family Structures
    • Communication and Social Interaction
    • Time Orientation
    • Concept of Health
    • References
  • Mexican-American
    • Food Habits and Their Relationship to Dietary Guidelines
    • Eating Practices, Food Preferences and Food Preparation Techniques
    • Teaching Implications
    • References
  • Puerto Rican
    • Food Habits and Their Relationship to Dietary Guidelines
    • Eating Practices, Food Preferences and Food Preparation Techniques
    • Teaching Implications
    • References
  • La Cocina—Southwestern Cuisine

5. Hispanic Health Status

  • Key Facts
  • Mortality and Morbidity
    • Smoking
    • Diet
    • Cholesterol
    • Weight and Exercise
    • Alcohol and Substance Abuse
    • Violence and Unintentional Injuries
    • Environment
  • Key Areas of Concern
    • AIDS and HIV
    • Cancer
    • Coronary Heart Disease, Stroke, and Hypertension
    • Diabetes
    • Environmental Health
    • Mental Health
    • Tuberculosis
  • Health Beliefs and Practices
    • Concept of Health
    • Potential Culture-Related Health Concerns Among Hispanic
    • Populations
    • Health Promotion, Prevention, and Treatment
    • Folk Beliefs of Some Hispanics About Health and Illness
    • That Can Affect Care and Treatment
    • Major Folk Illnesses Among Hispanic Populations
    • Major Systems of Folk Healing Among Hispanic Populations
    • Sources for Further Reading
  • Health Culture Sketch
    • Introduction
    • Geographic Distribution in U.S.
    • General Characteristics
    • Health Care Decision-Making

6. Cultural Diversity: Eating in America

  • Mexican-American
    • Food Habits and Their Relationship to Dietary Guidelines
    • Eating Practices, Food Preferences and Food Preparation Techniques
    • Teaching Implications
    • References
  • Puerto Rican
    • Food Habits and Their Relationship to Dietary Guidelines
    • Eating Practices, Food Preferences and Food Preparation Techniques
    • Teaching Implications
    • References
  • La Cocina—Southwestern Cuisine 88

7. Acculturation Erodes the Diet Quality of U.S. Hispanics

    • Status of Hispanics Varies by Origins
    • Table 1. U.S. Hispanic Populations Vary Widely in Age,
    • Earnings, Level of Schooling, and Household Size
    • Disease and Mortality Puzzle Policymakers
    • Hispanics Surpass Non-Hispanics in Diet Quality
    • . . . Especially Spanish-Speaking Hispanics
    • Table 2. Hispanic Spanish Speakers Score Highest on Healthy
    • Eating Index
    • Table 3. Hispanic Attitudes and Knowledge About Nutrition Diverge
    • References
  • Nutrition Counseling Tips For Hispanic-American Clients

8. Folk Medicine in Hispanics

    • Concept of Disease
    • Origins of Hispanic Folk Medicine
    • Utilization of Lay Healers Among Hispanics
    • Hypertension
    • Diabetes Mellitus
    • Folk Medicine-Treatments-Upper Respiratory Infection
    • Folk Medicine-Treatments-Osteoarthritis/Rheumatism
  • Treatment of Folk Illnesses
    • Conclusion
    • Folk Remedies Everyone Should Know
    • Illustrations: Plants and Herbs Commonly Used as Folk Remedies
    • Curandera Preparing for a Barrida

9. The Influence of Ethnicity on the Use of Herbal Remedies

  • Introduction
    • Discussion
    • Conclusion
    • Table 1. Herbal Users by Perceived Health Problems
    • Table 2. Botanical Nomenclature for Commonly Used Herbal Remedies
    • Table 3. Herb Users’ Sources of Information on Herbal Remedies
    • Table 4. Frequency of Use of the Top 10 Herbs Used by Herbal Users
    • Table 5. Most Frequently Used Herbal Remedies forTop Five Perceived Health Problems
    • References

10. Hispanics/Latinos: Health Disparities Overview

  • Terminology
  • Demographics
    • Size and Origin of Population
    • Location
    • Age
    • Family Size
    • Underlying Causes of Health Disparities: Income and Education
    • Education
    • Socioeconomic Status and Health Status
    • Income and Economic Status
    • Employment
  • Health Status
    • Leading Causes of Mortality
    • Specific Health Concerns
    • Traditional Health Beliefs and Practices
    • Traditional Illnesses
  • Risk Factors and Challenges
    • Racism
    • Environmental and Occupational Hazards
    • Health Insurance Coverage and Access to Quality Care
    • Language and Communication
    • Obesity
    • Smoking
    • Alcohol Use
    • Physical Activity
    • Practical Tips For Treating Hispanic Patients
    • Strengths and Protective Factors
    • Diet
  • Adherence Factors
    • Decision-making
    • Communication
  • Complementary and Alternative Medicine
    • References and Resources
  • Quality & Culture Quiz
  • Quality & Culture Quiz Answers

11. Cancer Health Disparities

  • Cancer Rates
    • Overall Incidence and Mortality Rates
    • African -Americans
    • Hispanics/Latinos
    • Asian Pacific Islanders
    • American Indian/Alaska Natives
  • What Are Cancer Health Disparities?
    • Financial Issues
    • Minorities Are More Likely Not to Have a Regular Doctor
    • Minorities Face Greater Difficulty in Communicating With Physicians
    • Transportation Can Limit Access
    • Accurate Information is Not Universally Available
    • Percentage of Adults Who Have Problems Communicating With Their Doctor
    • Percentage of U.S. Women Who Had Screening Tests
    • Available Information Does Not Reach All Populations
    • Potential Biases Can Affect Cancer Health
    • Not Everyone Receives the Screening Equally
    • Higher Percentage of Whites Receive Medicare Services in Managed Care Plans
    • Older African Americans Receive Lower Rate of Surgery And Have Lower Resulting Survival Rate

12. Disparities in Cardiovascular Disease (CVD)

  • Eliminate Disparities in Cardiovascular Disease (CVD)
    • What is the burden of cardiovascular disease in the United States?
    • Where are the disparities?
    • What is the goal?
    • What is the strategy?
    • What can healthcare providers do to help reduce the burden of CVD?
    • What can individuals do to decrease their risk of developing CVD?
    • For More Information About Cardiovascular Disease:

13. Unequal Treatment: What Healthcare Providers Need to Know

  • Do Racial and Ethnic Minorities Receive a Lower Quality of
    • Healthcare?
  • What Are the Sources of Healthcare Disparities?
    • Clinical Uncertainty
    • The Implicit Nature of Stereotypes
    • Healthcare Provider Prejudice or Bias
    • Medical Decisions Under Time Pressure with Limited Information
    • Patient Response: Mistrust and Refusal
  • What Can Healthcare Providers Do to Help Eliminate
    • Disparities in Care?
    • Guide to Information Sources
    • REFERENCES
    • Did You Know…

14. Diabetes in Hispanic Americans

  • Major Studies of Diabetes in Hispanic Americans
  • How Many Hispanic Americans Have Diabetes?
    • Table 1. Hispanic American Populations in the United States and Percentage With Diabetes
  • What Factors Increase the Chance of Developing Type 2 Diabetes?
    • Genetic Risk Factors
    • Figure 1. Prevalence of Diagnosed and Undiagnosed Diabetes in Mexican Americans, U.S., 1988-94
    • Figure 2. Genetic Origins of the Major Hispanic Subgroups in the United States
    • Medical and Lifestyle Risk Factors
    • Prediabetes (Impaired Glucose Tolerance and Impaired Fasting Glucose)
    • Gestational Diabetes
    • Hyperinsulinemia and Insulin Resistance
    • Obesity
    • Figure 3. Prevalence of Overweight Individuals Among Whites, Blacks, and Mexican Americans in the Population, 1988‑91
    • Physical Activity
  • How Does Diabetes Affect Hispanic Young People?
  • How Does Diabetes Affect Hispanic Women During Pregnancy?
  • How Do Diabetes Complications Affect Hispanic Americans?
    • Eye Disease
    • Kidney Disease
    • Nerve Disease
    • Peripheral Vascular Disease
    • Heart Disease
    • Diabetes and Diet
  • How Is NIDDK Addressing the Problem of Diabetes in Hispanic Americans?
    • Diabetes Prevention Program
    • National Diabetes Education Program
  • Points to Remember
    • References

15. Minority Women’s Health Concerns

  • What Health Problems Affect a Lot of Hispanic Americans/Latina Women?
    • Obesity and Overweight
    • Heart Disease
    • Stroke
    • Cancers
    • Maternal and Infant Health
    • Smoking and Pregnancy: A Critical Risk Factor for Pregnant Females
    • HIV/AIDS
    • Cultural Attitudes
    • Gender Roles
    • Attitudes About Sex
    • Other Sexually Transmitted Diseases
    • Diabetes Mellitus
    • Tuberculosis
    • Psychiatric Disorders
  • Violence Against Women
    • Hispanic American/Latina Women
    • Leading Causes of Death for Women in the United States, 2000
  • Getting Health Care
    • What types of care coverage exist? How do I find out about them?
    • For More Information

16. Factors Affecting The Health of Women of Color

  • Adolescent Females of Color
    • Access to Services
    • Health
    • Health Risk Behaviors
    • Sexual Intercourse
    • Substance Abuse
    • Unsafe Moter Vehicle Operation
    • Healthful Behaviors
  • Elderly Women of Color
    • Demographics
    • Native Americans
    • Hispanics
    • Black Americans
    • Asians and Pacific Islanders
    • Access to Health Care
    • Health Assessment

17. Maternal Health of Hispanic Women

    • Folic Acid Knowledge and Use Among Hispanic Women
    • Preventing Alcohol-Exposed Pregnancies Among Hispanic Women
  • Maternal Health Risks of Immigrant Women From Latin America
  • Maternal & Reproductive Health Beliefs
  • Understanding the Health Culture of Recent Immigrants to the United States: A Cross-Cultural Maternal Health Information Catalog
    • Examples of Cultural Beliefs Held by Certain Immigrant Groups
    • Examples of Epidemiological Data Affecting the Health of Childbearing Women
    • Examples of Proposed Links Between Epidemiological Data and Cultural Beliefs/Practices; and Associated Health Risks to Pregnant Women and Infants
    • Lessons for Health Care Professionals From Knowledge of Cultural Beliefs or Immigrant Experiences
    • REFERENCES
  • 18. Violence and Minority Women

    • Screening for Abuse in Spanish-Speaking Women
    • Women Abuse Screening Tool

19. Hispanic American Elders

  • Introduction
  • The Older Hispanic Population: Past, Present, and Future
    • Residence
    • Educational Level
    • Living Arrangements
    • Poverty
    • Health
    • Self-Rated Health Status
    • Access to Medical Care
    • Diversity of Hispanic Elders
    • Health and Chronic Illnesses
    • Hispanic Americans and Family Caregiving
    • Older Hispanic Americans and Poverty
    • Education
  • Elderly Abuse in Hispanic Families

20. Alcohol and Minorities

  • Ethnic Differences in Drinking Patterns
  • Ethnicity and Alcohol Problems
    • Medical Consequences
    • Social Consequences
  • Contributors to Ethnic Differences
    • Social Factors
    • Biological Factors
  • Prevention
    • School-Based Prevention
    • Family-Based Prevention
    • Alcohol Availability
  • Treatment
  • NIAAA Analysis Reveals Increased Risk for Liver Cirrhosis Death Among Hispanic Americans
    • References

21. Hispanics and Tobacco

  • Health Effects
  • Cigarette Smoking Prevalence
    • Prevalence of Other Forms of Tobacco Use
    • Tobacco Industry Influence
    • References

22. Mental Health

  • Latinos/Hispanic Americans
    • Need For Mental Health Care
    • High-Need Populations
    • Availability of Mental Health Services
    • Access to Mental Health Services
    • Use of Mental Health Services
    • Appropriateness and Outcomes of Mental Health Services
    • Culturally Specific Mental Health Resources

Learning Objectives

After completing the course you’ll be able to:

History of Hispanic American Immigration

  1. Recount the history of Hispanic immigration in the United States.

Understanding the Hispanic Culture

  1. Describe the core values and norms of the Hispanic culture.

What It Means to Be Latino

  1. Describe what it means to be a Latino.
  2. Explain what the terms Latino and Hispanic imply

Getting to Know The Hispanic/Latino Culture

  1. Explain the concepts of la familia, respeto, personalismo, and confianza in the context of Hispanic culture.

Hispanic Health Status

  1. Describe mortality and morbidity in Hispanic population.
  2. List top ten leading causes of death for Hispanics of all age groups.
  3. Describe the impact of various lifestyle and health behavioral factors on Hispanics’ health status.
  4. Describe the concept of health and preventive medicine in the context of Hispanic culture.
  5. Explain typical Hispanic health beliefs and practices.
  6. Explain major folk illnesses among Hispanic populations, defining curanderismo.

Cultural Diversity: Eating in America

  1. Describe the eating practices, food preferences and cultural implications of Mexican-American and Puerto Rican diet.

Acculturation Erodes the Diet Quality of U. S. Hispanics

  1. Discuss how acculturation erodes the diet quality of U.S. Hispanics.
  2. Discuss Hispanic attitudes and knowledge about nutrition among various population groups.

Folks Medicine in Hispanics

  1. Describe the origins and applications of Hispanic folk medicine.
  2. Identify common Hispanic folk illnesses and their remedies.
  3. Incorporate the knowledge of Hispanic folk medicine beliefs into the development of effective patient management and counseling plans.

The Influence of Ethnicity on the Use of Herbal Remedies

  1. Distinguish between non-Hispanic whites and Hispanics in their use of herbal remedies.

Hispanics/Latinos: Health Disparities Overview

  1. Describe the socioeconomic and health status of Hispanics and compare it with that of other population groups.
  2. Follow recommendations to confirm patient teaching and treatment with the traditional health beliefs and practices.
  3. Implement recommendations to improve communication with Hispanic patients.

Cancer Health Disparities

  1. Cite statistics that show cancer health disparities among various racial and ethnic groups.
  2. Discuss various sources of disparities in cancer treatment for minority population groups.

Unequal Treatment: What Healthcare Providers Need to Know

  1. Discuss how bias, prejudice, and stereotyping can contribute to unequal treatment of patients on the basis of race and ethnicity.

Diabetes in Hispanic Americans

  1. Discuss the epidemiology of diabetes in Hispanic Americans.
  2. Identify the factors that increase the chance of developing type 2 diabetes.

Minority Women’s Health Concerns

  1. Discuss the health problems affecting minority women.
  2. Describe the health impact of sexually transmitted diseases on minority women.
  3. Discuss the prevalence of psychiatric disorders among various women groups.

Factors Affecting The Health of Women of Color

  1. Discuss factors affecting the health of women of color and their access to services.
  2. Discuss health risk behaviors that place adolescent females of color at increased risk of morbidity or death.
  3. Describe the demographics of elderly women of color.
  4. Discuss the access to health care available to elderly women of color and its impact on morbidity and mortality.

Maternal Health of Hispanic Women

  1. Discuss the key findings of the report dealing with pregnancy-related mortality in Hispanic women in the United States.
  2. Describe maternal health beliefs and practices that are common to Hispanic culture.
  3. Cite examples of epidemiological data affecting the health of childbearing women from various immigrant groups.
  4. Make a link between epidemiological data and cultural beliefs and health risks to pregnant women and infants.
  5. Apply the knowledge of cultural beliefs and immigrant experience to providing effective health care.

Violence and Minority Women

  1. Define terms such as intimate partner violence, sexual assault, dating violence, elder abuse.

Hispanic American Elders

  1. Describe the special problems faced by Hispanic elders.
  2. Describe the prevalence of elderly abuse in Hispanic families.

Alcohol and Minorities

  1. Identify social and biological factors that contribute to ethnic differences in drinking.
  2. Describe ethnic differences in drinking patterns.

Hispanics and Tobacco

  1. Discuss the use of tobacco in the Hispanic population.

Mental Health

  1. Discuss the need for mental health care in Hispanic Americans..

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.


Customer Comments

“I liked the layout of the test questions & the titles in the book with explanations.” 

– J.J., RN, CA