People of African-American, European American, and Appalachian Heritage

Question 1: 

The family of Mr. and Mrs. Evans is situated in a 20 acres piece of land in America. It is an extended family consisting of the two parents, two girls aged 40 and 42 respectively; four grandchildren; and two year old great-grandsons (Purnell & Paulanka, 2013). The family has also other siblings who live to the adjacent door, including uncles and aunts (Purnell & Paulanka, 2013). Besides, there are other immediate siblings who live on an 80 acres piece of land across the road. In addition, there are members of the family residing on the opposite side of the road on a 70 acres piece of land, while their in-laws are found in Chicago. 

Mr. and Mrs. Evans family has some areas of strengths. For instance, family members reunite on yearly basis, while those living within the same locality meet on monthly basis for one hour session of socialization. Evans’ family values discipline and love, where all adult members of the family have a role to keep the discipline of their young ones under check. However, there exist some areas of weaknesses within Mr. and Mrs. Evans family. For example, a good number of family members are living in poor health conditions; where they suffer from hypertension. Dorothy has a bipolar condition and is on medication. The family too has some members suffering from cancerous growths (Purnell & Paulanka, 2013). The family is also financially unstable, as it relies majorly on pensions to cater for its basic needs. 

Question 2: 

The family of Mr. and Mrs. Evans values education systems. For example, couple are school system retirees, thus they survive under pension payments from school system and social security. In addition, couple coaches in Bible sessions (Purnell & Paulanka, 2013). 

Question 3: 

According to the family, child rearing is a responsibility of all family members. It is indicated that discipline is instilled by all the elders. Besides, the family remains an extended family meaning parents have a duty to continue taking care of their children even at maturity. 

Question 4: 

Spirituality has a big role to play in the family. For example, it has helped the family to maintain the virtue of unity and love for all family members, including catering for bills and medications. 

Question 5: 

Evans and his relatives may participate in choir singing, Bible class teachings, and community ministry as a way of keeping their bodies exercised with the purpose of preventing heart attack, diabetes, and insanity (Purnell & Paulanka, 2013). 

Question 6: 

Dorothy’s family has “non-biomedical interpretations” of brain impairment symptoms type of cultural views (Abdullah & Brown, 2011). They could be experiencing stigmatization from their mental illness, thus turning to religious practices such singing in choir, and Bible class teaching as a means of relieving their stigmatization. 

Question 7: 

Evans and his relatives are at a high risk of illness posed by poor environmental conditions. This is because they are living in poor environmental conditions worsened by the nearby road which highly pollutes the environment due to harmful gases and dust particles released by moving vehicles. 

Question 8: 

Suppose Susan chooses to become an organ donor, Evans family could be happy and regain some hopes. This is because the family is at a high risk of some family members requiring organ donation for survival due to several illnesses such as hypertension and lung cancer surrounding the family. 

Question 9: 

African-Americans have low chances of having advanced directives such as writing a will and a do-not-resuscitate order (Ramnarace, 2011). In most cases, they endure unnecessary medical descriptions and experience medical hardships as well as family strife as compared to their counterpart whites (Ramnarace, 2011). 

Question 10: 

According to Cowling (2006) hypertension and obesity are the most common types of nutritional diseases associated with the African-Americans. 

Question 11: 

Assessment of an African-American skin requires consideration of the following characteristics are: Historical presentation concern, social history, past history of medication, impact on quality of life, and family history (Onselen, 2016). 

Question 12: 

African-Americans consider eating some foods such as eggs and fish as a taboo. This is because such foods are believed to increase the size of the child hence cause difficulties during birth. According to African-Americans, sex during pregnancy is a taboo, as it leads to contamination of the baby while in the womb. 

Appalachian Case Study #1 

Question 1: 

Appalachians have made key migration patterns for the last 50 years. Most of the Appalachian migrations took place between 1970s and1990s, making the region cosmopolitan (Obermiller & Howe, 2000). Their settlement patterns have since then changed from long-range to short-range, including the occupation of all the states lying within and within the region (Obermiller & Howe, 2000). Currently, migration flows are concentrated to regions lying between urban and suburban counties; with about 50% of the Appalachian population situated in urban counties (Obermiller & Howe, 2000). 

Question 2: 

The Appalachians are capable of automating their workforce. For instance, they are able to improvise employment making machine parts which give them freedom while at work. 

Question 3: 

The common behaviors that pose high-risks in the Appalachian region include child delivery at home, using traditional methods of treatment, and lack of prenatal care. 

Question 4: 

Appalachian region has several health barriers that include negligence of residents to consult clinicians when they are sick, lack of enough medical facilities in rural areas, and cultural believes that traditional treatment is better than hospitals. 

Question 5: 

The physician should teach Mrs. Kapp on the importance of adhering to the prescriptions and the dangers aligned to failure to comply with the prescription. The nurse can also admit her so that she can be closely monitored at the clinic. 

Question 6: 

Regarding Mrs. Kapp home remedies of practicing traditional treatment, I would advise her to stop such practices as they pose a great danger to her health. I would encourage her to make regular visits to the clinic for medical check-ups in order to help improve her health status. 

Question 7: 

In order to make sure that Ruth makes an appointment together with her daughter, the nurse should have taken Ruth through a series of counseling, by explaining to her the importance of the appointment. The nurse should give Ruth a written material detailing importance of consulting physicians when one is sick. 

Question 8: 

Ruth should be discouraged from the home remedies she is practicing and instead be advised to seek better prescriptions from qualified personnel. Although the practice may seem to work, it may not be the best and may pose serious negative reputations to their health. 

Question 9: 

I think Mrs. Kapp may not turn up for the appointment the next week. This is because she has perception that her home practices work better than what she gets at the clinic. If she does not turn up for the appointment, I would buy time and visit her at home with the aim of encouraging her to honor the appointment. 

Question 10: 

Ruth may not make and keep appointments for herself and her daughter. This is because she is used to home treatment practices and she may not see the clinic appointment necessary. 

Question 11: 

I would help Mr. Kapp try to link his home practices with the clinical prescriptions, and then help him to compare the two and come into the best conclusion. This would enable him appreciate the physician’s prescriptions. 

Question 12: 

I would suggest additional services to Kapp’s family such as helping them secure government free treatment services in order to relieve him of the burden of the heavy medical bills. 

Question 13: 

The clinic should consider sending medical officers to the Kapp’s family to establish all the home practices that he utilizes at home and advice on which ones should be modified or abandoned completely. 

Question 14: 

Ruth should re-examine her food hygienic practices to check for any possible food poisoning. She should always ensure that her daughter Rebecca consumes properly cooked foods that are free from contamination. If the diarrhea persists, she should consider visiting a physician for further consultations. 

Conclusion 

Mr. and Mrs. Evans’ family is an example of a typical African-American family. It is an extended family and has both merits and demerits. For instance, one of Evans’ family strengths is that when one person is sick, he or she is taken care of by the other members. Besides, the family has high levels of discipline and love for one another. On the other hand, the family’s weakness is based on the family’s inability to provide the basic needs for its members. The family is at a high-risk of health problems, which is triggered by its negligence to utilize services provided by health centers and instead employs home medical care practices. It is recommended that the government considers sending health care providers to the African-American families in order to provide extension services to them and advise them on the importance of seeking medical attention from qualified clinicians, rather than relying on their home medical care practices. 

References 

Abdullah, T., Brown, T.L. (2011). Mental Illness Stigma and Ethnocultural Beliefs, Values, and Norms: An Integrative Review.  Clinical Psychology Review , 31: 934-948. 

Cowling, L. (2006). California Food Guide Health and Dietary Issues Affecting African Americans. 17: 1-19 

Obermiller, J.P., & Howe, R.S. (2000). Appalachian Migration Patterns, 1975-1980 and 1985-1990. (Online). Downloaded on https://www.arc.gov/assets/research_reports/AppalachianMigrationPatterns.pdf 

Onselen, J.V. (2016). Skin Assessment and the Language of Dermatology. (Online). Retrieved from https://www.nursinginpractice.com/article/skin-assessment-and-language-dermatology 

Purnell, L., & Paulanka, B. (2013). Transcultural Health Care: A Culturally Competence (4 th ed.): Philadelphia: F.A. Davis. (Chapters 6, 8, and 12). 

Ramnarace, C. (2011). Fewer African Americans Plan for End-of-Life Care. (Online). Retrieved from https://www.aarp.org/relationships/caregiving/info-01-2011/planning_end_of_life_care.html