Transcultural Health Care: A Culturally Competent Approach,

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German American Culture

Larry Purnell, PhD, RN, FAAN

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German American Overview/Heritage

Over 50 million Americans are of Germans heritage.
The first wave of German immigrants came to the USA for religious freedom.
The second wave arrived between 1840 and 1860 and was fleeing political persecution, poverty, and starvation.
Many worked as indentured servants.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German American Overview/Heritage

The 1930s and 1940s saw a third wave because of the rise of fascism in Germany.
Germans receive a stronger education than Americans.
The German undergraduate degree is equal to the American master’s degree, except for nursing which is at a lower level than that of the USA.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Communication

German is the official language of Germany.
German is a low-contextual language, with a greater emphasis on verbal than nonverbal communication.
A high degree of social approval is shown to people whose verbal skill in expressing ideas and feelings is precise, explicit, and straightforward.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Communication

For traditional Germans, sharing one’s feelings with others often creates a sense of vulnerability or is looked on as evidence of weakness.
Expressing fear, concern, happiness, or sorrow allows others a view of the personal and private self, creating a sense of discomfort and uneasiness.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Communication

“Being in control” includes harnessing one’s emotions and not revealing them to others.
Newer generations are more demonstrative in sharing their thoughts, ideas, and feelings with others.
In families where the father plays a dominant role, little touching occurs between the father and children.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Communication

Affection between a mother and her children is more evident.
Germans generally are careful not to touch people who are not family or close friends.
Most individuals place a high value on privacy. People may live side by side in a neighborhood and never develop a close friendship.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Communication

Germans would never consider dropping in on another German neighbor because this behavior is incongruent with their sense of order.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Communication

Even looking into a room from the outside is considered a visual intrusion.
Eye contact is maintained during conversations, but staring at strangers is considered rude.
A closed door requires a knock and an invitation to enter, regardless of whether the door is encountered in the home, business, or in-patient facility.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Communication

To focus on the present is to ensure the future.
The past, however, is equally important, and Germans often begin their discussions with background information.
There are rarely good excuses for tardiness, delays, or incompetence that disturbs the “schedule” of events.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Communication

Those in authority, older people, and subordinates are always addressed formally.
Younger generations or the more acculturated may be less formal in their interactions.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Family Roles and Organization

Traditional families view the father as head of the household.
In the USA, the husband and wife are more likely to make decisions mutually and share household duties.
Older people are sought for their advice and counsel, although the advice may not always be followed.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Family Roles and Organization

Helping parents or grandparents to remain in their own home is important to families.
Prescriptive behaviors for children include using good table manners, being polite, doing what they are told, respecting their elders, sharing, paying attention in school, and doing their chores.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Family Roles and Organization

Prescriptive behaviors for adolescents include staying away from bad influences, obeying the rules of the home, sitting like a lady, and wearing a robe over pajamas.
Restrictive and taboo behaviors for children include talking back to adults, talking to strangers, touching another person’s possessions, and getting into trouble.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Family Roles and Organization

Restrictive and taboo behaviors for adolescents include smoking, using drugs, chewing gum in public, having guests when parents are not at home, going without a slip (girls), and having run-ins with the law.
One’s family reputation is considered part of a person’s identity and serves to preserve one’s social position.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Family Roles and Organization

Because families are concerned about their reputations in the community, an unwed mother taints their reputation and may result in the family being ostracized by others. If marriage follows the pregnancy, less sanctioning occurs.
The fact that pregnancy existed before marriage creates a stigma for the woman, and sometimes for the child, that may last the rest of their lives.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Family Roles and Organization

Many older gays and lesbians may fear exposure because of the extreme discrimination homosexuals experienced in Nazi Germany.
Younger generations of gays and lesbians are less likely to fear exposure of their sexuality.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Workforce Issues

For Germans being on time is important.
Business communication should remain formal: shaking hands daily, using the person’s title with the last name, and keeping niceties to a minimum.
Employees are not addressed by their first names.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

ClickerCheck

Common German cultural individualist is values include

Timeliness and sharing emotions.

Timeliness and direct communication.

Smooth inexact communication and readily sharing emotions.

Readily sharing emotions and present orientation.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Correct Answer

Correct answer: B

German and German Americans value direct communication and timeliness in work and in social engagements.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Biocultural Ecology

Germans range from tall, blond, and blue-eyed to short, stocky, dark-haired, and brown-eyed.
Common health conditions for German Americans include cardiovascular disease, stomach cancer, muscular dystrophy, hereditary hemochromatosis, sarcoidosis, Dupuytren’s disease, peyronie’s disease, cystic fibrosis, hemophilia, and cholelithiasis.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German High-Risk Health Behaviors

Smoking and excessive alcohol consumption remain high-risk behaviors for most Germans.
Most individuals enjoy the outdoors, fresh air, and exercise.
Sports are played for exercise and the pleasure of participating in group activities.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Nutrition

Food is a symbol of celebration for Germans and is often equated with love.
Children are rewarded for good behavior with food.
Real cream and butter are used.
Gravies, sauces, fried foods, rich pastries, and sausages are only a few of the culinary favorites that are high in fat content.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Nutrition

Foods are also fried in butter, bacon fat, lard, or margarine.
Traditional food preparation methods use high-fat ingredients that add to nutritional risks.
Garlic and onions are eaten daily to prevent heart disease.
Those who are ill receive egg custards, ginger ale, or tomato soup (without cream) to settle their stomach.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Nutrition

Ginger ale or 7-Up relieves indigestion and settles an upset stomach.
After gastrointestinal illnesses, a recuperative diet is administered to the sick family member beginning with sips of ginger ale over ice.
Coddled eggs, a variation of scrambled eggs prepared with margarine and a little milk, is used for recuperation.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Pregnancy and Childbearing Practices

Heterologous artificial insemination, use of contraceptive pills, and unnatural contraception are forbidden among strict Catholic Germans.
Therapeutic or direct abortion is forbidden as the unjust taking of innocent life.
Prescriptive practices during pregnancy include getting plenty of exercise and increasing the quantity of food to provide for the fetus.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Pregnancy and Childbearing Practices

Restrictive practices during pregnancy include not stretching and not raising the arms above the head to minimize the risk of the cord wrapping around the baby’s neck.
Prescriptive practices for the postpartum period include getting plenty of exercise and fresh air for the baby.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Death Rituals

Death is a transition to life with God.
Because illness is sometimes perceived as a punishment, the duration and intensity of the dying process may be seen as a result of the quality of the life led by the person.
Careful selection of the clothes to be worn by the deceased and the flowers that represent the immediate family is important.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Death Rituals

The body of the deceased is prepared and “laid out” in the home where support from family and friends is readily available
A short service is held in the home before the body is taken to the church, where family and friends can attend a funeral service. After the church services, the body is taken to the cemetery for burial.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Death Rituals

After a short graveside service, the minister invites everyone at the graveside service to go to the home of the deceased for food.
The viewing provides an opportunity for family, friends, and acquaintances to view the body.
Crying in public is permissible among some families, but in others the display of grief is private.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Death Rituals

A tradition of wearing black or dark clothing when attending a viewing or a funeral may be expected of both family and friends.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Spirituality

Major religions among Germans include Roman Catholicism, Methodism, and Lutheranism.
Other religions, such as Judaism, Islam, and Buddhism, have substantial membership.
Prayers are often recited at the bedside with all who are present joining hands, bowing their heads, and receiving the blessing from the clergy.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Spirituality

Family and other loved ones are also sources of support in difficult times.
Home, family, friends, work, church, and education provide meaning in life for individuals of German heritage.
Family loyalty, duty, and honor to the family are strong values.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Health-care Practices

In traditional families, the mother usually ensures that children receive check-ups, get immunizations, and take vitamins.
Women in the family often administer folk/home remedies and treatments.
German Americans use a variety of over-the-counter drugs, believing that individuals are responsible for their own health.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Health-care Practices

Common, natural folk medicines include roots, herbs, soups, poultices, and medicinal agents such as camphor, peppermint, and spirits of ammonia.
Folk medicine includes “powwowing,” use of special words, and wearing charms.
Many value being stoic when experiencing pain.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Health-care Practices

Mental illness may be viewed as a flaw, resulting in this group being slow to seek help because of the lack of acceptance and the stigma attached to needing help.
Physical disabilities caused by injury are more acceptable than those caused by genetic problems.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Health-Care Practices

Blood transfusions, organ donation, and organ trans-plants are acceptable medical interventions unless a religious choice contradicts them.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

German Health-care Practitioners

Health-care providers hold a relatively high status among Germans.
This admiration stems from the love of education and respect for authority.
Most individuals accept care from either gender. Some younger and older, more traditional women prefer intimate care from a same-sex health-care provider.

The post Transcultural Health Care: A Culturally Competent Approach, appeared first on Infinite Essays.

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