N109: Foundations in Nursing Practice

N109: Foundations in Nursing Practice Study Guide

Cultural/Spiritual Beliefs Most cultural and religious groups have ritual beliefs surrounding the process of death and dying. Probably more than any other single factor, cultural and spiritual beliefs will determine how the individual and community respond to the process of death and dying. The duration, frequency, and intensity of the grief process may also vary based on the manner of death, the individual family, and cultural and spiritual beliefs, such as belief in God’s will and life after death. How and when rituals are practiced vary depending on the country of origin and level of acculturation into the mainstream society. The following are generalizations, but it important to remember to assess each patient as a unique individual. • Hispanics: Hispanics believe it is detrimental to sick family members to let them know about the seriousness of the illness. They feel like they should spare them unnecessary pain and that it is the family’s obligation to take control over the situation. Mexican Americans verbalize a preference for decision making as a family unit. Latino rituals are heavily influenced by Catholic beliefs, where spirituality is very important and there is a continuing relationship between the living and the dead through prayer and visits to the grave. Latino women grieve by crying openly, but Latino men may act according to “machismo,” a belief that men should act strong and not show overt emotion. There is preference for burial rather than cremation in the Latino community. • African Americans: Death rituals for African Americans vary widely because of the diversity in religious affiliations, geographic region, education, and economics. Emotional expression varies, with some African Americans crying and wailing, while others are silent and stoic. African Americans prefer to make decisions as a family unit. In the African American community, it is not uncommon for there to be large gatherings and an expressed obligation to pay respects to the dying or deceased. African Americans may mistrust the healthcare system, especially regarding advanced directives and end of life care. • Native Americans: Native Americans may follow some traditional rituals around death and dying. Many Native American groups require specific ceremonies before burial. Many Native Americans will not touch the body of a dead person. The nurse must be aware that in many Native American groups it is not acceptable to talk about the imminent death of the patient; instead, the nurse should speak about death as unrelated to the dying person. • Asians: In the Asian culture, the death of an infant or child is deeply mourned and family members may wear white clothing or headbands for a period of time. Traditional elaborate funeral ceremonies are the norm for marking the soul's passing to the afterlife. Sadness and grief may be expressed as somatic complaints, since mental illness is often considered a disgrace to the family. Chinese Americans’ beliefs and practices regarding death and dying include the following themes: saving face (the more people who cry for the deceased, the more the person was loved), filial piety (duty to one’s relative), and invoking luck, blessing, and fortune (belief in life, afterlife, and the presence of spirit). • Buddhists: The Buddhist belief uses death as an opportunity for improvement in the next life. To enter death surrounded by family helps the deceased to become reborn on a higher level. The body should be handled in a worthy and respectful way. • Hinduism: Hinduism is unique as a religion because its roots do not spring from single scripture but is described as a set of philosophies, cultures, and way of life. However, the approach to death is fairly uniform because the belief in the laws of reincarnation suggests that each birth is linked to actions taken in previous births, and that birth and death are part of a cycle ultimately leading to liberation of the soul. When a Hindu person dies, the body is

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