The Competence of Cultural Practices in Puerto Rico and Syria Cultures

Culture awareness can improve health outcomes and quality of care if the meaning of culture is understood. So, what is culture, (Wolters Kluwer, Fundamentals of Nursing, 2019. pg.81) defines culture as a shared system of beliefs, values, and behavioral expectations that provide social structure for daily living. It is a combination of a body of knowledge, a body of belief, and a body of behavior. Elements include personal identification, communications, actions, customs, beliefs, values, and institutions that are specific to ethnic, racial, religious, geographic, or social groups. (Wolters Kluwer, 2019. pg.81). Culture awareness is the willingness to study the differences in ethnicity backgrounds; allowing yourself to walk in someone else’s shoes in terms of their culture, embrace their beliefs which may include herbal remedies or healers. Cultural awareness can improve health outcomes and quality of care simply by engaging, and educating people about their healthcare needs, and how to address them, and then create a plan of care built around the cultural. Respect and trust play a key role in the healthcare field, cultural competence-patients who feel their healthcare providers respect their values, beliefs, traditions and such are more likely to communicate freely and honestly without being frowned upon or judged, which in return will reduce disparities in healthcare and improve patient outcomes.

Healthcare workers must be informed about the cultural factors that influence people's health beliefs and behaviors, and they must be provided with the tools they need to serve a multi-cultural patient community. This can be achieved through in-house training, case study review, live interactions with patients, role-playing, and training and continuing education healthcare videos. Staff should be periodically assessed based on established standards, and success rates can be tracked from patient satisfaction scores and with healthcare disparities data. When healthcare workers at all levels of care are given the tools and training, they need to become culturally competent, improved patient satisfaction and outcomes are the inevitable result.

In this paper we will be exploring the different cultural beliefs, and values between Puerto Rico and Syria. Puerto Rico is located on the continent of North America, in between the Caribbean Sea and the North Atlantic Ocean, east of the Dominican Republic and west of the Virgin Islands. Syria is in Western Asia, north of the Arabian Peninsula, at the eastern end of the Mediterranean Sea. It is bordered by Turkey to the north, Lebanon and Israel to the west and southwest, Iraq to the east, and Jordan to the south.

Puerto Rico and Syria Cultures

Starting with values, the Puerto Rican beliefs on family is that it is the primary focus, they feel very strongly towards family; meaning they are very close. Health decisions are family focused and they go to doctor appointments together. They have respect for their healthcare provider in regards to their healing abilities, education, training and the authority figure. When they are at the doctor they avoid eye contact, avoid disagreeing or expressing doubts, they are reluctant to ask questions, withhold information, and will not admit if they don’t understand something. They believe that the course of fate cannot be changed and that life’s events are beyond anyone’s control. God is the center of their life. Cultural understanding between physician and patients will improve adherence, patient care, and clinical outcomes if we familiarize ourselves with cultural backgrounds, understand and respect patients’ values, and beliefs, help them understand and respect ours, don’t impose our own values or culture.

We see that in Syria they have some of the same beliefs as Puerto Rico, Syrians often seek immediate medical care for physical injury or illness, they are anxious to begin treatment, and will generally listen to their physician’s advice and instructions. They tend to see physicians as the decision makers, and may have less confidence in non-physician health professionals. Although most Syrians are familiar with Western medical practices, like most populations, they tend to have certain care preferences, attitudes, and expectations driven by cultural norms, particularly religious beliefs, and expectations. There are private medical practices, in addition to the free medical care provided by the state. The health care system is poor but improving. Infectious diseases are a major health threat, especially in rural areas, where water quality is poor and sewage disposal systems are not well developed. There is a high child mortality rate that is due mainly to measles and digestive and respiratory diseases.

While many Syrians may have similar preferences due to shared cultural norms and past experiences, it is important to recognize that individuals in this population may have diverse preferences, attitudes, and expectations toward healthcare. For example, Syrian patients or their families might be more likely than the general U.S. patient population to: • Prefer a provider of the same gender.

Alternative Healthcare Measures

The breakdown of national health services and medical infrastructures in Syria, particularly in the north of the country, has led to an increase in people seeking traditional herbal treatments and “alternate medicines”. Examples of treatments used include mixtures of natural herbs with honey for a range of ailments, tree bark for antibacterial, urinary infections and rheumatism, flowers and fruits for conditions including hypertension, headaches, atherosclerosis, and even allegedly camel milk for breast cancer.

In Puerto Rico the power difference in the relationship between a man and a woman not only creates the social norm of machismo, but by consequence also creates the social concept of marianismo, which is the idea that women are meant to be pure and wholesome. It emphasizes the perfect femininity of a woman and her virginity. One could argue that in the similar manner of Patriarchy, the man is the head of the household while the 'fragile' woman is submissive and tends to remain behind the scenes. This brings to focus the idea that women are inferior and are thus dependent on their husbands. As a result, they not only rely on their husbands for financial support, but in the social realm are put at the same level as 'children under age 12, mentally ill persons, and spendthrifts. By way of tradition, not only are women given limited opportunities in what they are able to do and to be, but they are also viewed as people that cannot even take care of themselves. Getting married provides a woman with security under her husband's success, but also entails a lifelong commitment towards serving her husband and her children.

In Syria the Baath Party was one of the first in the Arab world to declare as one of its goals the emancipation and equal treatment of women; its constitution of 1964 states that all citizens have equal rights. While women are now entitled to receive the same education as men and to seek employment, the traditional attitude that views females as inferior beings prevails. A woman is considered the possession of a man rather than her own person. She is identified as her father's daughter until marriage; after the birth of a male child, her identity is transferred from the wife of her husband to the mother of her son.