Understanding Indian Culture with a Healthcare Perspective

India is a country in South Asia and it sometimes referred to as the Republic of India. This country houses a culture group known as Indians. Understanding Indian culture is important and crucial due to the vast amounts of immigrants in the United States. After interviewing a man from India, I have a better understanding of his fascinating culture. During this paper I will share with you some of the major differences that separate this culture from others. I know I can use this information in my nursing practice and I hope you take away new information that can help you in your nursing career as well. Now let's get back to my Interviewee, we will just call him Dr. Jai. Dr. Jai spent his childhood and young adulthood living in India and decided to immigrate to the United States after attending and graduating from medical school in India in 1997. Dr. Jai has black hair and brown skin. These same characteristics seem among his family and are typical traits seen in someone with Indian heritage. He is married and has two children, a boy and a girl. He currently resided in Plano, Texas where he practices medicine, specializing in cardiovascular disease. He is an interventional cardiologist. He shares a practice with a group of other physicians who currently practice in Plano, Texas, Sulphur Springs, Texas, and Paris, Texas. After the interview and some research brought the awareness that being culturally sensitive is a highly regarded skill. The knowledge learned here can be used toward providing better quality of care for our healthcare patients. Everything in healthcare should be patient specific; from the way they communicate, values, beliefs, dietary preferences, and even the approach in life and death care. Healthcare providers need to be aware of the different culture aspects when caring for Indian patients.

Language

Namaste! Hi! India has no national language but rather several different languages spoken depending on the geographical location they live in. Hindi is the official language spoken government. While my client speaks four different languages; English, Hindi, Marathi, and Punjabi. He prefers to communicate with the public in English. However, in the home and with his family he speaks Hindi. Thanks to English being a primary language in India, he is proficient in the language and does not need a translator nor does his family. It may be necessary to provide a translator in the hospital setting when someone is unable to communicate is English. After assessing the patient and identifying any communication barriers, it is best practice to ask if any interpreter will be needed. Always remember the difficulty someone may have understanding and communicating when from another country. Nurses and Doctors must have a good form of communication with their patients to make sure they have a good understanding with their patients in order to make sure they have a good understanding of their disease process and individual plan of care.

Religion

There are many different religions practiced in India. Some of the numerous different religions practiced include: Hinduism, Islam, Christianity, Buddhism, and Judaism. Hinduism is the most prominent religion of India and is the practiced religion by my client. A key role in nursing is understanding different religions. This is important to know in case there are any specific practices or traditions that you should be aware of as the provider. We will be specifically speaking of Hinduism, not only because it is the most commonly practiced religion of India, but it is the religion that my client follows. Many Hindus believe in and worship three gods that make up the Hindu trinity, Brahma the creator of the universe, Vishnu the preserver of the universe, and Shiva the destroyer of the universe. (Do You Know the Basics of Hinduism, 2018) Understanding certain practices of Hinduism is essential to providing care for your patient. Puja (pronounced pooja) means reverence or worship and is a ritual performed every morning after bathing and dressing but prior to taking in any food or drinks. (Hindu Worship, 2016.) This ritual or prayer can be performed many ways but one of the simplest is looking at a certain image for a time, and sometimes includes providing an offering or lighting a candle or incense. It is a way to connect them to their god or goddess. (Hindu Worship, 2016) This is just one form of worship or prayer time. Dr. Jai states, this timing of prayer is important and must be done after showering but before eating. As providers we must be careful not to interpret this as refusing to eat. Other rituals or practices you may notice in Hinduism include meditation or yoga. There are many different forms of yoga practices. Any of theses different types of yoga can be practiced at any given time. In America, yoga is often used as a form of exercise but in Hinduism it is much more. It is about the spiritual well being of oneself. It is about the spirit, body and the mind. The ability to clear your mind in your meditation allows you to be the best you possible. When you can center yourself and bring about the best possible you, you are giving something better to the universe. The universe will in return bless you, also known as Karma.

Dietary Needs

Part of providing care for a patient is being aware of any cultural needs they may have. One of these needs may be certain dietary stipulations. While being Indian alone does not necessarily account for any dietary considerations, their religion might. For, example many Hindus are vegan or vegetarian. An article published by Harvard Medical School defines the different types of vegetarians: Vegans are total vegetarians and do not eat meat, poultry, fish, or any products derived from animals, including eggs, dairy or gelatin. Lacto-ovo vegetarians: do not eat meat, poultry, fish, or eggs but do eat dairy products. Ovo vegetarians: do not eat meat, poultry, fish or dairy products but do eat eggs. Pesco Vegetarians: avoid mean but may eat poultry or fish. (Becoming a Vegetarian, 2009) It is important to assess the type of vegetarian the patient may be to provide adequate Not all Hindus are vegan or vegetarian, some just don't eat pork or beef. In Hinduism, the cow is considered the source of food and symbol of life and may never be killed. It's not that it is worshiped or sacred but more accurate to say that it is taboo to eat this in their religion. (Hindu Cow Taboo, 2018) Depending on the area of India in which the patient comes from and their view of Hinduism dictates what they eat. For example, they may be a pesco vegetarian and choose to eat only fish. In India there are certain states where alcohol is illegal. According to Wikipedia, Bihar, Gujarat, Nagaland, and the Union Territory of Lakshadweep alcohol is prohibited. (Alcohol Prohibition in India, 2018) While in other areas in India allows the sale and consumption of alcohol there are dry days in which the sale is not allowed. Such days are set by the state and include some national holidays. In the religion of Hinduism alcohol is a personal choice, much like making the personal choice of food consumption. In all clients in the healthcare system remember to assess their personal situation, not all clients follow he same guidelines in their culture or their religion. This is the case for my client who chooses to eat some meats and does drink occasionally. As far as cultural foods Dr. Jai describes them as having a wide variety of fresh fruits and vegetables. Dishes in India are made depending in what is available in the area and rich in spices, like curries. An important staple in Indian diet is rice. Usually three meals per day are eaten with he most important being breakfast.

Healthcare

Healthcare is vital in every culture. In the Indian culture western medicine is the dominant belief and followed by most people. However, the type of healthcare provided depends on location and availability. With the best care being in the inner cities and more urban areas. Whereas readily available healthcare in more rule areas may be harder to obtain. There are also many other types of medicine practiced, but these tend to be more religious and family-based practices which include Homeopathic medicine and Ayurveda. Homeopathic medicine is the practice of using natural herbs and minerals to cure illness and disease. People believe that the body will heal itself when using these different types of treatment. Ayurveda is the belief of three different energy sources. Every person possesses one of each type of energy when the body becomes out of sorts and causes disease. Each person is given herbs based on the disease process to return the body to aa natural balanced state. Always ask your patient and be aware of any other healthcare practices they may have. It is necessary to know of any types of herbs a patient may be taking while you are treating them. Various types of herbs may counter act or react with a medication or treatment you have for your client. Or the patient's symptoms may be a side effect of certain herbs. For example: Turmeric has been used as an herbal remedy for the digestive system, gallbladder, and liver. In larger doses it can cause gas pain, indigestion, nausea, and diarrhea. In the case of my client Dr. Jai, he believes in western medicine, when asked what he thought about this he chuckled and said, Well I hope so, I am a Doctor.

Health and Disease

Life expectancy for Indians is typically longer here in the United States. According to The World Bank, 2016, an average life expectancy here in the United States was about 79 years old and only about 69 years old in India. When I asked Dr. Jai what the thought about this finding, he replied Due to out better healthcare. There is an increased incidence of life-style related disease rising in India. These include: Diabetes Mellitus and Cardiovascular Disease increasing especially high in males of Indian heritage. (Qualifying Socioeconomic and Lifestyle Heath Risk: Burden of Cardiovascular Disease Among Indian Males, 2015.) My client and his family prove to be fortunate with his parents being alive and well. It is imperative to keep in mind this high prevalence of cardiovascular disease in this culture. A vital key of medicine is prevention. Early screening and monitoring client's health could lead to early detection and early treatment of any disease processes may occur.

Values and Beliefs

There are many values and beliefs that distinguish Indian culture from other countries. Just life many cultures around the world values and beliefs are embedded in their culture and passes down from generation to generation. Some family dynamics commonly seen is where the extended family structure is in the home. The home many consist of multigenerational families. In Indian culture family respect is highly regarded and roles for family members are clearly defined. Husbands often the bread winners and women rearing the children. The man is the leader of the home and often making decisions while the women supervise the household. One tradition hat is very different from here in the United States are dowries. Dowries in India is where the bride's parents give money to the groom and his parents before marriage so that their daughter can be happy. (Understanding Indian Culture and Bridging the Communication Gap, 2013.) When asked about marriages in India Dr. Jai talked about arranged marriages. He states, While not as common as it used to be, arranged marriages are still in existence today in India. Once married the women leave their families and live with her husband's family. The wedding ceremony is rich in tradition. It is usually a three-day affair, with vibrant colors and beautiful flowers. There are many different traditions honored here from the jewelry worn by the bride, a dance and song which only women attend, and the day before the wedding ceremony Henna is used to draw both on the hands and feet of the bride and groom. A tradition that is meant to bring joy, happiness, and bliss within a marriage. This is known as the Mehndi Ceremony. The clothing worn to such events is traditional Indian clothing. It includes a dress, called a Sari, for women and men wear a dhoti. These elaborate garments are typically very rich hues in color. The type of clothing worn varies based on the region of India but are all very similar. Dr. Jai and his family would wear such clothing to a wedding and are reserved for very special occasions.

Death and Dying

Death and the Dying is a difficult process in every culture. As a healthcare provider it is an inevitable part of the job. But knowing how to assist your patient and their families will help ease them through the transition. Embedded into our nursing practice are the four core concepts: Autonomy: The patient has the right to choose or refuse treatment. Beneficence: A care provider should act in the best interest of the patient. Non-maleficence: Do no harm, and Justice: Concerning the distribution of heath resources equitability. In the Indian culture it is common for the family to make decisions with the patient. The family may prefer to be informed of the news first and allow them to tell the patient. If death is imminent call the family and allow them to stay at the bedside. Remember Religion and prayer are very important. Allow for them to pray over the family member and perform rituals if allowed. In the Hindu religion which again is the most prominent religion in India there are many factors to keep in mind. According to Hindu Belief on Death and Dying Family is the most important part of the sacred funeral rite, even children participate in the rites and ritual and instead of being sheltered from death they are taught to accept it. A Hindu priest usually performs certain rites, but family can substitute if one is not available. It is traditional for those of Hindu faith to die in their own homes. The mantra is chanted, and holy ash placed on the forehead with holy water or milk dripped into the loved one's mouth while relatives stand near the body singing sacred songs and saying their goodbyes. Hindu custom is never embalmed, and organs are not removed for donation.

Conclusion

As you can see there are several characteristics that set the Indian culture apart from others: from their dark hair and skin, language, religious traditions, values, and beliefs, and even the way they view death and dying. I hope from this paper that you learned how important it is to understand the culture of your patients. It is best practice to know any language barriers, dietary considerations, religious practices, and rituals during the dying process. By getting to know your patient and their culture you will be proving to be culturally sensitive and this will help you facilitate a therapeutic nurse to patient relationship.

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